OREGON STATE BOARD OF NURSING GOVERNOR S BUDGET

Transcription

1 OREGON STATE BOARD OF NURSING GOVERNOR S BUDGET

2 Table of Contents i. Table of Contents... i ii. Certification... ii LEGISLATIVE ACTION Budget Reports and Related Legislation... 1 AGENCY SUMMARY 1. Agency Summary Narrative A. Budget Summary Graphics... 7 B. Mission Statement and Statutory Authority... 1 C. Agency Plans... 1 D. Program Descriptions E. Environmental Factors F. Agency Initiatives G. Criteria for Budget Development ORBITS Summary of Budget (BDV14) Program Prioritization for Reduction Options Organization Chart Organization Chart ORBITS AgencyWide Program Unit Summary (BPR1) REVENUES 1. Revenue Forecast Narrative Detail of Lottery Funds, Other Funds and Federal Funds Revenue (17BF7) Detail of Lottery Funds, Other Funds and Federal Funds Revenue (BPR12) PROGRAM UNITS 1. Program Option Package Narratives and Fiscal Impact Summaries ORBITS Essential and Policy Package Fiscal Impact Summary (BPR13) PICS Package Fiscal Impact Report (PPDPFISCAL) ORBITS Detail of Lottery Funds, Other Funds and Federal Funds Revenue (BPR12) SPECIAL REPORTS 1. Affirmative Action Report Summary Cross Reference Listing and Packages (BSU3A) Policy Package List by Priority (BSU4A) Budget Support Detail Revenues and Expenditures (BDV13A) Version/Column Comparison Report Detail (ANA1A) Package Comparison Report Detail (ANA11A) Summary List by Package by Summary (PPDPLBUDCL) Summary List by Package by Agency (PPBPLAGYCL) Detail Listing by Summary (PPBPLWSBUD) Package Fiscal Impact Report (PPDPFISCAL) _ Agency Request X Governor s Budget Legislatively Adopted Budget Page i

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4 SeventyEighth Oregon Legislative Assembly 215 Regular Session BUDGET REPORT AND MEASURE SUMMARY MEASURE: SB 5524 A CARRIER: Rep. Boone Joint Committee On Ways and Means Action: Do Pass. Action Date: 5/15/15 Vote: House Yeas: 1 Buckley, Gomberg, Huffman, Komp, Nathanson, Rayfield, Read, Smith, Whitsett, Williamson Exc: 2 McLane, Whisnant Senate Yeas: 11 Burdick, Devlin, Girod, Hansell, Johnson, Monroe, Roblan, Shields, Steiner Hayward, Whitsett, Winters Exc: 1 Thomsen Prepared By: Clair Clark, Department of Administrative Services Reviewed By: Matt Stayner, Legislative Fiscal Office Agency: Board of Nursing Biennium: Page 1 of 11 SB 5524 A

5 Budget Summary* Legislatively Approved Budget (1) Current Service Level Committee Recommendation Committee Change from Leg. Approved Other Funds Limited Total Position Summary Authorized Positions Fulltime Equivalent (FTE) positions $ Change % Change $ 14,493,71 $ 14,83,516 $ 14,877,611 $ 383,91 2.6% $ 14,493,71 $ 14,83,516 $ 14,877,611 $ 383,91 2.6% (1) Includes adjustments through December 214 * Excludes Capital Construction expenditures Revenue Summary The Board of Nursing is supported solely by Other Funds revenues generated primarily from examination, licensing and renewal application fees charged to nurses and nursing assistants. The Subcommittee approved the following fee changes conducted administratively during the interim: The establishment of fees related to the awarding of Prescriptive Privileges for Certified Registered Nurse Anesthetists (CRNA) as authorized by Senate Bill 136 (213). The initial application fee for Prescriptive Privileges will be $75 and $5 upon renewal. CRNAs with Prescriptive Privileges will also pay the Prescription Monitoring Program fee of $5. The establishment of these fees will generate an estimated $48, Other Funds revenues during the biennium. An increase of the late renewal fee for Registered Nurses, Licensed Practical Nurses, Nurse Practitioners, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists from $12 to $1 in lieu of pursuing civil penalties of $5 per day for up to 6 days for practicing without a license. Summary of Human Services Subcommittee Action The Board of Nursing protects the public s health, safety and wellbeing through the regulation of nursing practice and nursing education. It licenses Registered Nurses, Licensed Practical Nurses, Nurse Practitioners, Certified Registered Nurse Anesthetists and Clinical Nurse Specialists. The Board also certifies Certified Nursing Assistants and Certified Medication Aides. Page 2 of 11 SB 5524 A

6 The Subcommittee approved a budget for the Oregon State Board of Nursing of $14,877,611 Other Funds and 47.8 fulltime equivalent positions. This is a 2.6 percent increase from the Legislatively Approved Budget. The Subcommittee approved the following recommendations: Package 1, Virtual Environment Server & Software Upgrade, provides a onetime increase of $74,95 Other Funds expenditure limitation to fund the replacement of six node servers ($37,865) and an upgrade of six VMware software licenses ($36,23). The node servers and upgraded licenses will support ongoing maintenance and enhancement of the Board s Information Technology infrastructure. The new node servers will allow the agency to cluster their servers, improving the system s survivability in case of a power failure, improving processing speeds, and reducing downtime resulting from system failures. The upgraded software licenses will allow the Board to migrate data between servers without downtime, and enhance server management by providing monitoring, alerting, and reporting capabilities. Summary of Performance Measure Action See attached Legislatively Adopted Key Performance Measures form. Page 3 of 11 SB 5524 A

