H.F. 2533 Section 1. NEW SECTION . 84A.11 Nursing workforce data 1 clearinghouse. 2 1. a. The department of workforce development shall 3 establish a nursing workforce data clearinghouse for the 4 purpose of collecting and maintaining data from all available 5 and appropriate sources regarding Iowa’s nursing workforce. 6 b. The department of workforce development shall have access 7 to all data regarding Iowa’s nursing workforce collected or 8 maintained by any state department or agency to support the 9 data clearinghouse. 10 c. Information maintained in the nursing workforce data 11 clearinghouse shall be available to any state department or 12 agency. 13 2. The department of workforce development shall consult 14 with the board of nursing, the department of public health, 15 the department of education, and other appropriate entities in 16 developing recommendations to determine options for additional 17 data collection. 18 3. The department of workforce development, in consultation 19 with the board of nursing, shall adopt rules pursuant to 20 chapter 17A to administer the data clearinghouse. 21 4. The nursing workforce data clearinghouse shall be 22 established and maintained in a manner consistent with the 23 health care delivery infrastructure and health care workforce 24 resources strategic plan developed pursuant to section 135.164. 25 5. The department of workforce development shall submit a 26 report to the governor and the general assembly, annually by 27 January 15, regarding the nursing workforce data clearinghouse, 28 and, following establishment of the data clearinghouse, the 29 status of the nursing workforce in Iowa. 30 Sec. 2. Section 135.175, subsection 1, paragraph a, Code 31 Supplement 2009, is amended to read as follows: 32 a. A health care workforce support initiative is established 33 to provide for the coordination and support of various efforts 34 to address the health care workforce shortage in this state. 35 -1- LSB 5253HZ (3) 83 pf/nh 1/ 11

H.F. 2533 This initiative shall include the medical residency training 1 state matching grants program created in section 135.176, 2 the nurse residency state matching grants program created in 3 section 135.176A, the health care professional and nursing 4 workforce shortage Iowa needs nurses now initiative created 5 in sections 261.128 and 261.129, the safety net provider 6 recruitment and retention initiatives program created in 7 section 135.153A, health care workforce shortage national 8 initiatives, and the physician assistant mental health 9 fellowship program created in section 135.177. 10 Sec. 3. Section 135.175, subsection 3, Code Supplement 11 2009, is amended to read as follows: 12 3. The department and any entity identified in this section 13 as having control over any of the accounts within the fund, 14 may receive contributions, grants, and in-kind contributions 15 to support the purposes of the fund and the accounts within 16 the fund. Not more than five percent of the moneys allocated 17 to any account within the fund may be used for administrative 18 costs. 19 Sec. 4. Section 135.175, subsection 5, paragraph b, Code 20 Supplement 2009, is amended to read as follows: 21 b. The health care professional and nurse workforce 22 shortage Iowa needs nurses now initiative account. The health 23 care professional and nurse workforce shortage Iowa needs 24 nurses now initiative account shall be under the control of 25 the college student aid commission created in section 261.1 26 and the moneys in the account shall be used for the purposes 27 of the health care professional incentive payment program and 28 the nurse workforce shortage Iowa needs nurses now initiative 29 as specified in sections 261.128 and 261.129. Moneys in the 30 account shall consist of moneys appropriated or allocated 31 for deposit in or received by the fund or the account and 32 specifically dedicated to the health care professional and 33 nurse workforce shortage Iowa needs nurses now initiative or 34 the account for the purposes of the account. 35 -2- LSB 5253HZ (3) 83 pf/nh 2/ 11

