BILL ANALYSIS �
AB 705
Page 1
Date of Hearing: April 9, 2013
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Richard S. Gordon, Chair
AB 705 (Blumenfield) - As Amended: April 3, 2013
SUBJECT : Combat to Care Act.
SUMMARY : Requires the Board of Registered Nursing (BRN) to
promulgate regulations that identify the military education,
training, and experience that is equivalent or transferable to
coursework required for licensure as a registered nurse (RN)
and, upon receipt of an applicant's record of education,
training, and experience completed in the Armed Forces, provide
the applicant with a list of coursework, if any, that the
applicant must complete for license eligibility. Specifically,
this bill :
1)Requires BRN, by January 1, 2015, to promulgate regulations
identifying Armed Forces education, training, and experience
that is equivalent or transferable to coursework required for
RN licensure.
2)Requires BRN to provide a veteran applicant qualified as a
"medical service technician - independent duty" or the
equivalent with a list of coursework, if any, that the
applicant must complete to be eligible for RN licensure.
3)Makes Legislative findings and declarations.
4)Makes other technical and clarifying amendments.
EXISTING LAW :
1)Establishes BRN to license and regulate the practice of
nursing. (Business and Professions Code (BPC) Section 2701)
2)Requires all boards regulated under the BPC to provide for
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)
3)Requires the rules and regulations of the Department of
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Consumer Affairs 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)
4)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)
5)Requires BRN to evaluate for RN licensure the training record
submitted by any person who has served on active duty in the
medical corps of any of the Armed Forces and completed the
course of instruction required to qualify him or her for
rating as a medical service technician--independent duty, or
other equivalent rating in his particular branch, and whose
service in the armed forces has been under honorable
conditions. (BPC 2736.5)
6)Permits a person who has served on active duty in the medical
corps of any of the armed forces, in which no less than an
aggregate of 12 months was spent in rendering bedside patient
care, and who has completed the basic course of instruction in
nursing required by his or her particular branch of the armed
forces, and whose service in the armed forces has been under
honorable conditions to sit for an licensed vocational nurse
(LVN) license exam. (BPC 2873.5)
FISCAL EFFECT : Unknown
COMMENTS :
1)Purpose of this bill . This bill would require BRN to develop
regulations identifying the specific military coursework,
training, and experience that would count towards RN
licensure, and also identify any coursework that the RN
license applicant lacks. Current law already requires BRN to
recognize certain military coursework, training, and
experience, but BRN does not appear to be in compliance. This
bill would direct BRN to explicitly conform its regulatory
behavior to current law. This bill is author sponsored.
2)Author's statement . According to the author, "The second and
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third largest military occupational specialties require
high-quality medical training - training that, upon returning
to civilian life, veterans have difficulty transferring
towards credit for healthcare-related employment. According to
the California Employment Development Department, registered
nurses currently have more than 100,000 job openings
statewide. Recognizing the experience and training of veterans
with medical training as credit towards a nursing license
would help fill these much-needed healthcare positions with
highly trained veterans."
3)Issues with existing law and compliance . Several laws already
in effect require BRN to develop regulations that establish
criteria for evaluating military experience and training
towards RN licensure. The statute that this bill amends
explicitly directs BRN to evaluate the records of military
personnel who are designated as a "medical service
technician-independent duty," or the equivalent thereof, for
RN licensure. A "medical service technician-independent duty"
translates most directly to a LVN or physician assistant (PA)
civilian license, although there is coursework that is
applicable toward licensure as an RN. It is unclear whether
the regulations developed by BRN sufficiently aid veterans
toward licensure as a RN as directed by statute.
Until 2000, there were parallel training requirements in the
military and civilian worlds to qualify for the RN license
examination. BRN adopted regulations in 1976 and 1985 that
specifically identified military titles and supplemental
experience that would be exhaustive of BRN requirements. In
2000, BRN determined that the military coursework had changed
and was no longer directly transferrable. BRN then updated
the regulations for evaluating military training to be broadly
descriptive, which made identifying any specific relevant
military coursework difficult. BRN has not evaluated military
coursework since, although the board reports they were told by
military representatives in 2010 that the military does not
have a directly comparable RN training program.
4)Delegation of evaluation duties from BRN to the schools. As
noted above, current law requires BRN to evaluate military
education and training regardless of whether military and
civilian programs are identical. These laws are designed to
help military applicants identify what coursework and
experience completed in the military is transferrable so that
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military applicants do not duplicate their efforts in pursuit
of licensure.
