Title of Regulation: 12VAC5-510. Guidelines for General Assembly Nursing Scholarships (amending 12VAC5-510-10 through 12VAC5-510-70; adding 12VAC5-510-15, 12VAC5-510-80 through 12VAC5-510-110).

Statutory Authority: § 32.1-122.6:01 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: September 13, 2013.

Agency Contact: Michael Royster, M.D., Director, Office of Minority Health and Health Equity, Department of Health, 109 Governor Street, Richmond, VA 23219, telephone (804) 864-7435, FAX (804) 864-7440, or email michael.royster@vdh.virginia.gov.

Basis: Section 54.1-3011.1 of the Code of Virginia authorizes the collection of up to $1.00 in licensure and license renewal fees for every practical nurse and registered nurse to be deposited in a Nursing Scholarship and Loan Repayment Fund.

Section 54.1-3011.2 of the Code of Virginia establishes the Nursing Scholarship and Loan Repayment Fund for the purpose of financing scholarships for part-time and full-time students enrolled in or accepted for enrollment by nursing programs and gives the Board of Health authority to administer and award such funds.

Section 32.1-122.6:01 of the Code of Virginia authorizes the Board of Health to award scholarships available through the Nursing Scholarship and Loan Repayment Fund.

Sections 23-35.9 through 23-35.13 of the Code of Virginia further define some of the procedures for administering the scholarships, including the composition of the Advisory Committee to the State Board of Health, the basis for awards, the requirement for a written contract and contract provisions, provisions for renewal of awards, and definition of how payments should be made.

Purpose: The Virginia Department of Health administers the Nursing Scholarship Program, which provides annual nursing scholarships for students enrolled part-time or full-time in undergraduate and graduate nursing programs. Selected recipients agree to promptly begin and thereafter engage continuously in nursing practice in the Commonwealth in a region with a critical shortage of nurses for a duration of time based on the total amount of scholarship awarded.

Regulations for other similar scholarship programs are more comprehensive and include sections governing the administration of the program. A more comprehensive set of regulations for the administration of this program is essential for improving the efficacy of the program.

The intent of this program is to address the shortage of trained medical professionals in the Commonwealth. The primary advantage to improving the administration of this program would be to increase the availability of adequate, qualified medical providers in Virginia.

Substance: Amendments add a section pertaining to the definitions of terms used in the regulations and clarify the residency requirement for eligibility. Sections are also added to provide administrative guidance regarding the terms of service for the contract, the reporting requirements for scholarship recipients, the conditions that would lead to a breach of contract and the consequences for such a breach, and waiver provisions. The waiver provisions allow for flexibility within the program in situations where the recipient and the recipient's family encounter hardship, disability, or death.

The Nursing Scholarship Program has been in existence for over 20 years. Although the field of nursing has evolved since that time, the regulations have not kept up with these changes. Amendments are being proposed to ensure that this program is consistent with how the industry has evolved over time. This includes more realistic expectations pertaining to the length of time required to find full-time employment upon graduation. The recipient of a scholarship currently has 60 days after graduation to report on the status of full-time employment in the commonwealth. This time frame is not consistent with the time frame needed to take the licensure exam, receive a license, and seek and find full-time employment. The proposed amendments allow the recipient up to 180 days after graduation before being required to report on the status of full-time or part-time employment in the Commonwealth. Finally, amendments are proposed to change the definition of full-time employment from 40 hours per week to 32 or more hours per week to be consistent with industry standards.

Issues: The advantages of the amendments are that the public will have a better understanding of how the scholarship program is administered, and the agency administering the program will have better direction for administering the program.

The recipients of the scholarship and their families will benefit because the regulations will include more clarity pertaining to their obligations and include provisions for waivers in situations of hardship, disability, and death.

There are no known disadvantages to the public or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Virginia Department of Health administers the Nursing Scholarship program, which provides annual nursing scholarships for students enrolled part-time and/or full-time in undergraduate and graduate nursing programs. Selected recipients agree to promptly begin and thereafter engage continuously in nursing practice in the Commonwealth in a region with a critical shortage of nurses for a period of time based on the total amount of scholarship awarded.