H.F. 2533 Sec. 5. Section 135.175, subsection 5, Code Supplement 1 2009, is amended by adding the following new paragraphs: 2 NEW PARAGRAPH . f. The Iowa needs nurses now infrastructure 3 account. The Iowa needs nurses now infrastructure account 4 shall be under the control of the department and the moneys 5 in the account shall be used to award grants in accordance 6 with rules adopted by the department, in consultation with 7 the board of nursing, the department of education, and a 8 statewide association that represents nurses specified by the 9 director, pursuant to chapter 17A, for clinical simulators, 10 laboratory facilities, health information technology, and other 11 infrastructure to improve the training of nurses and nurse 12 educators in the state and to enhance the clinical experience 13 for nurses. Grants awarded shall authorize the use of a 14 reasonable portion of the grant moneys for training in the 15 use of the infrastructure purchased with the grant moneys. 16 Moneys in the account shall consist of moneys appropriated 17 or allocated for deposit in or received by the fund or the 18 account and specifically dedicated to the Iowa needs nurses now 19 infrastructure account for the purposes of the account. 20 NEW PARAGRAPH . g. The nurse residency state matching grants 21 program account. The nurse residency state matching grants 22 program account shall be under the control of the department 23 and the moneys in the account shall be used for the purposes of 24 the nurse residency state matching grants program as specified 25 in section 135.176A. Moneys in the account shall consist of 26 moneys appropriated or allocated for deposit in or received 27 by the fund or the account and specifically dedicated to the 28 nurse residency state matching grants program account for the 29 purposes of such account. 30 Sec. 6. Section 135.175, subsection 6, paragraph a, Code 31 Supplement 2009, is amended to read as follows: 32 a. Moneys in the fund and the accounts in the fund shall 33 only be appropriated in a manner consistent with the principles 34 specified and the strategic plan developed pursuant to 35 -3- LSB 5253HZ (3) 83 pf/nh 3/ 11

H.F. 2533 sections 135.163 and 135.164 to support the medical residency 1 training state matching grants program, the nurse residency 2 state matching grants program, the health care professional 3 incentive payment program, the nurse educator incentive payment 4 and nursing faculty fellowship programs Iowa needs nurses 5 now initiative , the safety net recruitment and retention 6 initiatives program, for national health care workforce 7 shortage initiatives, for the physician assistant mental health 8 fellowship program, for the purposes of the Iowa needs nurses 9 now infrastructure account, and to provide funding for state 10 health care workforce shortage programs as provided in this 11 section. 12 Sec. 7. NEW SECTION . 135.176A Nurse residency state 13 matching grants program —— repeal. 14 1. The department shall establish a nurse residency state 15 matching grants program to provide matching state funding 16 to sponsors of nurse residency programs in this state to 17 establish, expand, or support nurse residency programs that 18 meet standards adopted by rule of the department. Funding for 19 the program may be provided through the health care workforce 20 shortage fund or the nurse residency state matching grants 21 program account created in section 135.175. The department, 22 in cooperation with the Iowa board of nursing, the department 23 of education, Iowa institutions of higher education with board 24 of nursing-approved programs to educate nurses, and the Iowa 25 nurses association, shall adopt rules pursuant to chapter 17A 26 to establish minimum standards for nurse residency programs 27 to be eligible for a matching grant that address all of the 28 following: 29 a. Eligibility requirements for and qualifications of 30 a sponsor of a nurse residency program to receive a grant, 31 including that the program includes both rural and urban 32 components. 33 b. The application process for the grant. 34 c. Criteria for preference in awarding of the grants. 35 -4- LSB 5253HZ (3) 83 pf/nh 4/ 11

