Remarks by H. Martin Lancaster
President, N.C. Community College System
Western North Carolina Health Network
Haywood Community College
January 16, 2002
Thank you for inviting me to speak today. I appreciate the proactive position that the Western North Carolina Health Network has taken to seek collaborative solutions to shortages in health professions. As you are aware, we are experiencing an alarming shortage of qualified health care professionals, and this is of major concern to the North Carolina Community College System.
The North Carolina Division of Facility Services estimates that the nation will need approximately 758,000 more aide/direct care workers before the year 2008. North Carolina alone will need approximately 31,000.
Some of you may have attended the spring meeting of the North Carolina Community College Practical Nurse Educators. At that meeting, you heard from a representative from the North Carolina Center for Nursing. Data from the Center reveals that there is a 17% job vacancy rate for LPN’s in North Carolina. Of the hospitals surveyed, 33% reported an increasing number of LPN vacant positions. Last year, the Community College System graduated more than 9,000 nursing assistants, more than 480 practical nurses, and more than 1300 associate degree nurses. We are committed to meeting the needs of the health care profession.
Last May, members of the Joint Commission on Accreditation of Healthcare Organizations stated "while we have had crises in availability and distribution of nurses before, this shortage is unprecedented in its complexity and future implications." I believe that it is essential that educators understand the significance of the present healthcare provider shortage.
The North Carolina Community College System is committed to meeting the workforce demands of our health care facilities. Currently our system offers 50 curriculum programs in the health science area including dental assisting, opticianry, nursing, and many others. All of our 58 colleges offer programs in the health science area and almost 16,000 students are currently enrolled in these programs. We want to continue to provide the state with a qualified workforce to meet the increasing demand for healthcare professionals.
The Academic and Student Services Division of the NCCCS, under the leadership of Dr. Delores Parker, has developed a "Vision for the New Millennium." This is a model consisting of eight components that provides a framework for the colleges in meeting the educational challenges of the twenty-first century. Let me briefly describe each of the components of the model and explain how they play a critical role in our colleges providing educational opportunities to meet the demands of the healthcare industry.
Resource development is the process used to identify, expand and leverage BOTH external and internal resources to support and advance the NC Community College mission. Resource Development is at the center of the Academic and Student Services Division’s "Vision for the New Millennium" and helps facilitate the goals and objectives of the eight critical components.
We are all aware of the fact that many of our health programs are expensive to operate. Our current funding formula does not take into account the additional costs of implementing and operating health science programs; the funding is based on the number of students enrolled. Prior to 1997, legislative actions directed that a study be conducted to research the implementation of program-based funding or differential funding. A funding model has not been fully developed or implemented due to a lack of resources and insufficient data. Several attempts were made to capture accurate and supportable data to use program-based funding as a means of providing revenue. The existing data system and available resources are not adequate to accurately analyze and capture needed elements that would facilitate this concept. It has been recommended that consideration should be given for programs where limitations on the numbers of slots are set by accrediting or licensing bodies or where specific student/teacher ratios are present. We are hopeful that with the implementation of our new information system, we will be able to accurately capture this required data needed to fully develop a funding model based on differential funding.
Meanwhile, many of our colleges work collaboratively with their local medical societies, dental societies, and medical facilities to generate funding. With generous donations of equipment and money from these agencies, colleges have been able to implement new dental programs, nursing programs, and radiography programs. We value their support.
One example of obtaining external funds is with grants provided by Area Health Education Centers (AHEC). These grants are awarded to colleges for the development of preceptors and clinical sites in underserved areas of the state.
The North Carolina Center for Nursing in collaboration with the NCCCS, the University System, NC Board of Nursing, and AHEC was awarded a Helene Fuld Health Trust Educational Mobility Initiative Grant for 2001-2003. These grant funds will be used to continue the work of the Articulation Steering Committee. This committee's goal is to remove barriers and create a seamless articulation model for North Carolina’s nursing education programs. Students who wish to further their education should be assured that previous learning and work experiences are valued and formally recognized.
A Duke Endowment Grant provides the resources necessary to support a partnership between Wayne Memorial Hospital and Wayne Community College. This grant provides for the additional hiring of a clinical instructor in the nursing program beginning in 2002. This will decrease the faculty/student ratio and will allow for more individualized instruction. The instructors will also serve as tutors and mentors so that the graduates will be better prepared for the world of work. The ultimate goal is to increase retention.
Grants from Robert Wood Johnson and the Duke Endowment fund the Wayne County initiative for School Health Centers. These centers are located on the campuses of Wayne County Middle Schools and provide health care services for the students. Staff from Wayne Memorial Hospital and other community agencies operates the centers. The medical assisting program at Wayne Community College is currently utilizing these centers and provide the students with learning experiences involving office management and laboratory skills.