The Nursing Scholarship Program has been in existence for over twenty years. Although the field of nursing has evolved since that time, the regulations have not kept up with these changes. Amendments are being proposed to ensure that this program is consistent with how the industry has evolved over time. This includes more realistic expectations pertaining to the length of time required to find full-time employment upon graduation. Under the current regulations the recipient of a scholarship currently has 60 days after graduation to report on the status of full-time employment in the state. This time frame is not consistent with the time frame needed to take the licensure exam, receive a license and seek and find full time employment. The Board of Health (Board) proposes to allow the recipient up to 180 days after graduation before being required to report on the status of full-time or part-time employment in the state. Additionally, the Board proposes to add longstanding elements of the contract signed by the scholarship recipient to the regulations for clarity. Finally, amendments are being proposed to change the definition of full time employment from 40 hours per week to 32 or more hours per week to be consistent with industry standards.

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. The proposed amendments will make it easier for scholarship recipients to comply with requirements without risk or harm to the program. Thus the proposed amendments produce a net benefit.

Businesses and Entities Affected. The proposed amendments affect nursing students and prospective nursing students interested in applying for a General Assembly nursing scholarship.

Localities Particularly Affected. The proposed amendments do not disproportionately affect particular localities.

Projected Impact on Employment. The proposed amendments are unlikely to significantly affect employment.

Effects on the Use and Value of Private Property. The proposed amendments are unlikely to significantly affect the use and value of private property.

Small Businesses: Costs and Other Effects. The proposed amendments are unlikely to significantly affect small businesses.

Small Businesses: Alternative Method that Minimizes Adverse Impact. The proposed regulations do not adversely affect small businesses.

Real Estate Development Costs. The proposed regulations are unlikely to significantly affect real estate development costs.

Legal Mandate. The Department of Planning and Budget (DPB) has analyzed the economic impact of this proposed regulation in accordance with § 2.2-4007.04 of the Administrative Process Act and Executive Order Number 14 (10). Section 2.2-4007.04 requires that such economic impact analyses include, but need not be limited to, the projected number of businesses or other entities to whom the regulation would apply, the identity of any localities and types of businesses or other entities particularly affected, the projected number of persons and employment positions to be affected, the projected costs to affected businesses or entities to implement or comply with the regulation, and the impact on the use and value of private property. Further, if the proposed regulation has adverse effect on small businesses, § 2.2-4007.04 requires that such economic impact analyses include (i) an identification and estimate of the number of small businesses subject to the regulation; (ii) the projected reporting, recordkeeping, and other administrative costs required for small businesses to comply with the regulation, including the type of professional skills necessary for preparing required reports and other documents; (iii) a statement of the probable effect of the regulation on affected small businesses; and (iv) a description of any less intrusive or less costly alternative methods of achieving the purpose of the regulation. The analysis presented above represents DPB's best estimate of these economic impacts.

Agency's Response to Economic Impact Analysis: The Virginia Department of Health, Office of Minority Health and Health Equity (OMHHE) administers the Guidelines for General Assembly Nursing Scholarships (12VAC5-510). The OMHHE has reviewed the economic impact analysis and concurs with the analysis, specifically; the benefits likely exceed the costs for all proposed changes.

Summary:

The proposed amendments (i) allow the nursing program scholarship recipient up to 180 days after graduation before having to report on the status of full-time or part-time employment in the Commonwealth; (ii) add longstanding elements of the contract signed by the scholarship recipient to the regulations for clarity; and (iii) change the definition of full-time employment from 40 hours per week to 32 or more hours per week to be consistent with industry standards.

CHAPTER 510
GUIDELINES FOR GENERAL ASSEMBLY NURSING SCHOLARSHIPS

This chapter has been prepared to familiarize scholarship applicants, Deans/Directors of nursing programs, and Financial Aid Officers with the General Assembly Nursing Scholarship Program. The legislative authority for the scholarships in addition to the actual steps involved in the application process are reviewed.

Do not hesitate to contact the Office of Public Health Nursing, Virginia State Health Department, 1500 East Main Street, Suite 227, Richmond, VA 23219, with any questions relating to the scholarship program. The phone number at the Bureau office is (804) 371- 4090.

ALL SCHOLARSHIPS ARE AWARDED WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX OR NATIONAL ORIGIN.

12VAC5-510-10. Legislative authority.

