Office of Rural Health and Primary Care 2019 Missouri Nurse Student Loan and Loan Repayment Report 1 Table of Contents Introduction ........................................................................................................................................................... 3 Nurse Student and Loan Repayment Funding Allocation ....................................................................................... 4 2019 Nurse Student Loan (NSL) Program ............................................................................................................... 4 2019 NSL Program Recipients Financial Awards ....................................................................................................... 4 Figure 1: NSL Program Recipients Amount Awarded ............................................................................................ 4 2019 NSL Program Recipients by Degree Type ......................................................................................................... 5 Figure 2: Percentage NSL Program Recipients by Degree Type ........................................................................... 5 2019 NSL Program Recipients by Gender .................................................................................................................. 5 Figure 3: NSL Program Recipients by Gender ....................................................................................................... 5 2019 NSL Program Recipients by Age Group and Degree/License Type ................................................................... 6 Figure 4: NSL Program ADN Age Groups ............................................................................................................... 6 Figure 5: NSL Program BSN Age Groups ............................................................................................................... 6 Figure 6: NSL Program LPN Age Groups ................................................................................................................ 7 Figure 7: NSL Program MSN by Age Groups ......................................................................................................... 7 2019 Nurse Loan Repayment Program (NLRP) Recipients ...................................................................................... 8 2019 NLRP Program Recipients Financial Awards ..................................................................................................... 8 Figure 8: NLRP Program Recipients Amount Awarded ......................................................................................... 8 2019 NLRP Recipients by Degree Type ...................................................................................................................... 8 Figure 9: NLRP Recipients by Degree Type ........................................................................................................... 8 2019 NLRP Recipients by Gender .............................................................................................................................. 9 Figure 10: NLRP Recipients by Gender .................................................................................................................. 9 2019 NLRP Recipients by Age Group and Degree/License Type ............................................................................... 9 Figure 12: ADN NLRP Recipients by Age Group .................................................................................................... 9 Figure 13: BSN NLRP Recipients by Age Group ................................................................................................... 10 Figure 14: MSN NLRP Recipients by Age Group .................................................................................................. 10 2019 NLRP Recipients by Employer Setting ............................................................................................................ 11 Figure 15: NLRP Recipients by Employer Setting ................................................................................................ 11 Figure 16: NLRP Recipients Rural/Urban County Type ....................................................................................... 