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Texas Dashboard Indicator 2: Doctoral Degrees. Retrieved 12/18/2018.

Since the Future of Nursing: Campaign for Action began, it has measured the progress that nursing has made across the U.S. on a national data dashboard. Now at least four  states are creating their own dashboards, using as a yardstick—as does the Campaign—the goals laid out by the Institute of Medicine (now the Health and Medicine Division of the National Academies) in The Future of Nursing: Leading Change, Advancing Health report.

Texas

For example, scroll down the “about” page for the Texas Team: Using information from the Texas Board of Nursing and Texas Center for Nursing Workforce Studies, Texas reports in easy-to-understand graphics how close it’s coming to its 2020 goals in education. The Texas Team also depicts in a bemusing way the roadblocks it has overcome (and still faces) in changing the laws to increase the public’s access to nurse-provided health care.

Nebraska

Bringing the truth about nursing progress home for its residents, too, is Nebraska, which invites website visitors to take a spin through its successes on six indicators. For example, the national data dashboard posted by the Campaign shows the percentage of employed nurses with a baccalaureate (or higher) degree in nursing stands at 54 percent as of 2016. Nebraska’s close-up look shows its percentage as of 2016 stands at 64 percent. (Hooray  for all, but especially slide 3, which celebrates Nebraska’s becoming the 20th state to adopt full practice authority for nurse practitioners.)

Hawaii

Hawai’i has also honed in on its growth toward increasing the percentage of nurses with a bachelor’s or higher. Using data including the 2016-2017 Hawai’i State Nurse Education Capacity Survey, the state forecasts it will achieve the IOM goal of having an 80 percent BSN-prepared workforce more quickly than the nation as a whole.

Wisconsin

Wisconsin lays out its progress points on the Wisconsin Center for Nursing website, including the fact that the number of Badger State nurses with a BSN or higher is about 6 percent higher than the national average.

With strong visuals, leaders in these states can make the case for nursing more easily with information specific to their residents. Congratulations Texas, Nebraska, Hawai’i and Wisconsin for going the extra mile to translate the IOM’s national goals to the state level, making them more accessible for all.

If your state has created its own data dashboard, the Campaign would love to hear from you. Make sure to contact us.

The post A Dashboard of One’s Own: Four States Track Their Successes appeared first on Campaign for Action.

Laura Reichhardt, MS, APRN, AGNP-C

A recent report about the number of nurses in Hawai’i is wrong, writes Laura Reichhardt, MS, APRN, AGNP-C, in a newly published opinion piece in Becker’s Hospital Review.

Reichhardt, director of the Hawai`i State Center for Nursing and a co-leader of the Hawai’i Action Coalition, contacted Medicare Health Plans about the data used in its report, which has since been retracted. Her opinion piece also makes a larger point about how to go beyond numbers to truly assess health, and how her state’s nursing workforce is doing well.

The post Retraction Follows Hawai’i Nurse Leader’s Opinion Piece appeared first on Campaign for Action.

Credit: Photo courtesy of the University of Hawaii. Supporters of preceptor tax-credit legislation joined the sponsor, State Senator Rosalyn Baker (in orange), at a June 13th ceremony, where Hawaii Governor David Y. Ige (center) signed the bill into law. To his right stands Hawaii State Center for Nursing Director Laura Reichhardt (in black) and to his left, second row, is Hawaii Action Coalition co-lead Mary Boland (in navy).

Hawaii is now the fourth state in the nation to pass a law aimed at helping the United States reduce its chronic shortage of preceptors, with an innovative solution that uses the power of the tax code to try to bolster their numbers.

Preceptors are at the core of the clinical education of nurses and other health professionals, including physicians, physician assistants, and advanced practice registered nurses (APRNs). Working clinicians themselves, preceptors provide on-site clinical education and nurture students’ professional development.

Difficulties finding preceptors are longstanding, but they have been exacerbated by an explosion of doctor of nursing practice (DNP) programs and the rise of for-profit nursing schools that pay preceptors for what has traditionally been a voluntary activity aimed at giving back to one’s profession. Heightened competition for community-based clinical placements—and preceptors at these sites—further complicates matters for DNP programs.

“For nurse practitioners, the bulk of their training is to prepare them for primary care,” notes Tay Kopanos, DNP, NP, vice president of state government affairs for the American Association of Nurse Practitioners (AANP). If the goal is to ensure an adequate primary care workforce, she says, NPs must train in community clinics where they will encounter the types of patients they will ultimately care for.

Unfortunately, primary care providers, especially those in underserved rural areas, typically have a heavy workload, which discourages them from taking on the additional burden of precepting.

Since 2014, several states have taken steps to address the problem by providing a tax benefit to preceptors. Georgia led the way, passing a preceptor tax deduction for physicians in 2014. Hawaii Gov. David Y. Ige signed a far more robust bill into law on June 13, following similar legislation passed in Maryland and Colorado in 2016. In Hawaii, Maryland and Colorado, nurse practitioners and several other health professionals serving as preceptors are eligible for a tax credit. Unlike a tax deduction, which simply lowers one’s taxable income by the amount of the deduction, a tax credit reduces the amount of taxes owed to the state.