With monetary assistance from the Wake Dental Society, Wake Technical Community College is planning the implementation of a dental hygiene program.
In addition to these efforts, the NC Center for Nursing has awarded grants to colleges for creative approaches to nursing recruitment and retention.
There is a compelling need to continue to develop a coordinated, comprehensive and systemic resource development framework statewide to capture resources needed to provide educational opportunities. There are unlimited opportunities for the North Carolina Community Colleges to acquire additional resources to provide assistance in supporting health professional programs.
Internal and external partnerships are another example of creative, collaborative efforts among constituencies within the Community College System and also between the Community College System and outside agencies, including public and private groups, business and industry leaders and other four year institutions. These partnerships hold the "Vision for the New Millennium" wheel together by enhancing lines of communication, which lead to effective education and career pathways. Strengthening these internal and external partnerships will enable the NCCCS to establish a common "Vision for the New Millennium" for the state.
Specific examples of these partnerships include AHECs willingness to work with our college’s nursing programs to help develop new clinical sites, which are desperately needed. Over the years, the numbers of clinical sites developed have been impressive and have been in areas where students need experience, such as critical care, clinics, and public schools. The colleges also partner with AHECs to provide sites for off-campus RN and BSN programs in underserved parts of the state. Johnston CC and Montgomery CC provide sites for programs offered by UNC-CH. A number of community colleges also partner with local AHECs to offer skills lab for refresher students.
Another example of a strong external partnership is the working relationship between Forsyth CC and two hospitals in the Winston-Salem area. They share resources to provide practical nurse to RN completion programs. The lecture part of the class will soon be delivered via distance learning and the lab and clinical will be done at the hospitals.
Yet another example is the collaborative efforts to provide certified nursing assistants (CNAs) for employment in nursing home facilities. The General Assembly appropriated funds in House Bill 1840 to support training programs for recruitment of CNAs in nursing facilities. The NCCCS, the NC Division of Facility Services and the North Carolina Health Care Facilities Association agree to coordinate efforts to improve training, recruitment and reduce turnover of in nursing home facilities. Nine colleges are participating in the pilot program called "Safehands". The goal of the program is to increase the number of students interested in working as CNAs in nursing home facilities. A final evaluation of the project will be completed by June 2002.
Collaborative efforts among our community colleges and high schools have resulted in establishment of Medical Academies. Our colleges are offering nursing assistant courses and medical terminology courses at their local high schools. These academies assist in identifying freshman students who have an interest in the health care field. These students can enroll in the academy and take courses provided by the community college in medical ethics, nursing assisting and medical terminology. The students are also provided opportunities to "shadow" a health care provider and complete civic projects that are related to health care.
Another example of an external partnerships includes "The Power to Make a Difference" campaign developed by the NC Center for Nursing. The ultimate goal of this campaign is to assist communities across North Carolina to develop local nurse workforces capable of meeting the evolving health care needs. The campaign consists of research-based strategies designed to improve awareness of nursing careers among youth. Marketing strategies are an integral part of the campaign and include job shadowing, posters, public service announcements and career exploration programs. The NC Center for Nursing provides copies of the recruitment materials for our colleges to utilize in the recruitment of students. According to the NC Center for Nursing, "The Community College system is a critical component for disseminating information on nursing careers and for preparing our nurses." We are pleased to distribute this information to interested students.
The community colleges and the universities also work collaboratively in providing affordable educational opportunities and articulation for degree completion. The Associate in Arts pre-major degree in nursing, which is part of the comprehensive articulation agreement, is one example of this collaborative effort. During the last two academic years, nearly 2,000 students were enrolled in the pre-major nursing program at our colleges.
Bilateral agreements between community colleges and universities for the Associate in Applied Science in Nursing degree provide yet another opportunity for degree completion for students.
Another notable external partnership exists with the Allied Health Council which is composed of representatives from industry, universities, state agencies, private organizations and community colleges combining their efforts in identifying the areas of personnel shortages and addressing solutions to the shortage of allied health workers.
We are pleased to report that NC Board of Nursing has approved an enrollment increase for five nursing programs at our colleges. This increase in enrollment and collaborative efforts with medical facilities for clinical experiences will provide further educational availability for our students.
