BILL ANALYSIS
AB 657
Page 1
ASSEMBLY THIRD READING
AB 657 (Hernandez)
As Amended June 2, 2009
Majority vote
HEALTH 12-4 LABOR AND EMPLOYMENT 5-2
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|Ayes:|Jones, Ammiano, Block, |Ayes:|Monning, Eng, Furutani, |
| |Carter, | |Ma, Portantino |
| |De La Torre, De Leon, | | |
| |Hall, Hayashi, Hernandez, | | |
| |Bonnie Lowenthal, Hill, | | |
| |Salas | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Adams, Conway, Emmerson, |Nays:|Bill Berryhill, Gaines |
| |Gaines | | |
| | | | |
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APPROPRIATIONS 12-5
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|Ayes:|De Leon, Ammiano, |
| |Charles Calderon, Davis, |
| |Fuentes, Hall, John A. |
| |Perez, Price, Skinner, |
| |Solorio, Torlakson, |
| |Krekorian |
| | |
|-----+--------------------------|
|Nays:|Nielsen, Duvall, Harkey, |
| |Miller, Audra Strickland |
| | |
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SUMMARY : Requires the Office of Statewide Health Planning and
Development (OSHPD), in collaboration with the California
Workforce Investment Board (Board), to establish a task force to
assist OSHPD in developing a health care workforce master plan
for the state. Specifically, this bill requires:
1)OSHPD, in collaboration with the Board and based on
information provided by the Health Care Workforce
Clearinghouse, to establish and lead in coordinating the
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Health Professions Workforce Task Force (Task Force) to assist
in the development of a health professions workforce master
plan for the state. Specifies task force membership is
voluntary and without compensation. Requires the task force
to comprise not more than 21 members representing both rural
and urban areas and the following, as specified: a) The
Legislature; b) University of California (UC); c) The
California State University; d) California Community Colleges;
e) The Department of Education; f) Leadership of a health
sciences program in a school district; g) The Board and a
regional workforce investment board; h) Labor, health
insurers, and medical groups; i) Health professions, including
nursing and allied health; j) Community clinics and hospitals;
and, k) Community-based organizations.
2)The Task Force to hold its first meeting no later than October
31, 2009, and to meet no less than three times per year to do
all of the following:
a) Assess impact, capacity, and effectiveness of, and
report on, existing state and private workforce training
programs, as specified;
b) Review local workforce investment plans and assess
progress toward meeting current health workforce needs;
c) Identify education and employment trends in the health
professions;
d) Identify the ten health care professions with the
highest demand and develop a plan to meet that demand;
e) Recommend state policies to address workforce shortage
and distribution issues;
f) Compile, assess, and align with other strategic plans
for developing California's health workforce; and,
g) Submit to OSHPD, no later than October 31, 2013, a
complete health professions workforce master plan to OSHPD
and the Legislature.
3)The Task Force to seek, and OSHPD to accept, funds from the
federal government and private entities to support the
activities of the Task Force.
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FISCAL EFFECT : According to the Assembly Appropriations
Committee, annual costs in the range of $100,000 of federal or
private funding through 2013, if the Task Force succeeds in
securing such support.
COMMENTS : According to the author, this bill is needed because
there is currently no statewide strategic plan on the health
care workforce. The author states that demographic shifts are
causing widening gaps between health care workforce supply and
demand, as seen in shortages of primary care providers and other
health professionals. California's population is aging,
growing, and increasing in diversity, and California's workforce
of health professionals is ill-equipped to respond to new
pressures on the health care system. Additionally, the author
is concerned that state and private entities are working in
silos, leading to duplication of efforts and inefficiency.
