The official minutes of the University of South Carolina Board of Trustees are maintained by the Secretary of the Board. Certified copies of minutes may be requested by contacting the Board of Trustees’ Office. Electronic or other copies of original minutes are not official Board of Trustees' documents.
The Health Affairs Committee of the University of South Carolina Board of Trustees met on Thursday, September 13, 2001, at 1:05 p.m. in the Board Room of the Carolina Plaza.
Members present were: Mr. Samuel R. Foster, II, Chairman; Mr. Arthur S. Bahnmuller; Mr. Robert N. McLellan; Mr. John C. von Lehe, Jr.; and Mr. Mack I. Whittle, Jr., Board Chairman. Members absent were: Mr. A. C. Fennell, III; Mr. J. DuPre Miller; Mr. Othniel H. Wienges, Jr.; and Mr. Herbert C. Adams, Board Vice Chairman. Other Trustees present were: Mr. James Bradley and Mrs. Helen C. Harvey.
Others present were: President John M. Palms; Secretary Thomas L. Stepp; Executive Vice President for Academic Affairs and Provost Jerome D. Odom; Vice President for Information Technology and Chief Information Officer William F. Hogue; Vice President for Student and Alumni Services Dennis A. Pruitt; Vice President for Human Resources Jane M. Jameson; Vice Provost and Executive Dean for Regional Campuses and Continuing Education Chris P. Plyler; General Counsel Walter (Terry) H. Parham; Vice President for Medical Affairs and Dean of the School of Medicine Larry R. Faulkner; Dean of The Norman J. Arnold School of Public Health Harris Pastides; Dean of the College of Nursing Mary Ann Parsons; Professor and Dean of the College of Pharmacy Farid Sadik; Dean of the South Carolina Honors College Peter C. Sederberg; Associate Dean for Medical Education and Academic Affairs of the School of Medicine Richard Hoppmann; Clinical Associate Professor of the College of Nursing Renatta Loquist; Vice Chancellor for Academic Affairs, USC Spartanburg, Judith Prince; Representative for the Regional Campuses Ellen Chamberlain; Director of Public Affairs Russell McKinney; and a member of the media.
Chairman Foster called the meeting to order and welcomed those present.
A moment of silence was observed in remembrance of the victims of the September 11th terrorist attacks on New York, Washington, and Pennsylvania.
Mr. McKinney introduced a member of the media who was in attendance. Chairman Foster stated that the agenda had been posted and the press had been notified as required by the Freedom of Information Act; the agenda had been circulated to the Committee members; and a quorum was present to conduct business.
The South Carolina Colleagues in Caring Project was located at the College of Nursing to conduct intensive nursing workforce planning and development. Through a partnership with the State Board of Nursing and other healthcare organizations within the state, a grant had been received from the Robert Wood Johnson Foundation. Carolina had been one of twenty sites funded nationally. An additional 16 nonfunded sites had participated in Colleagues in Caring work because of the magnitude of the nursing shortage; these sites had been funded through public and private partnerships. The emphasis of the grant involved the development of the nursing workforce to ensure an adequate supply of nurses to meet the demands of the public for care.
It was reported that there was a twenty-member Coordinating Council which represented major stakeholders in nursing and healthcare; eleven Regional Clusters including partnerships of executives in healthcare organizations, chief nursing officers, and educational partners; and statewide task forces which focused on the three major goals of the project: 1) recruitment and retention; 2) workforce modeling; and 3) educational mobility.
Various quantitative and qualitative data collection had occurred during the last five years. The nursing licensure database had provided most of the analyzed data as nurses renewed their licenses annually. This data had been collected by the Board of Nursing in conjunction with the Office of Research and Statistics, a division of the Budget and Control Board. As a result of this partnership, access to the Joint Annual Report of Hospitals had been available which afforded insight about the utilization of nurses and patient flow. Surveys of nursing education programs, hospitals and other nursing employers, and practicing nurses had been used also.
Qualitative data had been collected through focus groups conducted statewide. An independent consultant had been hired to conduct key interviews of major healthcare providers concerning the nursing shortage. Regional cluster dialogue provided insight regarding issues that local facilities had experienced. A tremendous amount of literature had been produced about the nursing shortage, nationally and internationally, which addressed solutions for various areas. Project sites throughout the country had shared extensive information.
