A State may submit an annual plan for the recruitment and retention
of U.S. citizens and permanent resident aliens who are authorized to
perform nursing services in the State.
(a) Who should prepare and file the annual plan? The Governor of
each State that chooses to submit an annual State plan shall be
responsible for the preparation and filing of the annual plan. The
Governor may designate any public and/or private organization(s) to
assist the Governor in the development of the annual plan.
(b) When and where should the annual plan be filed? If a State
determines to file an annual State plan, the Governor shall submit the
original plan, signed by the Governor, by U.S. mail or private carrier,
to ETA at the following address: Director, U.S. Employment Service,
Employment and Training Administration, Department of Labor, 200
Constitution Avenue, NW., room N-4456, Washington, DC 20210. An annual
State plan may be filed with ETA at any time. However, for an individual
facility legitimately to attest to being subject to an annual State plan
for the purposes of the fourth attestation element, Alternative II (see
Sec. 655.310(g)(2)), such annual State plan shall have been approved
prior to the date the attestation was submitted to ETA for filing and be
in current effect. Therefore, if the Governor is aware that a facility
within the State plans to submit an attestation for filing with ETA, the
annual State plan should be mailed to ETA at least 35 days prior to the
facility's submission of its attestation to ETA.
(c) What overall issues shall the annual State plan address? The
annual State plan shall address the overall issue of supply of and
demand for nurses within the State, with particular emphasis on measures
to develop a sufficient supply of U.S. nurses to meet projected demand.
The State, as opposed to individual facilities, is in a position to--and
may be expected to--address broad issues and perform such functions as
conducting a Statewide needs assessment; overall management,
facilitation and coordination among various interested entities within
the State; and undertaking more regionally based approaches. The State
is also in a position to devote resources which individual facilities
may be lacking.
(d) How should the annual State plan address the timely and
significant steps? The annual State plan shall address all of the timely
and significant steps in Sec. 655.310(g)(1)(i)(A)(1) through
(g)(1)(i)(A)(5) generically, without regard to the specific criteria
therein, on a Statewide basis. However, for the annual State plan to
satisfy Alternative II of the fourth attestation requirement for an
individual facility (see Sec. 655.310(g)(2)), the annual State plan
shall indicate which of those timely and significant steps relate to
individual facilities, and that each individual facility shall take such
a step (either one step or more, as appropriate) to meet the appropriate
specific criteria as set forth in Sec. 655.310(g)(1).
(e) What other components may the annual State plan include? An
annual State plan may include the following components:
(1) The cooperation of high schools and colleges may be enlisted in
counseling health workers and other individuals to enter the nursing
profession.
(2) Geographic and salary data may be made available to assist in
linking nurses to facilities.
(3) Publications of vacancies and programs may be made in industry
and State newsletters.
(4) Training films and videotapes, as well as information on housing
and relocation services, may be developed and distributed.
(5) Measures may be taken to encourage other health professionals to
become nurses, such as: setting up home study programs with State
licensing boards to allow work credits for purposes of meeting
educational or State
clinical requirements; entering into cooperative agreements for
providing health care insurance and other job-related elements which
would allow greater flexibility for those attempting to combine careers
and school; providing monetary grants or long-term loans to persons
preparing to become nurses.
(6) Steps may be taken to encourage nurses who have left the nursing
field to return to nursing, by providing such inducements as child care,
holiday schedule adjustments, and substantial salary increases.
(7) The State may profile and publicize those facilities with
special model programs.
(8) The annual State plan may place demands on facilities for
comprehensive plans to reduce reliance on foreign nurses.
(f) Approval and disapproval of annual State plans. Determinations
of approval and disapproval of annual State plans shall be made by the
Director, USES. The annual State plan shall be reviewed by ETA, in
consultation with the Department of Health and Human Services, and a
determination to approve or disapprove the annual State plan made within
30 calendar days of ETA's receipt of the plan.
(1) If the annual State plan is approved, the Director shall notify
the Governor in writing.
(2) If the annual State plan is disapproved, the Director shall
notify the Governor in writing, specifying the reason(s) for
disapproval. The notice shall state that within 30 calendar days of the
date of the notice of disapproval, the Governor may correct the
deficiencies noted in the disapproval and resubmit the annual State plan
to ETA; and shall inform the state of its right to an appeal, by quoting
the language of Sec. 655.320(a).
(g) An approved annual State plan shall be valid for 12-month period
beginning on the date of its approval by DOL.
(Approved by the Office of Management and Budget under control number
1205-0305)
