Senate Bill 2298

AN ACT RELATING TO THE REDUCTION OF THE SHORTAGE OF NURSES IN MISSISSIPPI; TO AMEND SECTION 37-143-9, MISSISSIPPI CODE OF 1972, TO ESTABLISH A PROFESSIONAL NURSING SHORTAGE REDUCTION PROGRAM BY ESTABLISHING INCENTIVE SCHOLARSHIPS, LOAN REPAYMENTS AND GRANTS TO INCREASE ENROLLMENTS IN NURSING EDUCATION PROGRAMS AND INCREASING NURSING FACULTY; TO PROVIDE THAT REGISTERED NURSES IN POSTGRADUATE NURSING DEGREE PROGRAMS SHALL AUTOMATICALLY QUALIFY FOR RESIDENT TUITION; TO ESTABLISH A MATCHING FUND PROGRAM TO ALLOW A PRIVATE PERSON OR BUSINESS ENTITY TO SPONSOR A REGISTERED NURSING STUDENT OR LICENSED PRACTICAL NURSING STUDENT; TO AUTHORIZE THE BOARD OF TRUSTEES OF STATE INSTITUTIONS OF HIGHER LEARNING TO STRUCTURE THE SCHOLARSHIP PROGRAM, MATCHING FUND PROGRAM AND THE LOAN REPAYMENT PROGRAM TO SECURE ANY AVAILABLE FEDERAL OR PRIVATE GRANTS; TO AMEND SECTION 73-15-18, MISSISSIPPI CODE OF 1972, TO CLARIFY THE RESPONSIBILITIES OF THE OFFICE OF NURSING WORKFORCE WITH THE MISSISSIPPI BOARD OF NURSING; TO AMEND SECTION 37-129-1, MISSISSIPPI CODE OF 1972, IN CONFORMITY THERETO; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. Section 37-143-9, Mississippi Code of 1972, is amended as follows:

37-143-9. (1) This section shall be known and may be cited as the "Mississippi Nursing Shortage Reduction Act of 2003."

(2) The Legislature finds that:

(a) Mississippi is experiencing a significant shortage in the registered and licensed practical nurses it needs;

(b) The health care needs of Mississippi's growing elderly population create a need for more registered and licensed practical nurses;

(c) Mississippi's nurse work force is aging, and as nurses retire in increasing numbers, educating more registered and licensed practical nurses is critical;

(d) The health care industry plays an important role in the Mississippi economy and an adequate nursing work force is an essential component of the health care industry; and

(e) It is necessary to increase the number of registered and licensed practical nurses in the state to protect the health, safety and welfare of the public. It is the purpose of this section to establish a program to increase the ability of professional nursing educational programs to prepare the registered and licensed practical nurses that the state of Mississippi needs, to encourage persons to enter the nursing profession or to teach in a nursing program, and to enhance the nursing work force data center to address issues of supply and demand in nursing.

(3) In this subsection (3), "professional nursing program" means an education program for preparing students for initial licensure as registered nurses or licensed practical nurses. A professional nursing shortage reduction program is hereby established. The Board of Trustees of State Institutions of Higher Learning shall administer the professional nursing shortage reduction program to make grants to professional nursing programs and other entities involved with a professional nursing program in the preparation of students for initial licensure as registered nurses or licensed practical nurses in order to increase the number and types of nurses to meet the needs for nursing services in the state. A grant from the professional nursing shortage reduction program to a professional nursing program or other entity involved with a professional nursing program in the preparation of students for initial licensure as registered nurses or licensed practical nurses must be:

(a) Expended exclusively on costs related to (i) enrolling additional students; (ii) assuring the retention of an adequate number of qualified faculty, including providing faculty salaries; or (iii) encouraging innovation in the recruitment and retention of students, including the recruitment and retention of bilingual students;

(b) Contingent on the professional nursing program's having been approved by the Board of Trustees of State Institutions of Higher Learning pursuant to Section 37-129-1, or the State Department of Education through the Division of Vocational Education, as appropriate, or by an appropriate accrediting agency, and that such program is not on probation; and