In addition to these external partnerships our community colleges also work together to meet the needs of our students and the health care industry. These efforts involve collaborative agreements between our colleges. There are over fifty health-related collaborative agreements between our colleges. These agreements assist in providing educational resources to as many students as possible by:
- Providing classroom instruction in remote areas of the state
- Pooling available resources to provide cost efficient training
- Providing arrangements for joint utilization of clinical allotments
- Facilitating the transfer of credits for our students
Four colleges Nash, Edgecombe, Wilson and Halifax (NEWH LPN Consortium) have recently submitted applications for approval of the implementation of a practical nursing program in response to the requests of local hospitals. The colleges will be part of the NEWH Consortium. The data presented in the four applications collectively documents nearly 200 current employment positions and over 300 potential employment opportunities for the next 2 years. Student interest surveys conducted by these colleges document that there are over 300 students in their service areas who are interested in enrolling in one of the proposed practical nursing programs. The request will be presented to the Program Committee of the State Board of Community Colleges later this week. In February, the full Board will be asked to take action on this request. The NEWH LPN Consortium received approval from the NC Board of Nursing at the NC Board Nursing Education Committee meeting on December 6th. These efforts of joint support between our colleges illustrate how the community college system is committed to providing the resources necessary to educate our health care providers.
We are excited about the development of new partnerships and the strengthening of existing partnerships which will assist in expanding opportunities that helps us meet our goal of providing health care workers to meet the needs of the NC health care industry.
Another recognized component of our vision is Leadership and Professional Development, which is an organized process of renewal of job-training experiences for administrators, faculty, and staff. These experiences provide the knowledge, skills, and ability to guide students in their chosen profession or career field. To teach and provide our students with employment skills, faculty and staff must be provided substantive learning opportunities and experiences that address student needs from orientation through graduation.
We recognize that the current support for professional development is under-funded and that we do not have the resources required to provide the quality of training and professional development experiences necessary for college employees. We further recognize that local college resources for career skill upgrading in one’s profession remain limited. If college personnel are to remain up-to-date and competent, leadership and professional development training experiences and resources must be provided via: increased state-level funding, position collaboration (sharing of employees with clinical agencies to work as part-time clinical instructors), regional training consortiums, peer curriculum networking, statewide job retention, and administrative level institutes.
Faculty upgrade funds provided by the NC General Assembly are monies that are allocated for faculty professional up-grade. These funds are provided to the colleges for professional development activities such as "return to work" experiences or attending educational workshops. The "return to work" experience provides excellent opportunities for health care professional educators to remain current in their practice. Over 4,500 faculty and community college staff received funding this year for professional development activities.
The NCCCS 2001-2002 strategic plan includes goals and objectives that recognize the need for professional development. One of these goals states that " By 2003 we must assess the need for professional development programs for faculty and staff and develop a strategy for addressing the identified needs." Our staff is taking the necessary steps to meet this goal. A survey was conducted of NCCC faculty and administrators to identify the professional development need of faculty. Soliciting information directly from both administrators and faculty will provide a basis for planning for quality, relevant training opportunities both at the system and local college levels. The information secured from this on-line survey will be a valuable tool for planning professional development activities. The survey was conducted between November 13 and December 14, 2001. Over 2,000 individuals responded. Every institution in the Community College System was represented. Final results and written reports will be available by June 30, 2002.
We embrace diverse learner populations as a primary consideration of our vision. These are those students from different racial, ethnic, sociological and cultural groups who seek to acquire knowledge, attitudes, and skills needed to function effectively in society. These individuals present opportunities and challenges within the college setting as they seek to communicate, negotiate and interact with faculty, staff and students of differing backgrounds. These populations of students are not overlooked and are welcomed into our educational system. They are recognized as valuable future health care professionals. We provide opportunities for faculty to develop an understanding of cultural differences of learners and how to effectively provide the necessary educational programs.
Part of our vision encompasses emerging faculty and staff who are the future employees of the Community College System. Over 4,600 full-time faculty and 6,200 staff currently work in the community college system; however, retirements and resignations at our colleges indicate that 10-20% of our employees may turnover each year. A report from the American Nurses Association titled the "Aging of America: Implications for Health Workforce" addresses the impact of an aging population on various health professions. Supply and demand become a major issue as the demand increases and the supply decreases. We are seeing this in our colleges as health sciences educators’ "age" out. The average age of health science educators at our colleges is 48. Considering the current trend of retiring at an early age, this presents a major problem when we look at the future of our programs and availability of faculty. The addition of system-level resource support for faculty recruitment and retention activities will enable colleges to evaluate working conditions with the possibility of causing mediocrity and showcase positive programs of career benefits and long-term service.
