Board of Regents – Nursing Committee:
August 28, 2003
10:00 a.m. – 12:00
Room 102 B, Higher Education Complex, Helena, MT
Board of Nursing: Jill Caldwell, Karen Pollington, Kim Powell
Board of Public Education: Steve Meloy
Board of Regents: Lynn Hamilton, Richard Roehm
DLI, Counsel for Board of Nursing: Lorraine Schneider
Great Falls: Susan Luparell, Liz Irlitt, Tonia Morine, Susan Raph
Montana Hospital Association – Helena: Dick Brown
Montana Nurses Assn: Sami Butler
MSU-Bozeman: Jean Ballantyne, Rolf Groseth
OCHE: Carrol Krause, Sheila Stearns, Roger Barber, Arlene Parisot
UM College of Technology: R. Paul Williamson
UM-Missoula: Lois Muir
Item #9: Process for new program approval by both Board of Regents (BOR) and State Board of Nursing (SBON)
Interim Commissioner Krause gave an overview of the history of nursing education across the state from BOR perspective; promoting linkages – quality and access
Issue: proposals for new programs going before SBON before going to the BOR.
State Board of Nursing requires a two-year lead-time before implementation—notice of intent. The rationale involves: awareness, assessment of program in meeting standards, and quarterly meetings of the board.
The SBON application process was distributed to group.
Regent Roehm addressed the issues: clinical capacity, availability of faculty and resources
Interim Commissioner Krause recommended a simultaneous approach: 1) preliminary approval prior to developing application; 2) review of application by OCHE staff
Regent Hamilton asked that the committee consider both processes and avoid duplication.
Interim Commissioner Krause recommended that the BOR and the SBON convene a subcommittee to work on a document that will work for both in approving programs with a timeline for response by September 24, 2003. This will allow the issue to be discussed at the September BOR meeting.
Rolf Groseth wanted the group to remember the issue of clinical sites and capacity
Dick Brown, Montana Hospital Association, requested that they also be at the table of these approval discussions; he is concerned “when he hears two-years and beyond” for an approval process.
Dean Ballantyne asked that the group consider early on the impact of new program on viability of existing programs (nursing).
Arlene Parisot (OCHE), consider state agencies as other players in preparing the workforce for the healthcare field.
Steve Meloy, Board of Public Education, recommended the group “stay aware of overlapping jurisdiction.”
Kim Powell addressed the issues of the private colleges providing programs …are they also players?
Regent Hamilton felt it important for the board to know big picture of other “players” in particular the issues/programs—especially the private and tribal colleges
Paul Williamson expressed a concern from the two-year perspective: if we extend the time for program approval, it will limit the ability to be responsive to industry needs.
Commissioner Stearns would like to see a clarification of members of the subcommittee
Item #8: Need for a liaison between BOR/SBON
Interim Commissioner Krause suggested using the existing task force.
Regent Roehm supported the education committee/nursing committee maintain this liaison or use the Deputy Commissioner for BOR and the Executive Director for SBON. There is a concern that there be an identifiable point of contact. We need to keep this at lowest level for immediate questions.
Regent Hamilton suggested expanding the taskforce. This was supported by Interim Commissioner Krause.
Item #2: Statewide articulation
Interim Commissioner Krause posed questions: who and where are we?
Regent Roehm referenced Dr. Joyce Scott’s recommendation. See report.
Lois Muir stated that there are courses that are major prerequisite problems—A&P and Chemistry often need to be retaken.
Dean Ballantyne felt that moving back to a certificate model might make problem worse, in terms of clarification.
Tonia Morine was aware of the history of problem from MSU-Bozeman.
Karen Pollington spoke to articulation problems for students –LPN to RN—so students can go from one to the other.
Interim Commissioner Krause stated that differences may never be resolved and maybe shouldn’t be forced without damage to both LPN and RN programs.
Paul Williams recommended that we use courses as building blocks to achieve seamless transition if one is ready to change to RN.
Lois Muir felt students shouldn’t have to re-do total 1st two years.
Interim Commissioner Krause believes that we should never tell students they may not have to “repeat a course”
Rolf Groseth – it may be building blocks, but it isn’t seamless nor articulation.