(c) If granted to increase enrollments, contingent on the professional nursing program's ability to enroll additional students, including having the necessary classroom space and clinical slots. The board shall adopt rules and regulations for the administration of the professional nursing shortage reduction program. The board shall grant funds under this subsection (3) in an equitable manner among the various types of professional nursing programs, in a manner that best promotes innovation in the recruitment and retention of nursing students. In addition to funds appropriated by the Legislature for this purpose, the board may solicit, receive and expend grants, gifts and donations from public or private sources for the purposes of this subsection (3). Each professional nursing program participating in this subsection (3) shall submit an annual report to the board detailing its strategy for increasing the number of students that graduate from the program prepared for licensure as registered nurses or licensed practical nurses, which shall include the capacity of the program to graduate more students prepared for licensure, and the resources allocated to increase the number of students that graduate from the program prepared for licensure.

(4) Any institution of higher learning in Mississippi shall permit a registered nurse licensed in Mississippi to register by paying the tuition, fees and other charges required for Mississippi residents without regard to the length of time the registered nurse has resided in Mississippi, if the registered nurse (a) is enrolled in a program designed to lead to a master's degree or other higher degree in nursing, and (b) signs a statement declaring an intention to teach in a program in Mississippi designed to prepare students for licensure as registered nurses or licensed practical nurses.

(5) There is created a program for advanced study in nursing. Scholarships are established and shall be allocated to students who: (a) have graduated from an accredited high school and from a school of nursing and are licensed registered nurses in Mississippi; and (b) are approved by the Board of Trustees of State Institutions of Higher Learning; and (c) enter into contract with the board of trustees and its successors in office, obligating themselves to pursue to completion the course of study agreed upon, and immediately following the completion of such work, to spend a period of time, equal to the period of study provided under the scholarship, in teaching nursing at any accredited school of nursing in Mississippi, approved by the board of trustees, or in performing other work in the interest of public health in the state, to be approved by the board of trustees. Such period of service, after completion of study under a scholarship, shall in no event be less than one (1) year.

In addition to a scholarship, any such student may be allocated a loan not to exceed One Thousand Five Hundred Dollars ($1,500.00) per month for each month of full-time study in a graduate nursing program. The repayment of the principal and interest of such loans shall be eligible for deferment during attendance as a full-time student in an approved program for advanced study in an accredited school of nursing. For any student who receives this loan, the student's contract with the board of trustees shall obligate the student, immediately following completion of the course of study, to repay the loan by teaching nursing for not less than two (2) years at any accredited school of nursing in Mississippi approved by the board of trustees. Such teaching service shall convert the loan to an interest-free scholarship, and discharge the same, on the basis of two (2) years of service for one-year's loan amount, or the appropriate proportion of the total outstanding balance of principal and interest, all as established by rule and regulation of the board of trustees. Any such student who fails to complete all of the teaching service obligation shall be liable to the board of trustees for the remaining balance of the principal and interest that remains undischarged.

The board of trustees shall establish such rules and regulations as it deems necessary and proper to carry out the purposes and intent of this subsection (5).

(6) The Board of Trustees of State Institutions of Higher Learning shall establish and administer, using funds appropriated for that purpose or from other public or private sources, a matching fund program under which a person, hospital, clinic, physician or other business entity may sponsor a nursing student in a program preparing the student for initial licensure as a register nurse or licensed nurse practitioner or for graduate nursing degree study, by contributing to the costs of the student's education or loan repayments for such student's education, and having that contribution matched in whole or in part by state funds appropriated for that purpose or by other public or private sources. A scholarship or loan repayment matching fund program established under this subsection (6) shall be established and administered in a manner that the board determines best promotes the health care and educational needs of this state. The board may establish multiple categories of persons to receive scholarships, matching funds and loan repayment funds. The board may include faculty from professional nursing programs with master's degrees or doctorates among the categories of persons authorized to receive loan repayments. The criteria for selecting persons to be assisted under each category may include: (a) scholastic ability and performance; (b) financial need; (c) the geographical area in which the person is likely to practice; (d) whether the person receives TANF or other public assistance; (e) employment by a state agency; (f) employment on a nursing school faculty or a person's intention to seek employment on a nursing school faculty; (g) whether the person is practicing in a geographical area, a practice setting, or an area of practice with an acute nursing shortage or is likely to practice in such an area; (h) the type of certificate or academic degree held or pursued; or (i) any additional factors the board considers relevant to promoting the health care and educational needs of the state. The board shall adopt rules relating to the establishment and administration of the matching fund program providing for (a) eligibility criteria for sponsors and for students; (b) the minimum and maximum sponsor contributions that will be matched; (c) conflict resolution procedures for resolving disputes between the sponsor and the student; and (d) a standard agreement for use by the sponsor and the student. The board shall distribute information about the scholarship program, matching fund program and loan repayment program established under this subsection (6) to employers of nurses, associations of employers of nurses, professional associations of nurses and schools and institutions of higher learning. The board shall act as a clearinghouse for nursing education programs and health care providers to identify sites available for employers and students.

