BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 702
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          Date of Hearing:   April 19, 2005

                       ASSEMBLY COMMITTEE ON HIGHER EDUCATION
                                  Carol Liu, Chair
                     AB 702 (Koretz) - As Amended:  April 4, 2005
           
          SUBJECT  :  Nurse educator loan program

           SUMMARY  :  Requires the Office of Statewide Heath Planning and  
          Development (OSHPD) to establish a statewide Registered Nurse  
          Educator Loan Program.  Specifically, this bill  :

          1)Requires OSHPD to establish a statewide Registered Nurse  
            Educator Loan Program to facilitate education of registered  
            nurses by increasing the availability of registered nurse  
            educators.

          2)Requires OSHPD to contract with California public colleges and  
            universities that award degrees in nursing with the purpose of  
            assisting the institution in establishing, or expanding the  
            capacity of their registered nurse educator curriculum.

          3)Requires OSHPD to award loans to cover the educational costs  
            of students who are registered nurses seeking a master's or  
            doctorate degree in nursing and who intend to become nurse  
            educators.

          4)Specifies that when selecting loan recipients, they shall  
            consider an applicant's economic need, cultural and linguistic  
            skills, and demonstrated interest in becoming a registered  
            nurse educator.

          5)Specifies that the student agree to the following: 

             a)   Make all reasonable efforts to complete the  
               institution's registered nurse educator curriculum;
             b)   Seek employment as a registered nurse educator upon  
               completion of the curriculum; and
             c)   Serve as a registered nurse educator for at least three  
               full-time academic years or five part-time years.

          6)Requires OSHPD to adopt regulations for a repayment schedule,  
            which shall forgive repayment of the loan for students who  
            comply with the terms of the loan agreement.  









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          7)States that OSHPD shall only implement the program to the  
            extent that funds are available for this purpose, and only if  
            there are reasonable assurance that funds will be made  
            available to cover the student's education cost for a total of  
            five academic years. 

          8)Declares legislative intent that this act be funded through  
            the Budget Act or other measure, including funding from  
            discretionary funds available under the Workforce Investment  
            Act (WIA). 

          9)Makes various other legislative findings and declarations  
            regarding the shortage of nurses and nurse educators in  
            California and the need to expand nurse educator opportunities  
            in California public colleges and universities.    
            
           EXISTING LAW  

             1)   Requires OSHPD to establish the Health Professions  
               Education Foundation to provide scholarships or loans for  
               educational cost of underrepresented students in the health  
               professions.

             2)   Requires OSHPD to contract with institutions that award  
               degrees in the nursing profession to increase participation  
               of underrepresented groups.

             3)   Establishes the Song-Brown Family Physician Training Act  
               administered by OSHPD.  The program seeks to increase the  
               number of general practice health care providers by  
               providing clinical training opportunities to physician  
               residents, physician assistants, and family nurse  
               practitioners. 

           FISCAL EFFECT  :  Unknown

           COMMENTS  :
           
           1)There is well documented need for additional nurses in  
            California and nationally.  California ranks 49th out of fifty  
            states in the number of nurses per 100,000 residents.  The  
            Employment Development Department estimates that California  
            needs 30,000 additional nurses in the next four years, and by  
            2010, there will be a demand for 109,600 nurses.  This nursing  
            shortage threatens the public health and the health care  








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            delivery system.     

          2)In addition the nursing shortage, California faces a shortage  
            in nurse educators.  There are not enough nurse educators  
            holding master's and doctoral degrees to train future nurses.   
            The author cites a recent survey by the Board of Registered  
            Nursing, which found that the average age of a nurse educator  
            in California is 57.  As many nurse educators reach retirement  
            age in the next 10 years, there will be an even greater need  
            for educators.  The author argues that "with many of the nurse  
            educators retiring in the near future and the need for  
            additional nurse educators California will soon face a crisis  
            if something is not done to increase the number of educators,  
            thereby increasing the number of registered nurses."

          3)The purpose of this bill to help ensure that California has an  
            adequate number of registered nurse educators to train the  
            future nurse workforce.  This bill will offer financial  
            support and incentives, to the extent that funding is  
            available, for students who are registered nurses seeking  
            advance degrees and who agree to teach once they obtain their  
            master's or doctorate.  Currently, there is no incentive for  
            nurses to obtain degrees and go into teaching.  The author  
            believes that many nurses would be interested in teaching, but  
            the cost of obtaining the necessary degree is a barrier.   
            Moreover, nurse educators make less money than nurse  
            practitioners. The author hopes that by providing financial  
            incentives more nurses will be interested in pursing their  
            master's or doctorate degree and become nurse educators.

           4)Concerns with Legislative Intent Language.  Concerns were  
            raised by the California Nurses Association (CNA) regarding  
            the legislative intent language in the bill related to the  
            data on the nursing shortage and the need for additional  
            nurses.  According to CNA, the information in the intent  
            language does not reflect the need for nurses in hospitals and  
            undermines the ratios.  

          5)Nursing Legislation.   Much of the past and current legislation  
            related to nursing has focused on increasing the number  
            individuals in nursing professions.  This bill focuses nurse  
            educators, which is a critical component to meeting the  
            increase demand for nurses.  

