Tax Proposal Targets Nursing Shortage In Rural Oregon

Marianne Stone, an emergency-room nurse at Saint Alphonsus Medical Center in Baker City, often sees nurses work up to 60 hours a week to help out during staff shortages. Beyond the obvious stress that comes with working such long hours, she said there is a greater risk of making mistakes on the job, with administering medication, for instance.

“You’re setting them up for failure,” Stone said. “It’s a huge risk for both the patients and the nurses.”

Oregon, especially rural parts of the state, is facing a nursing shortage, caused in large part by a lack of educators. A 2010 study by the Oregon Center for Nursing showed that one-third of applicants to nursing programs in Oregon were turned away because there were not enough instructors to train them.   

That problem has grabbed the attention of Sen. Arnie Roblan, D-Coos Bay, who is considering a tax plan that would help rural community colleges recruit and retain qualified educators. His plan would provide tax credits of  $5,000 to $7,500 per year to working administrators and instructors.

The program would function similarly to the Oregon Rural Practitioner Tax Credit, which provides tax credits for the same amount to physicians, dentists and specialists in less-populated regions of the state. In that program, the amount credited depends on how far the applicant is from the nearest community with a population of at least 40,000.

The idea of adopting the same strategy to boost nursing educators, though still preliminary, is  expected to be introduced as a bill in the Legislature in the upcoming session.

“Lots of rural Oregonians realize that careers in nursing can provide them with rewarding work and a great living,” Roblan said. “With more instructors, we can help those hometown students become homegrown nurses who serve their communities.”

The proposed piece of legislation comes from the Southwestern Oregon Workforce Investment Board, a nonprofit organization that uses federal and state funds to solve workforce-related issues in Coos, Douglas and Curry counties.

Data from the Oregon Employment Department indicate that a growth in access to health care services has contributed to a statewide need for more nurses. The department predicts that the state will need almost 10,000 more nurses by 2027, a number seemingly out of reach.

Yet there’s no shortage of interest in nursing among students, said Jake McClelland, the workforce board’s executive director.

“Our community colleges are not able to produce enough nurses because they have a faculty issue,” McClelland said. “It’s only going to get worse over the next 10 years.”

A 2017 report by the Oregon Center for Nursing identified statewide distribution, not the total number of nurse educators, as the biggest problem. Community colleges in rural parts of Oregon are more affected by shortages than are schools in heavily populated areas.

“It’s less of a numbers game, where we don’t have enough people, and more of a, we have too many people in the wrong places,” said Jana Bitton, the center’s executive director. “We have nursing schools in (rural) areas, but not enough nurse faculty.”

Bitton said rural areas were more affected not only because of lower populations, but also because community colleges in those areas don’t pay as well as they might in Portland.

The 2017 report named low compensation as the number one factor behind educators leaving their positions, followed by workloads that are much higher for instructors than practicing nurses.

Most educators who leave their positions do so within the first five years of teaching, according to the report. Less than 20 percent said they left because they wanted to care for patients rather than teach. There is also the problem of an aging staff. According to a joint publication by the investment board and the center, more than half of Oregon’s nurse faculty is over the age of 55.

Joanne Noone, director of the nursing program at the Oregon Health & Science University’s Ashland campus, identified the shortage of instructors as the biggest struggle in her own workplace. While accepting 64 students each year, the Ashland nursing program has only 23 faculty members, with many shifting between full-time and part-time employment.

The Oregon Center for Nursing has tried to address the shortage, creating a task force of deans, directors and educators around the state to address the high turnover rate in nursing programs. In its 2017 report, the task force released a list of suggestions that included reducing workloads, increased coaching and mentoring and educating the public about the benefits of tax programs like Roblan’s.

The lack of nursing instructors is also a problem outside Oregon.

A report from the American Association of Colleges of Nursing found that in 2016 nearly 65,000 qualified candidates were turned away from baccalaureate and graduate nursing programs due to shortages in the budget and the number of faculty. That same year just over 820 nursing schools reported having more than 1,500 staff vacancies.

The association found that one of the problems is a pay gap between nurses and educators, with the latter earning about $20,000 less a year.

There are things being done to address the shortage. Bitton pointed to Maryland as an example. In 2006, that state implemented the second phase of its Nurse Support Program, which provides competitive institutional grants to nursing educators and state funds to current and prospective nurse faculty.

The program is funded by a 0.1 percent tax on patient revenues, with more than  $115 million collected in 2017.. McClelland, the head of the Southwestern Oregon Workforce Investment Board, said the idea for a bill in Oregon was inspired by Maryland’s program. Bitton said that while the tax credit would be a step in the right direction, the only way to solve the issue is with an adjustment of social priorities.

“We don’t value education,” she said. “That’s not a nursing problem.”

Stone, the Baker City nurse, shared that sentiment, saying the tax credit should be implemented, but that the solution will come down to money.

“We’re going to have to look at wages, and we’re going to have to look at our educators and start paying our educators what they’re worth,” she said. “None of us would be where we are at without our educators.”

You can reach Alex Visser at [email protected].


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