BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   AB 657|
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                                 THIRD READING


          Bill No:  AB 657
          Author:   Hernandez (D)
          Amended:  9/1/09 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  10-1, 7/8/09
          AYES:  Alquist, Strickland, Cedillo, Cox, DeSaulnier, Leno,  
            Maldonado, Negrete McLeod, Pavley, Wolk
          NOES:  Aanestad

           SENATE APPROPRIATIONS COMMITTEE  :  9-4, 8/27/09
          AYES:  Kehoe, Cox, Corbett, Hancock, Leno, Oropeza, Price,  
            Wolk, Yee
          NOES:  Denham, Runner, Walters, Wyland

           ASSEMBLY FLOOR  :  50-28, 6/3/09 - See last page for vote


           SUBJECT  :    Health professions workforce:  master plan

           SOURCE  :     California Academy of Family Physicians 
                      Latino Coalition for a Healthy California 


          DIGEST  :    This bill requires the Office of Statewide  
          Health Planning and Development to establish the Health  
          Professions Workforce Task Force to assist in the  
          development of a health professions workforce master plan  
          for the state. 

           ANALYSIS  :    

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          Existing law:

          1. Requires the California Workforce Investment Board  
             (CWIB) to assist the Governor in the development,  
             oversight, and continuous improvement of California's  
             workforce investment system, and requires the CWIB to  
             assist the Governor in developing the State Workforce  
             Investment Plan.

          2. Requires the Office of Statewide Health Planning and  
             Development (OSHPD) to establish a health care workforce  
             clearinghouse to serve as the central source of health  
             care workforce and educational data in the state.  The  
             clearinghouse is responsible for the collection,  
             analysis, and distribution of information on the  
             educational and employment trends for health care  
             occupations in the state.

          3. Establishes the California Healthcare Workforce Policy  
             Commission to identify specific areas of the state where  
             there are unmet priority needs for dentists, physicians,  
             and registered nurses.

          4. Establishes various health care provider loan repayment  
             programs funded by licensing fees paid by health care  
             providers who practice in specified locations, such as  
             underserved areas.

          This bill:

          1. Requires OSHPD, in collaboration with the CWIB and based  
             on information provided by the health care workforce  
             clearinghouse, to establish the Health Professions  
             Workforce Task Force (Task Force) to assist in the  
             development of a health professions workforce master  
             plan for the state. 

             The Task Force will be composed of 22 members from both  
             rural and urban areas representing various educational  
             institutions (the University of California, California  
             State University, California Community Colleges, the  
             Department of Education, an independent or private  
             postsecondary institution, and a member responsible for  
             leading a health sciences program in a school district),  







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             health care providers, labor, health insurers and  
             medical groups, health facilities, community-based  
             organizations, as well as two members representing the  
             Legislature.  This bill specifies who appoints the  
             various members, would require the Task Force to meet at  
             least three times a year, and would require Task Force  
             membership to be voluntary and without compensation.

             The Task Force will be required to assist OSHPD in the  
             development of a health professions workforce master  
             plan, and will be required to do all of the following:

             A.    Report, assess impact, and review capacity and  
                effectiveness of existing state and private workforce  
                training programs to leverage funding resources and  
                form new partnerships, foster shared learning,  
                identify best practices, and minimize duplication of  
                efforts.

             B.    Review local workforce investment plans and assess  
                progress toward meeting current health professions  
                workforce needs. 

             C.    Identify education and employment trends in the  
                health professions.

             D.    Identify the 10 health professions with the  
                highest demand, and develop a plan to meet that  
                demand.

             E.    Recommend state policies needed to address the  
                issues of health professions workforce shortage and  
                distribution.

             F.    Compile, assess, and align with other strategic  
                plans for developing California's health care  
                workforce.

          2. Requires the Task Force, by October 31, 2013, to submit  
             a complete statewide health professions workforce master  
             plan to OSHPD and the Legislature.  OSHPD would be the  
             lead in coordinating the Task Force.  The Task Force  
             will be required to seek funds, and OSHPD will be  
             required to accept funds from the federal government and  







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             private entities for the purpose of implementing this  
             section.  No state funds, including, but not limited to,  
             moneys from the General Fund or any special fund, shall  
             be used to implement this section.

