MN506 Unit 3 legislative process analysis example

From a Dean's Testimony to a Capped, Sunsetting Tax Credit: A Legislative Process Analysis of a Nurse Preceptor Incentive Bill

[Student Name]

Purdue University Global

MN506: Health Policy, Ethics, and Legal

Unit 3 Assignment

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[Date]

The state, bill, legislators and figures are composites written as a model document. Frameworks and other states' programs cited are real.

Timeline

January, year 1: the state nurses association's lobby day, where the dean of the state university's school of nursing testifies to legislators. February, year 1: House Bill 1187 introduced; referred to the House Health committee; no hearing. January, year 2: reintroduced; hearing held; amended and passed by House Health. February, year 2: fiscal note prices the original credit at 3.2 million dollars a year; bill referred to Ways and Means. March, year 2: Ways and Means amends and passes it; House floor passage. April, year 2: Senate Finance amends; Senate passes; House concurs. May, year 2: governor signs. January, year 3: credit takes effect under a revenue department rule.

Framing the Analysis

Longest (2016) describes policymaking as three interconnected phases: formulation, in which problems, possible solutions and political circumstances come together to produce legislation; implementation, in which agencies turn laws into rules and operations; and modification, in which experience with a policy feeds back into changes. The sections below follow the bill through those phases in the order it met them.

Problem Definition

The problem entered the process through testimony. The dean told legislators that her school had turned away qualified applicants for two consecutive years, not for lack of faculty or classroom space, but because it could not find enough clinical preceptors, nurses in practice willing to supervise students. She presented her school's own admissions data and a survey showing that the most common reason practicing nurses declined to precept was the time it took from their paid work. Nationally, schools of nursing have long reported turning away qualified applicants, citing clinical placement shortages among the main reasons (American Association of Colleges of Nursing, 2024). By defining the problem as a shortage of preceptors rather than a shortage of nursing faculty or funding, the testimony pointed toward a narrow solution: an incentive for preceptors.

Agenda Setting

The bill introduced in year 1 received no hearing. In year 2 it did, and three changes explain why. First, a new House Health chair who had worked as a hospital pharmacist made workforce bills a priority. Second, the state's largest newspaper ran a series on emergency department waits that quoted hospital leaders blaming nurse shortages. Third, the sponsor, a former school nurse in her second term, had been appointed to the Appropriations committee and could speak to the bill's cost. The problem had not changed between the two sessions; what changed was that a problem, an available solution and a receptive political moment arrived at the same time. That pattern matches the account of policy windows given by Kingdon (2011), which open when the problem, policy and political streams come together.

Committee Stage

Most changes happened in committee. The bill as drafted by legislative counsel gave a 2,000-dollar credit to any advanced practice registered nurse who supervised a student for at least 120 hours, with no annual cap. At the House Health hearing, the state hospital association testified in support but asked that staff registered nurses who precept prelicensure students also qualify, since most clinical hours for new nurses are supervised by staff nurses. The committee accepted that amendment.

The fiscal analyst's note then priced the expanded credit at 3.2 million dollars a year, and the bill was referred to Ways and Means. The Ways and Means chair, who had opposed new tax credits in previous sessions, supported the bill only after two amendments: a cap of 1,000 dollars per preceptor per year and a sunset clause ending the credit after five years unless renewed. The chair argued that a sunset would force a review of whether the credit actually increased preceptor numbers. Those amendments lowered the fiscal note to about 1.4 million dollars a year.

In the Senate, the Finance committee added a requirement that the qualifying rotation be for a student enrolled in a program located in the state, which answered a senator's concern that the credit might subsidize out-of-state online programs.

Actors and Their Interests

Five actors shaped the bill, and each had a distinct interest. The dean wanted more clinical placements for her students. The nurses association wanted recognition for the unpaid teaching its members already did. The hospital association wanted its staff nurses included, since hospitals supply most prelicensure clinical hours and expected pressure from staff to share in any benefit. The Ways and Means chair wanted to limit the state's revenue loss and to be able to end the program if it did not work. The fiscal analyst, though not an advocate, shaped the outcome by producing the cost estimate that brought the chair into the process. Reading the final law as a set of compromises among these interests explains each of its features: who qualifies, the cap, the in-state requirement and the sunset.

Floor Action and Enactment

The House passed the amended bill 88 to 9, the Senate passed its version 41 to 6, and the House concurred in the Senate amendment. The governor signed it in May. Several other states had already created tax incentives for community-based preceptors, including Maryland and Georgia, which the sponsor cited on the floor as evidence that the approach was workable.

Implementation

The statute directed the state revenue department to define a qualifying rotation by rule. The draft rule required 120 hours supervised within one academic term. After comments from the nurses association that many prelicensure rotations are shorter and spread across terms, the final rule allowed 120 hours within one calendar year across any number of students from in-state programs. That definition, set by an agency rather than by legislators, decided who could claim the credit, and it is an example of implementation shaping a policy as much as the statute did (Longest, 2016).

Modification

The sunset review due in 2030 will require the revenue department and the state board of nursing to report the number of preceptors claiming the credit, the change in clinical placements offered to in-state programs, and whether qualified applicants are still being turned away for lack of preceptors. Those measures will decide whether the credit is renewed, expanded or allowed to lapse.

Conclusion

House Bill 1187 became law because a clearly defined problem met a receptive moment, and it took its final shape in committee, where cost concerns produced the cap and the sunset. Its effect will depend on a rule the legislature did not write and on a review the sunset guarantees.

References

American Association of Colleges of Nursing. (2024). Nursing faculty shortage fact sheet. https://www.aacnnursing.org/news-data/fact-sheets/nursing-faculty-shortage

Kingdon, J. W. (2011). Agendas, alternatives, and public policies (2nd ed., updated). Longman.

Longest, B. B., Jr. (2016). Health policymaking in the United States (6th ed.). Health Administration Press.