(7) The board may structure the scholarship programs, the matching fund programs and the loan repayment programs established under this section to secure funds available under federal matching programs or other public and nonpublic matching programs. The board shall give priority in awarding grants to institutions proposing to address the shortage of nurses by promoting innovation in recruitment and retention of nursing students and faculty, and to institutions seeking to increase enrollments in their nursing programs through financial incentives to faculty to provide clinical and classroom instruction in addition to carrying a full teaching load.

SECTION 2. Section 73-15-18, Mississippi Code of 1972, is amended as follows:

73-15-18. (1) The Mississippi Board of Nursing is designated as the state agency responsible for the administration and supervision of the Nursing Workforce Program as an educational curriculum in the State of Mississippi. It is the intent of the Legislature to develop a nursing work force able to carry out the scope of service and leadership tasks required of the profession by promoting a strong educational infrastructure between nursing practice and nursing education.

(2) The Mississippi Board of Nursing is authorized to establish an Office of Nursing Workforce within the administrative framework of the board for the purpose of providing coordination and consultation to nursing education and practice. The Nursing Workforce Program shall encompass six (6) interdependent components:

(a) Collect data on nurses and other nursing personnel, including demographics, areas of practice supply demand and migration on an appropriate regional basis, to predict supply and demand for nursing personnel in Mississippi, and submit such data to the Board of Trustees of State Institutions of Higher Learning for purposes of the administration of the nursing shortage reduction scholarship, matching grant and loan repayment programs authorized under Section 37-143-9, Mississippi Code of 1972. The Nursing Workforce Program shall submit on a quarterly basis to the Board of Trustees of State Institutions of Higher Learning data regarding the education and employment trends for nursing personnel, the supply of and demand for nursing personnel, and other issues concerning nursing in the state as requested by the board.

(b) Develop and implement a state educational program directed toward nursing educators regarding health care delivery system changes resulting from managed care, case management and capitated health finance systems and the impact these changes will have on curriculum and on the retraining needs of nurses.

(c) Determine the continuing education needs of the nursing work force in an environment of restructuring from the hospital-bed-side setting to the home health and community practice settings, and implement such continuing education coursework through the university/college schools of nursing in the state and the community/junior college nursing programs in the state.

(d) Promote and coordinate through the schools of nursing opportunities for nurses prepared at the associate degree and bachelor degree levels to obtain higher degrees.

(e) Apply for and administer grants from public and private sources for the development of the Nursing Workforce Program prescribed in this section.

(f) Establish systems to ensure an adequate supply of nurses to meet the health care needs of the citizens of Mississippi. This will include, but is not limited to, gathering and quantifying dependable data on current nursing work force capacities and forecasting future requirements. The Office of Nursing Workforce will report its findings annually to the Board of Trustees of State Institutions of Higher Learning and the Mississippi Legislature.

(3) Pursuant to the provisions of subsections (1) and (2), the Board of Nursing is authorized to provide for the services of an Office of Nursing Workforce Director and such other professional and nonprofessional staff as may be needed and as funds are available to the Board of Nursing to implement the Nursing Workforce Program prescribed in this section. It shall be the responsibility of such professional staff to coordinate efforts of the Board of Trustees of State Institutions of Higher Learning, the bachelor degree schools of nursing, the associate degree schools of nursing and other appropriate agencies in the State of Mississippi to implement the Nursing Workforce Program.