The Hawaii legislation allocates $1.5 million per year to provide up to five $1,000 tax credits per preceptor, says Laura Reichhardt, MS, APRN, NP-C, director of Hawaii’s State Center for Nursing. Reichhardt says the funding would cover preceptors for all of the state’s students of advanced practice nursing, medicine, and pharmacy, which are the health professions covered by the legislation.

In Colorado’s case, preceptors must work in in a ‘rural or frontier’ area in order to qualify for the tax credits, worth $1,000. Maryland’s preceptor credit applies in those parts of the state where there is a ‘healthcare workforce shortage,’ a designation used by the Health Resources and Services Administration to indicate shortages of primary care, dental, and mental health providers. Maryland preceptors receive a $1,000 tax credit for each student (provided they’ve received no other compensation) up to a maximum of $10,000. According to Temi Oshiyoye, MPH, CHES, the plan’s administrator, in the first five months of 2018, 25 physicians and NPs were awarded credits averaging $4,200 each. The state’s program funds are capped at $100,000 a year for each group of health professionals.

Other states are expected to follow suit. Georgia is trying to turn its tax deduction into a credit and add APRNs to its program.  According to AANP, Kentucky, Minnesota, New York, and South Carolina also have or are considering pending tax benefit legislation.

It’s too soon to say how much difference these tax credits and deductions will make. Their success will likely depend on how the programs are designed as well as on how much money states invest. Nevertheless, proponents consider these legislative efforts a step in the right direction. “It’s recognition that your work is valuable,” says Reichhardt.  “We have a high level of provider burnout. We’ve tried giving adjunct faculty status, library access, and other incentives. We need to keep on trying.”

Some basics of tax benefit plans designed to encourage precepting:

• Nursing education programs are often constrained by a lack of clinical sites and preceptors.
• State lawmakers can pass legislation providing a state tax deduction or tax credit for preceptors on a per-student or per-rotation basis.
• A tax credit provides a dollar-for-dollar tax reduction. A preceptor who would normally owe $6,000 in state taxes, and has a tax credit of $3,000, would pay only $3,000 in state taxes that year.
• A tax deduction lowers one’s taxable income by the amount of the deduction. A preceptor with a $123,000 annual salary and a $3,000 tax deduction would pay state taxes on an annual income of $120,000.
• Currently four states—Georgia, Maryland, Colorado, and Hawaii—have passed tax benefit plans for health care providers.
• Preceptor tax-benefit legislation is pending or has been considered in Kentucky, Minnesota, New York, and South Carolina.

The post Hawaii Joins States Using Tax Laws to Support Nursing Education appeared first on Campaign for Action.

Each year the American Association of Nurse Practitioners (AANP) recognizes supporters of nursing from across the country, in two categories: nurse practitioners who have made outstanding contributions; and advocates who have made significant contributions toward increasing the awareness and acceptance of nurse practitioners.

This year AANP gives its State Award for Excellence to a number of advocates with close ties to the Future of Nursing: Campaign for Action, an initiative of AARP Foundation, AARP, and the Robert Wood Johnson Foundation. Those allies include two state legislators who work with AARP state offices and sponsored bills to allow advanced practice registered nurses the ability to practice to their full education and training.

In the advocate category, here are the award winners who also have ties with the Campaign:

• Stephanie Ahmed, DNP, FNP-BC, Massachusetts
• Renee Dahring, MSN, APRN, CNP, Minnesota
• Lauren Inouye, RN, MPP, District of Columbia (Action Coalition leader)
• Beverly Lang, MScN, RN, ANP-BC, Maryland
• Linda Lazure, PhD, RN, FAAN, Nebraska
• Denise Link, WHNP, CNE, FAAN, FAANP Arizona
• Lucy Marion, PhD, RN, FAAN, FAANP, Georgia
• Gaylene Miller, West Virginia (AARP State Director)
• Laura Reichhardt, MS, APRN, NP-C, Hawaii (Action Coalition Leader)

The two state legislators are Oklahoma Rep. Josh Cockroft and Texas Rep. Stephanie Klick. AARP state office representatives had thanks for both:

“Oklahoma is facing a health care crisis across the state, but especially in our rural areas. Courageous leaders like Rep. Josh Cockroft understand the immediate need and urgency of finding a solution,” said Chad Mullen, associate state director of Advocacy at AARP Oklahoma. “We appreciate his willingness to stand up against a powerful and entrenched industry in order to bring much needed access to care to Oklahomans across the state.”

In Texas, Blake Hutson, associate state director for Advocacy and Outreach at AARP Texas, said, “Rep. Klick has been a consistent leader at the Capitol on nurses’ issues and a close partner with AARP in our efforts to promote the role of Advance Practice Nurses. She’s not afraid to stand up against heavyweight interests that want to keep the status quo in medicine to the detriment of Texas patients.”

