S2981

An Act concerning nurses, revising various parts of the statutory law, supplementing P.L.2002, c.116 (C.18A:65-89 et seq.) and P.L.1947, c.262 (C.45:11-23 et seq.), and making an appropriation.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. (New section) The New Jersey Collaborating Center for Nursing (“NJCCN”) shall establish a program through which facilities for acute care, long-term care, public health, ambulatory care, home care and hospice providers, veterans’ memorial homes, and other qualifying facilities or providers may apply to receive financial, material, and technical support from the NJCCN to implement a transition-to-practice program created in accordance with P.L. , c. (C. ) (pending before the Legislature as this bill) for licensed practical nurses and registered professional nurses, or one of these professions.

2. (New section) a. The NJCCN shall:

(1) establish and update, as necessary, requirements for a transition-to-practice program created in accordance with P.L. , c. (C. ) (pending before the Legislature as this bill). The requirements shall include, at a minimum:

(a) a 12-month timeline for a transition-to-practice program;

(b) a full-time schedule for program participants;

(d) collection of data by the facility or provider to send to the NJCCN regarding the number of individuals who completed a transition-to-practice program with the facility or provider and remained at the facility or with the provider after programcompletion for full-time employment; and

(2) establish criteria for eligibility of facilities and providers to participate in the program created in accordance with section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).

b. To participate in the program, established pursuant to section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill), a facility or provider shall submit an application, through an application process developed by the NJCCN, and shall include the following information:

(1) the number of spots to be offered in the facility or provider’s transition-to-practice program;

(2) the type of facility or provider seeking approval; and

(3) whether the facility or provider’s transition-to-practiceprogram is newly established or being updated.

c. Applications shall be approved by the NJCCN on a first-come, first-served basis, with priority given to veterans’ memorial homes, long-term care facilities, and home care providers.

d. Upon approval of an application by the NJCCN, the New Jersey Board of Nursing shall provide funding to the NJCCN to offer the financial, material, and technical support to the approved facility or provider, in an amount determined based on various criteria, including, but not limited to, the information submitted in the application pursuant to paragraphs (1) through (3) of subsection b. of this section.

e. At no time shall the New Jersey Board of Nursing allocate an amount exceeding $2 million annually to the NJCCN for the financial, material, and technical support to facilities and providers participating in the program established pursuant to section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill).

3. Section 3 of P.L.2002, c.116 (C.18A:65-91) is amended to read as follows:

3. The New Jersey Collaborating Center for Nursing shall be governed by a 17-member board. A majority of the members first appointed to the board shall include nurse representatives from among the members of the New Jersey Colleagues in Caring collaborative.

a. The members shall be appointed as follows:

(1) four members appointed by the President of the Senate who include: one representative of acute care facilities recommended by the New Jersey Hospital Association; one representative of long-term care facilities recommended by the Health Care Association of New Jersey; one registered professional nurse recommended by the New Jersey State Nurses Association; and one representative of home health care agencies recommended by the Home Care Association of New Jersey;

(2) four members appointed by the Speaker of the General Assembly who include: one registered professional nurse recommended by the New Jersey State Nurses Association; one registered professional nurse recommended by the Organization of Nurse Executives - New Jersey; one school nurse representative [of acute care facilities] recommended by the New Jersey [Council of Teaching Hospitals] State School Nurses Association; and one licensed practical nurse who provides direct patient care; and

(3) nine members appointed by the Governor who include: one registered professional nurse recommended by the New Jersey State Nurses Association; one registered professional nurse recommended by the New Jersey League for Nursing; one health care facility staff nurse providing direct patient care, who is recommended by an organization that represents such nurses; two consumers of health care; one representative of baccalaureate and higher degree university nursing programs recommended by the Council of Baccalaureate and Higher Degree Programs; one representative of associate degree nursing programs recommended by the Council of Associate Degree programs; one representative of diploma nursing programs recommended by the Association of Diploma Schools of Professional Nursing; and one public health nurse representative [of practical nursing programs] recommended by the [Practical Nurses Educator's Council of] New Jersey Association of Public Health Nurse Administrators.

b. The term of office of each member shall be three years.

