Title
Conduct a public hearing to consider and approve:
a. Nursing Program Grant Agreement ("Agreement") with California State University, Monterey Bay ("CSUMB") to provide CSUMB with Grant funds to meet some of the direct costs of the Nursing Program of CSUMB, in an amount not to exceed $195,000 for the period August 28, 2012 to June 30, 2013, with an option for Natividad Medical Center ("NMC") to extend term for up to two additional years (4/5th Vote Required);
b. Resolution finding that the expenditure of funds from the NMC Fiscal Year 2012/2013 Budget to underwrite the Agreement has a direct and primary public purpose, benefiting Monterey County, in general, and NMC and the Monterey County Health Department, in particular (4/5th Vote Required); and
c. Authorizing the Purchasing Manager for NMC to execute the Agreement with CSUMB, in an amount not to exceed $195,000 for the period August 28, 2012 to June 30, 2013, with an option for NMC to extend term for up to two additional years (4/5th Vote Required).
Body
RECOMMENDATION:
It is recommended the Board of Supervisors consider and approve:
a. Nursing Program Grant Agreement ("Agreement") with California State University, Monterey Bay ("CSUMB") to provide CSUMB with Grant funds to meet some of the direct costs of the Nursing Program of CSUMB, in an amount not to exceed $195,000 for the period August 28, 2012 to June 30, 2013, with an option for Natividad Medical Center ("NMC") to extend term for up to two additional years (4/5th Vote Required);
b. Resolution finding that the expenditure of funds from the NMC Fiscal Year 2012/2013 Budget to underwrite the Agreement has a direct and primary public purpose, benefiting Monterey County, in general, and NMC and the Monterey County Health Department, in particular (4/5th Vote Required); and
c. Authorizing the Purchasing Manager for NMC to execute the Agreement with CSUMB, in an amount not to exceed $195,000 for the period August 28, 2012 to June 30, 2013, with an option for NMC to extend term for up to two additional years (4/5th Vote Required).
SUMMARY/DISCUSSION:
CSUMB is a university in the California State University system located in Seaside, California. CSUMB offers a four year Bachelor of Science Nursing ("BSN") degree program. The program educates and trains registered nurses for beginning positions in nursing in local health care facilities, including NMC and the County Health Department, provides students with the means for personal and professional advancement, and qualifies them for progression into programs that offer advanced degrees (the "Nursing Program").
Entry to the CSUMB BSN is only possible through one of the four regional Community College nursing programs- Monterey Peninsula, Hartnell, Cabrillo and Gavilan. There is no direct entry from CSUMB. Students will begin their education at one of the four partnering regional community colleges, spending time in a "blended" learning environment while completing their studies at the participating community college ("CC") and CSUMB. Students will receive an associate's degree from their community college and a bachelor's of science in nursing from CSUMB.
Some career paths are open only to nurses holding a bachelor's degree. A BSN is a prerequisite for admission to graduate nursing programs in research, consulting and teaching. Four of the most prestigious and highest-paid nursing specialties - clinical nurse specialists, nurse anesthetists, nurse-midwives, and nurse practitioners - require their candidates to have a bachelor's degree.
NMC desires to provide grant funds to CSUMB for use in meeting some of the direct costs of the Nursing Program, so as to sustain the program and facilitate the availability to NMC and the County Health Department of qualified nurses with a bachelor's degree. Expenditures under this CSUMB Nursing Grant Agreement shall serve a direct and primary public purpose, by providing funds to improve the quality and quantity of nurses available to provide nursing services, at an advanced degree level, in the community and, in particular, at NMC and the County Health Department, and by improving the skills and training of NMC and County Health Department staff who shall collaborate with CSUMB faculty who act as liaisons in the Nursing Program.
Pursuant to the CSUMB Nursing Grant Agreement, CSUMB shall provide NMC and the County Health Department with BSN graduates who are well prepared to participate in activities that enhance clinical practice such as quality and safety, leadership, and advancing information technology utilization. The BSN program will produce graduates who are well prepared to function in the practice environment of NMC and County Health Department and who possess a readiness to begin work with only needing minimal institutional hiring/training/orientation resources. The BSN program will provide a steady supply of BSN nurses who are prepared to begin assuming leadership positions at NMC and the County Health Department.
The proposed agreement is for one year with subsequent years subject to NMC approval. Assuming the agreement is extended for two additional years, the three-year period of activity and funding will involve the following:
The first year of activity will serve both the County Health Department and NMC. This early intensive phase of program implementation will require regularly scheduled meetings that assure the establishment of thorough communication between the leadership of the County Health Department, NMC and the CSUMB nursing program. The development of communication will serve to maximize student effectiveness to deliver enhanced safe high quality care in the clinical environment of the County Health Department and NMC.
