Report Title:

Nursing Scholarship Program Act; Appropriation

Description:

Establishes and appropriates moneys for the Nursing Scholarship Program to satisfy the growing demand for nurses in the State.

HOUSE OF REPRESENTATIVES

H.B. NO.

346

TWENTY-SECOND LEGISLATURE, 2003

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to nursing.

 

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

SECTION 1. The legislature finds that Hawaii's health care industry is the second largest industry in the State. To ensure access to quality health care services, an adequate supply of registered nurses is necessary. The availability of registered nurses to provide the necessary care for the residents of the State of Hawaii is of serious concern. There is now an acknowledged nursing shortage in the nation and worldwide. The primary cause of this impending chronic shortage of registered nurses is the aging of the workforce and the decline in younger women choosing nursing as a career.

According to a June 14, 2000, study titled "Implication of an Aging Registered Nurse Workforce," the average age of the working registered nurse increased by 4.5 years between 1983 and 1998. The number of full-time registered nurses observed in recent cohorts has been approximately thirty-five per cent lower than that observed at similar ages for cohorts that entered the labor market twenty years earlier. Over the next two decades, this trend will lead to further aging of the registered nurse workforce because the largest cohorts of registered nurses will be between the ages of fifty and sixty-nine years. Within the next ten years, the average age of registered nurses is forecast to be forty-five and a half years, an increase of three and a half years over the current age, with more than forty per cent of the registered nurse workforce expected to be older than fifty years. The total number of full-time equivalent registered nurses per capita is forecast to peak around the year 2007 and decline steadily thereafter as the largest cohorts of registered nurses retire. By the year 2020, the registered nurse workforce is forecast to be roughly the same size as it is today, declining nearly twenty per cent below projected registered nurse workforce requirements.

Recent registered nurse workforce data from the Community Initiative on Nursing in Hawaii finds that one-half of Hawaii's nine thousand actively practicing registered nurses will retire within the next fifteen years. Hawaii's schools of nursing will need to graduate four hundred registered nurses every year for the next fifteen years to replace the registered nurses retiring from the workforce. The need to graduate four hundred registered nurses per year does not include the demand for registered nurses caused by an expansion of the health care industry nor the increased need for nursing services by an aging of the overall population.

The number of registered nurse graduates from Hawaii's schools of nursing and nursing programs that remain in Hawaii is approximately two hundred eighty. This leaves a shortage of one hundred twenty registered nurses per year. To increase the number of registered nurse graduates, the number of nurse faculty members must also be increased. To graduate one hundred twenty more registered nurses, an addition of at least twelve nursing faculty members is necessary.

The last nursing shortage experienced by Hawaii and the nation was in the late 1980s and early 1990s. During that time, the health care industry spent more than $6,000,000 on mainland traveling nurses. The declining federal reimbursements to Hawaii's hospitals, long-term care facilities, and home care agencies have placed extreme financial pressures on the industry. The ability of the health care industry to meet the financial cost of hiring mainland travel nurses is highly questionable. In addition, due to the nationwide and worldwide shortage, the reality is that even if the health care industry could financially withstand the cost pressures of hiring mainland traveling nurses, there are not enough registered nurses to meet the growing demand for registered nurse services.

The legislature further finds that the United States Department of Health and Human Services, Health Resources, and Services Administration, through its December 2000, report "State Health Workforce Profiles," has issued an "early warning" on the issue of declining health care professionals, including registered nurses. Data from the "State Health Workforce Profile" shows that Hawaii's registered nurses per one hundred thousand population was 723.1 compared to 797.7 and ranked thirty-eight out of the fifty states.

The legislature believes that if Hawaii's health care industry is to continue providing high quality health care services to the residents of the State, it is imperative that an increase is spurred in the registered nurse workforce through the recruitment and retention of sufficient numbers of qualified individuals in the nursing profession.

The purpose of this Act is to establish a nursing scholarship pilot program as an incentive for young adults to enter the nursing profession.