Regent Hamilton asked whether the BOR in May 2002 asked for a core, transferable in nursing? Could this not be the foundation to build upon.
Nurse educator asked that we first have concern for student—differences of philosophy of generic program to RN—we need to align curricula with skill sets required at each level.
Arlene Parisot stated current initiative through a Department of Labor/Education incentive grant is focusing on development of career pathways in healthcare education, underscoring the need to work with state agencies involved in the process.
Interim Commissioner Krause recommends OCHE develop a progression model that shows what courses will fit toward which degrees.
Item #3: Governor’s Blue Ribbon Task Force
Interim Commissioner Krause referenced “Competing for Quality Care” see p. 23 of report. What has been done.
Reference p. 41 on proposal #15: Department of Labor data
Reference Dr. Scott memo
Item #5: Data on nursing programs meeting workforce demand
Regent Roehm requested the new commissioner and deputy commissioner respond to data questions.
Interim Commissioner Krause referenced Appendix B (JS memo)
Regent Roehm posed question: Implication to legislators: is the MUS capacity the same as graduates who pass NCLEX exam? Is migration out of state the issue? A nursing representative indicated only 10 (1st time test takers) out of state students sit for exam whereas 50% of recent graduates leave state. They are not being replaced by out-of-state 1st year nurses.
Kim Powell indicated that we have a competition issue—50th in hourly wage.
Jill Caldwell stated that Carroll College has expanded and is now accepting 45 students.
Dean Ballantyne: Data from Table II is outdated; MSU-Bozeman increased slots by 20% since 2002 data assembled. Campuses have been very responsive and have increased enrollments.
Regent Hamilton asked if we are concerned with attrition?
Dean Ballantyne stated that they need to keep better attrition data to be informed about why students leave. Not all attrition is related to academic performance.
Dick Brown will be doing a supply and demand needs survey this fall through the Montana Hospital Association and will share the results.
Interim Commissioner Krause questioned if the pay issue and working environment was our issue. If we are producing enough, then it is up to the profession to increase wage levels and improve environment.
Summary #5 and #15 of Task Force report will be reviewed and recommendations forward to BOR.
Regent Roehm recommended not to approve more programs until we have more data.
Regent Hamilton asked what data points they are going to look at. They need to justify to BOR why they should not approve programs at this time.
Interim Commissioner Krause: the data points include cost, need, capacity for clinical sites and realism in regard to faculty, testing, etc.—referenced Helena COT proposal – where would we place the students?
Paul Williamson would hate to see a freeze, as it would really affect supply and demand 3 to 5 years down the road. This would be unfair to students and hospitals.
Dick Brown agrees in opposing freeze. Would like input from OCHE/BOR as to questions that need to be asked.
Item #7: Evaluating Capacity
Lois Muir requested that we not forget the needs of place bound students as these will stay in state.
Kim Powell re: clinical: need common understanding of “clinical capacity” They have hired a consultant to determine “what is reasonable capacity.” What are appropriate clinical facilities for training? How many beds can support the clinicals?
Dick Brown would like to see rotations in rural areas: how to make it work; what part can technology play?
Regent Roehm: Is this an issue we can work together on? Should the proposed committee evaluate clinical site situation?
Interim Commissioner Krause suggested they do a search of guidelines.
Tonia Morine: Others also placing people in rural clinicals – see North Central Nursing Project.
Regent Hamilton: SBON and hospitals could help with resource issues such as scholarships for students, endowed chairs, etc.
Regent Roehm: Working on this issue is a Liaison responsibility.
Item #6: Evaluation of Nursing Graduates
Interim Commissioner Krause called attention to NCLEX pass rates – one important measure—SBON pays attention to these rates, as it is one measure for continuing program approval.
Regent Hamilton asked if it was important for the BOR to monitor pass rates or can they rely on SBON to do that.
Item #10: Review of proposed nursing programs
Regent Hamilton asked if there is value of national accreditation. The response was YES. This is especially important for students desiring to transfer to a higher degree level. They need to be from an accredited program. The accrediting bodies are: NLN-AS level and CCNE-BS level. Cost to institutions is an issue.
Suggestion: use currently accredited institutions as the lead. This would be an issue for the Task Force.
With no further business to come before the committee the meeting adjourned at 12:00.