A member shall hold office for the term of [his] the member’s appointment and until [his] the member’s successor has been appointed and qualified. All vacancies shall be filled for the balance of the unexpired term in the same manner as the original appointment. A member of the board is eligible for reappointment, but no member shall serve for more than two consecutive terms.

c. The board shall meet at least quarterly and shall meet as soon as practical following the appointment of its members to choose, from among the members and by a majority vote of the members, a chairperson and such other officers as it deems appropriate. The chairperson and other officers shall serve in their elected office for a term of two years and may not succeed themselves in office.

d. Members shall serve without compensation but shall be reimbursed for the reasonable travel and other out-of-pocket expenses incurred in the performance of their duties in a manner consistent with the policies and procedures of Rutgers, The State University of New Jersey.

(cf: P.L.2009, c.47, s.2)

4. Section 4 of P.L.2002, c.116 (C.18A:65-92) is amended to read as follows:

4. The board shall:

a. determine global policies for the center;

b. implement the primary goals of the center as established in this act;

c. appoint a multidisciplinary advisory council to provide input and advice on policy matters. The advisory council shall include representatives from all of the organizations represented in the collaborative of New Jersey Colleagues in Caring;

d. appoint a full-time executive director who shall serve at the pleasure of the board and shall be a person qualified by training and experience to perform the duties of the office. The board shall authorize the executive director to employ such other staff as the executive director deems necessary and within the limits of funds available to the center. All policies and procedures concerning the hiring of center employees shall be the same as and consistent with the applicable policies and procedures of Rutgers, The State University of New Jersey;

e. apply for and accept grants of money available for carrying out the policies and activities of the center from the federal government, and accept gifts, grants and bequests of funds from individuals, foundations, corporations, governmental agencies and other organizations and institutions to carry out the purposes of this act;

f. establish policies for the appointment of members of the board; and

g. submit a report to the Governor and the Legislature [one year after the center is established, and] every two years [thereafter,] on its activities and findings, including, but not limited to: (1) data on the participation of facilities and providers in the NJCCN program established pursuant to section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill); (2) data on the number of licensed practical nurses and registered professional nurses participating in a transition-to-practice program supported by the NJCCN program established pursuant to section 1 of P.L. , c. (C. ) (pending before the Legislature as this bill), including information on the health care settings in which the programs were supported; and (3) funds spent in the previous two years on materials and technical support supplied by the NJCCN to facilities and providers participating in a transition-to-practice program. The report may include such recommendations for legislative action as the board deems appropriate. The board shall make its [annual] biannual report available to members of the public, upon request.

(cf: P.L.2009, c.47, s.3)

5. Section 4 of P.L.2009, c.47 (C.18A:65-92.1) is amended to read as follows:

4. There is annually appropriated to the New Jersey Collaborating Center for Nursing in the College of Nursing of Rutgers, The State University of New Jersey, 5[%] percent, or $515,000, whichever amount is greater, of the initial and renewal licensing fees for professional and practical nurses collected by the New Jersey Board of Nursing each year.

(cf: P.L.2009, c.47, s.4)

6. Section 5 of P.L.2009, c.47 (C.45:11-27.1) is amended to read as follows:

5. a. Of the initial and renewal licensing fees charged by the New Jersey Board of Nursing pursuant to N.J.A.C.13:37-5.5 for professional and practical nurses, an amount equal to 5[%] percent, or $515,000, whichever amount is greater, of the fee shall be dedicated to funding the New Jersey Collaborating Center for Nursing in the College of Nursing of Rutgers, The State University of New Jersey.

b. The board may, by regulation, revise the fees charged pursuant to N.J.A.C.13:37-5.5 to account for the loss of revenue to the board as a result of the dedication of funding pursuant to this section.