According to BRN, it has effectively delegated the duty of
identifying eligible military coursework to approved RN
programs, for which BRN is required to approve the curriculum.
However, according to the Executive Director (ED), BRN does
not know to what extent, if any, schools are providing credit
for military experience and education. The ED stated that BRN
has never spoken to schools about accepting military
coursework and experience for credit, nor has BRN suggested
which military coursework may be transferrable. This raises a
concern about compliance, because those schools may not have
sufficient incentives to accept military credit because it
would cause students to spend less time and money (especially
lucrative GI Bill funding) on their programs.
In lieu of BRN providing any direct assistance to military
applicants, BRN directs applicants to the Board of Vocational
Nurses and Psychiatric Technicians (BVNPT). BVNPT has
identified a direct pathway to licensure as a vocational nurse
from military service. If a military applicant is lacking
coursework, BVNPT identifies which courses they need to be
eligible to sit for the licensing exam. BRN noted that after
gaining LVN licensure - credited in part to their military
training - the military applicant could take a LVN to RN
"bridge" program, which supplements the applicant's LVN
training to be eligible for the RN exam.
BRN insists that they are helping military applicants by
rerouting them towards LVN licensure so they can get a job as
soon as possible, but if a military applicant wants to become
an RN directly, BRN has little information to give. BRN does
not have any information what additional coursework applicants
may need based on their military transcripts, about which
schools (if any) give credit to military education and
experience, and which schools give more credit to military
coursework than others. BRN does, however, provide assistance
to non-military applicants. Upon receipt of a inadequate
application from an out-of-state or international applicant
for licensure, BRN reports that it notifies the applicants of
his or her transcript deficiencies and recommends supplemental
coursework. BRN did not offer an explanation for the
discrepancy.
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This bill directs BRN to reassert itself as the central
authority for RN licensure requirements so that military
applicants may go to one location to understand what further
education they may need based on their military training and
experience.
5)Question for the Committee . The Committee may wish to inquire
of BRN as to the deficiencies, if any, in existing law that
prevents BRN from effectuating the letter and spirit of the
statutes already in place directing BRN to aid veteran
applicants.
6)Related Legislation . AB 555 (Salas) directs the Legislature,
via intent language, to enact legislation that would
streamline the licensure process of various professions and
vocations for veterans and members of the military separating
from service. That bill is in the Assembly Business,
Professions and Consumer Protection Committee.
AB 704 (Blumenfield) would require the Emergency Medical
Services Authority to develop and adopt regulations to accept
military education, training, and practical 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 851 (Logue) would require the Dental Board of California
(DBC) to accept education, training, and practical experience
completed by an applicant in military service toward the
qualifications and requirements to receive a license or
certificate if that education, training, or experience is
equivalent to the standards of the board. If DBC accredits or
otherwise approves schools offering educational course credit
for meeting licensing and certification qualifications and
requirements, the bill would, not later than July 1, 2014,
require those schools seeking accreditation or approval to
have procedures in place to evaluate 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, as specified.
That bill is in the Assembly Business, Professions and
Consumer Protection Committee.
AB 859 (Gomez) would state the intent of the Legislature to
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enact legislation that would promote and pursue programmatic
changes to nursing and paramedic licensure requirements for
California's military medical personnel in order to recognize
the talent, skills, and training of these military medical
personnel. That bill is in the Assembly Rules 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 would have
required healing arts boards within DCA, as well as
professional licensure programs within the Department of
Public Health (DPH), to accept military training towards
licensure requirements, as applicable, and would have required
boards that accredit schools to ensure schools have procedures
in place to accept military training. 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 Jan. 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. That bill was held in the Senate
Rules Committee.
AB 2659 (Blumenfield) Chapter 406, Statutes of 2012 permits
the Department of Motor Vehicles (DMV) to waive the driving
skills test required to obtain a commercial driver's license
(CDL) for a person with a U.S. Armed Forces military driver's
license in compliance with federal regulations.
SB 289 (Ed Hernandez) Chapter 352, Statutes of 2012, clarifies
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, it will be referred to the Veterans Affairs
Committee.
AB 705
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REGISTERED SUPPORT / OPPOSITION :
Support
California Association of County Veterans Service Officers
Vietnam Veterans of America - California State Council
Opposition
None
Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
319-3301