BILL ANALYSIS                                                                                                                                                                                                    �






                             SENATE COMMITTEE ON HEALTH
                          Senator Ed Hernandez, O.D., Chair

          BILL NO:       SB 271
          AUTHOR:        Hernandez
          INTRODUCED:    February 14, 2013
          HEARING DATE:  April 3, 2013
          CONSULTANT:    Moreno

           SUBJECT  :  Associate Degree Nursing Scholarship Program.
           
          SUMMARY  :  Deletes the January 1, 2014, sunset date in the  
          section of existing law that establishes the Associate Degree  
          Nursing Scholarship Pilot Program (ADN Scholarship Program) and  
          makes other technical, conforming changes.

          Existing law: Establishes, until January 1, 2014, the ADN  
          Scholarship Program in the Office of Statewide Health Planning  
          and Development (OSHPD) to provide scholarships to students, as  
          specified, in counties determined to have the most need. 
          
          This bill: Deletes the January 1, 2014, sunset date in the  
          section of existing law that created the ADN Scholarship Program  
          and makes other technical, conforming changes.

           FISCAL EFFECT  :  This bill has not been analyzed by a fiscal  
          committee

           COMMENTS  :  
           1.Author's statement. Implementation of the Affordable Care Act  
            (ACA) will bring millions of uninsured Californians into the  
            health delivery system in 2014, exacerbating an already acute  
            health provider shortage. This shortage reflects a current  
            inadequate supply of providers attempting to meet the needs of  
            California's diverse population.  Coupled with a  
            disproportionate geographic distribution of providers and a  
            graying workforce, this shortage has significant potential to  
            negatively impact the overall quality of its patient care.  
            While the nation has been experiencing a shortage of nurses  
            for more than a decade, it has been particularly acute in  
            California, where a booming and aging population, combined  
            with higher education budget cuts, has led to challenges in  
            meeting the nursing demand. The Registered Nurse shortage has  
            also resulted in a diminished ability to educate the incoming  
            population of nursing students. This bill will ensure that  
            this valuable program continues to operate, providing patient  
                                                         Continued---



          SB 271 | Page 2




            access to practitioners in medically underserved areas (MUAs).
            
          2.Background. The ADN Scholarship Program provides scholarships  
            of up to $10,000 to ADN students in exchange for providing  
            direct patient care in a MUA in California after graduation.   
            The ADN Scholarship Program is funded from the Registered  
            Nurse Education Fund (RNEF), which is supported by a $10  
            surcharge on all RN licensure renewals. According to OSHPD,  
            the RNEF funds the following programs:
             a.   ADN Program 
             b.   Bachelor of Science Nursing (BSN) Scholarship Program 
             c.   BSN Loan Repayment Program 
             d.   Entry-Level Master's Degree Program
             e.   Registered Nurse Education Master's or Doctoral Degree  
               Teaching Program

            Currently, 30 percent of the RNEF's $1.7 million budget is  
            directed to the AND Scholarship Program for scholarships. To  
            be eligible for an ADN Program scholarship, an applicant must:  

             a.   Be currently accepted or enrolled in an ADN Scholarship  
               program in California.
             b.   Be free from any other service obligation. 
             c.   Have valid legal presence and ability to work and  
               provide care in the state of California.
             d.   Be willing to work in a MUA for two years.

            OSHPD states that the current demand for ADN Scholarship  
            Program scholarships vastly outweighs the supply of available  
            funding for the program. Since May 2003 through September  
            2011, the Health Professions Education Foundation has received  
            $10.6 million in scholarship applications, and approximately  
            $3.2 million in ADN Scholarship Program scholarships were  
            awarded. Below is data related to the number of applications  
            received and scholarships awarded.

             ----------------------------------------------------------- 
            |      |      Applications     |            Funds           |
             ----------------------------------------------------------- 
            |------+-----------+-----------+-------------+--------------|
            |  Year|  Received |  Awarded  |  Requested  |  Awarded     |
            |      |           |           |             |              |
            |------+-----------+-----------+-------------+--------------|
            |  2003|    94     |    29     |  $          |     $ 103,500|
            |      |           |           |             752,000|              |
            |------+-----------+-----------+-------------+--------------|




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            |  2004|    155    |    23     |   $1,240,000|     $ 152,000|
            |      |           |           |             |              |
            |------+-----------+-----------+-------------+--------------|
            |  2005|    160    |    35     |   $1,120,000|     $ 214,000|
            |      |           |           |             |              |
            |------+-----------+-----------+-------------+--------------|
            |  2006|    110    |    29     |  $          |     $ 152,000|
            |      |           |           |             524,000|              |
            |------+-----------+-----------+-------------+--------------|
            |  2007|    133    |    65     |  $          |     $ 476,000|
            |      |           |           |             824,000|              |
            |------+-----------+-----------+-------------+--------------|
            |  2008|    205    |    53     |  $          |     $ 343,000|
            |      |           |           |             580,000|              |
            |------+-----------+-----------+-------------+--------------|
            |  2009|    213    |    61     |   $1,305,000|     $ 575,000|
            |      |           |           |             |              |
            |------+-----------+-----------+-------------+--------------|
            |  2010|    247    |    128    |   $2,215,000|     $ 683,280|
            |      |           |           |             |              |
            |------+-----------+-----------+-------------+--------------|
            |  2011|    204    |    64     |   $2,040,000|     $ 484,836|
            |      |           |           |             |              |
            |------+-----------+-----------+-------------+--------------|
            | 2012 |    124    |    67     |   $1,240,000|$582,967      |
             ----------------------------------------------------------- 
            
          1.Support.  The California Hospital Association states that it  
            is difficult for health providers in rural and other  
            underserved regions of the state to attract a nursing  
            workforce due to various factors, such as geographic isolation  
            and a lack of amenities found in more urban environments. The  
            California Hospital Association further supports that this  
            program targets students from underserved communities and  
            provides support for them to obtain the necessary education  
            for licensure as a registered nurse. The California Nurses  
            Association states that scholarships are an effective means of  
            increasing the supply of educated and trained health  
            professionals, and that ADN Scholarship Program applicants and  
            awardees represent the state's diverse population, thereby  
            increasing access to culturally and linguistically appropriate  
            practitioners in MUAs.  

           SUPPORT AND OPPOSITION  :
          Support:  California Hospital Association




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                    California Nurses Association
                    California Optometric Association
                    United Nurses Association of California/Union of  
                              Health Care Professionals

          Oppose:   None received

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