7 DETAIL OF JOINT COMMITTEE ON WAYS AND MEANS ACTION SB 5524A Oregon State Board of Nursing Clair Clark OTHER FUNDS FEDERAL FUNDS TOTAL GENERAL LOTTERY ALL DESCRIPTION FUND FUNDS LIMITED NONLIMITED LIMITED NONLIMITED FUNDS POS FTE Legislatively Approved Budget at Dec 214 * $ $ $ 14,493,71 $ $ $ $ 14,493, Current Service Level (CSL)* $ $ $ 14,83,516 $ $ $ $ 14,83, SUBCOMMITTEE ADJUSTMENTS (from CSL) SCR 1 Operations Package 1: Virtual Environment Server & Software Upgrade Capital Outlay $ $ $ 74,95 $ $ $ $ 74,95 TOTAL ADJUSTMENTS $ $ $ 74,95 $ $ $ $ 74,95. SUBCOMMITTEE RECOMMENDATION * $ $ $ 14,877,611 $ $ $ $ 14,877, % Change from Leg Approved Budget.%.% 2.6%.%.%.% 2.6% % Change from Current Service Level.%.%.5%.%.%.%.5% *Excludes Capital Construction Expenditures Page 4 of 11 SB 5524 A

8 Legislatively Approved Key Performance Measures Agency: NURSING, BOARD of Mission: The mission of the Oregon State Board of Nursing is to safeguard the public's health and wellbeing by providing guidance for, and regulation of, entry into the profession, nursing education, and continuing safe practice. Legislatively Proposed KPMs Customer Service Category Agency Request Most Current Result Target 216 Target TIMELY RESOLUTION OF COMPLAINTS Percent of cases investigated and referred to Board within 12 days of receipt of complaint. Approved KPM REDUCTION OF RECIDIVISM Percent of disciplined licensees with a new complaint within three years of Board closing original case with a disciplinary action. Approved KPM CUSTOMER SERVICE Percent of customers rating their satisfaction with the agency's customer service as good or excellent: overall customer service, timeliness, accuracy, helpfulness, expertise and availability of information. Accuracy Approved KPM CUSTOMER SERVICE Percent of customers rating their satisfaction with the agency's customer service as good or excellent: overall customer service, timeliness, accuracy, helpfulness, expertise and availability of information. Availability of Information Approved KPM CUSTOMER SERVICE Percent of customers rating their satisfaction with the agency's customer service as good or excellent: overall customer service, timeliness, accuracy, helpfulness, expertise and availability of information. Expertise Approved KPM CUSTOMER SERVICE Percent of customers rating their satisfaction with the agency's customer service as good or excellent: overall customer service, timeliness, accuracy, helpfulness, expertise and availability of information. Helpfulness Approved KPM CUSTOMER SERVICE Percent of customers rating their satisfaction with the agency's customer service as good or excellent: overall customer service, timeliness, accuracy, helpfulness, expertise and availability of information. Overall Approved KPM Print Date: 5/12/215 Page 5 of 11

9 Agency: NURSING, BOARD of Mission: The mission of the Oregon State Board of Nursing is to safeguard the public's health and wellbeing by providing guidance for, and regulation of, entry into the profession, nursing education, and continuing safe practice. Legislatively Proposed KPMs Customer Service Category Agency Request Most Current Result Target 216 Target CUSTOMER SERVICE Percent of customers rating their satisfaction with the agency's customer service as good or excellent: overall customer service, timeliness, accuracy, helpfulness, expertise and availability of information. Timeliness Approved KPM ONLINE TRANSACTIONS: Percent of business transactions completed online. Approved KPM TIMELY LICENSING: Percent of licensing applications processed within target. Approved KPM EFFECTIVE GOVERNANCE: Percent of total best practices met by the Board. Approved KPM LFO Recommendation: Approve the Key Performance Measures and targets as proposed SubCommittee Action: The Subcommittee approved the key performance measures as recommended by LFO Print Date: 5/12/215 Page 6 of 11

10 Oregon State Board of Nursing Governor s Budget AGENCY SUMMARY Agency Summary Narrative The Oregon State Board of Nursing is an agency that regulates the practice of nurses and nursing assistants to protect the public. It sets standards for nursing practice, guidelines for education programs, and minimum competency levels for entry into the professions it regulates. It also imposes discipline upon licensees who violate the nurse practice act. Budget Summary: The Oregon State Board of Nursing is primarily (93%) supported by Other Fund revenues generated from examination, licensing and renewal application fees charged to registered nurses, licensed practical nurses, nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, certified nursing assistants, and certified medication aides. The Board also receives federal matching revenue (7%) through the Department of Human Services. Additional sources include sale of documents, employer subscription fees, and civil penalty fees. It is the policy of the Oregon State Board of Nursing to set fees in a manner that is as fair and equitable as is feasible. Fees shall not exceed the cost of administering the programs for which the fees are established. In the Legislative Adopted Budget, the estimated revenue and the operating reserve from were enough to cover the roll up costs of salary increases and inflation on the cost of goods. The Board did not request any fee increases in Other Fund Revenue Leg Approved Budget Net Transfer from DHS 1.47M 9% Licensing Fees Revenue 14.98M 91% Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 7 of 11

11 Oregon State Board of Nursing Governor s Budget In the Governor s Budget, the estimated revenue and the operating reserve from are enough to cover the roll up costs of salary increases and inflation on the cost of goods. The Board is not requesting any fee increases in Net Transfer from DHS 1.63M 7% Other Fund Revenue Governor's Budget Licensing Fees Revenue 14.49M 93% The budget is comprised of six organizational units: 1) Administration, 2) Nursing Policy Analysts, 3) Communications, 4) Fiscal Services, 5) Licensing, and 6) Investigations. The Budgeted Expenditures are shown below: Investigations 4% Expenditures Governor's Budget Administration 9% Fiscal 5% Policy Analysts 12% Licensing 25% Communications 9% Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 8 of 11

