BILL ANALYSIS �
AB 213
Page 1
Date of Hearing: April 9, 2013
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Richard S. Gordon, Chair
AB 213 (Logue) - As Amended: April 1, 2013
SUBJECT : Healing arts: licensure and certification
requirements: military experience.
SUMMARY : Establishes the Veterans Health Care Workforce Act of
2013, which requires schools accredited by healing arts boards
within the Department of Consumer Affairs (DCA) and the State
Department of Public Health (DPH) to accept satisfactory
evidence of an applicant's education, training, and practical
experience completed during military service towards licensure
or certification, as specified. Specifically, this bill :
1)Requires, by July 1, 2014, all healing arts boards under DCA
which accredit or otherwise approve schools offering
educational course credit for meeting licensing requirements
to mandate that those schools seeking accreditation or
approval submit proof to the board that those schools have
procedures in place to evaluate, upon satisfactory evidence by
the applicant, whether an applicant's military education,
training, and practical experience are equivalent to the
board's standards and may be applicable toward licensure.
2)Prohibits all healing arts boards that require schools to be
accredited by a national organization from imposing
requirements on those schools that conflict with the standards
of the national organization.
3)Requires the Department of Veterans Affairs, the Chancellor of
the California State University, and the Chancellor of the
California Community Colleges to assist DPH, the State Public
Health Officer, healing arts boards, and schools with
compliance, including the determination of equivalency and
obtaining state, federal, or private funds to support the
implementation of this bill.
4)Requires the following professions regulated by DPH to accept
satisfactory evidence of an applicant's education, training,
and practical experience completed as a member of the military
toward the qualifications and requirements for licensure or
AB 213
Page 2
certification by DPH if DPH determines that the education,
training, or practical experience is equivalent to its
standards:
a) Medical laboratory technicians;
b) Clinical laboratory scientists;
c) Radiologic technologists;
d) Nuclear medicine technologists;
e) Certified nurse assistants;
f) Certified home health aides;
g) Certified hemodialysis technicians; and
h) Nursing home administrators.
5)Requires, by July 1, 2014, if DPH accredits or otherwise
approves schools offering educational course credit for
meeting licensing and certification qualifications and
requirements, to require a school seeking accreditation or
approval to submit to DPH proof that the school has procedures
in place to fully accept an applicant's military education,
training, and practical experience toward the completion of an
educational program that would qualify a person to apply for
licensure or certification if the school determines that the
education, training, or practical experience is equivalent to
DPH's standards.
6)Prohibits DPH, if it requires a school to be accredited by a
national organization, from imposing requirements that would
conflict with the standards set by the national organization.
7)Makes Legislative findings and declarations.
EXISTING LAW :
1)Defines "board" as used in the Business and Professions Code
(BPC) to refer to "the board in which the administration of
the provision is vested, and unless otherwise expressly
provided, shall include 'bureau,' 'commission,' 'committee,'
'department,' 'division,' 'examining committee,' 'program,'
AB 213
Page 3
and 'agency.'" (BPC Section 22)
2)Places the following healing arts boards under the DCA:
a) State Board of Chiropractic Examiners;
b) Dental Board of California;
c) Medical Board of California;
d) Speech-Language Pathology and Audiology and Hearing
Aid Dispersers Board;
e) State Board of Optometry;
f) California Board of Occupational Therapy;
g) Physical Therapy Board of California;
h) Board of Registered Nursing;
i) Board of Vocational Nursing and Psychiatric
Technicians;
j) Board of Psychology;
aa) Physician Assistant Board;
bb) Osteopathic Medical Board;
cc) Naturopathic Medicine Committee;
dd) Respiratory Care Board of California;
ee) California State Board of Pharmacy;
ff) California Massage Therapy Council;
gg) Veterinary Medical Board;
hh) Acupuncture Board; and,
ii) Board of Behavioral Sciences. (BPC 500, et seq.)