(cf: P.L.2009, c.47, s.5)

7. (New section) The New Jersey Nursing Emotional Well-Being Institute (NJ-NEW) in the New Jersey Collaborating Center for Nursing shall establish a program of services designed to promote the mental health and well-being of nurses licensed in New Jersey and their families and prevent the psychological and physical sequelae of stress. At a minimum, the program shall:

(1) encourage all health care facilities in the State that employ nurses to access the NJ-NEW Virtual Schwartz Rounds program;

(2) work to make Virtual Schwartz rounds available to all nurses in the State on at least a monthly basis;

(3) coordinate with nursing associations, mental health associations, and community organizations to facilitate a Statewide NJ-NEW well-being hub, which shall be comprised of learning collaboratives that offer strategies to prevent work-related stress from causing physical and emotional symptoms, provide educational resources, and provide consultation services for health care organizations in New Jersey to promote emotional well-being for nurses and their families;

(4) provide stress first aid training or establish partnerships with stress first aid training providers to support health care organizations in promoting emotional well-being and resiliency for nurses and their families;

(5) establish an online repository of Statewide emotional well-being and mental health resources and referrals for nurses and their families; and

(6) establish any other evidence-based initiatives that meet the ongoing emotional well-being and mental health needs of nurses and their families.

8. (New section) a. The New Jersey Board of Nursing shall require each licensed practical nurse, registered nurse, advanced practice nurse, and homemaker-home health aide licensed or certified in the State, as a condition of initial licensure or certification or renewal of a license or certification, to complete a survey, which survey shall include the following information:

(1) the type of license or certificate held by the person and the status of that license or certificate;

(2) the person’s demographic information, including age, race, ethnicity, and gender;

(3) the person’s educational background;

(4) the person’s employment status;

(5) the person’s primary employment setting;

(6) the type of position held by the person;

(7) in the case of a nurse, whether the nurse is licensed under the multistate Nurse Licensure Compact and whether, during the course of the prior year, the nurse provided professional services in other states under the compact; and

(8) such other information as the board may require.

b. The New Jersey Board of Nursing shall require each school that offers a nurse training program, including programs that offer a diploma, an associate’s degree, a baccalaureate degree, or an advanced degree in nursing as well as licensed practical nursing programs, and each homemaker-home health aide training program, to complete an annual survey, no later than July 1 of each year, which survey shall include the following information:

(1) the number of applicants rejected by the school or program;

(2) the total number of available slots at the school or program;

(3) the total number of qualified candidates who applied for the school or program;

(4) the total number of current enrollees in the school or program;

(5) graduation rates from the school or program;

(6) in the case of nursing schools, passage rates for the National Council Licensure Examination;

(7) demographic information concerning current students and faculty, including data concerning age, race, ethnicity, and gender;

(8) faculty vacancy rates;

(9) the total number of faculty employed;

(10) the educational background of faculty members; and

(11) such other information as the board may require.

c. The Department of Health shall require each certified nurse aide licensed in the State to complete a survey as a condition of initial certification or renewal of a certification. The survey required pursuant to this subsection shall include the following information:

(1) the certification status of the person;

(2) the person’s demographic information, including age, race, ethnicity, and gender;

(3) the person’s educational background;

(4) the person’s employment status;

(5) the person’s primary employment setting;

(6) the type of position held by the person; and

(7) such other information as the department may require.

d. The Department of Health shall require certified nurse aide training programs to complete an annual survey. The survey required pursuant to this subsection shall be completed no later than July 1 of each year, and shall include the following information:

(1) the number of applicants rejected by the program;

(2) the total number of available slots at the program;

(3) the total number of qualified candidates who applied for the program;

(4) the total number of current enrollees in the program;

(5) graduation rates from the program;

(6) demographic information concerning current students and faculty, including data concerning age, race, ethnicity, and gender;

(7) faculty vacancy rates;

(8) the total number of faculty employed;

(9) the educational background of faculty members; and

(10) such other information as the department may require.

e. (1) The New Jersey Board of Nursing shall develop and annually review the surveys required pursuant to subsections a. and b. of this section in collaboration with the New Jersey Collaborating Center for Nursing.