12 Oregon State Board of Nursing Governor s Budget The Governor s Budget represents a 8.76% increase over the LAB. This estimated budget level provides sufficient revenue to establish a sufficient operating reserve for the agency, as recommended by the Department of Administrative Services. 18,, Comparison of Expenditures to ,, 5, 5, 1,643,453 5, 5, 1,643,453 14,, 12,, 1,643,453 4,455,417 4,81,822 4,81,822 6,346,328 1,, 8,, 6,, 4,, 8,9,398 9,55,592 1,91,715 1,91,715 2,, 1517 LAB 1719 CSL 1719 ARB 1719 GBB Personal Services Services & Supplies Special PaymentMonitoring Capital Outlay Dist to NonProfit Organization Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 9 of 11

13 Oregon State Board of Nursing Governor s Budget Mission Statement & Statutory Authority Mission Statement: The mission of the Oregon State Board of Nursing is to safeguard the public s health and wellbeing by providing guidance for, and regulation of, entry into the profession, nursing education, and continuing safe practice. Statutory Authority: Oregon Revised Statute to and Oregon Administrative Rules 8511 to Agency TwoYear Plan The Board of Nursing s strategic plan is developed and maintained by the Board specifically to meet its mission and vision. The vision of the Board is to be a respected leader in the professional regulatory community, recognized and emulated for its success in advancing nursing excellence for public protection. With the mission and vision guiding the organization, the board has adopted the following goals: Focus on Customer Service Effective, HighQuality Leadership and Governance Regulate and guide the Nursing Profession The agency is currently updating its twoyear plan, including an emphasis on public outreach, communication, online services, accountability, and development of the Board members and staff. The updated plan was presented to the Board at the September 216 Board meeting. Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 1 of 11

14 Oregon State Board of Nursing Governor s Budget Program Descriptions Administration The nine Board Members are appointed by the Governor and include two public members, four Registered Nurses, one Licensed Practical Nurse, one Nurse Practitioner (to represent all advanced practice nursing types), and one Certified Nursing Assistant. The four RN members represent various areas of nursing practice as follows: one nurse educator, one nurse administrator, and two directcare nonsupervisory nurses. The Board members also represent a variety of geographic locations. Board members serve threeyear terms. The Board of Nursing meets monthly, holding a mixture of inperson and teleconferenced meetings. It may hold special meetings if necessary. Board meetings are open to the public and the schedule is listed on the Board s website. The Administration section supports the work of the Board and provides organizational leadership for the agency. Since assuming her position in February 214, the Executive Director continues to work closely with the Oregon Health Authority and other health regulatory boards to refine the Health Professionals Services Program (HPSP), which was instituted by the legislature in 29 to monitor impaired health professionals. Other administrative work includes streamlining internal procedures to ensure optimum performance and identifying outdated statutes for possible legislative remedies. Nursing Policy Analysts This section is responsible for any Boarddirected revisions of administrative rules, policies and interpretive statements; a robust outreach program to provide education regarding the Nurse Practice Act; periodic consultations with investigative staff; and, the approval of educational programs for nurses and nursing assistants. The Education Policy Analyst surveyed nine RN and LPN programs in FY 215 and six programs in FY 216. The Nursing Assistant Program Policy Analyst approved or surveyed 34 nursing assistant or medication aide programs in FY 216. An important function of this department is management of the training and testing program for Certified Nursing Assistants and Certified Medication Aides. Applications from graduates of approved certified nursing aide programs are reviewed, and examinations are administered in both a written and manual form for certification. This section also oversees the development and administration of Certified Medication Aide (CMA) examinations. In FY 216, 2,67 CNA written examinations and 3,194 skills examinations were administered, as well as 175 CMA examinations. Additionally, this department maintains the Nurse Aide Registry for nursing assistants in compliance with the Federal Omnibus Reconciliation Act of 1987 (OBRA). Communications This section includes the agency s public information and information technology efforts. Much of the Board s work in the coming biennium will center around improving customer service, both in licensing and investigations, and information technology will be key element. The agency s Microsoft CRM Dynamics database allows the creation of workflows and audit trails to track investigative, licensure, and administrative processes more effectively, and create greater efficiencies. Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 11 of 11

15 Oregon State Board of Nursing Governor s Budget This biennium, we will work to redesign the agency s online services (license renewals, endorsements, complaint intake, and license verification) and add exam applications. We plan to add mailing list requests and licensing statistics to the list of services as well. Concurrently, the agency s website will undergo a remodel according to the state s new web design. The Board s AutoVerification Service for employers continues to be a great success. Subscribers to the service receive automated updates regarding changes to licensure status, including discipline, for a prescribed list of licensees. Approximately 11,193 licensees have been entered into the system by 38 employers. Board staff also launched a wellreceived online service in December 215, called the Application Wizard, to keep applicants appraised of the status of their application as it moves through the licensure process. A similar service aimed at keeping licensees under investigation informed regarding the progress of their case launched in November 216. Licensing and Fiscal Services The Licensing/Fiscal department implements all licensing and certification activities for nurses, nursing assistants, medication aides, and advanced practice nurses. Demographic information obtained through the licensure and certification process is shared with Oregon s Office of Health Policy and Research and other state agencies to assist in workforce analysis and compliance with state law. This information is often relied upon by other states and national entities seeking to find solutions to nursing workforce issues. Licensing technicians provide service to the public and licensees, informing them about licensure procedures and the agency. The agency licenses approximately 61,5 nurses and 19, nursing assistants, about a 9 percent increase since 215. Law Enforcement Data System (LEDS) checks are performed on all initial and renewal licensure applications, and federal fingerprint checks are done on every initial application. In FY 216, approximately 47, LEDS checks were performed and 9,939 new licenses requiring fingerprint background checks were issued. The Licensing/Fiscal Manager, along with the Executive Director, leads the Board s operational infrastructure in budget, accounting, purchasing, and contracts. Investigations This department investigates complaints regarding violations of the Oregon Nurse Practice Act and assists the Board in determining appropriate disciplinary action. Investigators prepare cases for hearing and monitor nurses and nursing assistants who have had disciplinary action taken against their licenses. They interpret the legal scope of nursing practice for nurses, employers, allied health personnel, and the public. In FY 216, agency investigative staff handled 2,13 complaints, 67 of which were conductrelated. The remaining 1,47 were generated by LEDS checks of applications. As mentioned earlier, the Board is continuing to work with its regulatory partners to refine the Health Professionals Services Program (HPSP) to create greater efficiencies and streamline costs. Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 12 of 11

