BILL ANALYSIS �
AB 705
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Date of Hearing: April 16, 2013
ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
Al Muratsuchi, 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
Consumer Affairs healing arts boards to provide for methods of
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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 at this time.
COMMENTS :
According to the author:
In California, the Board of Vocational Nursing and
Psychiatric Technicians (BVNPT) recognize military training
and experience so that an applicant can submit
documentation of that training and experience for credit
towards becoming a Licensed Vocational Nurse (LVN). BVNPT
will determine whether the applicant is deficient in
coursework, which the applicant must satisfy before being
issued a license. However, if this same applicant were to
apply with the Board of Registered Nursing to become an RN,
none of the applicant's training and experience would
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apply. This applicant would be required to re-take courses
in which they have already gained expertise. AB 705 would
correct this inconsistency for applicants who wish to be
nurses in California, and respect the training and
experience of our veterans.
According to the Committee on Business and Professions:
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?
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.
?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.
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?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. ?
Existing law directs BRN to consider military applicants'
experience and training. It is unclear why none of the military
coursework or experience is applicable to RN licensure or RN
programs at schools. At a minimum, courses in anatomy,
physiology, microbiology, English composition, nutrition, and
psychology, for example, appear from a quick review online of
several RN programs to be the kind of coursework that is
foundational for all/almost all nursing program levels. The
foundational nature of these courses seems to be recognized in
that military applicants are directed to an LVN program which
credits their military training and experience; the LVN program
can then serve as a bridge to becoming an RN. So military
experience and training is credited toward becoming an LVN, and
becoming an LVN is credited toward becoming an RN.
The National Council of State Boards of Nursing (NCSBN)
published, "A Comparison of Selected Military Health Care
Occupation Curricula with a Standard Licensed
Practical/Vocational Nurse Curriculum." This report is of
course in the context of LPN/LVN programs. That report
concluded in pertinent part:
For veterans with training and experience as health care
specialists (medics), corpsmen and airmen, civilian
BON-approved LPN/VN programs should develop bridge programs
that are based on individual assessments of each veteran
and geared towards helping these individuals acquire the
knowledge, skills and abilities needed to practice as an
LPN/VN safely without repeating previously acquired
content.
Each veteran will be leaving the military with varying
levels of experience. Some have inserted chest tubes and
performed other small surgical procedures, while others
have little, if any, experience doing these procedures and
instead had other types of responsibilities (nonhealth care
related) during their military service. Therefore, it is
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recommended that the knowledge, skills and abilities of all
veterans entering an LPN/VN program should be formally
evaluated/ assessed prior to beginning a program. If
proficiency is demonstrated, this should be accounted for
in the LPN/VN program to assist in accelerating the
education process.
This measure pertains to RN programs and licensure applicants,
not LPN/LVN programs/applicants. However, the bill in essence
implements these same kind of recommendations from the NCSBN at
the RN level. It seeks to have schools and the BRN conduct a
formal individualized assessment or at least consider what
training and experience military applicants have.
Policy Questions for Members :
Can BRN use a parallel procedure to what it offers to out
of state or international applicants when considering the
applications of former servicemembers for RN licensure?
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,
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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
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.
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.
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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.
REGISTERED SUPPORT / OPPOSITION :
Support
California Association of County Veterans Service Officers
Vietnam Veterans of America - California State Council
Opposition
American Nurses Association- California
California Nurses Association
Analysis Prepared by : John Spangler / V. A. / (916) 319-3550