Nursing and Nursing Education Public Policies and Private Actions (1983) / Chapter Skim
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CHAPTER III THE EFFECTS OF EDUCATION FINANCING ON GENERALIST NURSE SUPPLY
CHAPTER III THE EFFECTS OF EDUCATION FINANCING ON GENERALIST NURSE SUPPLY
Pages 89-115
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From page 89... ...
State and local governments face competing claims on public funds, of which postsecondary education is only one. Educational institutions must allocate the funds available to them from the state, private sources, and the federal government among nursing and other educational programs and, within nursing, among associate and baccalaureate degree programs leading to licensure as a RN, as well as LPN programs.
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From page 90... ...
Student Decision Making Potential nursing students contemplating a basic nursing education program are faced with difficult choices that have long-term implications. They have to consider the extent to which their abilities and interests match the requirements of the education program and the responsibilities of positions typically held by program graduates.
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From page 91... ...
academic year a few baccalaureate programs in private institutions report tuition close to $8,000.4 Other Out-of-Pocket Education Expenses Specific data on nursing students' other out-of-pocket education expenditures are not available, but they may be approximated from the expenses for all students in TABLE 19 Median Annual Tuition and Fees for Basic Nursing Education Programs, by Type of Program and Public-Private Control, 1981-1982 (dollars) Type of Control Type of ProgramPublic Private Associate degree$ 684 $3,196 Diploma1,083 1,572 Baccalaureate996 3,880 SOURCE: NLN nursing data book 1982, Tables 14, 15, and 16 (see Reference 2 for complete citation)
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From page 92... ...
Again if living expenses are assigned to increase by 6 percent annually, a resident student enrolled in a public baccalaureate program will face total out-of~ocket expenses of $18,800; if that student attends a private baccalaureate program, the total will be $31,200. The range of average total outlays is estimated to be from roughly $6,400 for a corr~nuter student attending a public AD program to almost $31,000 for a resident student who attends a private baccalaureate
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From page 93... ...
. TABLE 21 Estimated Total Out-of-Pocket Education Expenses for Full-Time Students in Basic Nurse Educat ion Programs, Ac ademic Year 1981-1982, and Est imated Total Expenses to Complete Each Type of Program for a Student Entering in 1981-1982 (dollars ~ Associate Degree Diploma Baccalaureate Period of Expenses Public Private Public Private Public Private 1981-1982 academic $ 920 $3,440 y eara Total programs 1,900 7,250 $1,330 $1,800 $1,250 $ 4,140 4,300 5,900 6,740 18,450 between the lowest and highest ~ Annual figures for 1981-1982 are computed by adding median tuition and fees for nursing students (Table 19)
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From page 94... ...
A student attending one of the private baccalaureate programs with annual tuition in the $7,000-38,000 range would face total outlays of roughly $40,000, if the student lives on campus. A self-supporting student in such a program would have to meet expenses of over $50,000.
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From page 95... ...
Private education institutions depend on student payments -- tuition and fees -- to cover a greater proportion of education costs than do publicly supported institutions. As has been shown in Table 19, median annual tuition charges by private AD and baccalaureate programs are several times the charges by public programs.
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From page 96... ...
Nursing students come largely from families of modest means. The annual survey of first-time, full-t~me freshman conducted annually by the Cooperative Institutional Research Program (CHIP)
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From page 97... ...
TABLE 23 Estimated Family Income Distribution of First-Time, Full-Time Freshmen, Fall 1981 Family Income Nursing Students All Students Estimated Estimated Estimated Estimated Number Percent Number Percent All 67,758100.01,729,985100.0 Under $5,999 4,7046.974,0934.3 $6,000-9,999 4,0976.083,3364.8 $10,000-14,999 7,51711.1169,8909.8 $15,000-24,999 14,39821.2375,86021.7 $25,000-29,999 5,5828.2168,2489.7 Over $30,000 16,00223.6580,40633.5 Income unknown 10,45715.4221,89312.8 Independent studentsb 5,001 7.1 56,263 3.2 Freshmen students enrolled in a nursing education program or indicating nursing as a career choice. bStudents who are independent of parental support and therefore not required to report family income.
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From page 98... ...
Sources of Education Financing for Nursing Students Nursing students finance their educational outlays and living costs from a combination of sources, including general federal programs of financial aid for postsecondary students, Nurse Training Act scholarship and loan programs (limited specifically to nursing students) , state and collegiate grant programs, earnings, savings, and family support.
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From page 99... ...
The study sample included 6,075, representing a population of over 67,000 nursing students. barograms of general federal financial aid for postsecondary students.
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From page 100... ...
1981 1982 1983a Pell Grants$2,346$2,419$2,419 Supplemental370355355 Educational Opportunity Grants Guaranteed Student Loans2,900b3,07 ~3,100 College work-study550528540 Vocational education67464872LE National Direct201179179 Student Loans State Student Incentive777460 Grants TOTAL$7,118$7,276$7,374 aPer continuing resolution, public law, December 21, 1982. Estimated by the Congressional Budget Office.
