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Michigan community colleges vie for 4-year nursing programs amid shortages

nurses at hospital
Michigan hospitals are suffering from a widening shortage of nurses and other healthcare workers nearly two years into a pandemic. The state’s community colleges want to expand from two- to four-year nursing programs to provide more highly trained workers in the field. (Lester Graham/ Michigan Radio)

A demand for more Michigan nurses during the pandemic is once again pitting the state’s community colleges against its four-year universities. 

Michigan community colleges currently provide only two-year associate nursing degrees. They want to expand to offer four-year bachelor degree programs, a move fiercely opposed by the state’s four-year universities.

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The debate comes at a time in which healthcare facilities nationwide face staffing shortages. But it’s not the first time lawmakers are debating what types of degrees community colleges can provide.

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Michigan House Bills 5556 and 5557 would allow community colleges to offer four-year bachelor of nursing programs. Backers contend the measures would bring more highly trained nurses into the field at a time when Michigan, like other states, needs more of them to combat a brutal pandemic. 

But other lawmakers are pushing back with bills that would take away tax revenue from community colleges that offer four-year nursing degrees. Rep. Scott VanSingel, R-Grant, and Rep. Samantha Steckloff, D-Farmington, are proposing House Bills 5361 and 5362. They say they are champions of community colleges, but are proposing that if community colleges expand the number of bachelor programs they offer, they shouldn’t be allowed to collect local property tax revenue. 

VanSingel said the proposal is about ensuring the state’s community colleges do not convert into new universities, as state demographic trends show declining birth rates. He said while it may seem like getting a four-year degree at a community college may be cheaper, there would be higher costs associated with such programs, and that could include taxpayers if his bill doesn’t pass. 

The House tax policy committee heard arguments for and against the tax policies Wednesday morning. 

How nursing programs work 

Students who graduate with either a two-year associate nursing degree or four-year bachelor of nursing degree can become registered nurses if they pass their nursing exams. But data from the American Association of Colleges of Nursing suggests that employers prefer nursing candidates with the four-year degree. 

About 40.6 percent of hospitals and other healthcare settings require new hires to have a bachelor’s degree in nursing, while 77.4 percent of employers expressed a strong preference for BSN program graduates, according to responses from 645 schools of nursing who participated in a survey by the AACN. 

The national median annual wage of a registered nurse in May 2020 is $75,330, according to the Bureau of Labor Statistics. It’s a profession that’s becoming increasingly in demand, as hospitals across the nation report worsening nursing shortages as COVID-19 has seen a flood of nurses and other healthcare workers leave the profession — exhausted, traumatized, and often angry at how they’ve been treated by administrators or patients amid deadly surges of the virus.   

BLS projects there will be 194,500 U.S. openings for registered nurses each year on average through 2030. 

Fewer healthcare workers mean hospitals often have fewer beds to offer patients. 

When comparing November 2021 with November 2020, there was a decline in 875 average daily inpatient beds that were staffed in Michigan, according to the Michigan Health & Hospital Association, an industry group. MHA spokesperson John Karasinski said the organization is also hearing from its members that many healthcare facilities have vacancy rates of 20 percent or more due to the lack of staff capacity. 

MHA supports allowing community colleges to provide bachelor of nursing programing. Karasinski said the bills “would increase access to high-quality nurses in areas served by Michigan’s small and rural hospitals where a four-year school does not currently exist.” 

Rep. John Roth, R-Traverse City, is sponsoring the bill that would allow community colleges to offer bachelor of nursing degrees. He said the proposal would allow rural areas to retain their young people for high demand jobs.

Roth’s wife is a registered nurse in a hospital. 

“The nursing shortage obviously probably started before the pandemic but it has been (exacerbated) by the pandemic,” Roth told Bridge Michigan. “Nurses are getting out of the field. We have to do everything. We have to open up the floodgates to get them in. Not just because hospitals need them, but also our care facilities, our assisted-living facilities. We need more in the field and we’ve gotta push for it.” 

Daniel Hurley, CEO of the Michigan Association of State Universities, which represents the state’s 15 public universities, said the way forward is collaboration between community colleges and four-year universities. He said if the state is serious about increasing its pool of trained nurses, then it should focus its attention on the Michigan Reconnect program, which allows people 25 and older to receive scholarship money to complete an associate degree or certification program. 

Michigan Community College Association President Brandy Johnson countered that allowing community colleges the ability to offer bachelor of nursing degrees saves students money and transit time by allowing them to stay closer to home, including the ability to train in a local healthcare facility while working to finish their bachelor degree. Community colleges are simply more affordable, she said. 

Each college and university’s prices differ. 

Michigan State University, for example, costs roughly $14,914 in tuition and fees for a year of college for an in-state student, a figure that does not include room and board. At nearby Lansing Community College, estimated tuition and fees are $7,800 for in-state students or $4,300 a year if the student lives in an area that pays property tax to support the college. 

“Yes, I am confident that it would be more affordable than at a four-year university,” Johnson said. 

In 2012, the state legislature authorized community colleges to begin providing four-year bachelor degrees, but only in specific areas: cement technology, maritime technology, energy production technology and culinary arts. Nursing has come up for discussion before, but was never approved by the Legislature. 

Six community colleges currently offer baccalaureate programs, according to the legislative analysis of the tax bills. 

Hurley told BridgeMichigan it doesn’t make sense to offer these programs at community colleges when someone will have to foot the bill for more expensive degrees. That could lead to a rise in community college tuition, a rise in need for state appropriation or a rise in local taxes that the community college collects.

Michigan Independent Colleges and Universities, which represents the state’s 25 private, nonprofit colleges and universities, has joined the public universities in opposing four-year nursing programs at community colleges. The group says offering these programs will not immediately address the nursing shortage, but would create duplication of services. 

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MICU President Robert LeFevre said healthcare facilities are facing more than just nursing shortages, and said community colleges can help contribute to reducing the shortages of other healthcare workers, such as lab technicians. 

Johnson, of the community college group, said the nursing profession has changed and that individual community colleges would likely not build out a bachelor of nursing program unless there was high demand for the program in that area.

The head of the Michigan Nurses Association, the state’s largest union for registered nurses, said the narrative about nursing capacity in the state is misplaced. 

“While the Michigan Nurses Association does not have a position on this legislation, we believe it’s important for legislators to be mindful of the false narrative that there is a shortage of licensed registered nurses in Michigan,” said Jamie Brown, a critical care nurse and president of the nursing association. “In reality, there is a shortage of nurses willing to work in the conditions hospitals have created over the years. 

“Until conditions improve at the bedside — through solutions such as passing bipartisan legislation capping patient assignments and limiting mandatory overtime — nurses will continue to leave hospital care at high rates and avoid going into bedside care in the first place.”

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