SECTION 2. The Hawaii Revised Statutes is amended by adding a new chapter to be appropriately designated and to read as follows:

"CHAPTER    

NURSING SCHOLARSHIP PROGRAM

§   -1 Short title. This chapter shall be known and may be cited as the Nursing Scholarship Program Act.

§   -2 Definitions. As used in this chapter, unless the context otherwise requires:

"Approved course of study" means a course of study that leads to enrollment in a nursing program approved by the State of Hawaii board of nursing and a course of study in a nursing program approved by the State of Hawaii board of nursing.

"Approved educational institution" means a public or private post-secondary educational institution located in this State that has been accredited by a nationally recognized accrediting agency that is listed by the United States Secretary of Education.

"Department" means the department of health.

"Incumbent worker" means a person who is employed not less than           hours per week while enrolled in an approved educational institution on a full-time or part-time basis.

"Program" means the nursing scholarship program established under this chapter.

"Student" means any individual domiciled in this State who attends or is about to attend a postsecondary educational institution located in this State.

"Work requirement" means postgraduate, full-time employment as a registered nurse (at least thirty-six hours) with an employer located in this State. The term does not include volunteer service or employment before graduation.

§   -3 Nursing scholarship program; establishment, administration. (a) There is established a five-year pilot program to be known as the nursing scholarship program to be placed under the department of health.

(b) Under the parameters of the scholarship program, the department may provide scholarship grants to an eligible student who is a resident of this State upon confirmation from an approved educational institution that the student has been accepted for enrollment in an approved course of study. Scholarship grants shall only be for the amounts set forth in sections    -4(a) and    -5(a) and shall only be used for tuition, books, laboratory fees, and any other required fees.

(c) The department shall establish lists of approved courses of study for the various types of approved educational institutions to be addressed by the program.

(d) To receive a scholarship grant under this chapter, a student shall meet all of the following requirements:

(1) Graduation from a high school in this State or earned a general educational development diploma or the equivalent thereof;

(2) Maintenance of domicile in Hawaii during the term of the scholarship grants;

(3) Compliance with any conditions placed on the scholarship grant by the department;

(4) For those attending a post-secondary education institution, maintenance of a grade point average of 3.0 or higher, on a scale of 4.0 or its equivalent, beginning with the first semester of the freshman year and through the term of the scholarship or the last year of college if the student is applying under section    -4 or    -5; and

(5) Enter into a written agreement with the department to:

(A) Satisfy all degree requirements and other requirements under this chapter;

(B) Commence employment in this State within one year after completion of an approved degree in nursing for a period of one year for each academic year the student received a scholarship grant under this chapter, unless the department determines that there are extenuating circumstances; and

(C) Reimburse the State all amounts received under this chapter and interest thereon, as determined by the department, if the student fails to comply with this paragraph.

(e) A student shall apply to the department and include all information and documentation required by the department. The application of a student under eighteen years of age shall include the signature of a parent or guardian. The application shall include a verified statement of grade point average from the appropriate approved educational institution.

(f) The work requirement under subsection (d)(5)(B) shall begin after the receipt of the associate, bachelor's, master's, or doctoral degree.

(g) If a student terminates enrollment in the approved educational institution during the academic year or prior to completion of the approved course of study and is eligible to have all or a portion of the tuition payments refunded under the refund policies of the institution, the approved educational institution shall notify the department in writing and shall return all unused portions of the scholarship grant. Returned amounts shall be used to fund other scholarship grants under this chapter.

(h) A scholarship under this chapter is only transferable to another approved educational institution if approved by the department.

(i) Grants awarded under the program shall be limited to funds appropriated for the purpose or funds otherwise matched by external entities. First priority for awarding grants shall be given to renewal applicants.

§   -4 Scholarships; nursing degree programs. (a) The department shall award a scholarship grant in an amount up to $10,000 per academic year to a student enrolled full-time in an approved educational institution pursuing a degree in nursing through an approved course of study.