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From page 101... ...
Not all states had grant programs for postsecondary students when the SSIG program began; however, by 1978, all eligible states and territories had became part of the SSIG program. Level of state commitments to student aid vary greatly.
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From page 102... ...
If enacted, such large reductions in federal student aid programs will reduce the number of students attending postsecondary education institutions generally and could be expected to have adverse effects on the numbers of students entering nursing education programs, especially in private institutions. Research on the demand for higher education has shown that individuals are responsive to the price of higher education, such that the proportion attending higher education decreases as the price increases (price is defined as the student's out-of-pocket cost, less financial aid)
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From page 103... ...
In 1981, almost 9,000 students received these scholarships (see Appendix 2~; this was down from almost 35,000 students in 1973.32 Total funds awarded under these NTA authorities to students in basic nursing education program, by type of programs, for the fiscal years 1965 through 1979 are shown in Table 26. TABLE 26 Nurse Training Act Scholarship and Loan Funds Awarded to Basic Nursing Education Programs, by Type of Program, Fiscal Years 1965-1979 Dollars (in mil lions ~ TOTAL $386.6 Associate All Basic 13acc alaureate Degree Diploma Programs Programs Programs Programs $175.6 $105.3 $105.9 Scholarshipsa 12 6.5 57.6 39.5 30.
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From page 104... ...
RE COMMENDATION 3 The federal government should maintain its general programs of financial aid to postsecondary students so that qualified prospective nursing students will continue to have the opportunity to enter generalist nursing education programs in numbers sufficient to maintain the necessary aggregate supply. State and Institutional Decision Making The future supply of nurses will be shaped not only by students' decisions to enter nursing education and their choices among the types of basic education programs, but also by the collective decisions of individual educational institutions with regard to the number, size, and type of nursing education programs they will offer.
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From page 105... ...
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From page 106... ...
Private educational institutions also receive a substantial portion of their revenues from endowment income and private donors. As related in Chapter I, approximately 80 percent of nursing education programs and enrolled nursing students are based in higher education institutions.
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From page 107... ...
The Medicare program estimates that participating hospitals incurred approximately $350 million of "allowable nursing education costs" in 1979.35 This figure, based on the amounts reported under "nursing education" on the Medicare cost report, can be assumed to represent expenses for diploma nursing programs. However, for a number of reasons, it should be viewed as a minimal estimate of nursing education costs in hospitals.
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From page 108... ...
If differential tuition were to become more common than it is at present, nursing students would tend to face higher than average tuition Levels, because nursing education programs tend to be more costly than the average because of relatively low student-faculty ratios required for clinical teaching. In the current circumstance of constrained resources and economic recession, higher education institutions are finding it necessary to make difficult decisions as to the allocation of available funds.
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From page 109... ...
At the University of Maryland, for example, the average cost per full-time equivalent (FTE) student in nursing has been estimated at approximately $3,900 in 1982; the average cost per FTE for all undergraduates is $2,150.41 The Colorado Commission on Higher Education estimated that in 1976 the average annual cost for a FTE undergraduate in nursing was $1,739, compared with $1,175 for an FTE student in education.42 Data from the community college system in Florida indicate that in the 1980-1981 academic year the cost per credit hour for students in nursing and allied health fields was $47.18, whereas the overall average cost was $23.59.43 Of course, basic nursing education programs vary in their cost.
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From page 110... ...
Particularly persuasive to educational institutions and policymakers is a willingness on the part of employers to bear a portion of the education costs by subsidizing tuition, by funding joint research projects, and even by paying faculty salaries, as has occurred in engineering. Rising salary offers to graduates also provide strong evidence of employer demands.
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From page 111... ...
Unlike the federal government, states provide the bulk of operational support for many basic nursing programs within senior colleges and universities as well as community colleges. State authorities also often exercise the power to approve new programs and to eliminate existing programse Despite their powers, however, states usually do not interfere extensively or directly in the traditional prerogatives of educational institutions.
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From page 112... ...
Fiscal pressures on the educational budgets of state and local governments, as well as cost containment efforts aimed at hospitals, threaten to reduce funds available for nursing education from these sources. RECOMMENDATION 4 Institutional and student financial support should be maintained by state and local governments, higher education institutions, hospitals, and third-party payers to assure that generalist nursing education programs have capacity and enrollments sufficient to graduate the numbers and kinds of nurses commensurate with state and local goals for the nurse supply.
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From page 113... ...
NLN nursing data book 1981 (Publication No.
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From page 114... ...
Effects on enrollment of changes in student aid policies and programs. New Directions for Institutional Research, 1980, 25, 1-14.
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From page 115... ...
College cost book 1981-1982. New York: College Entrance Examination Board, National League for Nursing.
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