BILL ANALYSIS SENATE COMMITTEE ON EDUCATION Gloria Romero, Chair 2009-2010 Regular Session BILL NO: AB 867 AUTHOR: Nava and Arambula AMENDED: April 14, 2009 FISCAL COMM: Yes HEARING DATE: July 1, 2009 URGENCY: No CONSULTANT:Nancy Anton SUBJECT : California State University: Doctor of Nursing Practice Degree. SUMMARY This bill authorizes the California State University (CSU) to award a Doctor of Nursing Practice (DNP) degree subject to specified conditions. BACKGROUND Current law provides that the primary mission of the CSU is undergraduate and graduate instruction through the master's degree. It specifies that CSU (1) shall offer undergraduate and graduate instruction through the master's degree, and (2) may offer doctoral degrees jointly with the University of California (UC) or other independent institutions of higher education provided they are approved by the California Postsecondary Education Commission (CPEC). Current law also authorizes CSU to independently award the Doctor of Education (Ed.D) degree focused solely on preparing administrative leaders for California public K-14 schools. In setting forth the missions and functions of California public and independent institutions of higher education, current law provides, among other things, that UC "has the sole authority in public higher education to award the doctoral degree in all fields of learning, except that it may agree with the CSU to award joint doctoral degrees in selected fields." ANALYSIS This bill authorizes CSU to award the Doctor of Nursing AB 867 Page 2 Practice (DNP) degree to prepare nurses for advanced practice nursing and prepare clinical faculty to teach in postsecondary nursing education programs subject to the following specifications: 1) The DNP program shall be designed to enable students to earn the degree while working full time. 2) DNP program funding shall be from within CSU's annual Budget Act appropriation for enrollment growth. Initial funding shall be from within existing budgets for academic programs without diminishing the quality of undergraduate academic programs. In addition, enrollment in Doctor of Nursing Practice (DNP) programs: a) Shall not alter the CSU ratio of graduate instruction to total enrollment. b) Shall not diminish enrollment growth in university undergraduate programs. c) Shall be funded at the marginal cost calculation that the CSU receives for graduate enrollment. 3) If CSU establishes a DNP degree program, it shall report annually on the status of the program/s to the California Postsecondary Education Commission (CPEC), the Legislative Analyst's Office (LAO), and the appropriate legislative budget subcommittees prior to the meeting of legislative budget hearings. STAFF COMMENTS 1) Where will the funding come from ? The bill requires that initial funding be "from within existing budgets for academic programs support, without diminishing the quality of program support offered to CSU undergraduate programs." The bill also specifies that ongoing funding come from enrollment growth without altering the graduate/undergraduate instruction ratio. Given these limitations, where will the funding come from: graduate programs? If so, which graduate programs? Will DNP programs be established at the expense of Master's degree nursing programs? If so, AB 867 Page 3 does this make sense? Staff recommends that the bill be amended to clarify where such funding is expected to come from. 2) What about Master's level nursing programs ? Is it CSU's intent to replace master's level nursing programs with DNP programs? Should the bill be amended to ensure that any DNP programs established compliment or supplement the preparation provided in existing advance nursing practice master's level degree programs and not to supplant or replace them? 3) CPEC approval ? Current law generally requires colleges to seek and receive approval by CPEC prior to commencing new programs of study. It is unclear if CSU DNP programs authorized by this bill are to be subject to or exempted from this process. As the process serves to improve the quality of programs, avoid duplication, and ensure best use of state resources, staff recommends that the bill be amended to clarify that although this bill authorizes CSU to offer DNP degree programs, such programs are not exempted from any existing review and approval processes. 4) Are DNP programs the answer to the nursing faculty shortage ? While numerous studies point to a shortage of nursing faculty one of the contributing factors to the overall shortage of nursing faculty, they do not identify additional DNP programs as the primary solution. For example, one of the difficulties in recruiting/retaining nurse faculty is that their salaries may be only half what can be earned as a clinical nurse. A June 2008 study by the California Institute for Nursing & Health care (CINHC) identified seven critical areas for strategic nursing education redesign and additional DNP programs were not one of their recommendations. The most common barriers to expanding nursing programs were lack of clinical sites and lagging faculty salaries. In addition, a CSU Advisory Committee found that an Ed.D program - which CSU is already authorized to provide - which focuses on nursing should likely meet the need for nursing faculty and a survey of CSU and community college nursing directors found that the Ed.D was the AB 867 Page 4 preferred doctoral degree for nursing faculty. 5) Existing DNP programs have capacity . In California there are currently three higher education institutions which offer DNP programs: University of San Francisco, University of San Diego and the Western University of Health Sciences (in Pomona). While one program typically runs at capacity, the other two do not. In addition, UC Irvine is considering offering such a program. If there is available capacity in existing DNP programs, does it make sense to alter CSU mission's to authorize them to also offer such programs? 6) Prior legislation . On April 17, 2008, the Senate Education Committee heard and passed (9-0) Senate Bill 1288 (Scott) which would have authorized CSU to offer DNP degree programs. SB 1288 was held in the Senate Appropriations committee. SUPPORT American Nurses Association/California American Federation of State, County and Municipal Employees Asian Americans for Community Involvement California Hospital Association California State Student Association California State University Coast Community College District Greater Fresno Area Chamber of Commerce Joint Venture Silicon Valley Oxnard Chamber of Commerce San Jose Silicon Valley Chamber of Commerce Silicon Valley Leadership Group Thousand Oaks-Westlake Village Regional chamber of Commerce OPPOSITION None received.