See the list of all award winners.

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Approach:  A collective leadership training using a Hawaiian sense of place was developed for a cohort of public health nurses.  The training drew on both western and indigenous concepts and practices specific to Hawai`i. The process was guided by four key components that are interconnected and work together as a collective leadership ecosystem.  The key components include place, culture, community and leadership.

Products/Outcome:  Themes were identified by the cohort across relationships to the self, to others, to place and past and future.

Implications:  Nurses as leaders can support a more universal view of health and wellness developed by community rather than for the community.  Nurses and community leaders can share a relationship and responsibility together to support community based solutions.

The post Culture of Health in Hawai`i, Leading Through a Hawaiian Sense of Place appeared first on Campaign for Action.

• Distribution of population by race/ethnicity
• Percentage of population living in rural versus urban areas
• Distribution of population by federal poverty level
• Areas in which there is a shortage of primary health professionals

These statistics can guide your Action Coalition’s work in shaping a nursing workforce to better meet local needs and overcoming health disparities in your state. As you integrate other Culture of Health aspects into your work, consider how demographics play a role in health equity and fostering cross-sector collaboration.

The post Demographic and Workforce Facts appeared first on Campaign for Action.

The post More States Removing Barriers to Nursing Practice and Care appeared first on Campaign for Action.

In Idaho, Margaret Wainwright Henbest, RN, MSN, CPNP, executive director of the Idaho Alliance for Leaders in Nursing, is one of 19 officials—and the only nurse—on the board of Your Health Idaho, the health insurance exchange in the Gem State.

A former state lawmaker, Henbest was appointed to the position earlier this year after legislation creating the exchange was approved by the state legislature. She is also former co-lead of the Idaho Action Coalition which, like the other Action Coalitions, is working to transform the nursing profession and improve health and health care.

Action Coalitions are now in place in all 50 states and the District of Columbia, and are the driving force behind the Future of Nursing: Campaign for Action. One of the key goals of the Campaign is to develop more nurse leaders so they can play a significant role in the redesign of the nation’s health care system.

Henbest, for her part, is thrilled to represent her profession on the exchange. “I think it’s really important to have somebody who’s knowledgeable about the health care system and who also has a strong consumer focus,” she said. “Nurses are really pretty unique in their ability to do that. They understand consumer needs and the health care system in a sophisticated manner.”

Nurse leaders on exchanges serve another function—as role models for other nurses, said Deborah Gardner, PhD, RN, FNAP, immediate past executive director of the Hawaii State Center for Nursing and immediate past co-lead of the Hawaii Action Coalition. “When nurses lead in the policy arena, other nurses take notice and are exposed to the possibilities.”

Gardner sees that happening in Hawaii, where Coral Andrews, FACHE, MBA, RN, the former vice president of the Healthcare Association of Hawaii and a member of the Hawaii Action Coalition, is serving as executive director of the Hawaii insurance exchange.

The Hawaii Health Connector, in fact, is stocked with nurses. Clementina Ceria-Ulep, PhD, MSN, RN, an associate professor and department chair at the University of Hawaii at Manoa School of Nursing and Dental Hygiene, serves on the group’s board of directors, and another nurse is one of the group’s program specialists. Gardner, meanwhile, is working to educate consumers about the Hawaii exchange.

A Valuable Commodity

A background in nursing is a valuable commodity in health care reform, Andrews said. “Nurses are systems thinkers, educators, and consensus builders,” she said, noting that those skills have helped her garner broad stakeholder support for the Hawaii exchange. “Over the past 30 years, as a nurse, I have been exposed to diverse environments. I am able to leverage that and apply it in one environment focused on improving the health and well-being of our community.”

In Texas, the federal government is responsible for launching the state’s new insurance marketplace, but nurses are monitoring it and discussing opportunities to educate nurses and other health care professionals about the information available to them there, according to Alexia Green, PhD, RN, FAAN, a board member of the Texas Institute of Health Care Quality and Efficiency and co-lead of the “Texas Team,” the state’s Action Coalition.

In Idaho and Hawaii, Henbest and Andrews are devoting their energies to getting their respective exchanges up and running in time for applicants to enroll over the months following the Oct. 1 launch.

They expect to be able to put their expertise as nurses to good use. In Idaho, the inclusion of advanced practice registered nurses in provider networks, and payment and coverage for case management, care coordination, and patient education may come under consideration in the future, Henbest said.

Andrews also cited payment reform as an issue she may address as her exchange’s executive director, and anticipates a role for nurses in consumer education and outreach.

“Health literacy is critical to enabling consumers to be empowered in their own decision-making,” Andrews said. “Nurses as educators can play an important role in this area.”

This story appeared in the November 2013 issue of Advancing Health: News from the Campaign for Action.

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