BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 213
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          Date of Hearing:   April 16, 2013

                       ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
                                Al Muratsuchi, 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  
            certification by DPH if DPH determines that the education,  








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            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,'  
            and 'agency.'" (BPC Section 22) 








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          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  
            methods of evaluating education, training, and experience  








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            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 at this time.

           COMMENTS  :   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,  








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            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.

          According to the Committee on Business and Professions:

            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, ? suggest that while  
            DCA boards generally have sufficient authority to accept  
            military service towards licensure, DPH may not. 
           
             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 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  








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            for approval. 

          This statute will address the need for additional statutory  
          authority at DPH to consider military training and experience  
          for the professions enumerated above.  It will also make it  
          mandatory that DPH consider such training and experience in all  
          of its programs.

          In addition, there is currently no program in place to require  
          that DCA or DPH healing arts boards' accredited schools accept  
          military education, training, or practical experience.  It is  
          unknown how many such schools already do accept such education,  
          training, and experience.  In theory, initiating this  
          requirement will expand the number of schools at least  
          considering military experience and training which is in  
          alignment with the policy expressed in BPC 35.  Schools retain  
          the ability to decide what military training and experience will  
          count toward their programs, but they must at least have a  
          process in place.

           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.  

           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.  
           
          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  








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          with a list of the coursework he or she must still complete to  
          be eligible for licensure.  
           
          AB 851 (Logue) is similar to this bill, but would relate only to  
          the Dental Board of California.  
           
          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.  

          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.   

          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.   

           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









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           Opposition 
           
          California Society of Radiologic Technologists
           
          Analysis Prepared by  :    John Spangler / V. A. / (916) 319-3550