(2) The Department of Health shall develop and annually review the surveys required pursuant to subsections c. and d. of this section in collaboration with the New Jersey Collaborating Center for Nursing.

f. (1) The New Jersey Board of Nursing shall ensure compliance with the survey requirements of subsection a. of this section. A survey shall not be deemed complete unless all survey questions are answered.

(2) The New Jersey Collaborating Center for Nursing shall be responsible for distributing the survey required pursuant to subsection b. of this section, based on a list of schools that provide nurse training programs and a list of homemaker-home health aide training programs. The New Jersey Collaborating Center for Nursing shall notify the New Jersey Board of Nursing of any school or training program that fails to complete a survey distributed by the New Jersey Collaborating Center for Nursing pursuant to this paragraph. A survey shall not be deemed complete unless all survey questions are answered.

(3) The Department of Health shall be responsible for distributing and ensuring compliance with the survey requirements set forth in subsections c. and d. of this section.

g. (1) The New Jersey Board of Nursing shall transmit de-identified survey data collected pursuant to subsection a. of this section to the New Jersey Collaborating Center for Nursing. The New Jersey Collaborating Center for Nursing shall analyze data transmitted to it pursuant to this paragraph and produce an annual aggregate report of the data, which shall be made available on the websites of the New Jersey Board of Nursing and the New Jersey Collaborating Center for Nursing.

(2) The New Jersey Collaborating Center for Nursing shall analyze the survey data collected pursuant to subsection b. of this section and shall produce an annual aggregate report of the data, which shall be made available on the Internet websites of the New Jersey Board of Nursing and the New Jersey Collaborating Center for Nursing.

(3) The Department of Health shall analyze the survey data collected pursuant to subsections c. and d. of this section and shall produce an annual aggregate report of the data, which shall be made available on the Internet websites of the department and the New Jersey Collaborating Center for Nursing. The department may contract with the New Jersey Collaborating Center for Nursing to analyze the survey data and produce the annual aggregate report required pursuant to this paragraph, in which case the department shall provide the New Jersey Collaborating Center for Nursing with five percent of the total certified nurse aide certification fees collected for the current reporting period. The New Jersey Collaborating Center for Nursing may not charge the department any additional compensation for analyzing the survey data and producing the aggregate report above the fee authorized under this paragraph.

9. (New section) The New Jersey Board of Nursing and the Department of Health shall adopt rules and regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), as shall be necessary to implement the provisions of this act.

10. a. There is appropriated from the General Fund to the New Jersey Collaborating Center for Nursing in the College of Nursing of Rutgers, The State University of New Jersey the sum of $500,000 to effectuate the provisions of sections 1 and 2of this act.

b. There is appropriated from the General Fund to the Department of State such sums as are sufficient, as determined by the Secretary of State, for allocation to the NJ-NEW to support the operations of NJ-NEW and the initiatives undertaken by NJ-NEW pursuant to section 7 of this act.

11. This act shall take effect immediately, except that section 8 of this act shall remain inoperative until the first July 1 that is at least four months after the date of enactment.

STATEMENT

This bill implements certain measures to support nurses and the nursing workforce. Specifically, the bill establishes requirements for the New Jersey Collaborating Center for Nursing (NJCCN) to develop new graduate transition-to-practice programs; revises the membership of the NJCCN’s governing board; increases State funding for the NJCCN; requires the New Jersey Nursing Emotional Well-Being Institute (NJ-NEW) to establish a program of services and a peer support helpline to promote the mental health and emotional well-being of nurses and their families; and establishes annual survey requirements for nurses, homemaker-home health aides (HHAs) and certified nurse aides (CNAs), as well as for schools that offer nurse training programs and HHA and CNA training programs.