3)Requires all boards regulated under the BPC to provide for
AB 213
Page 4
methods of evaluating education, training, and experience
obtained in the armed services, if applicable to the
requirements of the business, occupation, or profession
regulated. (BPC 35)
4)Requires the rules and regulations of DCA healing arts boards
to provide for methods of evaluating education, training, and
experience obtained in military service if such training is
applicable to the requirements of the particular profession or
vocation regulated by the board. (BPC 710)
5)Requires, by July 1, 2015, the Chancellor of the California
Community Colleges, using common course descriptors and
pertinent standards of the American Council on Education, to
determine for which courses credit should be awarded for prior
military experience. (Education Code Section 66025.7)
6)Authorizes DPH to license or certify the following health care
professions:
a) Medical laboratory technician; (BPC 1260.3)
b) Clinical laboratory scientist; (BPC 1261)
c) Radiologic technologist; (Health and Safety Code
(HSC) Section 114840, et seq.)
d) Nuclear medicine technologist; (HSC 107150 et seq.)
e) Certified nurse assistant; (HSC 1337)
f) Certified home health aide; (HSC 1736.1)
g) Certified hemodialysis technician; (BPC 1247.3) and
h) Nursing home administrator. (HSC 1416.2.)
FISCAL EFFECT : Unknown
COMMENTS :
1)Purpose of this bill . This bill requires schools accredited by
healing arts boards within DCA and DPH to accept satisfactory
evidence of an applicant's education, training, and practical
experience completed during military service towards licensure
AB 213
Page 5
or certification. While there is already existing law
specifically requiring healing arts boards in DCA to provide
for methods of evaluating education, training, and experience
obtained in the military, there is not a similar blanket
mandate for programs under DPH, though some accommodations do
exist in individual programs. This bill is sponsored by the
author.
2)Author's statement . According to the author, "In order to
honor the service of our nation's returning heroes and address
California's healthcare workforce needs, this bill would
ensure that veterans with healthcare education, training, and
practical experience are expedited into civilian employment as
healthcare professionals.
"This bill would break down barriers facing returning
veterans, by requiring state entities that license healthcare
professionals to establish policies that recognize the
education, training, and practical experience of a veteran
applicant. It would also require these entities to work with
the college programs they accredit to ensure that the colleges
have procedures in place so that veteran applicants are not
forced to retake classes they have already completed at a
military institute, and so that veterans are able to quickly
complete the additional coursework necessary for licensure."
3)Overview . Because of similarities in training and experience
compared to their civilian counterparts, individuals with
military training and experience in health care may be
well-positioned to meet the state's health care needs upon
their separation from service.
Both DCA and DPH were required to submit a report to the
Legislature in October 2012 detailing how professional
licensure programs under their respective jurisdictions
address military experience. The results, described below,
suggest that while DCA boards generally have sufficient
authority to accept military service towards licensure, DPH
may not.
4)Status of DCA's efforts to accept military service as credit .
The Legislative Analyst's Office "Supplemental Report of the
2012-13 Budget" (Item 1110-001-XXXX) directed DCA to prepare a
report to the Legislature on the implementation of BPC Section
35, which requires DCA to credit military experience and
AB 213
Page 6
education towards licensure. DCA presented its "Report to the
California State Legislature: Acceptance of Military
Experience & Education Toward Licensure" on October 1, 2012,
which provided a list of boards that accept military
experience and a description of the statutes and regulations
that authorize the acceptance of military experience towards
licensure.
DCA reports that the following healing arts programs have some
statutes, rules, or regulations for accepting military
experience or education from veterans towards licensure:
a) Board of Pharmacy;
b) Physical Therapy Board of California;
c) Board of Registered Nursing;
d) Respiratory Care Board; and
e) Board of Vocational Nursing and Psychiatric
Technicians.