11 2014-2018 Default Rate for NSL and NLRP Recipients .......................................................................................... 12 Default Rate for NSL and NLRP Recipients Receiving Awards between 2014 and 2018 ......................................... 12 Figure 17: NSL and NLRP Default Rates .............................................................................................................. 12 2019 NSL and NLRP Currently Serving by County ................................................................................................. 12 Summary of Findings ........................................................................................................................................... 19 2 Introduction The Department of Health and Senior Services (DHSS), Office of Rural Health and Primary Care (ORHPC) administers two (2) Nurse Loan and Loan Repayment programs designed to increase access to care for Missourians in Health Professional Shortage Areas (HPSA). These programs recruit and retain nurses by awarding loans to help students and currently licensed nurses pay for eligible educational expenses or debt. The applicants are chosen based on a competitive subjective review with the HPSA designation and financial need as the most prevalent criteria. The Nurse Student Loan (NSL) Program awards funding for eligible educational expenses to qualified students pursuing careers as Licensed Practical Nurses or Professional Nurses in Missouri, in exchange for providing nursing services in a Missouri hospital or HPSA. Missouri residents, who are pursuing a Practical Nursing (PN) Degree, and the following Professional Nursing Degrees/Programs: Diploma in Nursing (DN), Associate Degree in Nursing (ADN), Bachelor of Science Degree in Nursing (BSN), Master of Science Degree in Nursing (MSN), and Doctor of Nursing Practice (DNP) Degree may qualify for a NSL. Throughout this report, reference may be made to a Registered Nurse (RN) or an Advanced Practice Registered Nurse (APRN). A RN may hold either a DN, ADN, or BSN. An APRN may hold a MSN or DNP. Upon graduation and licensure, the NSL recipients earn forgiveness by providing nursing health care services for one year, per loan. The award amounts include a one-time payment of $2,500 for Practical Nursing Degree students and $5,000, per academic year until graduation for Professional Nursing Students. Practical Nursing Students only receive one award. The Professional Nursing Students must apply every year to receive funding throughout their educational careers. The Nurse Loan Repayment Program (NLRP) awards funding for the repayment of eligible educational student loan debt for qualified Missouri Professional Nurses, in exchange for providing nursing services in a Missouri hospital or HPSA. If you are a licensed Missouri Professional Nurse and a Missouri resident, you may qualify for a NLRP award. The NLRP recipients earn forgiveness by providing nursing health care services for two-years, per loan award. Professional Missouri Registered Nurses (RN) receive $10,000, per loan award. The Advanced Practice Nurses (APN, NP, CRNA, and FNP) receive $20,000, per loan award. The NLRP recipients who continue to have qualifying educational debt may apply for an additional loan, after serving their two- year service obligation. The Office of Rural Health and Primary Care 2019 Missouri Nurse Student Loan and Loan Repayment Report demonstrates the characteristics and demographic depictions of NSL and NLRP recipients. 3 Nurse Student and Loan Repayment Funding Allocation The funding sources allocated for the Nursing programs include the Practical and Professional Nursing licensing fees, repayment of funds from recipients defaulting on their loan obligation, and the tax intercepts from the defaulting recipients. Missouri General Assembly authorizes the amount of funding utilized through appropriation of funds. The total amount expended for 2019 was $850,635, of which $202,500 was allocated for the NSL Program recipients, and $648,135 was allocated for the NLRP recipients. The NLRP recipients receive a larger award amount, as compared to the NSL program, and thereby require additional funds. In 2019, even though there was not an equal amount of funds allocated for each program, 43 NSL Program recipients and 45 NLRP recipients received a loan award. 