BILL ANALYSIS
AB 867
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Date of Hearing: April 28, 2009
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
AB 867 (Nava) - As Amended: April 14, 2009
SUBJECT : California State University: Doctor of Nursing
Practice degree.
SUMMARY : Authorizes the California State University (CSU) to
independently award a Doctor of Nursing Practice (DNP) degree.
Specifically, this bill :
1)Limits the degree to the field of "nursing practice."
2)Requires the DNP degree to be distinct from the doctor of
philosophy (Ph.D) degree offered at, or in conjunction with,
the University of California (UC) and shall allow
professionals to earn the DNP degree while working full time.
3)Requires funding to be provided through the enrollment growth
provided to CSU in the annual Budget Act.
4)Prohibits enrollments in the DNP program from altering CSU's
ratio of graduate instruction to total enrollment and from
diminishing enrollment growth in CSU undergraduate programs.
5)Requires funding provided from the state for each Full Time
Equivalent Students (FTES) to be at the agreed-upon marginal
cost calculation that CSU receives for graduate enrollment.
6)Requires CSU to provide any needed startup funding from within
existing budgets for academic program support without
diminishing the quality of program support offered to CSU
undergraduate programs.
7)Requires CSU to annually report on the status of the degree
program to the California Postsecondary Education Commission
(CPEC), the Legislative Analyst's Office (LAO), and the
appropriate budget subcommittees in each house of the
legislature, prior to any legislative budget subcommittee
hearing related to the degree program.
8)Codifies legislative intent that this authority is an
exception to the Master Plan for Higher Education (Master
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Plan).
EXISTING LAW :
1)Establishes the California State University and its various
campuses under the administration of the Trustees of the
California State University.
2)Requires the California State University to offer
undergraduate and graduate instruction through the master's
degree in the liberal arts and sciences and professional
education, including teacher education.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office,
"Alleviating the current nursing faculty shortage is crucial and
the Board of Registered Nursing concluded in their 2005-2006
Annual School Report, 'Without more faculty, RN programs will
not be able to continue their expansion.'"
Background . This bill resulted from a study by the CSU Nursing
Doctorate Advisory Committee (CSU Advisory Committee), comprised
of CSU representatives and a research consultant, to determine
how best to address California's nursing faculty shortage.
According to CSU, this bill is necessary to allow CSU to train
future CSU and CCC nursing faculty. CSU's 18 pre-licensure
nursing programs are full and unable to expand, in part because
there are not enough faculty available to meet the low
student-to-faculty ratios required by accreditors and licensing
boards for these programs. In addition, CSU points out that it
will be able to train more advance practice nurses, which may be
the educational level necessary for certification in the future.
According to a June 2008 study by the California Institute for
Nursing & Health Care (CINHC), more baccalaureate- and
graduate-prepared nurses will be needed as California strives to
fill a forecasted shortage of 116,000 nurses by 2020.
Currently, 70% of graduating nurses have two-year Associate of
Arts degrees, and only 26% of these go on to secure a Bachelor
of Science in Nursing or graduate-level degree.
The CSU Advisory Committee considered several types of degrees,
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including the Ph.D, the Doctor of Nursing Science (DNS), the
Ed.D, and the DNP, and surveyed CSU and CCC nursing faculty to
ascertain which degree is most useful for educating nursing
faculty. The CSU Advisory Committee determined that CSU does
not have the research capacity to provide the Ph.D or DNS.
While the nursing faculty surveyed preferred the Ed.D, the CSU
Advisory Committee determined that the DNP would allow CSU to
both educate nursing faculty and to produce more DNPs in the
event the doctoral degree becomes the industry standard for
advanced practice nurses.
In addition to being licensed by the state as RNs, advanced
practice nurses are certified by the state upon completion of an
accredited master's program. In October 2006, the American
Association of Colleges of Nursing (AACN) issued a
recommendation that advanced practice nurses, including nurse
practitioners, nurse anesthetists, midwives, and clinical nurse
specialists, be prepared with a professional degree beginning in
2015. However, the advanced nursing community has mixed views
on the issue, since it would increase the cost to students who
seek to be advance practice nurses, may further increase health
care costs, and would likely limit the supply of advanced
practice nurses. Since the California Board of Registered
Nurses (CBRN) accredits California's nursing programs, it would
take action on the part of the state to adopt professional
degree requirements for advanced practice nurses.
According to the AACN, 86 institutions nationwide offer DNP
programs and more than 50 nursing schools are considering
starting DNP programs. In California, the University of San
Francisco, the University of San Diego, and the Western
University of Health Sciences in Pomona have DNP programs; one
of the programs is full, and two have capacity for more
students. While UC offers Ph.D degrees in nursing, it does not
currently offer DNPs; UC Irvine is considering a DNP program,
however.
While numerous studies point to the need for more nurse
educators, they do not identify additional DNP programs as the
primary solution. For example, a critical barrier to improving
the state's nursing education infrastructure, according to the
CINHC report, is the difficulty in recruiting experienced nurse
educators. Entry level teaching salaries may be only half of
what can be earned as clinical nurse with 20 years of
experience. While the report identified seven critical areas
for strategic nursing education redesign, additional DNP
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programs were not part of the recommendations. Further, the
CBRN, in its 2007-08 Annual School Report, found that the most
common barriers to nursing program expansion were lack of
clinical sites and uncompetitive faculty salaries.
Doctoral degree programs are more costly to operate than
baccalaureate or master's level programs, and nursing programs
are among the most expensive programs. CSU has sustained
significant budget cuts in recent years, including $97.6 million
in 2008-09 Budget Act and an additional $66.3 million in
2009-10. According to CSU, these reductions place it $283
million below its operational needs-approximately 10%. CSU is
reducing enrollments by 10,000 undergraduate students for the
2009-10 academic year because of the lack of funding for
enrollment growth in the budget. At the same time, several
recent reports have found that California's economy will require
a 50% increase in the number workers with baccalaureate degrees.
Related legislation . SB 1288 (Scott) of 2008, which was held in
the Senate Appropriations Committee, was substantially similar
to this bill.
AB 1295 (Fuller) of 2009, establishes a transfer pathway between
CCC and CSU nursing programs.
SB 1309 (Scott), Chapter 837, Statutes of 2006, enacted numerous
programs to increase the number of registered nurses.
REGISTERED SUPPORT / OPPOSITION :
Support
California State University (sponsor)
American Nurses Association/California
Cypress College
MiraCosta College
United Nurses Associations of California/Union of Health Care
Professionals (UNAC/UHAP)
Opposition
None on file.
Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301
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