Rural nursing education

AN ACT Relating to establishing the rural nursing education 1
program; adding new sections to chapter 43.70 RCW; and creating a new 2
section. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
NEW SECTION. Sec. 1. The legislature finds that sustainable 5
change is needed for rural health care nursing education. Nursing is 6
the largest health care profession in the United States, yet rural 7
hospitals, affiliated clinics, and underserved rural communities are 8
experiencing a shortage of skilled registered nurses, including nurse 9
practitioners who begin their careers as registered nurses, making it 10
even more difficult to meet the health care needs of rural and 11
underserved populations.12
The legislature finds the major barriers that rural nursing 13
students face are lack of access to affordable child care, lack of 14
transportation and safe and extended commute times, and lack of 15
access to internet services and computers. The added burden of the 16
COVID-19 pandemic, subsequent reports of staff burnout, nurses 17
leaving the profession, and higher salaries in urban areas has made 18
it difficult for rural health care facilities, such as the state's 39 19
critical access hospitals, to compete with larger hospital systems in 20
attracting and retaining a qualified workforce. Nurses living and 21
S-0553.1
SENATE BILL 5335
State of Washington 69th Legislature 2025 Regular Session
By Senators Slatter, Harris, Bateman, Chapman, Hasegawa, Holy,
Krishnadasan, Nobles, Salomon, Trudeau, and Valdez
Read first time 01/17/25. Referred to Committee on Health & Long-
Term Care.
p. 1 SB 5335
working in rural communities are in short supply and high demand. 1
Rural hospitals rely heavily on a substitute workforce such as 2
traveling nurses, which is costly, unsustainable, and has significant 3
recruitment and retention challenges. 4
The legislature recognizes the rural nursing education program, a 5
statewide program created in 2023 by a collaboration of health care 6
stakeholders, addresses the concerns of the rural nursing workforce. 7
The program fosters community-based collaborations between academic 8
institutions, students, and rural community health care partners and 9
has developed a remote grow-your-own nursing education plan that 10
educates prelicensure students as registered nurses who want to 11
learn, live, and work in their rural communities as registered 12
nurses. The program plans to initially offer associate degree 13
prelicensure education with the addition of future programs when 14
resources are available. The legislature intends to codify the 15
program as the rural nursing education program to create a future 16
where underserved rural communities are fully staffed with qualified 17
nurses and thrive with robust health care services staffed by local 18
talent. 19
NEW SECTION. Sec. 2. The definitions in this section apply 20
throughout sections 3 and 4 of this act unless the context clearly 21
requires otherwise.22
(1) "Institution of higher education" has the same meaning as in 23
RCW 28B.10.016. 24
(2) "Nurse" or "nursing" has the same meaning as in RCW 25
18.79.020. 26
(3) "Participant" means a student at a participating institution 27
of higher education who is admitted into the program.28
(4) "Participating hospital" means a rural hospital licensed 29
under chapter 70.41 RCW that is participating in the rural nursing 30
education program. 31
(5) "Program" means the rural nursing education program 32
established under section 3 of this act. 33
(6) "Rural" means a geographic area that has a shortage of 34
nursing health services, as determined by the department.35
(7) "Rural nursing education" means education and training 36
programs with access to distance nursing education and training 37
opportunities designed to prepare students for initial licensure as 38
p. 2 SB 5335
registered nurses, provided or developed in collaboration with an 1
institution of higher education and rural community partners.2
NEW SECTION. Sec. 3. The rural nursing education program is 3
established within the department to provide distance nursing 4
education, sustain lasting change in rural health care nursing 5
education, and improve quality nursing care for underserved rural 6
populations across the state.7
(1) In administering the program, the department shall:8
(a) Develop participant selection criteria, including the 9
requirement that an eligible participant: 10
(i) Is eligible to enroll in a nursing education or training 11
program; and 12
(ii) Has declared an intention to serve in a rural area upon 13
completion of the participant's nursing education or training 14
program; 15
(b) Develop a program application in collaboration with rural 16
health care community partners, rural hospitals, and participating 17
institutions of higher education; 18
(c) Collaborate with rural health care community partners, 19
including academic partners, local workforce development councils, 20
the Washington state board of nursing, the Washington state hospital 21
association, and exclusive bargaining representatives of nursing 22
professions in the development of a remote rural nursing education 23
program to connect participants, institutions of higher education, 24
and community partners. The program must address barriers and provide 25
support services to assist participants in learning, living, and 26
working within their rural communities; 27
(d) Collaborate with rural health care community partners, 28
including critical access hospitals and other rural hospitals, rural 29
health clinics, federally qualified health centers, long-term care 30
facilities, community and behavioral health sites, and tribal health 31
systems to identify, evaluate, and address rural nursing shortages; 32
and 33
(e) Collaborate with participating institutions of higher 34
education and rural health care partners to design innovative and 35
uniquely tailored models of rural nursing education, such as 36
dedicated education units and innovative maternal health and 37
pediatric clinical experiences, including the use of remote 38
simulation and learning. 39
p. 3 SB 5335
(2) Participating rural hospitals and health care facilities 1
shall: 2
(a) Establish and update methods to identify and recruit active 3
employees who meet or are likely to meet participant selection 4
criteria and conduct communications and outreach to these potential 5
participants; and 6
(b) Encourage potential participants to contact the program and a 7
participating institution of higher education for application 8
information. 9
(3) Participating institutions of higher education shall:10
(a) Establish and update methods to communicate with community 11
partners to identify and recruit students who meet or are likely to 12
meet participant selection criteria and conduct communications and 13
outreach to these potential participants; 14
(b) Establish a program cohort within the institution's nursing 15
program for participants; and 16
(c) Implement innovative and uniquely tailored models of rural 17
nursing education and clinical experiences for participants as 18
established in subsection (1)(e) of this section. 19
NEW SECTION. Sec. 4. (1) By November 1, 2026, the department 20
shall submit a preliminary report to the appropriate committees of 21
the legislature, in accordance with RCW 43.01.036, on the 22
demographics and number of participants, preceptors, and clinical 23
faculty training participants of the program established in section 3 24
of this act.25
(2) Beginning November 1, 2028, and every two years thereafter, 26
the department shall report to the appropriate committees of the 27
legislature, in accordance with RCW 43.01.036, the outcomes of the 28
program established in section 3 of this act. The report must 29
include: 30
(a) The number and demographics of participants;31
(b) The number of participants who have completed the program;32
(c) The number of participants who have completed the program and 33
are employed as registered nurses in rural communities;34
(d) The number of preceptors and clinical faculty training 35
participants; and 36
(e) Program outcomes, including clinical sites and experiences, 37
satisfaction surveys, and evaluation measures. 38
p. 4 SB 5335
NEW SECTION. Sec. 5. Sections 2 through 4 of this act are each 1
added to chapter 43.70 RCW.2
--- END ---
p. 5 SB 5335