16 Oregon State Board of Nursing Governor s Budget Environmental Factors Any perceived nursing shortage currently is due to the geographical distribution of the workforce. Rural areas of Oregon are having trouble attracting healthcare workers of all types, while urban areas are experiencing a wealth of applicants. Although there is not a widespread shortage of nurses in Oregon at the moment, this will not always be the case. The expected growth of the older adult population in the U.S. over the next decade will have an unprecedented impact on the state s health care system. A major impact will be in terms of supply of and demand for health care workers, including nurses and nursing assistants. The supply of these health care providers is expected to decrease as large numbers of nurses and nursing assistants retire and/or reduce their working hours. At the same time, demand for such services will grow because older adults consume a disproportionate share of American health care services. The aging of the population also will affect the nature of the skills and services that the health care workforce must be educated to provide, as well as the settings in which this care is provided. A more pressing situation in Oregon is the shortage of nursing faculty that is causing potential students to be turned away from the state s nursing schools. According to the Oregon Center for Nursing in 215, 42 percent of nursing faculty are between 55 and 64 years old, and 12 percent are older than 65. Thirty percent of nurse educators plan to retire by 22, and other 2 percent plan to retire by 225. Without sufficient support for current nurse faculty and adequate incentives to encourage more nurses to become faculty, nursing schools will fail to have the teaching infrastructure necessary to educate and train the number of nurses that the state and nation will need in the coming decade. In addition, there is a need to reinvent nursing education to address the needs and values of and to appeal to a new generation of nurses. This work began several years ago in Oregon with the establishment of the Oregon Consortium of Nursing Education (OCNE), a new model of nursing education, and the utilization of clinical simulation centers that will adapt nursing education to meet the future healthcare needs of Oregonians. Continued funding of these new models will be important. The crossjurisdictional practice of nursing, which includes telehealth, is an issue sparking lively debate across the country. In this age of the internet, where a person can accomplish anything from scheduling their car maintenance to transferring money by using their cellphone, consumers expect the same accessibility from their healthcare providers. Healthcare systems are increasingly switching to medical records software to give patients fingertip access to their medical charts, regardless of their physical location. In addition, a growing number of healthcare workers are seeking increased portability of their license across state lines. States are grappling with the problem of allowing consumers the access they require and reducing barriers to workforce mobility, while still ensuring public safety. Oregon is no different. Legislation passed in 216 to allow the Oregon Board of Physical Therapists to enact the national physical therapist licensing compact, and the Oregon emergency medical technicians are pursuing the Emergency Medical Services Personnel Licensure Interstate Compact during this legislative session. In the coming biennium, the Board of Nursing will work with employers, labor, and other stakeholders to consider various paths forward, including the national nurse licensure compact. Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 13 of 11

17 Oregon State Board of Nursing Governor s Budget Agency Initiatives and Accomplishments: During the past biennium, the Board has worked diligently on strengthening and improving its internal processes. When the new Executive Director joined the agency in February 214, she identified a need for increased staff training. To that end, the agency worked to provide 41 staff members with updated job and career training in fiscal years 215 and 216. The agency also began an extensive process workflow examination to review and update job classifications, ensuring that staff duties are properly captured and compensated. In addition, the agency converted most of its licensee practice policies to interpretive guidelines, and is working to modernize outdated language in legislative statutes to better reflect current healthcare practices, especially in licensing, education, and advanced practice. Staff also refined the agency s existing Board member orientation program, creating a more robust training to acquaint new members with their responsibilities to the board and Oregonians. Criteria for Budget Development The biennial budget request reflects an Other Fund budget that stabilizes and enhances the agency s efforts to meet their mission and initiatives. The specific objectives of the budget development are as follows: 1. To ensure that all Board activities comply with both regulatory and legal requirements. 2. To maximize technology to improve customer service, respond to disciplinary issues in the most efficient manner possible, and ensure operational efficiency. 3. To ensure that the agency has an adequate operating reserve to meet salary and benefit increases in and to address unexpected financing issues as they arise during the biennium. Assumptions made in the budget development: 1. The overall budget increase at the Governor s Budget level over LAB is 8.76%, contributed by a 13.38% increase in personal services and a 7.98% increase in Services & Supplies costs. The primary driver in the increased S & S budget is inflation. 2. Revenues are expected to increase due to growth in the number of newly licensed nurses and those endorsing into the state. The Board has sufficient funds to cover both the Current Service Level Budget expenditures and a sufficient operating reserve amount. Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 14 of 11

