BILL ANALYSIS
AB 867
Page 1
ASSEMBLY THIRD READING
AB 867 (Nava)
As Amended April 14, 2009
Majority vote
HIGHER EDUCATION 8-0 BUSINESS & PROFESSIONS
8-0
-----------------------------------------------------------------
|Ayes:|Conway, Block, Cook, |Ayes:|Hayashi, Conway, Eng, |
| |Fong, Galgiani, Huber, | |Hernandez, Nava, John A. |
| |Ma, Ruskin | |Perez, Ruskin, Smyth |
-----------------------------------------------------------------
APPROPRIATIONS 13-4
--------------------------------------
|Ayes:|De Leon, Ammiano, Charles |
| |Calderon, Davis, Fuentes, Hall, |
| |John A. Perez, Price, Skinner, |
| |Solorio, Audra Strickland, |
| |Torlakson, Krekorian |
| | |
|-----+--------------------------------|
|Nays:|Nielsen, Duvall, Harkey, |
| |Miller, |
| | |
--------------------------------------
SUMMARY : Authorizes the California State University (CSU) to
independently award a Doctor of Nursing Practice (DNP) degree,
subject to the following specifications:
1)This authority shall be limited to the field of "nursing
practice."
2)The DNP degree shall 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)Funding shall be provided through the enrollment growth
provided to CSU in the annual Budget Act.
4)Enrollments in the DNP program shall not alter CSU's ratio of
AB 867
Page 2
graduate instruction to total enrollment and shall not
diminish enrollment growth in CSU undergraduate programs.
5)Funding provided from the state for each Full Time Equivalent
Students (FTES) shall be at the agreed-upon marginal cost
calculation that CSU receives for graduate enrollment.
6)CSU shall 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
Plan).
FISCAL EFFECT : According to the Assembly Appropriations
Committee, CSU staff indicates that two to three campuses would
be selected to implement DNP programs with initial enrollments
not expected for around three years. Assuming 10 students in
each entering class, first-year General Fund costs for three
programs would be $246,000 and second-year costs would be
$492,000. This bill specifies that these costs will come from
CSU's budget allocation for enrollment growth.
COMMENTS : Master Plan: One of the major features of the Master
Plan is the differentiation of functions among the public
postsecondary segments. One of the advantages of this structure
is that it focuses limited state resources on a few key
responsibilities in each of the three public sectors, as
follows:
1)UC is designated as the state's primary academic research
institution and is to provide undergraduate, graduate, and
professional education. UC is given exclusive jurisdiction in
public higher education for doctoral degrees (with the
exception that CSU can award joint doctorates) and for
AB 867
Page 3
instruction in law, medicine, dentistry, and veterinary
medicine.
2)CSU's primary mission is undergraduate education and graduate
education through the master's degree including professional
and teacher education. Faculty research is authorized
consistent with the primary function of instruction.
Doctorates can be awarded jointly with UC or an independent
institution, with the approval of CPEC.
3)The California Community Colleges (CCC) have the primary
mission of providing academic and vocational instruction for
older and younger students through the first two years of
undergraduate education. In addition, CCC is authorized to
provide remedial instruction, English as a Second Language
courses, adult noncredit instruction, community service
courses, and workforce training services.
In 2005, an exception to the Master Plan was approved to
authorize CSU to offer the doctor of education (Ed.D) degree
because data indicated that California lagged behind the nation
in Ed.D degrees per K-12 students, and UC did not offer Ed.D
programs [AB 724 (Scott), Chapter 269, Statutes of 2005].
Need for this bill: 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.
Nurse educator shortage: 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
AB 867
Page 4
to secure a Bachelor of Science in Nursing or graduate-level
degree.
Why the DNP? The CSU Advisory Committee considered several
types of degrees, 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.
Licensure requirements 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 per the standards contained in
section 1484 of the California Code of Regulations. 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.
Is additional capacity needed? 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; although, UC
Irvine is considering a DNP program. If existing DNP programs
have capacity, are more DNP programs necessary, or should the
state consider other options, such as providing Cal Grants or
AB 867
Page 5
other incentives for students to enroll in existing DNP
programs?
Are DNP programs the answer to the nursing faculty shortage?
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
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.
What's the cost? Doctoral degree programs are more costly to
operate than baccalaureate or master's level programs, and
nursing programs are among the most expensive programs. Given
this, what is the expected cost to CSU to start-up and operate
such programs, and what fees are students expected to pay? How
will CSU fund these costs? Will other graduate programs,
including masters nursing programs, be affected?
Should the DNP program take priority over other CSU funding
needs? 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. Should future enrollment growth funds be
used for DNP programs or for other system needs, including
baccalaureate degree production, increased financial aid,
decreased time-to-degree, and more slots for undergraduate
students?
Should this issue be further studied? At its March 2009
meeting, CPEC approved a statewide study of nursing education
AB 867
Page 6
and supply issues with the following goals: 1) modeling nursing
supply and demand; 2) assessing the general and unique
contributions and benefits of the four systems of higher
education on nursing education; and 3) determining the
cost-effectiveness of recent nursing legislation and
initiatives. The second goal will seek to determine the
appropriate mix of nursing degree programs by system and degree
level to meet California's nursing needs. In addition, the
Legislature may be establishing a joint committee to review the
Master Plan as it approaches its 50th anniversary. Should
expansion of CSU's authority to award doctorate degrees be
considered in greater context?
Analysis Prepared by : Sandra Fried / HIGHER ED. / (916)
319-3960
FN: 0001140