DCA indicated that the following healing arts programs do not
have specific statutes, rules, or regulations for accepting
military credit from veterans. Instead, these programs have
broad authority and discretion to accept experience or
education towards licensure:
a) Dental Board of California;
b) Medical Board of California;
c) California Board of Occupational Therapy;
d) Osteopathic Medical Board of California;
e) Physician Assistants Committee;
f) Psychology Board;
g) Veterinary Medical Board;
h) Board of Behavioral Sciences;
AB 213
Page 7
i) Dental Hygiene Committee of California;
j) Board of Optometry;
aa) Board of Podiatric Medicine; and,
bb) Speech-Language Pathology and Audiology and Hearing
Aid Dispensers Board.
DCA reports that the following programs do not accept military
credit towards licensure and there does not appear to be
similar military job classifications available:
a) Acupuncture Board - DCA is not currently aware of
any military programs training acupuncturists; however,
curriculum requirements for acupuncturist educational
programs require a certain amount of the curriculum to
involve western medical practices. A veteran could use
training or education regarding western medicine earned
in the military towards these requirements; however, that
determination for accepting credit would be left to the
educational program, not the Acupuncture Board.
b) Naturopathic Committee - DCA is not currently aware
of any military facilities that provide training or
education in the naturopathic field or any military job
classifications for naturopathic doctors.
DCA was not asked as part of the report, nor does it currently
track, which schools accredited or approved by boards have
procedures in place to evaluate and accept military education
and experience. DCA also does not track the effectiveness of
the current statutes and regulations toward licensing former
members of the military.
1)DPH needs additional statutory authority to accept military
service for some professions . The Legislative Analyst's
Office "Supplemental Report of the 2012-13 Budget" (Item
4265-001-0001) also requested that DPH submit a report to the
Legislature on DPH's efforts to accept military training and
experience towards licensure or certification. That report,
"Consideration of Military Experience for Professional
Licensure" was provided to the Legislature on October 1, 2012.
Although there is no explicit statute currently requiring
DPH-regulated professions to accommodate military training and
AB 213
Page 8
experience, some do voluntarily.
In the report, DPH indicated that it has some policies in
place to evaluate education, training, and experience obtained
in military service for Medical Laboratory Technicians,
Clinical Laboratory Scientists, Radiologic Technologists,
Nuclear Medicine Technologists, Certified Nurse Assistants,
and Nursing Home Administrators.
DPH does not currently have the statutory authority to issue a
certification as a Certified Hemodialysis Technician or a
Certified Home Health Aide based on military experience or
education, though military training programs may apply to CDPH
for approval.
2)Arguments in support . The Office of the Deputy Assistant
Secretary of Defense, Military Community and Family Policy
writes in support of this bill that "[s]eparating Service
members are frequently delayed getting post-Service employment
even though they have applicable military education, training,
and experience which can qualify them for academic credit
towards degree requirements or help them meet state licensing
requirements. Reported unemployment rates of separating
Service members that are higher than national averages have
brought attention to supporting issues such as academic credit
and state licensing for service to alleviate this problem."
3)Arguments in opposition . The California Society of Radiologic
Technologists (CSRT) write, "To ensure equivocal education the
legislation MUST include a CSRT Board member and California
Radiology Program Educator as part of the Board suggested in
the proposed legislation. Those who do not meet the criteria
for immediate testing and licensure should be considered for
advanced placement within a school designated for the remedial
training required."
4)Questions for the committee . The Committee may wish to inquire
of the author and sponsor as to what may be considered
"satisfactory evidence" of education, training, and practical
experience gained while in military service. In considering
the criteria, it may be worthwhile to consider accepting,
among other evidence, the DD Form 2586, "Verification of
Military Experience and Training." This is automatically
created from individuals' records from the Army, Navy, Air
Force, and Marine Corps and lists military job experience and
AB 213
Page 9
training history, recommended college credit information, and
civilian equivalent job titles.
It remains unclear beyond anecdotal evidence to what extent
veterans actually experience difficulty translating their
military experience to California licensure or certification.