18 Description Summary of Biennium Budget Nursing, Board of Governor's Budget Nursing, Board of Cross Reference Number: Biennium Positions FullTime Equivalent (FTE) ALL FUNDS General Fund Lottery Funds Other Funds Federal Funds Nonlimited Other Funds Nonlimited Federal Funds Leg Adopted Budget ,265,753 15,265, Emergency Boards 37,61 37, Leg Approved Budget ,573,363 15,573, Base Budget Adjustments Net Cost of Position Actions Administrative Biennialized EBoard, PhaseOut (1) (.9) 575, ,421 Estimated Cost of Merit Increase Base Debt Service Adjustment Base Nonlimited Adjustment Capital Construction Subtotal Base Budget ,148,784 16,148,784 Essential Packages 1 NonPICS Pers Svc/Vacancy Factor Vacancy Factor (Increase)/Decrease 28,838 28,838 NonPICS Personal Service Increase/(Decrease) 45,935 45,935 Subtotal 74,773 74,773 2 Phase In / Out Pgm & Onetime Cost 21 Phase In 22 Phaseout Pgm & Onetime Costs (74,95) (74,95) Subtotal (74,95) (74,95) 3 Inflation & Price List Adjustments Cost of Goods & Services Increase/(Decrease) 239,24 239,24 State Gov''t & Services Charges Increase/(Decrease) 116, ,381 1/2/17 Page 1 of 6 BDV14 Biennial Budget Summary 3:5 PM BDV14 Page 15 of 11

19 Description Summary of Biennium Budget Nursing, Board of Governor's Budget Nursing, Board of Cross Reference Number: Biennium Positions FullTime Equivalent (FTE) ALL FUNDS General Fund Lottery Funds Other Funds Federal Funds Nonlimited Other Funds Nonlimited Federal Funds Subtotal 355,45 355,45 4 Mandated Caseload 4 Mandated Caseload 5 Fundshifts and Revenue Reductions 5 Fundshifts 6 Technical Adjustments 6 Technical Adjustments Subtotal: Current Service Level ,54,867 16,54,867 1/2/17 Page 2 of 6 BDV14 Biennial Budget Summary 3:5 PM BDV14 Page 16 of 11

20 Description Summary of Biennium Budget Nursing, Board of Governor's Budget Nursing, Board of Cross Reference Number: Biennium Positions FullTime Equivalent (FTE) ALL FUNDS General Fund Lottery Funds Other Funds Federal Funds Nonlimited Other Funds Nonlimited Federal Funds Subtotal: Current Service Level ,54,867 16,54,867 7 Revenue Reductions/Shortfall 7 Revenue Shortfalls Modified Current Service Level ,54,867 16,54,867 8 EBoards 8 May 216 EBoard , ,123 Subtotal Emergency Board Packages , ,123 Policy Packages 81 September 216 Emergency Board 9 Analyst Adjustments 91 Statewide Adjustment DAS Chgs (55,4) (55,4) 92 Statewide AG Adjustment (52,943) (52,943) Subtotal Policy Packages (17,947) (17,947) Total Governor's Budget ,938,43 16,938,43 Percentage Change From Leg Approved Budget 2.8% 2.3% 8.76% 8.76% Percentage Change From Current Service Level 4.26% 4.26% 2.62% 2.62% 1/2/17 Page 3 of 6 BDV14 Biennial Budget Summary 3:5 PM BDV14 Page 17 of 11

21 Description Summary of Biennium Budget Nursing, Board of Governor's Budget Board Operations Cross Reference Number: Biennium Positions FullTime Equivalent (FTE) ALL FUNDS General Fund Lottery Funds Other Funds Federal Funds Nonlimited Other Funds Nonlimited Federal Funds Leg Adopted Budget ,265,753 15,265, Emergency Boards 37,61 37, Leg Approved Budget ,573,363 15,573, Base Budget Adjustments Net Cost of Position Actions Administrative Biennialized EBoard, PhaseOut (1) (.9) 575, ,421 Estimated Cost of Merit Increase Base Debt Service Adjustment Base Nonlimited Adjustment Capital Construction Subtotal Base Budget ,148,784 16,148,784 Essential Packages 1 NonPICS Pers Svc/Vacancy Factor Vacancy Factor (Increase)/Decrease 28,838 28,838 NonPICS Personal Service Increase/(Decrease) 45,935 45,935 Subtotal 74,773 74,773 2 Phase In / Out Pgm & Onetime Cost 21 Phase In 22 Phaseout Pgm & Onetime Costs (74,95) (74,95) Subtotal (74,95) (74,95) 3 Inflation & Price List Adjustments Cost of Goods & Services Increase/(Decrease) 239,24 239,24 State Gov''t & Services Charges Increase/(Decrease) 116, ,381 1/2/17 Page 4 of 6 BDV14 Biennial Budget Summary 3:5 PM BDV14 Page 18 of 11

22 Description Summary of Biennium Budget Nursing, Board of Governor's Budget Board Operations Cross Reference Number: Biennium Positions FullTime Equivalent (FTE) ALL FUNDS General Fund Lottery Funds Other Funds Federal Funds Nonlimited Other Funds Nonlimited Federal Funds Subtotal 355,45 355,45 4 Mandated Caseload 4 Mandated Caseload 5 Fundshifts and Revenue Reductions 5 Fundshifts 6 Technical Adjustments 6 Technical Adjustments Subtotal: Current Service Level ,54,867 16,54,867 1/2/17 Page 5 of 6 BDV14 Biennial Budget Summary 3:5 PM BDV14 Page 19 of 11

