2009/10 Support Budget II

Additional Challenges

Clinical Nursing Support, $5.0 Million

Each year, Californiaís demand for nurses exceeds the number of students prepared to enter the nursing workforce. To help meet Californiaís demand for qualified nurses, the California State University seeks funding for a second cohort of students in its Bachelor of Science in Nursing (BSN) program. This program received state budget support in 2006/07 and 2007/08, for the first cohort of what has been planned as a three-year level of sustained expansion of CSU nursing program enrollments.

According to the most recent report from the California Legislative Analystís Office, the state will need a net increase of more than 40,000 full-time registered nurses within the next decade in order to meet projected demand. As of 2005/06 (most recent available data), Californiaís institutions of higher education graduate 7,500 nurses annually. To meet Californiaís demand, the CSU estimates California higher education will need to graduate at least an additional 6,000 nurses for a total of roughly 13,500 annually.

Baccalaureate-prepared nurses are increasingly sought by hospitals due to associations with better patient outcomes when compared to non-baccalaureate nursing staffs. A study by a team of physicians (published in the Journal of the American Medical Association in 2003) examined the correlation of nursing education to patient care. The study found that a 10 percent increase in the proportion of nurses holding a bachelorís degree was associated with a 5 percent decrease in both the likelihood of patients dying within 30 days of admission and a 5 percent decrease in the odds of failure to rescue patients. The physicians concluded from their findings that in hospitals with higher proportions of nurses educated at the baccalaureate level or higher, surgical patients experienced lower mortality and failure-to-rescue rates. [Aiken, L.H., et. al., Educational Levels of Hospital Nurses and Surgical Patient Mortality, J. Amer Med Assn 290, 1617-1623 (September 2003)].

Historically, only 15 to 20 percent of students seeking admission to the CSUís clinical nursing programs can be accommodated due to limited numbers of qualified faculty, facilities, and clinical placement opportunities in health care facilities. This supplemental funding request would help alleviate these constraints on nursing enrollment demand.

For 2009/10, the CSU requests $5 million to increase funding support for the new second cohort of 340 students in its BSN degree program. The state funded marginal cost rate for nursing students in fiscal year 2009/10 is $14,729 based on marginal cost methodology recognized by the state legislative analyst. This supplemental budget request of $5 million is based on a rounded marginal cost of $14,706 per FTES.

Nursing faculty are in serious shortage, which drives up the average starting salary for full-time nursing faculty. In addition, nursing faculty are required to fulfill clinical placement activities. The current CSU estimate for starting academic year (AY) nursing faculty salary is $77,656, which would be multiplied by a factor of 1.1 to account for clinical placement activities. The resultant estimated faculty salary requirement for 2009/10 is $85,422. Accreditors set the nursing student to faculty ratio (SFR) at 10.5:1. Given the SFR of 10.5:1, the average cost of faculty salary per student would be $8,135, to which benefits at 37.34 percent are added, yielding $3,038 in cost per student. In total, nursing new-faculty compensation cost per student is projected to be $11,173.

The remaining $3,533 per FTES marginal cost funding would address additional costs that are traditionally recognized in the CSU enrollment growth methodology, such as instructional support costs to cover a half-time computer tech plus a half-time skills lab tech, and other standard charges for Academic Support, Student Services, Institutional Support, and Operation and Maintenance of Plant. These additional costs would also be supported with student fee revenue. Specialized instructional equipment costs (for simulated patients and gas supply) are not included in the 2009/10 cost calculation because the CSU received $2 million in 2006/07 budget for these one-time costs.

CSU Marginal Cost - Legislative Analystís Office Methodology, 2009/10

Faculty Salary $8,135
Faculty Benefits 3,038
Instructional Equipment 110
Instructional Support 1,004
Academic Support 1,405
Student Services 1,398
Institutional Support 1,197
Operation and Maintenance of Plant 1,106
Totals $17,393
Less Student Fee Revenue (2,664)
State Funding Rate $14,729