It is also unclear whether or not such difficulties are
attributable to flaws in the regulatory framework, to a lack
of DCA/DPH outreach and education about California's licensing
system, or some other cause. The Committee may wish to
consider whether it might be useful to request that DCA and
DPH actually track the efficacy of their existing programs,
and suggest improvements based on actual data.
The Committee may also wish to consider whether the six months
allotted by this bill gives schools sufficient time to
implement the requirements of this bill.
5)Suggested technical amendments . The author may wish to
consider clarifying the reference to "completed by the
applicant as a member of the United States Armed Forces?"
because that could encompass classes/experience gained in
civilian life while the applicant was an active duty
serviceperson. For example, the current language would
require course credit given to an active duty military member
who is not a Clinical Laboratory Scientist in his or her
military capacity but who took a class after work, unapproved
by DPH, to become a Clinical Laboratory Scientist after his or
her separation from the military. To ensure that the
experience and education submitted is from military service
directly, the phrase "completed as part of the applicant's
military service" or similar language may be more accurate.
6)Related Legislation . AB 555 (Salas) would require a board to
consider any relevant training an applicant received while
serving in the armed forces of the United States for purposes
of satisfying the requirements for a license, if applicable to
the requirements for the particular business, occupation, or
profession regulated by the board. That bill would also
authorize a board to consult with the Department of Veterans
Affairs and the Military Department when evaluating whether
training acquired during service in the armed forces of the
United States is applicable to a particular license. That bill
is in the Assembly Business, Professions and Consumer
Protection Committee.
AB 213
Page 10
AB 704 (Blumenfield) would require the Emergency Medical
Services Authority to develop and adopt regulations to, upon
presentation of satisfactory evidence, accept the education,
training, and practical experience completed by an applicant
with military experience toward the qualifications and
requirements for EMT-I certification, EMT-II certification, or
EMT-P licensure, as specified. That bill is in the Assembly
Business, Professions and Consumer Protection Committee.
AB 705 (Blumenfield) would require the Board of Registered
Nursing to adopt regulations that identify the Armed Forces
coursework, training, and experience that is equivalent or
transferable to coursework required for licensure by the
board. This bill would require the board, after evaluating a
military applicant's education and training, to provide the
applicant with a list of the coursework he or she must still
complete to be eligible for licensure. That bill is in the
Assembly Business, Professions and Consumer Protection
Committee.
AB 851 (Logue) is similar to this bill, but would relate only
to the Dental Board of California. That bill is in the
Assembly Business, Professions and Consumer Protection
Committee.
AB 1057 (Medina) would require each BPC board to inquire in
every application for licensure if the applicant is serving
in, or has previously served in, the military. That bill is in
the Assembly Business, Professions and Consumer Protection
Committee.
7)Previous Legislation . AB 1976 (Logue) of 2012 was
substantially similar to this bill. That bill was held in the
Assembly Appropriations Committee.
AB 1932 (Cook) of 2012 would have required DCA healing arts
boards to issue a written report to the California Department
of Veterans Affairs by January 1, 2014 detailing the methods
for evaluating the education, training, and experience
obtained by applicants in military service and whether that
education, training, and experience is applicable to the
boards' requirements for licensure. This bill was held in the
Senate Rules Committee.
AB 213
Page 11
SB 289 (Ed Hernandez), Chapter 352, Statutes of 2012,
clarified that DPH has the authority to approve certain
clinical laboratory scientist training programs owned and
operated by the United States military that are at least 52
weeks long.
8)Double-Referral . This bill is double-referred, and if passed
by this Committee will be referred to the Veterans Affairs
Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
American Legion-Department of California
AMVETS - Department of California
Association of California Healthcare Districts
California Association of County Veterans Service Officers
California Association for Health Services at Home
California State Commanders Veterans Council
Office of the Deputy Assistant Secretary of Defense, Military
Community and Family Policy
VFW Department of California
Vietnam Veterans of America - California State Council
Opposition
California Society of Radiologic Technologists
Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
319-3301