23 Description Summary of Biennium Budget Nursing, Board of Governor's Budget Board Operations Cross Reference Number: Biennium Positions FullTime Equivalent (FTE) ALL FUNDS General Fund Lottery Funds Other Funds Federal Funds Nonlimited Other Funds Nonlimited Federal Funds Subtotal: Current Service Level ,54,867 16,54,867 7 Revenue Reductions/Shortfall 7 Revenue Shortfalls Modified Current Service Level ,54,867 16,54,867 8 EBoards 8 May 216 EBoard , ,123 Subtotal Emergency Board Packages , ,123 Policy Packages 81 September 216 Emergency Board 9 Analyst Adjustments 91 Statewide Adjustment DAS Chgs (55,4) (55,4) 92 Statewide AG Adjustment (52,943) (52,943) Subtotal Policy Packages (17,947) (17,947) Total Governor's Budget ,938,43 16,938,43 Percentage Change From Leg Approved Budget 2.8% 2.3% 8.76% 8.76% Percentage Change From Current Service Level 4.26% 4.26% 2.62% 2.62% 1/2/17 Page 6 of 6 BDV14 Biennial Budget Summary 3:5 PM BDV14 Page 2 of 11

24 Nursing, Board of Agency Number: 851 Agencywide Program Unit Summary Version: Y 1 Governor's Budget Biennium Summary Cross Reference Number Cross Reference Description Actuals Leg Adopted Budget Leg Approved Budget Agency Request Budget Governor's Budget Leg Adopted Budget 1 Board Operations TOTAL AGENCY Other Funds 13,57,35 15,265,753 15,573,363 17,45,99 16,938,43 Other Funds 13,57,35 15,265,753 15,573,363 17,45,99 16,938,43 Agency Request X Governor's Budget Legislatively Adopted Biennium Page Agencywide Program Unit Summary BPR1 Page 21 of 11

25 Program Prioritization for Agency Name: Oregon Board of Nursing Biennium Agency Number: 851 Program/Division Priorities for Biennium Priority (ranked with highest priority first) Agency Initials Program or Activity Initials Program Unit/Activity Description Identify Key Performance Measure(s) Primary Purpose Program Activity Code GF LF OF NLOF FF NLFF TOTAL FUNDS Pos. FTE New or Enhanced Program (Y/N) Included as Reduction Option (Y/N) Legal Req. Code (C, D, FM, FO, S) Legal Citation Explain What is Mandatory (for C, FM, and FO Only) Comments on Proposed Changes to CSL included in Agency Request Agcy Prgm/ Div 851 OSBN OSBN Agency wide OSBN 3 16,938,43 $ 16,938, N Y $ $ $ $ $ $ $ 16,938,43 $ 16,938, Within each Program/Division area, prioritize each Budget Program Unit (Activities) by detail budget level in ORBITS Document criteria used to prioritize activities: 7. Primary Purpose Program/Activity Exists 19. Legal Requirement Code 1 Civil Justice C Constitutional 2 Community Development D Debt Service 3 Consumer Protection FM Federal Mandatory 4 Administrative Function FO Federal Optional (once you choose to participate, certain requirements exist) 5 Criminal Justice S Statutory 6 Economic Development 7 Education & Skill Development 8 Emergency Services 9 Environmental Protection 1 Public Health 11 Recreation, Heritage, or Cultural 12 Social Support Program 1 Page 22 of 11 17BF23

26 Oregon State Board of Nursing Governor s Budget Reduction Options ACTIVITY OR PROGRAM DESCRIBE REDUCTION AMOUNT AND FUND TYPE RANK AND JUSTIFICATION Health Professionals Services Program (HPSP) Since the Board of Nursing successfully transferred all Nurse Monitoring Program participants to HPSP in July 21, the number of participants has steadily declined. The number of participants as of July 25, 216, is 12 (94 Boardreferred and eight selfreferred). With the transfer of NMP participants to the HPSP, the cost has more than doubled. Transfer participants to probation Total Reduction Amount The estimated cost of the program during is $1,643,453. The estimated cost per participant is $13,253. Elimination of HPSP program participation would result in program participants being placed on probation. Two additional compliance monitors would need to be hired at a cost of approximately $337, per biennium, resulting in an overall savings of $1,36,453. OF $1,36,453 OF $1,36,453 Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 23 of 11

27 Oregon State Board of Nursing Governor s Budget This page intentionally left blank Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 24 of 11

28 Oregon State Board of Nursing Governor s Budget Current Staffing Organization Chart (21517) Governor State Board of Nursing Executive Director PEM F 1 Position Human Resources Manager HR Analyst 3 1 Position Executive Assistant Executive Assistant 1 Position Organizational Development Manager PEM.5 Position Administrative Specialist 1 1 Position Administrative Specialist 1 1 Position Investigations Licensing/Fiscal Communications Nursing Policy Investigations Manager PEM D 1 Position Licensing/Fiscal Manager PEM D 1 Position Communications Manager PEM E 1 Position Nursing Education Operations Policy Analyst 4 1 Position Nurse Investigators 4 Positions Investigator 3 7 Positions Accountant 1 1 Position Accounting Tech 2 1 Position Database Administrator Info Systems Specialist 8 1 Position APRN Operations Policy Analyst 4.8 Position Admin Specialist 1 3 Positions Admin Specialist 2 3 Positions Public Service Rep 3 8 Positions Administrative Specialist 1 1 Position Network Administrator Info Systems Specialist 7 1 Position NA Training Operations Policy Analyst 4 1 Position Compliance Specialist 3 1 Position Compliance Specialist 2 2 Positions LEDS Coordinator 1 Position LEDS Assistant.5 Position IT Specialist Info Systems Specialist 6 1 Position Nursing Practice Operations Policy Analyst 4 1 Position Operations Policy Analyst 2 1 Position Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 25 of 11

