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Nurse Support Programs

Hospital-Specific Nurse Support Program (NSP I)

The Health Services Cost Review Commission (HSCRC) initiated nurse education support funding (formerly titled the Nurse Education Support Program or NESP) in 1986 through the collaborative efforts of hospitals, payers, and nursing representatives. Originally, the NESP focused on supporting scholarships for college and hospital-based training of Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). Over the years, the NESP was expanded to encourage new and innovative approaches to address the challenges and demands facing the nursing and allied professions. Thirty-seven hospitals participated in the NESP from 1986 through 1995 when the program concluded. Over $7 million was allocated from hospital rates for this program.

In July 1, 2001, the five-year Nurse Support Program I (NSP I) was instituted at the request of the hospital industry to encourage hospital-based programs aimed at addressing the short and long term nursing shortage impacting Maryland hospitals. Hospitals were eligible to receive the lesser of their budget request or up to 0.1% of the hospital's gross patient revenue for the previous fiscal year, to be provided through hospital rate adjustments, for approved projects that address the individual needs of the hospitals as they relate to nurse recruitment and retention.

To receive funding for NSP I, hospitals were initially required to submit a proposal to HSCRC which was reviewed, using preset criteria, by an evaluation committee, composed of hospital and Maryland Hospital Association representatives, and HSCRC staff. HSCRC staff evaluated subsequent proposal modifications and renewals. Most proposals were approved, some following suggested programmatic or budgetary modifications.

Nearly all hospitals participated in the program in a variety of initiatives such as:

  • Student nurse scholarships
  • Internship programs
  • Mentoring programs
  • High school outreach
  • International recruitment
  • Retention initiatives

Hospitals were required to provide an annual report to HSCRC regarding NSP I program activities and budget expenses. The HSCRC provided a report format, which elicited a largely narrative response.

Over the life of the program, approximately $36 million in NSP I funds was distributed to 50 acute care and specialty hospitals in Maryland.

During the fifth year of the program, HSCRC began an overall evaluation of the NSP I. This review was prompted as part of ongoing program evaluation, particularly because of difficulties in summarizing program outcomes and demonstrating accountability; unclear parameters for eligible program activities; and the need to reconsider the scope of the NSP I program given the initiation of the Nurse Support Program II (NSP II) program in FY 2006.

On April 12, 2006, the HSCRC approved a one-year extension of the NSP I through June 30, 2007 in order to provide the opportunity for staff to continue to evaluate and update the program with the intent of improving accountability, establishing uniform reporting, and funding programs with best outcomes. During the extension in FY 2007, approximately $9.5 in hospital rate adjustments were provided for this purpose.

Fiscal year 2007 was a year of transition. Staff completed the program evaluation and on April 11, 2007 the Commission approved the creation of a new five-year NSP I funding cycle with the following updates:

  1. Redefined the categories of initiatives eligible for funding;
  2. Established categories of initiatives that were not eligible for funding;
  3. Simplified application process for grant funding;
  4. Streamlined the review and evaluation process for initiative approvals and renewals;
  5. Included a plan for ongoing review of the funding mechanism;
  6. Standardized quantitative annual report requirements to include:
    • Uniform financial reporting; and
    • Uniform annual data reporting.

In FY 2008, the Annual Report was expanded and was available online to streamline reporting.

Quick Guide to NSP I and II Programs

Annual Reporting


Staff Recommendations

NSP I Five-Year Cycle Renewal Workgroup Meetings 2012