Iowa Recruits Practitioners to Address Health Needs of an Aging Population
Despite an overall minority population in the state of less than 5 percent, Iowa Project L.I.N.C. recruited minority students into the program. Some 23 percent of all enrolled students were minority students.
The project was part of the Robert Wood Johnson Foundation (RWJF) Ladders in Nursing Careers Program national program.
Iowa Project L.I.N.C. accomplished the following under the grant:
- Recruited 26 minority students already enrolled in nursing programs who were at risk of dropping out because of lack of financial and other support.
- Worked with the State Department of Labor through its federal Job Training Partnership Act (JTPA) program to bring 15 welfare recipients into the program.
Despite these positive results, Project L.I.N.C. was not institutionalized in Iowa.
RWJF provided $542,673 in funding from February 1993 to July 1997 to support the project.
Iowa's demographics an aging population that needs more nursing care, and an aging nurse work force whose members are retiring provided strong evidence for the need for Project L.I.N.C. The population of Iowa has been aging more rapidly than the nation as a whole. In the last two national censuses, the state has had the highest proportion of residents 85 or older. Between 1990 and 2000, the 85-and-older age category in Iowa was expected to jump by 387 percent. The nurses were aging, too. In 1992, more than 3,000 were expected to retire. In 2012, more than 6,700 nurses are expected to retire. A 1989 study conducted for the General Assembly of Iowa predicted that by the year 2000, Iowa will have potential shortages of 4,000 to 12,000 RNs and 1,000 to 2,500 LPNs.
Although many in Iowa believed that the nursing shortage in the state was over when Project L.I.N.C. began, it was able to build partnerships and secure funding. The program worked with universities, hospitals and nursing homes, physician offices, rural and migrant health clinics, public health departments, state and local government agencies, and the Iowa Medical Society. Significant funding sources included the Northwest Area Foundation, the Roy J. Carver Charitable Trust, Blue Cross and Blue Shield of Iowa, Iowa Farm Bureau Federation, and Iowa College Foundation.
Iowa Project L.I.N.C.'s goals encompassed both nursing supply and other work force issues. They were to:
- Help health care organizations "home grow" needed health care personnel.
- Assist employees, especially low-income and minority individuals, in overcoming barriers to obtaining higher education in nursing and other allied health care fields with a shortage of practitioners.
- Develop a long-term mechanism for dealing with cyclical shortages in nursing and allied health personnel.
Iowa worked with any type of health care organization in the state willing to participate in the program from hospitals and nursing homes to public health departments and ambulatory clinics to help them further develop existing personnel to meet current and future work force needs. Simultaneous with working at this micro level, Iowa L.I.N.C. worked closely with the Iowa Board of Nursing, Iowa Nursing Association, the Iowa Department of Economic Development, and the newly-formed Iowa Workforce Development Center to assure that the statewide "big picture" health care work force needs for the state were addressed. Toward this end, Iowa L.I.N.C. focused on enrolling advanced practice nurses to meet the needs of Iowa residents in rural, medically underserved counties.
Project L.I.N.C. received $1.3 million in additional support, including an estimated $256,000 in in-kind support from the Association of Iowa Hospital and Health Systems and the Iowa Hospital Education and Research Foundation, $300,732 from the Northwest Area Foundation, and $150,000 from the Roy J. Carver Charitable Trust.
In Iowa, less than one percent of the employees in the health care field are minorities, but Iowa L.I.N.C. was able to enroll 32 minority students in the program representing over 22 percent of Iowa L.I.N.C.'s total student enrollment of 141. One particularly successful strategy Iowa L.I.N.C. used was to recruit minority students already enrolled in nursing programs who were at risk of dropping out because of lack of financial and other support. This strategy added 26 minority students to Iowa L.I.N.C.'s rolls.
Iowa L.I.N.C. also worked with the State Department of Labor through its federal Job Training Partnership Act (JTPA) program to bring welfare recipients into the program. When JTPA funds were cut, and many JTPA beneficiaries lost the financial assistance they needed to continue their schooling, Iowa L.I.N.C. stepped in providing financial support and educational counseling to help keep 15 students in school.
Iowa and North Dakota Evaluation
With funding from the Northwest Area Foundation, Iowa Project L.I.N.C. and North Dakota Project L.I.N.C. conducted an evaluation of their two programs. The Iowa evaluation showed that counseling services provided by the programs were vital to both entry-level and advanced students; and, that students needed assistance to navigate the financial aid maze in order to maximize financial aid dollars.
Iowa Project L.I.N.C. published a quarterly newsletter, LINC Letter, and created a L.I.N.C. videotape. The Qualitative Evaluation Report: North Central Project L.I.N.C. was published by the University of Nebraska Medical Center. Project staff made five presentations at Iowa conferences, including at three conferences for the heads of nursing programs (in 1995, 1996, and 1997), and one at the Annual Iowa Hospitals and Health Systems Board Retreat.
AFTER THE GRANT
Iowa Hospital Education and Research Foundation (IHERF) decided to end Project L.I.N.C. with the end of RWJF funding for several reasons: an oversupply of nurses in the state, unwillingness among health care organizations to allocate resources for Project L.I.N.C., and assumption of Project L.I.N.C.'s mission by state government agencies. Financial support was provided through Summer 1998 until all L.I.N.C. students graduated.
IHERF plans to apply the lessons learned from the program in a collaborative initiative with the Iowa Department of Public Health, the Iowa Department of Economic Development, and Iowa State University Extension Services to develop a Healthy Communities proposal for a program aimed at improving health status for Iowa communities through local coalition building. IHERF staff will assist hospitals and other community leaders as they consider work force issues to address their health needs.
GRANT DETAILS & CONTACT INFORMATION
Iowa Project L.I.N.C.
Iowa Hospital Education and Research Foundation (Des Moines, IA)
Dates: February 1993 to December 1993
Dates: January 1994 to July 1997
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Books and Reports
Westmoreland D. and K. Grigsby. Qualitative Evaluation Report: North Central Project L.I.N.C. Omaha, Neb.: University of Nebraska Medical Center, 1996.
Brochures and Fact Sheets
Iowa Project L.I.N.C. brochure, "Project L.I.N.C.: Ladders in Nursing Careers," 1995.
Quarterly Iowa Project L.I.N.C. newsletter, LINC Letter, April 1995.
Presentations and Testimony
Ann Mowery and Linda Brown, "Project L.I.N.C. and the Seasons of Growth," at the Heads of Nursing Program Conference, October 1995, Des Moines, Iowa.
Linda Brown. "Project L.I.N.C. as a Work Force Development Tool," at the "Heads of Nursing Program Conference," October 1996, Des Moines, Iowa.
Linda Brown. "Work Force Changes in Nursing: Where Do We Go from Here?" at the Seventh District Iowa Nurses Association Conference," November 1996, Des Moines, Iowa.
Linda Brown and Philip Latessa. "Project L.I.N.C. and Beyond," at the "Annual Iowa Hospitals and Health Systems Board Retreat," August 1997, Okoboji, Iowa.
Linda Brown. "Iowa Project L.I.N.C. and its Cost-Effectiveness," at the "Heads of Nursing Program Conference," October 1997, Des Moines, Iowa.
Audio-Visuals and Computer Software
Iowa Project L.I.N.C. student orientation tape, "Family Issues: Parents Going Back to School," 1995.
Report prepared by: Karin Gillespie
Reviewed by: Patricia Patrizi
Reviewed by: Molly McKaughan
Original Program Officer: Polly M. Seitz
Current Program Officer: Rosemary Gibson