A summary of findings concluded that a nursing shortage existed and was predicted to be long term, both nationally and in South Carolina. The shortage had been due to both a diminishing supply of nurses coupled with an increased demand. The nursing workforce had been aging at a rate which was higher than most other professions and a large group of nurses were predicted to retire between 2010 and 2015. Collaboration among multiple stakeholders and governmental intervention at the state and federal levels would be necessary to resolve this situation.
Based on 1996 census data, South Carolina ranked 42nd in the number of registered nurses (RNs) per 100,000 population, which was approximately 4,000 less than the national average. The 2000 census data had not been released, although it was presumed that the RN to population ratio had increased to reveal an even greater shortage. There was a serious concern that by the year 2015, 30 percent of the current RN workforce would be age 55 or older, while only 6 percent were predicted to be under the age of 30. Of the RNs licensed in South Carolina, 88 percent were currently employed in the state. Nurses not employed in South Carolina may have maintained a South Carolina license.
Another concern involved the anticipated retirement of faculty in schools of nursing. Programs had been surveyed and preliminary data revealed that nearly 100 faculty vacancies would occur during the next five years - 25 percent of the current positions in nursing education.
Professor Loquist presented several charts which outlined a ten year retrospective analysis and a projection for the future. South Carolina had continually gained in the numbers of RNs. The shortage was not attributed solely to a decline in the number of nurses, because the supply had been replenished, but also to an increase in demand. This trend was predicted to shift in the year 2010, when a decline in the actual supply of nurses coupled with increased demand was expected.
Concerning the number of nurses employed in South Carolina, approximately 400 to 500 per year had returned to the workforce from an inactive status. Other nurses had been recruited from out of state and new graduates had also been hired from South Carolina programs.
From 1989 to 1994, there had been a steady growth in the number of new nursing graduates from South Carolina programs. However, a decline in the graduation rate had occurred in 1994 and 1995; as a result, recruitment initiatives had begun in 1997. South Carolina had relied heavily on out-of-state recruitment; however, as the nursing shortage spread nationally, it had been more difficult to rely on out-of-state recruitment.
For nearly every category, educational levels in South Carolina had been below the national average with the exception of nurses with associate degrees.
In terms of race and gender composition, the nursing population had been predominately white and female, which was a serious concern. Focus had been placed on recruitment and retention initiatives to influence minorities and the male gender into the workforce.
Two-thirds of the doctorate-prepared faculty in schools of nursing had been above the age of 50 and one-third had been above the age of 60. These individuals had been teaching in nursing education programs or serving in senior administrative nursing positions within the state.
Student capacity in the South Carolina nursing education programs had been largely determined by available faculty, and clinical and financial resources. Also, Board of Nursing regulations required a 1 to 8 faculty-student ratio in the clinical area. Increasing enrollment while maintaining standards had been difficult. Progress had been made over the years in terms of graduates from various programs. Approximately 400 students per year in the baccalaureate programs had been expected to graduate; these programs boasted the highest graduation rate of any of the programs. Approximately, 88 percent of enrolled students graduated from the baccalaureate programs. For the associate degree programs, the number of graduates was nearly 60 percent; for the LPN programs, the graduation rate was 50 percent.
The collected data revealed that South Carolina was behind in the national RN to population ratio by approximately 5,000 nurses. Nearly 9,000 nurses were expected to retire during the next several years. A decline in the projected numbers of registered nurses from out of state could produce a deficit of an additional 3,000 to 7,500 nurses.
Strategies to promote the development of the nursing workforce included building and strengthening collaborative efforts in local communities to work toward long-term solutions regarding the nursing shortage; establishing and sustaining an aggressive recruitment campaign among youth, minorities and males; designing an educational infrastructure which would promote career mobility and life-long learning within the profession; assisting employers in creating satisfying and cost-effective work environments which produced quality outcomes; developing incentive programs such as loan forgiveness programs for students pursuing a nursing career; and sustaining future collaborative workforce planning by establishing a South Carolina Center for Nursing with broad-based statewide representation.
Dean Parsons stated that 406 nursing students had graduated from baccalaureate programs in South Carolina last year; of that number, 95 had graduated from the University of South Carolina.