(4) The Board of Nursing shall appoint a Nursing Workforce Advisory Committee composed of health care professionals, health agency administrators, nursing educators and other appropriate individuals to provide technical advice to the Office of Nursing Workforce created in this section. The members of the committee shall be appointed by the Board of Nursing from a list of nominees submitted by appropriate nursing and health care organizations in the State of Mississippi. The members of the committee shall receive no compensation for their services, but may be reimbursed for actual travel expenses and mileage authorized by law for necessary committee business.

(5) All funds made available to the Board of Nursing for the purpose of nursing work force shall be administered by the board office for that purpose. The Board of Nursing is authorized to enter into contract with any private person, organization or entity capable of contracting for the purpose of administering this section.

(6) The Nursing Workforce Program and the Office of Nursing Workforce provided for in this section will be established and implemented only if sufficient funds are appropriated to or otherwise available to the Board of Nursing for that purpose.

SECTION 3. Section 37-129-1, Mississippi Code of 1972, is amended as follows:

37-129-1. In addition to all other powers and duties now vested by law in the Board of Trustees of State Institutions of Higher Learning of the State of Mississippi, said board is hereby empowered and required to:

(a) Establish by rules and regulations and promulgate uniform standards for accreditation of schools of nursing in the State of Mississippi (1) insofar as concerns the eligibility of graduates of such schools to take the examination prescribed by law to become registered nurses authorized to practice the profession of nursing as registered nurses in Mississippi, and (2) insofar as concerns student nurses attending such schools being eligible to participate in any student nurse scholarship program or other program of assistance now existing or hereafter established by legislative enactment;

(b) Issue to such schools of nursing upon an annual basis certificates of accreditation as may be proper under such standards;

(c) Administer any scholarship program or other program of assistance heretofore or hereafter established by legislative enactment for the benefit of students attending accredited schools of nursing in this state, including specifically the provisions of Section 37-143-9, Mississippi Code of 1972, relating to the Mississippi Nursing Shortage Reduction Program, and the board shall be fully authorized to coordinate the provisions of Section 37-143-9 with the State Department of Education through the Division of Vocational Education relating to associate degree nursing programs, and with the Nursing Workforce Program in the Mississippi Board of Nursing;

(d) Administer any other funds available or which may be made available for the promotion of nursing education in the state, with the exception of nursing faculty supplement funds to the public junior colleges, which funds shall be appropriated to and administered by the Division of Junior Colleges of the State Department of Education, except as otherwise provided in Section 37-143-9 for nursing shortage reduction program funds;

(e) Adopt rules and regulations to provide that a nurse in training may, during the two-year period in an approved hospital, be allowed to transfer at any time with full credit after six (6) months in training, to any other hospital of her choice at which there is a vacancy; suitable provision shall be made to protect her against coercion or intimidation concerning such a contemplated transfer.

In addition to other powers now vested by law in the Board of Trustees of State Institutions of Higher Learning, said board is hereby empowered to establish and maintain a nurse-midwifery education program that meets the accreditation standards of the American College of Nurse-Midwives at a state institution of higher learning under the jurisdiction of the board of trustees.

In order to implement subsection (d) above, the Board of Trustees of State Institutions of Higher Learning is hereby authorized and directed to arrange and contract with hospitals, senior colleges and hospital schools of nursing for the financial support of programs of nursing education. The said board is further authorized to adopt such terms for contracts, and such rules and regulations for reimbursing contracting agencies for costs of instruction in schools of nursing as may be feasible in accordance with appropriations made by the Legislature for this purpose. However, no reimbursement may be made to contracting agencies in excess of the actual cost of instruction in the schools of nursing.

No provision of this section shall be construed to authorize any department, agency, officer or employee of the State of Mississippi to exercise any controls over the admissions policy of any private educational institution offering a baccalaureate degree in nursing.

SECTION 4. This act shall take effect and be in force from and after July 1, 2003.