           6)Related Legislation  .   AB 167 (Cohn) of 2005, establishes the  








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            Nursing Workforce Education Investment Act designed to educate  
            and train licensed vocational nurses and registered nurses.   
            AB 167 requires the program to be funded under the federal WIA  
            discretionary funding commencing in the 2007-08 fiscal year.

          SB 102 (Ducheny) of 2005, authorizes the Employment Training  
            Panel (ETP) to allocate funds available in the annual Budget  
            Act for up to 5 licensed nurse training pilot programs to  
            train individuals who are currently working as nurse  
            assistants or caregivers in a health facility. 

            AB 232 (Arambula) of 2005 establishes common prerequisites for  
            admission to registered nursing (RN) training programs at the  
            California State University (CSU) and the California Community  
            Colleges and appropriates $45 million from the General Fund to  
            the California Workforce Investment Board for allocation of  
            grants to local workforce investment boards to promote  
            enrollment in RN training programs

           7)Prior Legislation  .  SB 1245 (Kuehl) Chapter 718, Statutes of  
            2004, established the Entry-Level Master's Nursing Programs  
            Act and required the Chancellor of the CSU, in consultation  
            with the Board of Registered Nursing, to select 4 CSU campuses  
            eligible for supplemental funds for establishing entry-level  
            master's programs in nursing.

           8)California Nurse Education Initiative  :  On April 13, 2005,  
            Governor Schwarzenegger announced the California Nurse  
            Education Initiative.  This proposed plan would provide $90  
            million to expand and increase nurse education opportunities,  
            partner with public and private colleges and universities to  
            build more nurse education programs, recruit more qualified  
            instructors, establish high school and college nursing  
            academies and apprenticeships, and seek additional funds for  
            nurse education from federal and other funding sources.

           9)Proposed clarifying amendment  .  In its current form, it is not  
            clear whether it is the intent to fund the program through the  
            Budget Act or from discretionary funds under WIA.  Staff  
            recommends amending the bill to clarify the language in  
            accordance with the author's stated intent to fund the program  
            through the Budget Act or other measure including WIA funds.    
             Specifically  ,  on in line 36 after "measure," add "including  
            funding available under the federal Workforce Investment Act  
            of 1998," and in line 36-37 delete "from discretionary fund  








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            available under the federal Workforce Investment Act of 1998."  
             
           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Adventist Health, Feather River Hospital
          Alameda Hospital
          Alliance of Catholic Health Care
          Alta Bates Summit Medical Center
          American Nurses Association California
          Anaheim Memorial Medical Center
          Arroyo Grande Community Hospital
          Bakersfield Heart Hospital 
          Bakersfield Memorial Hospital
          Ballard Rehabilitation Hospital
          California Association for Health Services at Home
          California Hospital Association (SPONSOR)
          California School Nurses Organization
          Childrens Hospital of Los Angeles
          Colusa Regional Medical Center
          Community Hospital of San Bernardino
          Corcoran District Hospital
          Desert Valley Hospital
          Doctors Hospital of Manteca
          Doctors Medical Center
          Dominican Hospital
          Eastern Plumas Health Care
          Eastern Plumas Health Care
          Encino Hospital
          Enloe Medical Center
          Glendale Memorial Hospital and Health Center
          Glenn Medical Center
          Good Samaritan Hospital
          Hazel Hawkins Memorial Hospital and Convalescent Centers
          Henry Mayo Newhall Memorial Hospital
          Indian Valley Health Care District
          John Muir/Mt. Diablo Health System
          Kaiser Foundation Hospital, San Rafael
          Kaweah Delta Health Care District
          Los Robles Hospital and Medical Center
          Marian Medical Center
          Mark Twain St. Joseph's Hospital
          Marshall Medical Center
          Mayers Memorial Hospital








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          Mendocino Coast District Hospital
          Mercy Hospital of Folsom
          Mercy Hospitals Bakersfield
          Mercy Medical Center Mt. Shasta
          Methodist Hospital of Sacramento
          Methodist Hospital of Southern California
          Modoc Medical Center
          Motion Picture & Television Fund
          Mt. Diablo Medical Center
          Northridge Hospital Medical Center
          Pacific Hospital of Long Beach
          Plumas District Hospital
          Pomona Valley Hospital
          Redwood Memorial Hospital
          Rehabilitation Institute at Santa Barbara
          Saddleback Memorial Medical Center-San Clemente Campus
          Saint Agnes Medical Center
          Saint John's Health Center
          San Gabriel Valley Medical Center 
          San Joaquin Valley Rehabilitation Hospital
          San Mateo Medical Center
          Scripps Health
          Sharp Chula Vista Medical Center
          Sierra Vista Regional Medical Center
          St. Francis Medical Center
          St. Joseph's Medical Center
          St. Mary Medical Center 
          Sutter Medical Center of Santa Rosa
          Tehachapi Valley Healthcare District
          Tulare District HealthCare System
          Twin Cities Community Hospital 
          United Nurses Associations of California/Union of Health Care  
          Professionals
          University California, Davis
          University Community Medical Center
          University of California, San Diego Medical Center
          Valley Care Health System

           Opposition 
           
          None on File.
           
          Analysis Prepared by  :    Luis Esparza / HIGHER ED. / (916)  
          319-3960 
           








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