A recurring budget issue over the past decade has been the level of faculty salaries in our colleges. Periodic data from the Southern Regional Education Board suggest that NC typically ranks relatively low among the 15 participating states in the average salary of its community college faculty.
During the 1999 NC General Assembly session, state lawmakers considered issues related to "the employment of community college faculty." The Faculty Salary Study was conducted last year at the express request of the General Assembly. Several reports over the past few years have found faculty salaries to be unacceptably low and have recommended increases.
In the 2001-2003 strategic plan one of our primary goals is the promotion of recruitment, retention and development of high quality faculty necessary to achieve the educational training and objectives of the System. During this year, the System will develop a strategy to increase by five percent the year-to-year retention of full-time faculty. In addition to improving faculty salaries, the System is identifying strategies for aggressively recruiting highly qualified individuals for faculty positions.
Another important component of our vision is best practices: assessment, and dissemination, which are initiatives and strategies in the community college system that lead to the successful preparation of learners. Activities that require learners to consider multiple perspectives of a problem or to encounter multiple tasks in a job-like setting will help them begin to exercise judgment and make critical choices. Assessment of these best practices and implementation of best practices will assure that learners are receiving quality education which enables them to become academically, occupationally, and socially competent. A reference manual is currently being developed for nursing education directors to use for program improvement. One of the chapters focuses on best practices and offers suggestions on implementation of these practices. The manual will be completed by June 2002 and will be distributed at the orientation sessions that are being developed by system office staff for directors of nursing education programs.
No vision of the millennium will be complete without consideration of technology. Technology is a valuable learning tool to enhance teaching and learning in the classroom. Distance learning is also valuable because it eliminates the barriers of time and space. Technology can empower learners, increase interaction, foster discovery and research, and increase skill applications.
We are proud of our Virtual Learning Community, which was started in 1999 as a way to develop courses needed for Internet delivery. The VLC concept was to gather qualified instructors from across the system and allow them to develop internet course material as a team. 61 courses are now online and additional 50 courses are being developed this year. The majority of courses developed for the VLC are general education courses, which allows the student the opportunity to complete the general education requirements on-line. Two courses have been developed in medical terminology and are already available on-line. Four additional courses in the health science area are currently being developed and should be available in the fall.
As part of our vision, we recognize that lifelong learning is a critical process for understanding change and upgrading skills and knowledge for functioning more effectively in the workplace and society. This learning is paramount for both individuals and organizations to develop strategies necessary for making improvements based on changes. The benefit of lifelong learning is that adults will be prepared to adjust to rapid advances of knowledge in the health field. The concept of lifelong learning is evident in our health care professional curriculums. Students often return to the colleges after graduation to earn units in continuing education and to further their education.
Global education is a recognized component of the vision and involves teaching and learning about the global society in which we live and the development of skills needed to function effectively in that society. Global education empowers learners and the local community to function effectively in a global society. Colleges have a critical role in global education in:
- The education and training of new residents from foreign countries,
- Assistance to American learners in the acquisition of global knowledge and skills
- Assistance to business and industry as they become more global, and
- The provision of global learning opportunities to the community at large.
System office staff and representatives from Wake Technical CC have met with representatives from Thailand and Moldova to discuss educational opportunities for health care professionals in their counties. We recognize that health care professionals from foreign counties are valued employees in our health care facilities and we will continue to provide the educational opportunities they may need to meet the qualifications for certification or licensing
Let me review quickly the eight components of the "Vision of the New Millennium."
- Developing Internal and External Partnerships to enhance lines of communication, which lead to effective education and career pathways.
- Leadership and Professional Development -- an organized process of renewal of job-training experiences for administrators, faculty, and staff.
- Embracing Diverse Learner Populations.
- Encouraging the talents of Emerging Faculty and Staff.
- Best practices : assessment, and dissemination, which are initiatives and strategies in the community college system that lead to the successful preparation of learners.
- Encouraging the process of Lifelong Learning.
- Making Global Education a priority.
- Embracing the Use of Technology in Learning.
And of course, at the heart of the wheel is Resource Development.
These eight components in the "Vision for the New Millennium" wheel which I have shared with you today are critical issues for the Community College System in the 21st century. My staff at the System office is dedicated to helping local colleges address these issues through identifying resources for implementing necessary changes.
We would not be able to provide the quality or number of educational opportunities for our citizens if it was not for collaborative efforts with our local high schools, universities, local AHEC’s, the NC Board of Nursing, the NC Center for Nursing, hospitals and medical facilities and other state and private agencies such as yourself. With our continued efforts and commitment to meeting the needs of our citizens we will strive to reduce the shortage of health care professionals.
I thank you for your time and am now open for questions.
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