29 Oregon State Board of Nursing Governor s Budget Proposed Staffing Organization Chart (217219) Governor State Board of Nursing Executive Director PEM F 1 Position Human Resources Manager HR Analyst 3 1 Position Executive Assistant Executive Assistant 1 Position Administrative Specialist 1 1 Position Administrative Specialist 1 1 Position Investigations Licensing/Fiscal Communications Nursing Policy Investigations Manager PEM D 1 Position Licensing/Fiscal Manager PEM D 1 Position Communications Manager PEM E 1 Position Nursing Education Operations Policy Analyst 4 1 Position Nurse Investigators 4 Positions Investigator 3 7 Positions Accountant 1 1 Position Accounting Tech 2 1 Position Database Administrator Info Systems Specialist 8 1 Position APRN Operations Policy Analyst 4.8 Position Admin Specialist 1 3 Positions Admin Specialist 2 3 Positions Public Service Rep 3 8 Positions Administrative Specialist 1 1 Position Network Administrator Info Systems Specialist 7 1 Position NA Training Operations Policy Analyst 4 1 Position Compliance Specialist 3 1 Position Compliance Specialist 2 2 Positions LEDS Coordinator 1 Position LEDS Assistant.5 Position IT Specialist Info Systems Specialist 6 1 Position Nursing Practice Operations Policy Analyst 4 1 Position Operations Policy Analyst 2 1 Position Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 26 of 11

30 Nursing, Board of Agency Number: 851 Agencywide Program Unit Summary Version: Y 1 Governor's Budget Biennium Summary Cross Reference Number Cross Reference Description Actuals Leg Adopted Budget Leg Approved Budget Agency Request Budget Governor's Budget Leg Adopted Budget 1 Board Operations TOTAL AGENCY Other Funds 13,57,35 15,265,753 15,573,363 17,45,99 16,938,43 Other Funds 13,57,35 15,265,753 15,573,363 17,45,99 16,938,43 Agency Request X Governor's Budget Legislatively Adopted Biennium Page Agencywide Program Unit Summary BPR1 Page 27 of 11

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32 Oregon State Board of Nursing Governor s Budget REVENUES Revenue Forecast Narrative Revenue Sources The Oregon State Board of Nursing is primarily supported (93%) by Other Fund revenues generated from examination, licensing and renewal application fees charged to registered nurses (RN), licensed practical nurses (LPN), nurse practitioners, certified registered nurse anesthetists (CRNA), clinical nurse specialists (CNS), certified nursing assistants (CNA), and certified medication aides (CMA). In addition, the Board receives federal matching revenue (7%) through the Department of Human Services. Additional sources include the sale of documents, employer subscription fees, and civil penalty fees. Match Rates The Board of Nursing has the statutory authority to regulate nursing assistants in Oregon in compliance with the Federal Omnibus Reconciliation Act of 1987 (OBRA). Funding for the CNA Program is received through an agreement with the Department of Human Services Seniors and People with Disabilities Division. This consists of a Title XVIII (Medicare) grant, which requires no matching funds, and a Title XIX (Medicaid) grant that requires matching funds to be collected by the Board of Nursing. For the biennium, the matching rate for the CNA Program is 2:1 for Title XIX funding and the Title XVIII grant covers approximately 6% in related CNA program costs. Match Funds from Seniors and People with Disabilities Division The Board is expected to receive a net of $1.63 million in matching revenue from the Seniors and People with Disabilities division of DHS. Programs Funded All agency programs are funded primarily through Other Funds revenues. Those program elements that serve a specific group of licensees are funded only through fees from that group. General Limitations on Use ORS directs that all money received by the Board be used only for the administration and enforcement of ORS to Basis for the Estimates The Board made the following assumptions in projecting the revenue estimates for the biennial budget: RN/LPN Licensure Fees Licensure fee projections are based on the actual number of RN, LPN, and advanced practice licenses issued in the current biennium and the prior two biennia. A linear trend analysis was applied to the data and then adjusted for certain programmatic variables, resulting in an increase in base revenue for of 1%. The Oregon State Board of Nursing's major source of revenue is nurse licensure fees, and the majority of that amount (66%) comes from the renewal of licenses. The number of active nursing licenses has grown steadily since the early 199 s, at a rate of about 23% per year. On July 21, 216, the number of registered and practical nurses was 61,487. The number of new applicants continues to grow dramatically each year. The number of advanced practice nurses also continues to grow; although the Board licenses approximately 4,6 advanced practice nurses, the revenues constitute less than 5% of agency license revenues. The Board is also collecting prescription monitoring fund _ Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 28 of 11

33 Oregon State Board of Nursing Governor s Budget fees for advanced practitioners with prescriptive authority, and is retaining 1% to cover administration costs. Since February 211, the Board has collected $5 for each license renewal for workforce development needs; the Board transfers those funds to the Oregon Health Authority. As of July 1, 216, that amount decreased to $4 for each license renewal. Since September 1, 215, the Board has collected $9 for each RN and LPN license renewal and exam application for the Nursing Advancement Fund; endorsement applications were added as of July 1, 216. Nursing Assistant Certification Fees Certification fee projections are based on the number of nursing assistant and medication aide certificates issued in the current and the prior two biennia, and projected activity. Examination fee projections are based on historical and projected licensure and certification activity. The number of active CNAs has held steady at about 19,. The Board expects to collect $1.88 million in CNA revenue during the biennium and $1.89 million during the biennium. The primary revenue generating factors for CNAs are renewal and examination fees. Civil Penalties Revenue projections are based on historical data and projected activity. Approximately $156, in civil penalty revenue is projected for this biennium. Revenue generated by civil penalties includes Boarddirected discipline for practicing without a current license. Others Revenue projections are based on historical data and projected activity. Other revenue consists of miscellaneous items such as Nurse Practice Act sales and Board meeting packet subscriptions. Charges for Services In 25, the agency received statutory authority to fingerprint applicants for new licenses. The program began in January 28 and during the 279 biennium, we had processed approximately 14, fingerprint cards. That number has steadily increased. The Board transitioned to accepting livescan fingerprint files in September 215 to be in compliance with new statewide requirements, making the process more efficient and costeffective. Proposed Changes in Revenue Sources or Fees None. Proposals for Legislative Changes None. _ Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 29 of 11