(b) A grant shall be awarded beginning no earlier than the second academic year of enrollment in an approved educational institution. The grant shall be for a maximum of three academic years or for up to four academic years if the student is enrolled in an approved course of study that, according to the department, requires five academic years to complete. To qualify for renewals beyond three years, the student must be in compliance with the requirements of section    -3(d) and the department must determine that the student is making satisfactory progress toward completing a degree.

(c) A student who accepts a grant under this section shall complete a college-approved or university-approved internship program in nursing with an employer located in this State prior to receiving a bachelor's degree. The student shall comply with any conditions placed upon the internship by the department. Proof of completion of the internship or work experience requirements must be submitted to the department prior to graduation, unless otherwise authorized by the department.

§   -5 Scholarships; associate and certificate programs. (a) The department shall award a scholarship grant in an amount up to $2,000 per academic year to a student enrolled full-time in an approved educational institution pursuing an associate's degree or a certificate provided by a vendor educational program, or in a degree-granting institution subject to chapter 446E in an academic program approved by the department. A student who is enrolled part-time and is an incumbent worker pursuing an associate's degree, certification, or other specialized program approved by the department is eligible for a grant of twenty per cent tuition and mandatory fees.

(b) The grant shall be for a maximum of two academic years or for up to three academic years if the student is enrolled in an approved course of study that, according to the department, requires three academic years to complete. To qualify for a grant three times, the student must be in compliance with section    -3(d), and the approved educational institution must determine that the student is making satisfactory progress toward completing an associate's degree or the requirements of the certificate program.

(c) The department may waive the one-year employment requirement for an incumbent worker for extenuating circumstances related to the student's employment within the last year.

§   -6 Program administration. (a) The department shall monitor and verify a student's fulfillment of all internship and work requirements under this chapter.

(b) The department may enter into a contract with a private or public entity to administer the program.

(c) The department shall enforce repayment of all scholarship grants for a student who does not comply with this chapter. Repayment shall include the use of all lawful collection procedures and the use of private collection agencies.

(d) Scholarship grants received by a student from the program shall not be considered taxable income under chapter 235.

(e) Scholarship grants received by a student from the program shall not be considered financial assistance or appropriations to the approved educational institution.

(f) No funds under this chapter shall be granted to a person enrolled in a customized job training partnership program or continuing education course from a post-secondary educational institution for which an employer is providing over fifty per cent of the financial support, directly or indirectly, and for which the student is not being charged tuition or fees.

(g) Any person who knowingly or intentionally procures, obtains, or aids another to procure or obtain a grant under this chapter through fraudulent means shall be disqualified from participation in the program and shall be liable to the department for an amount equal to three times the amount obtained.

(h) Any appeal under this chapter shall be subject to chapter 91.

§   -7 Annual report. (a) The department shall publish a report by September 1, 2004, and every year thereafter. The report shall include information regarding the operation of the program including:

(1) The total number of students receiving scholarship grants;

(2) The total amount of scholarship funds awarded;

(3) The number of full-time and part-time students receiving scholarship grants attending four-year educational institutions, community colleges, independent two-year colleges, degree-granting institutions, vendor educational programs, and certificate programs reported by institution and category of institution;

(4) The amount of scholarship funds awarded to students attending four-year educational institutions, community colleges, independent two-year colleges, degree-granting institutions, vendor educational programs, and certificate programs reported by institution and category of institution; and

(5) The total number of students who withdraw from the program or internship or work requirements and the number of faculty members.

(b) The annual report shall be submitted to the governor and the legislature not later than twenty days prior to the convening of each regular session."

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $1, or so much thereof as may be necessary for fiscal year 2003-2004, and the same sum, or so much thereof as may be necessary for fiscal year 2004-2005, to establish and implement the nursing scholarship program.

The sums appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $1, or so much thereof as may be necessary for fiscal year 2003–2004, and the same sum, or so much thereof as may be necessary for fiscal year 2004-2005, to increase the nursing faculty to administer the nursing scholarship program.

The sums appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 5. This Act shall take effect on July 1, 2003.

INTRODUCED BY:

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