The UC Office of the President's Final Report of the Advisory
Council on Future Growth in the Health Professions (UC report)
notes California has more residents age 65 and older than any
other state, and more than one in four California residents is
born outside the U.S. According to the UC report, by 2015,
nearly 37% of California's population will be of Hispanic or
Latino origin, nearly 14% will be of Asian or Pacific Islander
heritage, and 6% will be African-American. The report indicates
that there are shortages in nearly all health professions,
including the approximately 200 allied health occupations. The
UC report projects that California will face a shortfall of
approximately 47,600 nurses by 2010, and shortfalls of 116,000
nurses and nearly 17,000 doctors by 2015.
In addition to the provider shortage, health care professionals
are not proportionately representative of the populations they
serve. According to the Sullivan Commission Report, "Missing
Persons: Minorities in the Health Professions" (Sullivan
Report), African-Americans, Hispanic-Americans, and American
Indians make up more than 25% of the U.S. population but only 9%
of the nation's nurses, 6% of its physicians, and 5% of
dentists. The Sullivan Report further links poorer minority
health to the shortage of minority health care providers.
The UC report indicates that California has limited capacity to
educate and train health care providers and has long relied on
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in-migration of health professionals trained in other states and
countries. According to the California Medical Association,
California ranks 39th in the nation in the number of medical
students per capita. UC indicates that 60% of qualified nursing
students were turned away because of a lack of educational
slots.
In 2007, Governor Schwarzenegger convened through OSHPD the
Healthcare Workforce Diversity Advisory Council (Council), which
was composed of diverse stakeholders and funded by a $120,000
grant from the California Wellness Foundation (TCWF) for one
year. The Council's final report recommended in part that the
State develop a comprehensive, multi-year strategy and
implementation plan to develop health workforce diversity.
In 2006, The California Endowment awarded a grant to the Public
Health Institute and the UC Berkeley School of Public Health to
conduct a comprehensive study on health professions workforce
diversity for the state. This study, called the Connecting the
Dots (CTD) Initiative, examined current and potential roles for
all stakeholders, including K-12 schools, local communities,
health professions employers, and local and state government.
CTD recommends, in part, the state develop a comprehensive
health workforce master plan, institutionalize the Council, and
improve health professions data collection through licensing
agencies.
In May 2007, the Assembly Health Committee held an informational
hearing on the California health care workforce, during which
speakers spoke of the need for new programs to increase the
diversity of California's health care workforce. A speaker
representing TCWF pointed out that increasing diversity in the
health professions is not only an avenue for improving quality
of care and access to care, but also an important workforce
development strategy. TCWF noted that jobs in the healthcare
sector, particularly among the allied health professions, are
now among the fastest growing in the economy, and data indicate
that in the next 15 years California will require tens of
thousands of nurses and other allied health professionals to
meet demand.
In March 2009, the Senate Health Committee held an informational
hearing entitled "California's Healthcare Workforce - Toward a
Comprehensive Solution." Witnesses at this hearing highlighted
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California's health workforce shortages and lack of diversity
and recommended that the state develop a comprehensive health
workforce master plan.
The California Academy of Family Physicians (CAFP), sponsor of
this bill, writes some seven million Californians live in health
professions shortage areas (HPSAs) with less than one primary
care physician per 3,500 residents. CAFP argues HPSA residents
suffer higher rates of preventable diseases, poorly treated
chronic conditions, and preventable complications such as
end-stage renal disease. The California Dental Association
writes in support that a workforce master plan could produce
findings for use by dental and other health professions to
develop policies on recruitment, retention, training and
educational programs to improve access to care in the state.
The San Bernardino County Board of Supervisors writes in support
of a prior version that an adequate supply of well-prepared
public health professionals is essential to an effective public
health system, and it has had continuing difficulties in hiring
qualified public health professionals, leading to chronic
understaffing, difficult working conditions, the loss of
population-based services and direct patient services, and
delaying the start-up of new programs. The California
Pan-Ethnic Health Network and the American Federation of State,
County, and Municipal Employees, AFL-CIO also support this bill.
Analysis Prepared by : Allegra Kim / HEALTH / (916) 319-2097
FN:
0001381