H.F. 2533 d. Determination of the amount of a grant. 1 e. Use of the funds awarded. Funds may be used to pay 2 the costs of establishing, expanding, or supporting a nurse 3 residency program as specified in this section, including but 4 not limited to the costs associated with residency stipends and 5 nursing faculty stipends. 6 2. This section is repealed June 30, 2014. 7 Sec. 8. Section 261.2, subsection 10, Code Supplement 2009, 8 is amended to read as follows: 9 10. Administer the health care professional incentive 10 payment program established in section 261.128 and the nursing 11 workforce shortage Iowa needs nurses now initiative created in 12 section 261.129. This subsection is repealed June 30, 2014. 13 Sec. 9. Section 261.128, subsection 1, Code Supplement 14 2009, is amended to read as follows: 15 1. The commission shall establish a health care 16 professional incentive payment program to recruit and retain 17 health care professionals in this state. Funding for the 18 program may be provided through the health care workforce 19 shortage fund or the health care professional and nurse 20 workforce shortage Iowa needs nurses now initiative account 21 created in section 135.175. 22 Sec. 10. Section 261.129, Code Supplement 2009, is amended 23 to read as follows: 24 261.129 Nursing workforce shortage Iowa needs nurses 25 now initiative —— repeal. 26 1. Nurse educator incentive payment program. 27 a. The commission shall establish a nurse educator incentive 28 payment program. Funding for the program may be provided 29 through the health care workforce shortage fund or the health 30 care professional and nurse workforce shortage Iowa needs 31 nurses now initiative account created in section 135.175. 32 For the purposes of this subsection, “nurse educator” means 33 a registered nurse who holds a master’s degree or doctorate 34 degree and is employed as a faculty member who teaches nursing 35 -5- LSB 5253HZ (3) 83 pf/nh 5/ 11

H.F. 2533 in a nursing education program as provided in 655 IAC 2.6 at 1 a community college, an accredited private institution, or an 2 institution of higher education governed by the state board of 3 regents. 4 b. The program shall consist of incentive payments to 5 recruit and retain nurse educators. The program shall provide 6 for incentive payments of up to twenty thousand dollars for a 7 nurse educator who remains teaching in a qualifying teaching 8 position for a period of not less than four consecutive 9 academic years. 10 c. The nurse educator and the commission shall enter into an 11 agreement specifying the obligations of the nurse educator and 12 the commission. If the nurse educator leaves the qualifying 13 teaching position prior to teaching for four consecutive 14 academic years, the nurse educator shall be liable to repay 15 the incentive payment amount to the state, plus interest as 16 specified by rule. However, if the nurse educator leaves 17 the qualifying teaching position involuntarily, the nurse 18 educator shall be liable to repay only a pro rata amount of the 19 incentive payment based on incompleted years of service. 20 d. The commission, in consultation with the department 21 of public health, the board of nursing, the department of 22 education, and the Iowa nurses association, shall adopt rules 23 pursuant to chapter 17A relating to the establishment and 24 administration of the nurse educator incentive payment program. 25 The rules shall include provisions specifying what constitutes 26 a qualifying teaching position. 27 2. Nursing faculty fellowship program. 28 a. The commission shall establish a nursing faculty 29 fellowship program to provide funds to nursing schools in the 30 state, including but not limited to nursing schools located at 31 community colleges, for fellowships for individuals employed 32 in qualifying positions on the nursing faculty. Funding for 33 the program may be provided through the health care workforce 34 shortage fund or the health care professional and nurse 35 -6- LSB 5253HZ (3) 83 pf/nh 6/ 11

H.F. 2533 workforce shortage the Iowa needs nurses now initiative account 1 created in section 135.175. The program shall be designed 2 to assist nursing schools in filling vacancies in qualifying 3 positions throughout the state. 4 b. The commission, in consultation with the department 5 of public health , the board of nursing, the department of 6 education, and the Iowa nurses association, and in cooperation 7 with nursing schools throughout the state, shall develop a 8 distribution formula which shall provide that no more than 9 thirty percent of the available moneys are awarded to a single 10 nursing school. Additionally, the program shall limit funding 11 for a qualifying position in a nursing school to no more than 12 ten thousand dollars per year for up to three years. 13 c. The commission, in consultation with the department 14 of public health, the board of nursing, the department of 15 education, and the Iowa nurses association, shall adopt 16 rules pursuant to chapter 17A to administer the program. The 17 rules shall include provisions specifying what constitutes a 18 qualifying position at a nursing school. 19 d. In determining eligibility for a fellowship, the 20 commission shall consider all of the following: 21 (1) The length of time a qualifying position has gone 22 unfilled at a nursing school. 23 (2) Documented recruiting efforts by a nursing school. 24 (3) The geographic location of a nursing school. 25 (4) The type of nursing program offered at the nursing 26 school, including associate, bachelor’s, master’s, or doctoral 27 degrees in nursing, and the need for the specific nursing 28 program in the state. 29 3. Nurse educator scholarship program. 30 a. The commission shall establish a nurse educator 31 scholarship program. Funding for the program may be provided 32 through the health care workforce shortage fund or the health 33 care professional and the Iowa needs nurses now initiative 34 account created in section 135.175. The goal of the nurse 35 -7- LSB 5253HZ (3) 83 pf/nh 7/ 11