34 Oregon State Board of Nursing Governor s Budget Detail of Lottery Funds, Other Funds, and Federal Funds Revenue ORBITS Source Fund Revenue Acct Actual Legislatively Legislatively Adopted Approved Agency Request Governor s Legislatively Adopted Business Licenses and Fees OF 25 12,961,467 13,757,843 13,757,843 13,769,592 13,769,592 Nonbusiness Licenses and Fees OF 21 4,35 26, 26, 26, 26, Charges for Services Fines and Forfeitures Transfer from DHS (SPD) OF OF OF ,85,268 91,214 2,65,369 1,487,46 22, 2,924,34 1,487,46 22, 2,924,34 1,557,323 18, 3,11,755 1,557,323 18, 3,11,755 Transfer to DHS OF 21 (1,24,153) (1,455,94) (1,455,94) (1,385,878) (1,385,878) Transfer to OHA OF 2443 (456,18) (52,978) (52,978) (536,828) (536,828) TOTAL $15,123,2 $16,457,211 $16,457,211 $16,621,964 $16,621,964 $ 17BF7 _ Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 3 of 11

35 DETAIL OF LOTTERY FUNDS, OTHER FUNDS, AND FEDERAL FUNDS REVENUE Nursing, Board of Agency Number: Biennium Cross Reference Number: 851 Source Actuals Leg Adopted Budget Leg Approved Budget Agency Request Budget Governor's Budget Leg Adopted Budget Other Funds Business Lic and Fees Nonbusiness Lic. and Fees Charges for Services Fines and Forfeitures Tsfr From Human Svcs, Dept of Tsfr To Human Svcs, Dept of Tsfr To Oregon Health Authority Total Other Funds 12,961,467 13,757,843 13,757,843 13,769,592 13,769,592 4,35 26, 26, 26, 26, 1,85,268 1,487,46 1,487,46 1,557,323 1,557,323 91,214 22, 22, 18, 18, 2,65,369 2,924,34 2,924,34 3,11,755 3,11,755 (1,24,153) (1,455,94) (1,455,94) (1,385,878) (1,385,878) (456,18) (52,978) (52,978) (536,828) (536,828) $15,123,2 $16,457,211 $16,457,211 $16,621,964 $16,621,964 Agency Request X Governor's Budget Legislatively Adopted Biennium Page Detail of LF, OF, and FF Revenues BPR12 Page 31 of 11

36 DETAIL OF LOTTERY FUNDS, OTHER FUNDS, AND FEDERAL FUNDS REVENUE Nursing, Board of Agency Number: Biennium Cross Reference Number: 8511 Source Actuals Leg Adopted Budget Leg Approved Budget Agency Request Budget Governor's Budget Leg Adopted Budget Other Funds Business Lic and Fees Nonbusiness Lic. and Fees Charges for Services Fines and Forfeitures Tsfr From Human Svcs, Dept of Tsfr To Human Svcs, Dept of Tsfr To Oregon Health Authority Total Other Funds 12,961,467 13,757,843 13,757,843 13,769,592 13,769,592 4,35 26, 26, 26, 26, 1,85,268 1,487,46 1,487,46 1,557,323 1,557,323 91,214 22, 22, 18, 18, 2,65,369 2,924,34 2,924,34 3,11,755 3,11,755 (1,24,153) (1,455,94) (1,455,94) (1,385,878) (1,385,878) (456,18) (52,978) (52,978) (536,828) (536,828) $15,123,2 $16,457,211 $16,457,211 $16,621,964 $16,621,964 Agency Request X Governor's Budget Legislatively Adopted Biennium Page Detail of LF, OF, and FF Revenues BPR12 Page 32 of 11

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38 Oregon State Board of Nursing Governor s Budget PROGRAM UNITS Essential and Policy Package Narrative and Fiscal Impact Summary The Essential Packages represent changes made to the budget that estimates the cost to continue current legislatively approved programs into the biennium. 1 NonPICS Personal Services /Vacancy Factor Vacancy Factor (attrition) adjusted the PICS generated personal services budget for the current positions. The adjustment represents the projected savings from staff turnover that occurs throughout a biennium. This package contains only the change from the prior approved budget. NonPICS related items include the cost of inflation for temporary, overtime, shift differentials, unemployment assessment and mass transit taxes (rate.6 times personal services budget amount). This package reflects the inflation increase for these items at 2.27%. PERS Bond Contribution represents the amount budgeted for the budget in accordance with the Department of Administrative Services instructions. The Pension Bond Debt Contribution has increased by $43,171 over the LAB, based on the amount calculated by the Department of Administrative Services. Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 33 of 11

39 Oregon State Board of Nursing Governor s Budget 3, 31, 32 Inflation & Price List Adjustments The majority of the Costs of Goods and Services expenses are increased by 3.7%, the standard inflation amount allowed by the Department of Administrative Services. In addition to the standard inflation rate, some categories are allowed an adjusted inflation rate. The current service level budget includes a 5.7% increase in Attorney General rates, 6.9% increase in Facilities Rent and % increase in central Hearings. NonState Government Service Charges LAB GB Difference % Change Department of Justice 712, ,891 4, % Central Hearings 185, 185,.% Facilities Rent 452,37 483,228 31, % Total 1,349,282 1,421,119 71, % Agency Request X Governor s Budget Legislatively Adopted Budget Page Page 34 of 11