Dean Parsons also noted that the establishment of a South Carolina Center for Nursing at the University of South Carolina had been recommended; a report about this nursing center would be forthcoming.
Mr. Bahnmuller inquired about several items concerning the associate degree, the State Board examination to be licensed as an RN, and the salary ranges for nurses. Professor Loquist and Dean Parsons addressed his concerns and provided additional remarks.
Mr. Stepp requested confirmation regarding the shortage of nurses per capita in South Carolina as compared to the national average. Professor Loquist replied that the previously stated number of approximately 4,000 was correct.
Regarding the salary structure, Professor Loquist added that this topic was continually discussed; the sheer number of nurses in the workforce created difficulty related to this issue.
Mr. Bahnmuller inquired about the number of USC nursing students selected versus the number of students who applied. Dean Parsons replied that 48 students had been admitted in the fall and again in the spring. In any one application period, approximately 80 applications were submitted for those 48 available positions.
Dean Faulkner commented on the ongoing need to monitor and advocate for a nursing workforce in South Carolina after the South Carolina Colleagues in Caring Project grant had expired. He noted that an umbrella organization was needed to review nursing workforce issues in the state and to advocate for changes in the structure of nursing education.
Mr. Whittle inquired about the shortage of physicians in the state and whether a correlation between the shortage of nurses and the shortage of physicians existed. Dean Faulkner stated that there had been a shortage of primary care physicians in South Carolina. The shortage of nurses had been greater than that of physicians.
Mr. McLellan asked about the amount of money required to establish a loan forgiveness program. Professor Loquist stated that some states had allocated a specific amount. Mr. McLellan suggested that a surcharge be applied to health coverage and imposed on the carriers to establish a fund.
Chairman Foster stated that this report was received for information.
Dr. Hoppmann discussed recruiting activities and stated that this process had been ongoing. Efforts included visits to various college campuses in the state; tours and scientific demonstrations for high school students; "Day in the Life Program" presentations for prospective students; "Role Models for Medicine" for outstanding high school students; as well as brochures, website and alumni activities. Dr. Hoppmann provided additional information about each program.
During the previous five years, a decrease in the number of applicants for medical school had occurred both nationally and within the state. Resident applicants had been focused on heavily; that figure was approximately one-third of the total number. The number of African-American applicants had remained steady with an increase in the quality of those applicants.
A breakdown of the School of Medicine classes from 1998 to 2000 indicated an average of 73 students per year; nearly 60 percent had been male and 40 percent had been female. For the year 2001, the figure had been fifty percent with roughly the same number of students. During the same four year period, the majority of students had been South Carolina residents; 5 to 11 percent had been nonresidents with close South Carolina ties. A further breakdown of the classes indicated that in 2001, 75 percent of the students had been white, 11 percent had been African-American, and 14 percent had been Asian.
Dr. Hoppmann discussed test scores during the last five years and explained that USC had been comparable to the national GPA scores, but below the national average and the Southeast MCAT scores. However, Dr. Hoppmann noted that over the past several years, USC students had scored at or above the average on medical exams given at the end of the second and third years, which reflected the quality of education the students had received.
Dr. Hoppmann reviewed the applicant evaluation process and noted that criteria other than academic preparation was required including letters of recommendation, personal statements, and life experiences such as obstacles, medical experiences and volunteer work. As part of the process, various members of the Admissions Committee interviewed each medical school applicant twice.
Dr. Hoppmann concluded his report by providing additional statistical information about the class of 2001 including the average age of students and the number of South Carolina colleges represented.
Dean Faulkner discussed the success of the admissions process in relationship to the graduation rate. On average, 90 percent of USC students had graduated with an MD degree. This percentage reflected the national average. A huge amount of time and effort had been dedicated to this process.
Mr. Bahnmuller inquired about the number of applicants; Dean Faulkner replied that nearly 1,300 applications had been received. The application pool consisted of approximately 350 South Carolina applicants; out-of-state students were not accepted.
Chairman Foster stated that this report was received for information.
There were no other matters to come before the Committee, and Chairman Foster declared the meeting adjourned at 2:00 p.m.
Respectfully submitted,
Thomas L. Stepp
Secretary