           Background  

          Statewide shortages of health providers currently exist in  
          several major health professions, such as nursing, primary  
          care providers, and allied health (allied health  
          professions are clinical health care professions distinct  
          from medicine, dentistry, and nursing).  Health care  
          workforce needs are projected to increase dramatically due  
          to the aging of the population and the state's increasing  
          diversity.  In February of this year, the Senate Health  
          Committee held a hearing on California's health care  
          workforce.  The background paper prepared by the Senate  
          Office of Research stated the health care worker shortage  
          is defined in many ways, citing as examples the following:

          1. The state will face a shortage of up to 17,000  
             physicians by 2015. 

          2. The Center for California Health Workforce Studies  
             researchers indicate that the current registered nurse  
             shortage is between 7,000 and 21,000. This shortage is  
             expected to grow due to both the aging of the general  
             population and the nursing workforce. 

          3. California presently ranks 48th in the nation in the  
             number of pharmacists per capita.  It is projected that  
             California will need a 26.1 percent growth in the number  
             of pharmacists from 2006 to 2016.

          4. Fifty percent of the public health workforce and 70  
             percent of community clinic administrators will retire  
             in the next five to 10 years.

          5. Seventy-six percent of clinics report a staffing  
             shortage of allied health workers.

          In addition to the shortages of certain health  
          professionals, the Senate Office of Research stated  
          California's health professions workforce does not reflect  







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          the state's demographic racial and ethnic composition and  
          language proficiency.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

           SUPPORT  :   (Verified  9/1/09)

          California Academy of Family Physicians (co-source)
          Latino Coalition for a Healthy California (co-source)
          American Federation of State, County and Municipal  
          Employees, AFL-CIO
          Asian and Pacific Islander American Health Forum
          Association of California Healthcare Districts               
            
          California Commission on Aging
          California Dental Association
          California Pan-Ethnic Health Network
          California State Association of Counties
          California Society for Clinical Social Work
          California WIC Association
          Congress of California Seniors
          County Health Executives Association of California
          Greenlining Institute
          Having Our Say
          National Hispanic Medical Association
          Osteopathic Physicians and Surgeons
          San Bernardino County Board of Supervisors
          Service Employees International Union
          United Nurses Association of California/Union of Health  
          Care Professionals


           ARGUMENTS IN SUPPORT  :    The Latino Coalition for a Healthy  
          California (LCHC), a co-sponsor of this bill, writes that  
          demographic shifts are causing gaps between health  
          workforce supply and demand as seen in the shortages of  
          primary care providers and other health professionals.   
          LCHC states California's population is aging, and is  
          becoming increasingly more diverse, but its health  
          professionals have not reflected these changes.  LCHC  
          states that California's efforts to develop its health  
          workforce have been piece-meal, and that California is  
          missing an overarching vision, action plan, and  







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          infrastructure.

          The California Academy of Family Physicians, which is also  
          a co-sponsor, argues the state is in dire need of immediate  
          and long-term action on health care workforce shortages,  
          and this bill takes an important step forward in beginning  
          to address these shortages.  


           ASSEMBLY FLOOR  : 
          AYES:  Ammiano, Arambula, Beall, Blumenfield, Brownley,  
            Buchanan, Caballero, Charles Calderon, Carter, Chesbro,  
            Coto, Davis, De La Torre, De Leon, Emmerson, Eng, Evans,  
            Feuer, Fong, Fuentes, Furutani, Galgiani, Hall, Hayashi,  
            Hernandez, Hill, Huber, Huffman, Jones, Krekorian, Lieu,  
            Bonnie Lowenthal, Ma, Mendoza, Monning, Nava, John A.  
            Perez, V. Manuel Perez, Portantino, Price, Ruskin, Salas,  
            Saldana, Skinner, Solorio, Swanson, Torlakson, Torres,  
            Torrico, Bass
          NOES:  Adams, Anderson, Bill Berryhill, Tom Berryhill,  
            Blakeslee, Conway, Cook, DeVore, Duvall, Fletcher,  
            Fuller, Gaines, Garrick, Gilmore, Hagman, Harkey,  
            Jeffries, Knight, Logue, Miller, Nestande, Niello,  
            Nielsen, Silva, Smyth, Audra Strickland, Tran, Villines
          NO VOTE RECORDED:  Block, Yamada


          CTW/RJG:mw  9/1/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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