Graduate Nursing Transition-to-Practice Programs

The bill establishes a program through which facilities for acute care, long-term care, public health, ambulatory care, home care and hospice providers, veterans’ memorial homes, and other qualifying facilities or providers may apply to receive financial, material and technical support from the New Jersey Collaborating Center for Nursing (“NJCCN”) to implement a transition-to-practice program for licensed practical nurses and registered professional nurses, or one of these professions. To manage the operations of the program, the bill appropriates $500,000 to NJCCN.

The NJCCN is to 1) establish and update, as necessary, requirements for a transition-to-practice program and 2) establish criteria for eligibility of facilities and providers to participate in the program created in accordance with the bill. Requirements for a transition-to-practice program are to include, at a minimum: 1) a 12-month timeline for a transition-to-practice program; 2) a full-time schedule for program participants; 3) support for program participants by a preceptor or mentor; and 4) collection of data by the facility or provider to send to the NJCCN regarding the number of individuals who completed a transition-to-practice program with the facility or provider and remained at the facility or with the provider after program completion for full-time employment.

To participate in the NJCCN program, facilities and providers are to file an application that includes information on: 1) the number of spots to be offered in the facility or provider’s transition-to-practice program; 2) the type of facility or provider seeking approval; and 3) whether the facility or provider’s transition-to-practice program is newly established or being updated. Approval of an application by the NJCCN will be made on a first-come, first-serve basis, with priority given to veterans’ memorial homes, long-term care facilities, and home care providers. Upon approval of an application by the NJCNN, the New Jersey Board of Nursing will provide funding to the NJCCN to offer the financial, material, and technical support to the approved facility or provider, in an amount determined based on various criteria, including, but not limited to, the information submitted in the application on the number of spots in a transition-to-practice program, the type of facility, and if the transition-to-practice program is new or being updated. The bill directs that at no time is the New Jersey Board of Nursing to allocate an amount exceeding $2 million annually to the NJCCN for the financial, material, and technical support to facilities and providers participating in the program created in the bill.

Finally, a biannual report currently required of the NJCCN to submit to the Governor and Legislature is to now include various data on the transition-to-practice programs established for licensed practical nurses and registered professional nurses.

New Jersey Collaborating Center for Nursing’s Governing Board Membership

The bill updates and revises the membership of the New Jersey Collaborating Center for Nursing’s governing board to include: a member who is a school nurse representative recommended by the New Jersey State School Nurses Association, instead of a school nurse representative of acute care facilities recommended by the New Jersey Council of Teaching Hospitals; and a member who is a public health nurse representative recommended by the New Jersey Association of Public Health Nurse Administrators, instead of a public health nurse representative of practical nursing programs recommended by the Practical Nurses Educator's Council of New Jersey.

New Jersey Collaborating Center for Nursing Funding

The bill amends current law to provide that an amount equal to at least $515,000 of the initial and renewal licensing fees charged by the New Jersey Board of Nursing for professional and practical nurses is dedicated to funding, and annually appropriated to, the NJCCN. Under current law, five percent of the initial and renewal licensing fees charged by the board are dedicated to funding, and annually appropriated to, the NJCCN. The NJCCN will annually receive five percent, or $515,000, whichever amount is greater.

