2010 Salary Survey Results

Family planners hold the line on salaries, jobs — Keep an eye on legislation, economy in coming year

In a year when belt-tightening seemed to be a national pastime, about 35% of participants in the Contraceptive Technology Update Salary Survey reported a 1-3% uptick in salary, with 43% seeing no change in pay levels.

This finding is consistent with results from the previous year, when 38% said they got a 1-3% bump and 40% noting no change. (See "In the past year, how has your salary changed?" graphic, below.)

For the 43% of survey respondents who identified their employers as state/county/city government, know that the past two years have seen changes in the employment landscape, says Donna Brown, government affairs counsel for the National Association of County and City Health Officials (NACCHO) in Washington, DC. The organization represents the nation's 2,800 local governmental health departments.

"In our most recent research brief, which covered calendar year 2009, in maternal and child health, 25% of health departments had cut programs, and 12% had cut them in communicable disease screening and treatment," says Brown. (Read the full report on NACCHO's Job Loss and Program Cuts survey at www.naccho.org/topics/infrastructure/lhdbudget/upload/Job-Losses-and-Program-Cuts-5-10.pdf.)

In this year's salary survey responses, 38% said they worked in a health department, while 30% said they were in a clinic facility. A total of 16% were in a college health center, while 10% worked for an agency.

Location also plays a part in the employment scenario: 45% said their practice was in a rural location; 22% were in an urban setting, with 20% in a medium-sized city. The remaining 11% said they practiced in a suburban location. (See the salary survey snapshot, below, for an overview of the results.)

Public health advocates are pushing to protect vulnerable funding for reproductive health programs.

NACCHO was a chief proponent of the 2010 proposed Local Jobs for America Act (H.R. 4812), submitted by House Education and Labor Committee Chairman George Miller (D-CA). The proposed bill took steps to address the impacts of current local government budgetary shortfalls. It would have enabled local governments to provide local health departments with the resources necessary to reinstate laid-off personnel, return furloughed employees to full-time work, and restore core public health services. The bill, however, failed to move in 2010. With Congressional leadership changes coming in the upcoming session, it is unlikely to gain traction, says Brown.

When it comes to staffing levels, 53% of CTU survey respondents reported no change in head count in the last year. About 36% reported a staffing decrease, while 10% reported an increase in positions, similar to statistics reported in the previous year.

In terms of adding to the public health workforce, NACCHO has been a solid proponent of training and job development for those employed in local health departments. It rallied in September 2010 to combat a Senate amendment that would removed funding for the Prevention and Public Health Fund. The Fund, afforded through the Patient Protection and Affordable Care Act, provides expanded and sustained federal support for prevention and public health programs such as those provided by local health departments.

Nurses who work in the public health sector should pay particular attention to the fate of the Patient Protection and Affordable Care Act. It contains several provisions that will accelerate mid-career training and provide loan repayment for persons in the public health profession sector, including nurses and nurse practitioners, says Brown.

About 42% of 2010 CTU survey respondents have a graduate degree; about 47% have worked in their present field for 15 years or less. (See "What is your highest academic degree?" and "How long have you worked in your present field?" graphics, below.)

With a new Congress coming in session, public health advocates are gearing up for battle to implement the Patient Protection and Affordable Care Act, says Brown. "We were very pleased to see that [training section] authorized in the Affordable Care Act," Brown states. "The next battle is to actually get it funded."

Keep eye on Title X

Those who work in Title X family planning clinics also are keeping a weather eye on the fate of health care reform. According to the National Family Planning and Reproductive Health Association (NFPRHA) in Washington, DC, the propensity for change in family planning service delivery is greater than any since the program's 1970 inception.

The federal Title X-funded network is impacted on several fronts, since it also is funded by Medicaid, Maternal and Child Health, Social Services Block Grant, and sexually transmitted disease programs, as well as other state and federal programs, as well as patient fees and commercial insurance.

As the federal government dramatically increases the role of Medicaid and commercial insurance exchanges as sources for coverage for patient care, the Title X network will need to adapt and change in order to meet new realities, NFPRHA officials state. With changes swirling, it is difficult to predict what may happen to those working in the public health setting and particularly in the Title X setting, says Susan Wysocki, WHNP-BC, FAANP, president and chief executive officer of the Washington, DC-based National Association of Nurse Practitioners in Women's Health.

"On one hand, if there is universal access to contraception through health care reform, one might argue that the need for Title X clinics would go down," Wysocki says. "On the other, and possibly more likely side, is the challenge of having enough providers with health care reform. So whether or not women can get contraception regardless of where they go for care, access to methods alone will not be enough."

There simply are not enough providers to provide contraceptive care without the public health systems, including Title X clinics, says Wysocki.

"I suspect the system will look different over time," she states. "However, I do not see major changes overnight."

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Survey Snapshot

• About half of the 2010 Contraceptive Technology Update Salary Survey respondents identified themselves as nurse practitioners (NPs), with about 20% as registered nurses, and 5% as nurse-midwives. Administrators comprised about 22% of the current year's responses. About 4% identified themselves as physicians. The survey was mailed in August 2010 to 874 subscribers with 97 responses, for a response rate of 11%.

• About 40% of all respondents indicated they made $59,000 or less; about 49% reported salaries between $59,000 and $99,999. About 11% said they earned a six-figure salary. (See "What is your salary level" graphic, below.)

• About 35% say they supervise between 4-10 people. (See "How many people do you supervise, directly or indirectly?" graphic on p. 3.) About 60% report working 40 hours or less a week. (See "How many hours a week do you work?" graphic below.)

Source: 2010 Contraceptive Technology Update Salary Survey results.