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 15, 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  




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          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 ones?  Private  
               funds? A mix of both?  Staff recommends that the bill  
               be amended to identify the funding source(s).




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           2)   What about Master's level nursing programs  ?  It is not  
               clear if the DNP programs authorized by this bill are  
               intended to replace or supplant master's level nursing  
               programs.  Information from the author's office  
               indicates that this is not their intent.  Accordingly,  
               staff recommends that the bill be amended to include  
               language so clarifying.  This language would  
               essentially be the same language that was included in  
               SB 1288 (Scott) of last session. 

           3)   CPEC approval  ?  Current law generally requires  
               colleges to seek and receive approval by CPEC prior to  
               commencing new programs of study.  The bill is unclear  
               if the CSU DNP programs authorized by this bill are to  
               be subject to or exempted from this process.   
               Information from the author's office indicates that it  
               is not their intent to exempt these programs;  
               accordingly, staff recommends that the bill be amended  
               to clarify that although this bill authorizes CSU to  
               offer DNP degree programs, such programs are still  
               subject to 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  
               preferred doctoral degree for nursing faculty.  

           5)   Existing DNP programs have capacity  .  In California  




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               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)   Premature  ?  A March 2009 report from the California  
               Postsecondary Education Commission (CPEC) indicates  
               the need to understand nursing education and supply  
               issues within the context of statewide program  
               planning, which they are undertaking.  Given this, is  
               it premature for CSU to expand their nursing degree  
               offerings before CPEC has completed its study project?

           7)   Why not a joint doctorate?   Current law authorizes CSU  
               to offer a joint doctorate with the University of  
               California.  Should this option be explored prior to  
               authorizing CSU to establish its own nursing doctoral  
               degree program?

           8)   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




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          Thousand Oaks-Westlake Village Regional chamber of Commerce

           OPPOSITION

           None received.