Nurse Emotional Well-Being and Mental Health Support

The bill requires the New Jersey Nursing Emotional Well-Being Institute (NJ-NEW) in the NJCCN to establish a program of services designed to promote the mental health and emotional well-being of nurses, as well as to provide a nurse-to-nurse peer support helpline. Specifically, NJ-NEW will be required to establish a program of services designed to promote the mental health and well-being of nurses licensed in New Jersey and their families and prevent the psychological and physical sequelae of stress. At a minimum, the program will:

(1) encourage all health care facilities in the State that employ nurses to access the NJ-NEW Virtual Schwartz Rounds program;

(2) work to make Virtual Schwartz rounds available to all nurses in the State on at least a monthly basis;

(3) coordinate with nursing associations, mental health associations, and community organizations to facilitate a Statewide NJ-NEW well-being hub, which will comprise learning collaboratives that offer strategies to prevent work-related stress from causing physical and emotional symptoms, provide educational resources, and provide consultation services for health care organizations in New Jersey to promote emotional well-being for nurses and their families;

(5) establish an online repository of Statewide emotional well-being and mental health resources and referrals for nurses and their families; and

(6) establish any other evidence-based initiatives that meet the ongoing emotional well-being and mental health needs of nurses and their families. The bill appropriates from the General Fund to the Department of State such sums as are sufficient, as determined by the Secretary of State, for allocation to the NJ-NEW to support the operations of NJ-NEW and the initiatives undertaken by NJ-NEW pursuant to the bill.

Workforce and Training Program Survey Requirements

The bill codifies certain existing surveys for nurses and creates new surveys for homemaker-home health aides (HHAs) and certified nurse aides (CNAs), as well as for schools that offer nurse training programs and HHA and CNA training programs.

Specifically, the survey for nurses, HHAs, and CNAs will solicit information concerning: 1) the person’s licensure or certification status; 2) the person’s demographic information, including age, race, ethnicity, and gender; 3) the person’s educational background; 4) the person’s employment status; 5) the person’s primary employment setting; 6) the type of position held by the person; and any other information as may be required. Nurses will additionally be asked whether the nurse is licensed under the multistate Nurse Licensure Compact and whether, during the course of the prior year, the nurse provided professional services in other states under the compact. The survey is to be completed by the professional in connection with the professional’s initial licensure or certification and in connection with the renewal of the professional’s license or certification.

The survey for schools that offer training programs for nurses will include programs that offer a diploma, an associate’s degree, a baccalaureate degree, or an advanced degree in nursing, as well as licensed practical nurse training programs.

The nurse training program survey and the surveys for HHA and CNA training programs will solicit the following information: 1) the number of applicants rejected by the school or program; 2) the total number of available slots at the school or program; 3) the total number of qualified candidates who applied to the school or program; 4) the total number of current enrollees in the school or program; 5) graduation rates from the school or program; 6) in the case of nursing schools, pass rates for program graduates for the National Council Licensure Examination; 7) demographic information concerning current students and faculty, including data concerning age, race, ethnicity, and gender; 8) faculty vacancy rates; 9) the total number of faculty employed; 10) the educational background of faculty members; and 11) such other information as may be required. The survey is to be completed by the school or training program no later than July 1 of each year.

The New Jersey Board of Nursing and the DOH will be required to develop and annually review the surveys required under the bill in collaboration with the New Jersey Collaborating Center for Nursing (NJCCN).

The New Jersey Board of Nursing will ensure compliance with the nurse and HHA survey requirements and the DOH will ensure compliance with the CNAs and CNA training program survey requirements. A survey will not be deemed complete unless all survey questions are answered.

The New Jersey Board of Nursing will transmit de-identified nurse and HHA survey data to the NJCCN, which will analyze the data and produce an annual aggregate report. The NJCCN will additionally analyze and produce an annual aggregate report of nursing school and HHA training program survey data. The DOH will be required to analyze CNA and CNA training program survey data and produce an annual aggregate report; however, the department will be authorized to contract with the NJCCN to analyze the data and produce the report, the costs of which will be offset by the department furnishing the NJCCN with five percent of CNA licensure fees collected for the current reporting period.

The reports of survey data for nurses, HHAs, schools that offer training programs for nurses, and HHA training programs will be made available on the Internet websites of the New Jersey Board of Nursing and the NJCCN. The CNA and CNA training program reports will be made available on the Internet websites of the DOH and the NJCCN.