H.F. 2533 educator scholarship program is to address the waiting list of 1 qualified applicants to Iowa’s nursing schools by providing 2 incentives for the training of additional nursing educators. 3 For the purposes of this subsection, “nurse educator” means 4 a registered nurse who holds a master’s degree or doctorate 5 degree and is employed as a faculty member who teaches nursing 6 in a nursing education program as provided in 655 IAC 2.6 at 7 a community college, an accredited private institution, or an 8 institution of higher education governed by the state board of 9 regents. 10 b. The program shall consist of scholarships to further 11 advance the education of nurses to become nurse educators. The 12 program shall provide for scholarship payments in an amount 13 established by rule for students who are preparing to teach in 14 qualifying teaching positions. 15 c. The commission, in consultation with the department 16 of public health, the board of nursing, the department of 17 education, and the Iowa nurses association, shall adopt rules 18 pursuant to chapter 17A relating to the establishment and 19 administration of the nurse educator scholarship program. The 20 rules shall include provisions specifying what constitutes a 21 qualifying teaching position and the amount of any scholarship. 22 4. Nurse educator scholarship-in-exchange- 23 for-service program. 24 a. The commission shall establish a nurse educator 25 scholarship-in-exchange-for-service program. Funding for the 26 program may be provided through the health care workforce 27 shortage fund or the health care professional and Iowa needs 28 nurses now initiative account created in section 135.175. The 29 goal of the nurse educator scholarship-in-exchange-for-service 30 program is to address the waiting list of qualified applicants 31 to Iowa’s nursing schools by providing incentives for the 32 education of additional nursing educators. For the purposes 33 of this subsection, “nurse educator” means a registered nurse 34 who holds a master’s degree or doctorate degree and is employed 35 -8- LSB 5253HZ (3) 83 pf/nh 8/ 11

H.F. 2533 as a faculty member who teaches nursing in a nursing education 1 program as provided in 655 IAC 2.6 at a community college, an 2 accredited private institution, or an institution of higher 3 education governed by the state board of regents. 4 b. The program shall consist of scholarships to further 5 advance the education of nurses to become nurse educators. The 6 program shall provide for scholarship-in-exchange-for-service 7 payments in an amount established by rule for students who 8 are preparing to teach in qualifying teaching positions for a 9 period of not less than four consecutive academic years. 10 c. The scholarship-in-exchange-for-service recipient 11 and the commission shall enter into an agreement specifying 12 the obligations of the applicant and the commission. 13 If the nurse educator leaves the qualifying teaching 14 position prior to teaching for four consecutive academic 15 years, the nurse educator shall be liable to repay the 16 scholarship-in-exchange-for-service amount to the state plus 17 interest as specified by rule. However, if the nurse educator 18 leaves the qualified teaching position involuntarily, the nurse 19 educator shall be liable to repay only a pro rata amount of the 20 scholarship based on incomplete years of service. 21 d. The receipt of a nurse educator 22 scholarship-in-exchange-for-service shall not impact 23 eligibility of an individual for other financial incentives 24 including but not limited to loan forgiveness programs. 25 e. The commission, in consultation with the department 26 of public health, the board of nursing, the department 27 of education, and the Iowa nurses association, shall 28 adopt rules pursuant to chapter 17A relating to the 29 establishment and administration of the nurse educator 30 scholarship-in-exchange-for-service program. The rules 31 shall include the provisions specifying what constitutes 32 a qualifying teaching position and the amount of any 33 scholarship-in-exchange-for-service. 34 3. 5. Repeal. This section is repealed June 30, 2014. 35 -9- LSB 5253HZ (3) 83 pf/nh 9/ 11