2019 Nurse Student Loan (NSL) Program 2019 NSL Program Recipients Financial Awards The total amount expended for the NSL Program was $202,500. The students pursuing a BSN were awarded the majority of the NSL funds, among all nursing degree types. Figure 1: NSL Program Recipients Amount Awarded by Degree Type 2019 NSL Award Amount $10,000.00 $17,500.00 $5,000.00 ■ ADN ■ BSN ■ LPN ■ MSN $170,000.00 4 2019 NSL Program Recipients by Degree Type The students pursuing a BSN received the majority of 2019 student loans. Figure 2: Percentage NSL Program Recipients by Degree Type 2019 NSL Program Recipients by Degree Type 80.00% 77% 70.00% 60.00% 50.00% 40.00% 30.00% 16% 20.00% 5% 2% 10.00% 0.00% ■ ADN ■ BSN ■ LPN ■ MSN 2019 NSL Program Recipients by Gender Female students pursuing their BSN were awarded the majority of funds. Female students were awarded the majority of awards among all types of degrees. The only male students to receive an award were those pursuing a BSN. Figure 3: NSL Program Recipients by Gender 2019 NSL Program Recipents by Gender 66% 70.0% 60.0% 50.0% 40.0% 16% 30.0% 11% 2% 20.0% 5% 10.0% 0.0% Male Female ■ ADN ■ BSN ■ LPN ■ MSN 5 2019 NSL Program Recipients by Age Group and Degree/License Type Among all the age groups and all the degree types, the students between the ages of 20 and 25 were awarded the majority of loans. For students pursuing an ADN, all recipients were between the ages of 20 and 25 and between the ages of 31 and 35. Figure 4: NSL Program ADN Age Groups 2019 NSL Program ADN Age Groups 3% 3% 2% 3% 2% 2% 1% 1% 0% ■ 20-25 ■ 26-30 ■ 31-35 ■ 36-40 ■ 41-45 ■ 46-50 ■ 51 and Older For students pursuing a BSN, the majority of the recipients were between the ages of 20 to 25. Figure 5: NSL Program BSN Age Groups 2019 NSL Program BSN Age Groups 38% 40.0% 35.0% 26% 30.0% 25.0% 20.0% 15.0% 2% 5% 2% 2% 10.0% 2% 5.0% 0.0% ■ 20-25 ■ 26-30 ■ 31-35 ■ 36-40 ■ 41-45 ■ 46-50 ■ 51 and Older 6 For students pursuing a LPN, the majority of recipients were between the ages of 26-30. Figure 6: NSL Program LPN Age Groups 2019 NSL Program LPN Age Groups 6% / ,,, / 6% / ,--- 5% ,,,;/ 4% ~--- 2% ~~ 2% 2% 2% 2% 3% 2% 1% / / / 0% ■ 20-25 ■ 26-30 ■ 31-35 ■ 36-40 ■ 41-45 ■ 46-50 ■ 51 and Older For students pursuing a MSN, all recipients were between the ages of 26-30. Figure 7: NSL Program MSN by Age Groups 2019 NSL Program MSN Age Groups 2% 2% 2% 1% 1% 0% ■ 20-25 ■ 26-30 ■ 31-35 ■ 36-40 ■ 41-45 ■ 46-50 ■ 51 and Older 7 2019 Nurse Loan Repayment Program (NLRP) Recipients 2019 NLRP Program Recipients Financial Awards The total amount expended for the NLRP was $668,135. The NLRP recipients with MSN degrees were awarded the majority of funds. Figure 8: NLRP Program Recipients Amount Awarded 2019 NLRP Total Amount Awarded $121,038.00 $460,000.00 • ADN $87,097.00 • BSN • MSN 2019 NLRP Recipients by Degree Type The NLRP recipients with MSN degrees received the majority of awards. Figure 9: NLRP Recipients by Degree Type 2019 NLRP Recipients by Degree Type 49% 50% 29% 40% 22% 30% 20% 10% 0% ■ ADN ■ BSN ■ MSN 8 2019 NLRP Recipients by Gender The female NLRP recipients with MSN degrees received the majority of awards. The male NLRP recipients with ADNs, were the only males who received an award in 2019. Figure 10: NLRP Recipients by Gender 2019 NLRP Recipents by Gender 49% 50.0% 40.0% 22% 22% 30.0% 20.0% 7% 10.0% 0.0% Male Female ■ ADN ■ BSN ■ MSN 2019 NLRP Recipients by Age Group and Degree/License Type For the NLRP recipients with ADNs, the majority of the recipients were between the ages of 31-35. Figure 12: ADN NLRP Recipients by Age Group 2019 ADN 9% 10% 7% 8% 5% 6% 2% 2% 2% 2% 4% 2% 0% ADN ■ 21-25 ■ 26-30 ■ 31-35 ■ 36-40 ■ 41-45 ■ 46-50 ■ 51-55 ■ 56 and Older 9 For the NLRP recipients with BSNs, the majority of the recipients were between the ages of 36-40. Figure 13: BSN NLRP Recipients by Age Group 2019 BSN 12% , , , ,, ,, ,, rr 11% 10% , / , r , , , / ,,. 8% _,,/ , ,, 4% 3% 6% , , , , 2% , 2% 4% , , , , 2% / ;l';l';l';I' 0% BSN ■ 21-25 ■ 26-30 ■ 31-35 ■ 36-40 ■ 41-45 ■ 46-50 ■ 51-55 ■ 56 and Older For the NLRP recipients with MSNs, the majority of recipients were between the ages of 31-35. Figure 14: MSN NLRP Recipients by Age Group 2019 MSN , , 20% / , 20% , , , / 15% 11% / 10% / 7% / 4% 5% 2% 5% , , , 0% ■ 21-25 ■ 26-30 ■ 31-35 ■ 36-40 ■ 41-45 ■ 46-50 ■ 51-55 ■ 56 and Older 10