BILL ANALYSIS                                                                                                                                                                                                    Ó



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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          2105 (Rodriguez)


          As Amended  August 10, 2016


          Majority vote


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          |ASSEMBLY:  |79-0  |(May 5, 2016)  |SENATE: |37-0  |(August 15,      |
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          Original Committee Reference:  J., E.D., & E.


          SUMMARY:  Requires the Department of Consumer Affairs (DCA) to  
          engage in a specified stakeholder process to update policies and  
          remove barriers to facilitate the development of earn and learn  
          training programs in the allied health professions.  The  
          stakeholder process is required to include all of the following:


          1)A range of allied health workforce stakeholders including, but  
            not limited to, relevant DCA licensure boards, the Division of  
            Apprenticeship, representatives appointed by the board the  
            California community college system, the California Workforce  
            Development Board (CWDB), the State Department of Public  
            Health, the Office of Statewide Health Planning and  
            Development, employer and worker representatives, and  
            community-based organizations.


          2)A review of barriers that limit the use of earn and learn  








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            training programs in the allied health professions, including  
            those identified in the 2015 report Expanding Earn and Learn  
            Models in the California Health Care Industry, as well as  
            other relevant issues that include, but are not limited to,  
            pre-licensure classifications in allied health occupations  
            that would allow students, in a supervised setting, to gain  
            experience in their chosen field before obtaining licensure,  
            and the payment of wages while in a workplace-based training  
            program.


          3)Statutory barriers being shared with the relevant committees  
            of the Legislature.


          4)Completion of the process by January 1, 2020.


          AS PASSED BY THE ASSEMBLY, this bill required the California  
          Workforce Development Board (CWD) to consider the  
          recommendations in a specified report on "earn and learn" job  
          training programs in the allied health professions for the  
          purpose of determining whether any or all of the recommendations  
          should be included within the CWD's work plan for the 2017-18  
          fiscal year or referred to another state entity for possible  
          action.  


          The Senate amendments delete the more general requirement to  
          move forward on reviewing and implementing, where appropriate,  
          the recommendations from the 2015 report Expanding Earn and  
          Learn Models in the California Health Care Industry, and instead  
          provide a specific stakeholder driven process for updating  
          policies and removing entrance and advancement barriers in the  
          allied health fields.


          EXISTING LAW:


          1)Requires the CWD, in consultation with the Division of  
            Apprenticeship Standards, to undertake a review of allied  








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            health professions and produce a report by January 1, 2016.   
            The report is required to address the following:


             a)   Identification of "earn and learn" job training  
               opportunities that meet the industry's workforce demands  
               and that are in high-wage, high-demand jobs;
             b)   Identification of specific requirements and  
               qualifications for entry into "earn and learn" job training  
               models;


             c)   Establishment of standards for "earn and learn" job  
               training programs that are outcome oriented and  
               accountable.  The standards are required to measure the  
               results from program participation, including a measurement  
               of how many individuals complete the program with an  
               industry-recognized credential, as specified;


             d)   Development of the means to identify and prepare a pool  
               of qualified candidates seeking to enter "earn and learn"  
               job training models.


          1)Defines "earn and learn" to include, but not be limited to, a  
            program that does either of the following:
             a)   Combines applied learning in a workplace setting with  
               compensation allowing workers or students to gain work  
               experience and secure a wage as they develop skills and  
               competencies directly relevant to the occupation or career  
               for which they are preparing; or 
             b)   Brings together classroom instruction with on-the-job  
               training to combine both formal instruction and actual paid  
               work experience.


          2)Defines "earn and learn" programs to include, but not be  
            limited to, all of the following:
             a)   Apprenticeships;
             b)   Pre-apprenticeships;









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             c)   Incumbent worker training;


             d)   Transitional and subsidized employment, particularly for  
               individuals with barriers to employment;


             e)   Paid internships and externships; and


             f)   Project-based compensated learning.


          FISCAL EFFECT:  According to Senate Appropriations Committee  
          pursuant to Senate Rule 28.8, negligible state costs.