H.F. 2533 Sec. 11. BOARD OF NURSING —— DATA COLLECTION REGARDING 1 NURSING WORKFORCE. The board of nursing shall replace 2 its existing database and data platform to allow for the 3 maintenance of archival information and enhanced public access 4 and shall update its nursing survey instrument to ensure the 5 collection of more complete and usable data in assessing Iowa’s 6 nursing workforce. 7 Sec. 12. CODE EDITOR DIRECTIVE. The Code editor shall 8 amend the title of the division in chapter 261, which includes 9 section 261.129, as amended in this Act, as the Iowa needs 10 nurses now initiative. 11 Sec. 13. IMPLEMENTATION. This Act shall be implemented only 12 to the extent funding is available. 13 EXPLANATION 14 This bill includes provisions relating to the nursing 15 workforce. 16 The bill directs the department of workforce development 17 to establish a nursing workforce data clearinghouse for 18 the purpose of collecting and maintaining data from all 19 available and appropriate sources regarding Iowa’s nursing 20 workforce. The department is to have access to all data 21 regarding Iowa’s nursing workforce collected or maintained 22 by any state department or agency to support the data 23 clearinghouse, and the information maintained in the nursing 24 workforce data clearinghouse is to be available to any state 25 department or agency. The bill directs the department of 26 workforce development to consult with the board of nursing, 27 the department of public health (DPH), the department of 28 education, and other appropriate entities in developing 29 recommendations to determine options for additional data 30 collection. The bill provides rulemaking authority to the 31 department of workforce development in consultation with the 32 board of nursing to administer the data clearinghouse, and 33 directs that a nursing workforce data clearinghouse shall be 34 established and maintained in a manner consistent with the 35 -10- LSB 5253HZ (3) 83 pf/nh 10/ 11

H.F. 2533 health care delivery infrastructure and health care workforce 1 resources strategic plan developed by DPH. The bill requires 2 the department of workforce development to submit an annual 3 report to the governor and the general assembly regarding the 4 data clearinghouse, and, following its establishment, the 5 status of the nursing workforce in Iowa. 6 The bill also adds two accounts to the health care workforce 7 shortage fund: the Iowa needs nurses now infrastructure 8 account under the control of DPH to provide for the awarding of 9 grants for clinical simulators, laboratory facilities, health 10 information technology, and other infrastructure to improve 11 the training of nurses and nurse educators in the state and 12 to enhance the clinical experience for nurses; and the nurse 13 residency state matching grants program account under the 14 control of DPH to provide matching state funding to sponsors of 15 nurse residency programs in this state to establish, expand, or 16 support nurse residency programs that meet standards adopted 17 by rule of DPH. 18 The bill changes the name of the nursing workforce shortage 19 initiative within the health care workforce support initiative 20 to the Iowa needs nurses now initiative and makes a similar 21 change to the name of the account for the initiative. The 22 bill also requires the college student aid commission, which 23 currently controls the Iowa needs nurses now initiative, to 24 consult with the Iowa board of nursing, the department of 25 education, and the Iowa nurses association in adopting rules 26 for the initiative and distributing funds. 27 The bill adds two programs to the Iowa needs nurses now 28 initiative: the nurse educator scholarship program and the 29 nurse educator scholarship-in-exchange-for-service program. 30 The bill also provides that implementation is subject to the 31 extent of funding available. 32 -11- LSB 5253HZ (3) 83 pf/nh 11/ 11