In the first and following years of the agreement, the Director and up to three Registered Nurse Faculty will share the liaison, direction and supervision of specific BSN related activities and on site student activities between the MCHD and NMC. The Annual Budget, approved by the Joint Oversight Committee, NMC and County as described in the Agreement, will outline the specific effort and dollar amounts for the CSUMB Director, BSN Faculty, Administrative Support and Consulting Services.
In collaboration with MCHD, NMC, and local community college leadership and staff the CSUMB faculty and students will participate in the delivery of care to hospital and community based patients. In addition during each term, the CSUMB faculty and students will be available to NMC and MCHD to assist directly with the development of interdisciplinary simulation exercises, develop quality and safety protocols, develop and guide research programs to enhance evidenced based nursing actions, all toward the goal of enhancing the clinical environment.
Three cohorts of students will serve in the NMC and MCHD sites during the three-year duration of the Bachelor's degree. The number of immersed training hours during the three-year period will total over 37,500 hours.
The first and subsequent classes of students in the CSUMB BSN program will have a total enrollment target of 32 students who will be expected to participate in many different field activities. In the first year each student will be engaged and serve in activities in the MCHD. In the following two years a target of 24 students in the CSUMB nursing program will serve in NMC in each of the four semesters detailed below.
OTHER AGENCY INVOLVEMENT:
County Counsel has reviewed and approved this Agreement as to legal form and risk provisions. Auditor-Controller has reviewed and approved this Agreement as to fiscal provisions. The CAO-Budget and Analysis did not have sufficient information to consider the costs/benefits or potential opportunity for funding other county programs. The Agreement has also been reviewed and approved by Natividad Medical Center's Board of Trustees.
FINANCING:
There is no impact to the General Fund. The cost for this Agreement is $195,000 and is included in the Fiscal Year 2012/2013 Adopted Budget.
NMC seeks approval of this Agreement, including the option to extend the term for up to two years. If NMC elects to exercise the two additional options to extend, it will seek additional Board approval for each option exercised. If all options are exercised, the total cost of this agreement shall be $545,000 over a three year term. At this time, Natividad seeks approval of the first year only. The CAO-Budget and Analysis was not provided sufficient time or information to consider the costs/benefit or potential lost opportunity for funding other county programs with these funds.
FIRST YEAR at CSUMB exclusively 2012 -2013
Semester 1: 32 students x 8 hours each = 256 hours at MCHD Summer 2012
Semester 2: 32 students x 8 hours each = 256 Hours at MCHD Fall 2012
Semester 3: 32 students x 8 hours each = 256 hours at MCHD Spring 2013
Semester 4: 32 students x 8 hours each = 256 hours at MCHD Summer 2013
End of First year of the BSN program total student hours in MCHD = 1,024.
Also supports CSUMB faculty to support liaison, support and planning activities.
Support for the first year of funding = $195,000
SECOND YEAR CSUMB and Community College year 2013 - 2014
Cohort 1 Semester 5: 24 students x 16 hours per week x 15 weeks = 5,760 hours at NMC Fall 2013
Cohort 1 Semester 6: 24 students x 16 hours per week x 15 weeks = 5,760 hours at NMC Spring 2014
Cohort 2 enters the program at CSUMB in the summer of 2013 accumulating student hours in the MCHD = 1,024.
Cohort 1 end of second year of the program, total hours = 11,520 hours.
Cohort 2 end of first year of the program total student hours in MCHD = 1,024.
End of Second year total hours for all students in Cohorts 1 + 2 = 12,544 hours.
Support for the second year of funding = $175,000/12,544 hours.
THIRD YEAR CSUMB and Community College year 2014 - 2015
Cohort 1 Semester 7: 24 student x 16 hours per week x 15 weeks = 5,760 hours at NMC Fall 2014
Cohort 1 Semester 8: 24 student x 16 hours per week x 15 weeks = 5,760 hours at NMC Spring 2015
Cohort 2 Semester 5: 24 student x 16 hours per week x 15 weeks = 5,760 hours at NMC Fall 2014
Cohort 2 Semester 6: 24 student x 16 hours per week x 15 weeks = 5,760 hours at NMC Spring 2015
Cohort 3 enters the program in the summer of 2014 accumulating the same number of student hours in the MCHD as in year one = 1,024.
End of Third year total hours all students in Cohorts 1+ 2 + 3 = 24,064
Support for the third year of funding = $175,000/24,064 hours
TOTAL HOURS students immersed in the proposed three year period of funding 2012 - 2015 spent in the MCHD and NMC systems Cohorts 1 + 2 + 3 = 37,632 hours
Prepared by: Daniel Leon, Chief Financial Officer, 783-2561
Approved by: Harry Weis, Chief Executive Officer, 783-2553
Attachments: Agreement, Exhibit A, Resolution