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Nurse Support Program II (NSP II)

The Nurse Support Program (NSP) II is distinct from, and in addition to, the NSP I hospital-specific program. As with NSP I, the goal of NSP II is ultimately to increase the number of bedside nurses in Maryland hospitals. The NSP II, however, focuses on the education of nurses and, therefore, concentrates on the nursing educational system, including schools with nursing programs and hospital and school consortia.

Background

In July, 2001, the Health Services Cost Review Commission (HSCRC) implemented the first phase of the Nurse Support Program (NSP I) to address the issues of recruiting and retaining nurses in Maryland hospitals. The NSP I exposed the inability of nursing programs to accept large numbers of students because of limited capacity due to nursing faculty shortages. At a time when there was a critical demand for registered nurses, Maryland registered nursing (RN) programs were admitting and enrolling less than half of the qualified applicants seeking admission. In Fall 2005, 2,357 qualified applicants were denied admission to RN programs. Seventy-nine percent (79%) of the RN programs reported that they had met or exceeded their enrollment capacity in Fall 2005. The shortage of qualified nursing faculty was the fundamental obstacle to expanding the enrollments in nursing programs, thereby exacerbating the nursing shortage in future years.

At its May 4, 2005, public meeting, the HSCRC unanimously approved an increase of 0.1% of regulated patient revenue for the use in expanding the pool of nurses in the State by increasing the capacity of nursing programs in Maryland. This funding represents approximately $8.8 million devoted to Nurse Support Program II on an annual basis over the next ten years.

HSCRC contracted with the Maryland Higher Education Commission (MHEC) to administer the Nurse Support Program II. Monthly NSP II payments are transferred from Maryland hospitals to MHEC and distributed by MHEC to institutions of higher education, hospitals, faculty, and students selected to receive NSP II funding. Maryland Higher Education Commission also assists HSCRC with (1) the development of applications and guidelines, (2) the review and selection of applicants, and (3) the monitoring and evaluation of recipients of NSP II awards.

MHEC provides the programmatic and administrative support necessary to successfully administer the NSP II program. As the coordinating board for all Maryland institutions of higher education, MHEC contributes its extensive experience and expertise with (1) the management of institutional grants, (2) the administration of student financial aid, and (3) the collection, review, and evaluation of programmatic and financial data from Maryland's higher education institutions. In addition, MHEC is responsible for working collaboratively with Maryland's colleges, universities, and community colleges to address Maryland's workforce needs, including the State's critical nursing shortage. In 2005, MHEC was mandated by the Maryland General Assembly to conduct a nursing enrollment capacity study. As part of this effort, MHEC administered telephone and written surveys of Maryland's 24 nursing deans and directors to identify (1) the current enrollment capacity of Maryland's nursing programs and (2) strategies to increase the enrollment capacity of Maryland's nursing programs. This and other data collected by MHEC are available to guide the NSP II program.

For Phases 1 through 4 of NSP II, 81 proposals for the Competitive Institutional Grants were received. Review panels, consisting of nursing administrators and nursing faculty from neighboring states, former HSCRC commission members, and State agency staff members, evaluated each proposal based on the criteria set forth in the request for applications, the comparative outcomes of each initiative, geographic distribution across the State, and the racial diversity of the program participants.

The review panels recommended a total of 40 proposals for funding to the HSCRC over the first 4 funding years. These recommended projects were deemed to best address the multiple aspects of the nursing shortage by accelerating the number of associate degree in nursing (ADN) graduates, expanding the pipeline of ADN to Bachelor of Science in nursing (BSN) students, and creating pathways to nursing faculty positions through Master of Science in nursing (MSN) and doctoral programs. The 40 projects include an additional 60 hospital and higher education institution partners and consortium members.

The total funding over the lifetime of the 40 Competitive Institutional Grant projects is nearly $35 million. An additional $5.47 million was awarded for Statewide Initiatives in the first 4 years, for a total of $40.4 million in awards for the NSP II. Unallocated funds will be used to fund future projects and Statewide initiatives to increase the number of qualified bedside nurses in the state.

Quick Guide to NSP I and II Programs

Reports

Staff Recommendations