BILL ANALYSIS                                                                                                                                                                                                    

        |Hearing Date:June 28, 2010         |Bill No:AB                         |
        |                                   |2344                               |

                               AND ECONOMIC DEVELOPMENT
                         Senator Gloria Negrete McLeod, Chair

                         Bill No:        AB 2344Author:Nielsen
                    As Introduced:     February 19, 2010 Fiscal:Yes

        SUBJECT:    Nursing:  approved schools. 
        SUMMARY:  Clarifies that "institution of higher education," for the  
        purposes of the Board of Registered Nursing approval of nursing  
        schools, includes community colleges and private postsecondary  
        institutions offering an Associate of Arts (AA) or an Associate of  
        Science (AS) degree.  Clarifies that a nursing school that is not an  
        "institution of higher education" may affiliate with an institution of  
        higher education offering either an AA or an AS degree to individuals  
        who graduate from the nursing school.

        Existing law:
        1) Creates the Board of Registered Nursing (BRN) within the Department  
           of Consumer Affairs (DCA).  Provides for the licensure and  
           regulation of registered nurses by BRN and requires BRN to maintain  
           a list of approved nursing schools.  

        2) Defines an approved school as an institution of higher education or  
           school that is affiliated with an institution of higher education  
           that offers an AA degree to individuals that graduate from the  
           affiliated nursing school.  

        3) Provides that an "institution of higher education" includes a  
           community college that offers an AA degree. 

        4) Requires BRN to determine by regulation the required subjects of  
           instruction to be completed in an approved school of nursing,  
           including the minimum units of theory and clinical experience  
           necessary to achieve essential clinical competency at the entry  
           level of a registered nurse (RN).


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        5) Establishes the Bureau of Private Postsecondary Education (BPPE)  
           within DCA and provides for Bureau oversight and regulation of  
           California private postsecondary institutions. 

        This bill:

        1)Provides that an "institution of higher education" includes but is  
          not limited to a community college offering an AA or AS and private  
          postsecondary institutions offering an AA or AS.

        2)Clarifies that an approved school is as an institution of higher  
          education or school that is affiliated with an institution of higher  
          education that offers an AA or AS to individuals that graduate from  
          the affiliated nursing school.
        FISCAL EFFECT:   According to the Assembly Appropriations Committee,  
        "Negligible fiscal impact to the BRN, as the bill's clarification will  
        not measurably impact the board's workload.

        1. Purpose.  The Author is the Sponsor of this measure.  According to  
           the Author, current law is ambiguous as to whether a college that  
           offers an Associate of Arts Degree (AA) or an Associate of Science  
           Degree (AS) can be approved by BRN.  The Author cites the  
           experience of Cambridge Junior College in Yuba City, a private  
           college accredited by the Accreditation Council for Independent  
           Colleges and Schools (ACICS), as need for this measure.  That  
           school was denied BRN approval to offer a nursing degree because it  
           only offers an AA in nursing.  The Author argues that this bill is  
           intended to clarify that a higher education institution offering an  
           AA and/or an AS degree, or school affiliated with such an  
           institution that meets with other established requirements, may  
           become approved for nursing schools by BRN.

        2. Background.  Current law, Business and Professions Code 2786, does  
           not define "institution of higher education" but provides that the  
           term includes community colleges offering  associate degrees  .   
           Current law also requires that a school that is not an "institution  
           of higher education" which seeks to offer a nursing program must  
           make an agreement with an institution of higher education to grant  
           an  associate of arts degree  , or a baccalaureate degree if  
           appropriate, to individuals who graduate from the nursing program.   
           According to a Legislative Counsel Bureau opinion provided by the  
           Author, a private postsecondary institution offering an AS may  


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           qualify as an "institution of higher education" for the purposes of  
           approval of a nursing program by BRN, notwithstanding the fact that  
           the institution does not have an AA degree.  
        3. Health Care Workforce Shortage.  With an increasingly aging  
           population, California is in the midst of a health care workforce  
           shortage.  The supply of skilled, trained health care professionals  
           has diminished in recent years and according to the non-profit  
           California Institute for Nursing and Health Care, the state will  
           see a shortage of over 100,000 nurses by 2020.  On March 23, 2009,  
           this Committee held an informational hearing entitled "The Role of  
           Private Education Institutions in Preparing California's Diverse  
           Workforce: Meeting the Challenges of our Workforce and Job Training  
           Needs."  The hearing examined the ability of private postsecondary  
           institutions to fill the career preparation needs of California's  
           workforce and evaluate policy options that allow them to expand  
           their workforce development programs with the requisite amount of  
           oversight required to protect students. 
        4. Relationship of BPPE to DCA Boards.  Nine boards within DCA have a  
           direct connection to BPPE.  While some are required to review the  
           curriculum and often institutions offering programs, others require  
           BPPE approval in order to meet educational requirements for  
           licensure, certification or registration.  The Board of Barbering  
           and Cosmetology (BBC) for example, approves curriculum, facilities,  
           equipment and textbooks for schools offering training programs for  
           eventual licensees.  The Board of Vocational Nursing and  
           Psychiatric Technicians (BVNPT) staff grants approval and  
           ultimately accreditation of Vocational Nursing and Psychiatric  
           Technician programs but does not have oversight of institutions  
           offering these programs.  

           Title 16, Division 14, Article 3 of the California Code of  
           Regulations (CCR) details very explicit regulations specifying the  
           role of BRN in school approval.  BRN reviews the administration and  
           organization of a program, faculty qualifications, faculty  
           responsibilities, curriculum, clinical facilities and assurances of  
           a procedure for resolving student grievances.  Recent budgetary and  
           capacity issues in California's public postsecondary schools,  
           coupled with a sharp increase in demand for nurses, have resulted  
           in a tremendous impact to many currently approved nursing programs.  
            Private postsecondary schools interested in offering a nursing  
           program, or approved coursework for a licensed vocational nurse  
           (LVN) to continue his or her education and to become eligible to  
           take the RN license exam, report lengthy delays in BRN approval.   
           These delays, combined with potential dual oversight and duplicate,  


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           substantial materials required by the recently recreated BPPE, put  
           California in the position of potentially having a shortage in  
           available RN programs, at the same time that there is a growing  
           shortage of qualified, trained and licensed RNs.  This Committee  
           plans to hold an Informational Hearing to comprehensively review  
           the role that the DCA boards and the BPPE play in the accreditation  
           and approval of schools and programs, and to also evaluate whether  
           there is any duplication in the requirements for approval or  
           oversight of these schools, and examine the possibilities for  
           improving the availability of private career and education training  
           while ensuring quality education and appropriate consumer  
           protections for students.

         Support:   None on file as of June 21, 2010.

         Opposition:  None on file as of June 21, 2010. 

        Consultant: Sarah Mason