Recently signed bill aims to strengthen Arizona’s nurse workforce by intervening at every step of the pipeline


Soraya Marashi


House Bill 2691, signed by Gov. Doug Ducey on June 29th, will appropriate $15.5 million from the state General Fund (GF) to the Arizona Department of Health Services (ADHS) in fiscal years 2023 through 2025, and $32 million from the state GF to the Arizona Health Care Cost Containment System (AHCCCS) over the same period.


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The funding is to be used for healthcare workforce grant programs, placing special emphasis on the nursing profession. Provisions in the bill call for the establishing of the Arizona Nurse Education Investment Pilot Program, or the Nurse Program, within ADHS, for which $15 million from the state GF is allocated between FYs 2023 and 2025. 

According to Heather Ross, PhD, Government Affairs Officer at the Arizona Nurses Association (AzNA), the programs in HB 2691 will bolster the nursing workforce by providing funding at every step of the nursing workforce pipeline.

“[The bill addresses] graduating new nurses by expanding both pre-licensure education at our colleges and universities and the clinical preceptorships that give nursing students the hands-on experience they need, supporting the training of advanced practice nurses (nurse practitioners, clinical nurse midwives, nurse anesthetists, and clinical nurse specialists) by supporting hands-on preceptorships, and transition-to-practice programs for new nurses working in hospitals and other healthcare settings to help keep new nurses in the profession and caring for patients at the bedside,” Ross told State of Reform.

The Nurse Program aims to increase the capacity of nursing education programs at local public universities and community colleges in Arizona by, according to the bill text, “… fostering collaboration among the health care community, educational community, and government entities,” with the goal of increasing the number of all levels of nurses graduating from the state’s nursing education programs between FY 2022 and 2027. 

HB 2691 also provides $27 million from the state GF each year between FYs 2023 and 2025 for AHCCCS’s Student Nurse Clinical Rotation and Licensed or Certified Nurse Training Pilot Program. AHCCCS is required to use this funding to provide grants to licensed healthcare institutions to expand clinical training placements for nursing students.

The bill also allows AHCCCS to use up to $2 million from the Student Nurse Clinical Rotation and Licensed or Certified Nurse Training Pilot Program appropriation as a grant to a statewide hospital association to implement a Licensed Registered Nurse Transition to Practice Program. 

Much of the funding included in HB 2691 is intended to address the statewide nursing workforce shortages that have seen drastic levels during the pandemic. As of January 2022, Arizona ranked in the top 5 states with the most severe healthcare staffing shortages, and demand for specialized nurses is projected to grow by 23% by 2025. 

Ross said AzNA will continue to advocate for the state’s nurse workforce in next year’s legislative session.

“While AzNA is focused on nursing, we know that healthcare is a team effort and we need the entire team working together to serve our patients and communities,” she said. “At the end of the day, our policy strategy is doubly focused on nurses and patients, so we take an all-hands-on-deck approach to make Arizona a great place for students to become nurses, for new nurses to become expert nurses, and for all Arizonans to know that when they need us, they’ll have a strong nurse there to care for them …

Regarding funding, we were pleased that the 2022 legislation, HB 2691, included funding over three years, so the extensive programs enabled in the 2022 budget aren’t a one-and-done effort. We are working closely with partners statewide to ensure that those programs are launched successfully and yield workforce gains for our state.”

Dawna Cato, PhD, CEO of AzNA, highlighted AzNA’s legislative priorities moving forward in an interview with State of Reform at our 2022 Arizona conference in May.

“The Arizona Nurses Association is really concerned about our workforce, not only at our state level but at our national level,” she said. “We’re keeping an eye on policy that affects the workforce, that supports the recruitment and retention of nurses, as well as policies that help us expand to reach our full potential and practice at the highest licensure … to better serve our patient populations.”

Cato said AzNA is also focused on initiatives to recruit more school nurses in the state and support their psychological wellbeing.