Section 32.1-122.6:01 of the Code of Virginia provides the Board of Health the authority to award certain nursing scholarships and loan repayment funds. Fee requirements are specified in § 54.1-3011.1 of the Code of Virginia. Section 54.1-3011.2 of the Code of Virginia establishes the nursing scholarship and loan repayment fund.

Sections 23-35.9 through 23-35.13 of the Code of Virginia authorize annual nursing scholarships for students enrolled in undergraduate and graduate nursing programs. Undergraduate nursing programs are defined as those leading to an associate degree, diploma, or baccalaureate degree in nursing. Graduate nursing programs are those offering masters and doctoral degrees.

Under the law, all All scholarship awards are made by an Advisory Committee appointed by the State Board of Health. The Advisory Committee consists of eight members: four deans or directors of schools of nursing or their designees, two former scholarship recipients, and two members with experience in the administration of student financial aid programs. Committee appointments are for two-year terms and members may not serve for more than two successive terms in addition to the portion of any unexpired term for which such a member was appointed. The State Board of Health shall schedule appointments to the Advisory Committee in such a manner that at least two persons who have not served during the previous two years are appointed to the Committee.

The Office of Public Health Nursing of the State Health Department of Health serves as the staff element to the Advisory Committee and plays no role in the determination of scholarship recipients.

The basis for determining scholarship recipients is established by the Advisory Committee shall make the awards with due regard given to scholastic attainment, financial need, character, and adaptability to the nursing profession. With due consideration of the number of applications and the qualifications of all such applicants, the Advisory Committee will, so far as practical, award an equal number of scholarships among the various congressional districts within the Commonwealth.

12VAC5-510-15. Definitions.

The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Board" or "Board of Health" means the State Board of Health.

"Commissioner" means the State Health Commissioner.

"Continuous" means that there are no breaks in service greater than a period of six weeks.

"Department" means the Virginia Department of Health.

"Full-time" means the equivalent of 32 or more hours per week for at least 45 weeks per year.

"Interest" means the legal rate of interest pursuant to the Code of Virginia.

"Licensed Practical Nurse" or "LPN" means a nurse who has successfully completed a state-approved practical nursing program, passed a licensing examination known as the NCLEX-PN, and is licensed by the Commonwealth of Virginia to provide routine care under the supervision of a licensed medical practitioner, a professional registered nurse, or other licensed health professional authorized by regulations of the Board of Nursing.

"Penalty" means the amount of money equal to twice the amount of all monetary payments to the scholarship recipient, less any service obligation completed.

"Practice" means the provision of direct patient care as an LPN or RN in a region of the Commonwealth of Virginia with a critical shortage of nurses.

"Recipient" means a student in an LPN or RN program who enters into a contract with the Board of Health and participates in the scholarship program.

"Registered Nurse" or "RN" means a nurse who has graduated from an approved nursing program, passed the national licensing examination known as the NCLEX-RN, and has been licensed to practice as a registered nurse by the Board of Nursing in the Commonwealth of Virginia.

12VAC5-510-20. Eligibility.

In order to be considered for a General Assembly Nursing Scholarship, applicants must meet the following criteria:

1. Be a resident of the State of Virginia for at least one year eligible for in-state tuition pursuant to § 23-7.4 of the Code of Virginia at the time a scholarship is awarded.

2. Be accepted or enrolled in a school of nursing in the State Commonwealth of Virginia which is approved by the State Board of Nursing. The only exception is for students pursuing graduate degrees not offered in the Commonwealth.

3. If already enrolled in a nursing program, the applicant must demonstrate a cumulative grade point average of at least 2.5.

4. Submit a completed application form and appropriate grade transcript to the Office of Public Health Nursing department prior to the established published deadline dates.

5. Demonstrate financial need which is verified by the Financial Aid Officer/authorized person.

FAILURE TO COMPLY WITH ALL OF THESE CRITERIA WILL CAUSE THE APPLICANT TO BE INELIGIBLE FOR A SCHOLARSHIP.

Failure to comply with all of these criteria will cause the applicant to be ineligible for a scholarship.

12VAC5-510-30. Conditions of scholarships.