          COMMENTS:  In December 2015, the CWDB and the California State  
          Division of Apprenticeship Standards released the study,  
          Expanding Earn and Learn Models in the California Health Care  
          Industry, pursuant to the requirements of AB 1797 (Rodriguez),  
          Chapter 157, Statutes of 2014.  The report noted that while  
          there were many advantages to expanding apprenticeship programs  
          in the allied health industries, there were also barriers,  
          including, but not limited to, the following:


          1)No clear career ladders for entry-level workers to advance  
            into clinical roles, or for lateral movement from one health  
            care role into another;
          2)Few residency programs or even commitments to hire prior to  
            completion of the license or credential;


          3)Misalignment of time-based standards used for registered  
            apprenticeships and the competency-based training models  
            commonly used in health care fields;


          4)No funding available for public health care employers to  
            invest in program development, outreach, administration (e.g.,  








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            record-keeping and journey-level supervision of apprentices),  
            or, more fundamentally, the industry model of wage  
            progression;


          5)Limited flexibility or agility by public education  
            institutions to adopt and implement new curricula.  As an  
            example, it can take more than a year to approve new curricula  
            by a community college and longer if an existing course must  
            be modified to include apprenticeship indicators;


          6)Licensing boards have traditionally acted as gatekeepers to  
            their professions and have not been open to expanding entry  
            into some of the skilled health care professions for fear of  
            diminishing wages.  There is also evidence that accreditation  
            boards can be reluctant to create flexible or alternative  
            pathways to entry over concerns that this will lower quality  
            standards;


          7)Misaligned funding incentives for community college  
            participation.  In this example, the reimbursement rate for a  
            general education credit is approximately $8.50 per hour, as  
            compared to $5.46 per hour for students taking apprenticeship  
            classes.  This creates a structural disincentive for colleges  
            to partner with employers and unions on allied health-related  
            programs;


          8)Poor track record in maintaining funding levels for public  
            apprenticeship programs.  Funding issues may be deterring  
            potential employers and partners from participating in a new  
            round of program development; and  


          9)Lack of cross-sector collaboration on the development of new  
            apprenticeship programs, especially from the federal entities  
            which administer the Medicare and Medicaid programs.


          California Employment:  California's labor force is comprised of  








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          approximately 19 million people with an estimated 17.8 million  
          people being employed.  Chart 1 shows 2015 employment by  
          industry sector.  Based on total employment, the trade,  
          transportation, and utilities sector is largest, employing 2.9  
          million people, which is 15.5% of all jobs.  The Education and  
          Health Services sector is the third highest industry sector in  
          California, representing 12.9% of the state's workforce. 





          Chart 2 displays projected job growth by industry sectors for  
          the period of 2012 to 2022.  As discussed in more detail below,  
          future growth of the California economy is highly linked to the  
          state's adaptation to globalization, including the state's  
          ability to link goods and services across state and regional  
          boundaries, as well as to prepare a rapidly changing workforce  
          for the 21st Century economy. 





          The Employment Development Department's (EDD's) 2012 to 2022  
          forecast estimates that California's labor force employment will  
          reach 18.7 million, including self-employment, unpaid family  
          workers, private household workers, and farm and nonfarm  
          workers.  This estimate represents a 14.9% increase over the 10  
          year period with an additional 2,296,700 being added to nonfarm  
          employment.  As shown in Chart 2, 72% of the increase in jobs is  
          expected in four industry sectors:  education and health care  
          services; professional and business services; leisure and  
          hospitality; and retail trade.


          Approximately 25% of the project job growth will be in the  
          educational services (private), health care, and social  
          assistance sector, accounting for 576,300 jobs during the  
          10-year period.  EDD estimates that as the population grows and  
          demographics change, the demand for workers in this sector will  
          remain high. 








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          The greatest concentration of job gains is projected to occur in  
          the following subsectors:  Social assistance (201,300);  
          Ambulatory health care services (181,900); Educational services  
          (private) (79,200).


          Analysis Prepared by:                                             
                          Toni Symonds / J., E.D., & E. / (916) 319-2090    
                                                                    FN:  
          0003973