It is important that all applicants fully understand the conditions of acceptance of a General Assembly Nursing Scholarship. These awards are not outright gifts. For each $100 of scholarship money received, the The scholarship recipient agrees to engage in a term of service involving continuous full-time (40 hours per week) nursing practice in a region of the Commonwealth for one month with a critical shortage of nurses. Therefore, if a student receives $500 in scholarship awards, they must repay that amount by working continuously for 5 months. Full-time employment The maximum award amounts and terms of service are determined as per §§ 23-35.9 and 23-35.11 of the Code of Virginia. Employment must begin within 60 180 days of the recipient's graduation date. Time spent in an "on-call" status shall not be counted toward the number of hours worked per week. Voluntary military service, even if stationed in Virginia, cannot be used to repay scholarship awards the service obligation. If the recipient begins employment at a practice site, but that employment is later terminated, the recipient must transfer to another approved practice site in the Commonwealth within 90 days of termination.

If a scholarship recipient fails to complete their studies, or engage in full-time nursing practice in Virginia, the full amount of money represented in the scholarship(s) received, plus an annual interest charge, must be refunded.

If a recipient leaves the State, or ceases to engage in full-time nursing practice before all employment conditions of the scholarship award are fulfilled, the recipient must repay the balance on his/her account plus an annual interest charge.

All refund checks should be made payable to the Commonwealth of Virginia and mailed to:

Office of Public Health Nursing

State Health Department

1500 East Main Street

Suite 227

Richmond, Virginia 23219

Before any scholarship is awarded, the applicant must sign a written contract agreeing to the terms established by law and the Advisory Committee.

12VAC5-510-40. Number of applications per student.

Scholarships are awarded for single academic years. However, the same student may, after demonstrating satisfactory progress in his/her his studies, apply for and receive scholarship awards for any succeeding academic year or years. No student may receive scholarships for more than a total of five four years.

12VAC5-510-50. Amounts of scholarships.

The amount of each scholarship award is dependent upon the amount of money appropriated by the General Assembly and the number of qualified applicants. No recipient will shall receive an award for less than one hundred and fifty dollars $150. Graduate nursing scholarships may not exceed four thousand dollars annually.

12VAC5-510-60. How to apply.

Applications and Guidelines are available from the Dean/Director of your school or from the Financial Aid Office guidelines are made available to all prospective students online through the department's website.

If a student is pursuing a graduate degree not available in Virginia, applications may be obtained directly from the Office of Public Health Nursing, State Health Department, 1500 East Main Street, Suite 227, Richmond, VA 23219.

12VAC5-510-70. Deadline dates.

Applications will not be accepted in the Office of Public Health Nursing more than 6 months in advance of the following deadline dates: by the department outside of the application cycle.

March 15 - for students already enrolled in schools of nursing.

June 15 - for new students entering nursing programs.

APPLICATIONS AND/OR TRANSCRIPTS RECEIVED AFTER 5:00 PM ON THE ABOVE DATES WILL NOT BE CONSIDERED FOR SCHOLARSHIP AWARDS.

Applications and transcripts received after the published deadline date and time for the application cycle will not be considered for scholarship awards.

FLOW CHART OF RESPONSIBILITIES
D - Dean or Director FAO - Financial Aid Officer S-R - Student-Recipient
RESPONSIBILITY		D	FAO	S-R
Distribute applications & Guidelines to those students who otherwise could not provide sufficient funds for themselves while in school.		X	X
Maintain supply of current scholarship applications and guidelines. Notify the Office of Public Health Nursing when applications are needed.		X
Make certain all parts of the application are completed, including the Financial Aid Officer/Authorized Person and Dean/Director signatures.				X
Be certain that a current transcript of grades (high school, or college if now attending) is sent to the Office of Public Health Nursing when applying for a scholarship (original and repeat requests) before deadline dates.				X
Review entire Section V Financial Data of application. Review whatever school records are accessible to determine the individual applicant's assets and expenditures.			X
Recommend amount of scholarship to be awarded. Should there be a conflict between the student's request and the Financial Aid Officer's/Authorized Person's opinion of the amount that is needed, an explanation should be included.			X
Review the completed application form before affixing the signature thereby indicating:		X
	A. The applicant has properly completed the application form.
	B. The Financial Aid Officer has verified proof of need.
	C. The applicant's entrance and graduation dates are correct.
	D. The school of nursing is recommending the applicant for a scholarship based upon potential nursing ability.
Furnish whatever pertinent data that would be helpful to the scholarship committee when making the awards.		X	X	X
Forward the completed and signed application to the Office of Public Health Nursing before deadline dates.				X
Submit a transcript of grades to the Office of Public Health Nursing at the end of each grading period during scholarship year.				X
Notify the Office of Public Health Nursing when student-recipient fails, transfers or withdraws from the school.		X		X
Notify the Office of Public Health Nursing when student-recipient graduation date is changed.		X		X
Notify the Office of Public Health Nursing when there is a change in recipient's name and/or address				X
Upon graduation, notify the Office of Public Health Nursing of plans for employment and beginning date of employment.				X
Submit verification of employment to Office of Public Health Nursing at least every 6 months until work obligation is fulfilled.				X

12VAC5-510-80. Scholarship contract.

Applicants selected to receive scholarship awards by the Advisory Committee must sign and return a written contract to the department by the specified deadline date. Failure to return the contract by the specified deadline date may result in the award being rescinded. At minimum, the scholarship contract shall include the following elements:

1. Agreement with the total amount of the award and the award period.

2. Agreement to pursue an LPN or RN degree in nursing at a school of nursing in the Commonwealth of Virginia that is approved by the Board of Nursing.

3. Agreement to begin continuous full-time employment within 180 days of the recipient's graduation.

4. Agreement to comply with all reporting requirements.

5. Agreement with the terms of service requiring continuous full-time nursing practice in the Commonwealth for a specified period of time and the terms and conditions associated with a breach of contract.

A recipient may terminate a contract while enrolled in school after notice to the board and upon repayment within 90 days of the entire amount of the scholarship plus interest.

12VAC5-510-90. Reporting requirements.

Monitoring of the service obligation of recipients shall be conducted on an ongoing basis by the department.

The recipient shall permit the nursing school to provide information regarding enrollment status and progress in the program.

The recipient shall notify the department, within 180 days of being awarded a nursing diploma or degree, of the type of nursing practice to be performed and give the name and address of the employer for approval.

The recipient shall submit to the department verification of employment documentation every four months until the contract obligation has been completely fulfilled.

The recipient shall maintain practice records in a manner that will allow the department to readily determine compliance with the terms and conditions of the contract.

The recipient shall notify the department in writing within 30 days of any of the following events:

1. Recipient changes name;

2. Recipient changes address;

3. Recipient changes nursing program;

4. Recipient changes practice site;

5. Recipient no longer intends to fulfill service obligation as a nurse in the Commonwealth; or

6. Recipient ceases to practice as an RN or LPN.

12VAC5-510-100. Breach of contract.

The following are the conditions that constitute a breach of contract:

1. The recipient fails to complete his nursing studies.

2. The recipient fails to begin or complete the term of obligated service within the time frames as specified in the scholarship contract.

3. The recipient falsifies or misrepresents information on the program application, the verification of employment forms, or other required documents.

In the event of a breach of contract where the recipient fails to complete his nursing studies, the recipient shall reimburse the Commonwealth of Virginia for the total amount of the scholarship award, plus interest.

In the event of a breach of contract where the recipient fails to begin or complete the term of obligated service within the time frames as specified in the scholarship contract, the recipient shall reimburse the Commonwealth of Virginia for the total amount of the scholarship, plus penalty and interest.

In the event of a breach of contract where the recipient has partially fulfilled their obligation, the total amount of reimbursement shall be prorated by the proportion of obligation completed.

12VAC5-510-110. Deferment and waivers.

The requirement for continuous engagement in full-time nursing practice may be deferred by the board if the scholarship recipient requests a deferment to pursue a more advanced degree in nursing or a nursing-related field. This deferment, if granted, shall not relieve the recipient of the responsibility to complete the remaining portion of the obligation upon completion of the advanced nursing degree.

If the recipient is in default due to death or permanent disability, the obligation to reimburse the Commonwealth of Virginia for the total amount of the scholarship award plus interest may be partially or completely waived by the board upon application of the recipient or the recipient's estate to the board.

Other individual situations involving severe hardship may be considered by the board for deferment of the service obligation or partial or total waiver of the repayment obligation. Deferment and waiver requests will not be permitted as a matter of course, but may be allowed in the most compelling cases.

All requests for deferments or waivers must be submitted in writing to the department for consideration and final disposition by the Advisory Committee or the board.