BILL ANALYSIS                                                                                                                                                                                                    �



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          Date of Hearing:   April 24, 2012

                       ASSEMBLY COMMITTEE ON VETERANS AFFAIRS
                                 Paul J. Cook, Chair
                    AB 1976 (Logue) - As Amended:  April 11, 2012
           
          SUBJECT  :   Professions and vocations: licensure and 
          certification requirements: military experience.

           SUMMARY  :   Establishes the Veterans Health Care Workforce Act of 
          2012 and imposes specified requirements on healing arts boards 
          within the Department of Consumer Affairs (DCA) and on the 
          Department of Public Health (DPH) to facilitate the licensing or 
          certification of veterans with appropriate health-care related 
          education, training, or practical experience.  Specifically, 
           this bill  :  

          1)Requires healing arts boards within DCA to, upon the 
            presentation of satisfactory evidence by an applicant for 
            licensure, accept the education, training, and practical 
            experience completed by an applicant as a member of the United 
            States (U.S.) Armed Forces or Military Reserves of the U.S., 
            the national guard of any state, the military reserves of any 
            state, or the naval militia of any state, toward the 
            qualifications and requirements to receive a license issued by 
            that board unless the board determines that the education, 
            training, or practical experience is not substantially 
            equivalent to the standards of the board.

          2)Requires, by July 1, 2014, any DCA healing arts board that 
            accredits or otherwise approves schools offering educational 
            course credit for meeting licensing qualifications and 
            requirements to require those schools seeking accreditation or 
            approval to have procedures in place to fully accept 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.

          3)Requires each DCA healing arts board to determine whether it 
            is necessary to adopt regulations to implement the above 
            provisions.  If a board determines it is necessary to adopt 
            regulations, the board shall adopt those regulations not later 
            than January 1, 2014.  

          4)If a board determines it is not necessary to adopt 








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            regulations, the board shall, not later than January 1, 2014, 
            submit to the Governor and the Legislature a written report 
            explaining why such regulations are not necessary. This 
            provision becomes inoperative on January 1, 2017.

          5)Requires the California Department of Veterans Affairs (CDVA) 
            to provide technical assistance to DCA healing arts boards and 
            the DCA director with respect to complying with the above 
            requirements, including the determination of substantial 
            equivalency between the education, training, or practical 
            experience of an applicant and the board's standards, and 
            obtaining state, federal, or private funds to support 
            compliance with this bill's requirements.








          6)Requires the DCA director to submit a written report to the 
            Governor and the Legislature by January 1, 2016, on the 
            progress of DCA healing arts boards toward compliance with 
            this bill's provisions, as specified.  This provision becomes 
            inoperative on January 1, 2017.

          7)Establishes identical provisions as outlined above for DPH, 
            for applicants for licensure or certification in any of the 
            following professions:

             a)   Medical Laboratory Technician (MLT);

             b)   Clinical Laboratory Scientist (CLS);

             c)   Radiologic Technologist (RT);

             d)   Nuclear Medicine Technologist (NMT);

             e)   Certified Nurse Assistant (CNA);

             f)   Certified Home Health Aide (HHA);

             g)   Certified Hemodialysis Technician (CHT); and,









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             h)   Nursing Home Administrator (NHA). 

          8)States findings and declarations.

           EXISTING LAW  

          1)Provides for the licensure and regulation of various healing 
            arts professions by boards within DCA.

          2)Requires the rules and regulations of these healing arts 
            boards to provide for methods of 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.

          3)Authorizes DPH to license or certify a number of healing arts 
            professionals.

          4)Specifies that CDVA has specified powers and duties relating 
            to various programs serving veterans.

           FISCAL EFFECT  :   Unknown

           COMMENTS  :    Purpose of this bill  .  According to the author, "In 
          order to honor the service of our nation's returning heroes and 
          address California's healthcare workforce needs, this bill would 
          ensure that veterans with healthcare education, training, and 
          practical experience are expedited into civilian employment as 
          healthcare professionals.

          "This bill would break down barriers facing returning veterans, 
          by requiring state entities that license healthcare 
          professionals to establish policies that recognize the 
          education, training, and practical experience of a veteran 
          applicant.  It would also require these entities to work with 
          the college programs they accredit to ensure that the colleges 
          have procedures in place so that veteran applicants are not 
          forced to retake classes they have already completed at a 
          military institute, and so that veterans are able to quickly 
          complete the additional coursework necessary for licensure."

           Background  .  Current law requires DCA's healing arts boards to 
          provide for methods of evaluating education, training, and 
          experience obtained in military service if such training is 
          applicable to the requirements of the particular profession or 








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          vocation regulated by the board.  Although DPH is not subject to 
          a similar statutory requirement, DPH reports having procedures 
          in place to evaluate education, training, and experience 
          obtained in military service for the professions of MLT, CLS, 
          RT, NMT and CNA. There are currently no procedures in place for 
          HHAs, CHTs, NHAs.  

          According to the Assembly Committee on Business & Professions:

               DPH approves 120 schools for the purposes of training for 
               CLS.  The current procedure requires a laboratory scientist 
               trainee license for any military applicant who needs 
               further training to obtain a California CLS license.  In 
               issuing this trainee license, DPH has procedures in place 
               to evaluate military training and experience of applicants. 
                The schools accept the scientist trainee license as 
               qualification to enter their program.
                 
               DPH approves 643 CNA training programs, 267 HHA training 
               programs, and 498 Certified CHT training programs.  DPH, 
               not the schools, would approve training, education, and 
               experience equivalency.  DPH currently has procedures in 
               place to evaluate military training, education, and 
               experience for CNA applicants, but not for HHA or CHT 
               applicants.

               There are no school programs for NHAs seeking initial 
               licensure.  DPH does approve NHA courses for continuing 
               education requirements after the individual is licensed.  
               CDPH does not currently have procedures in place for 
               evaluating military training, experience, or education for 
               NHA applicants.
                                      
               CDPH does not have statutory authority to approve NMT 
               schools.  The Joint Review Committee on Educational 
               Programs in Nuclear Medicine Technology (JRCNMT) accredits 
               these programs.  JRCNMT is the only programmatic 
               accrediting agency recognized to accredit NMT educational 
               programs offered through traditional and distance education 
               formats in the U.S. and its territories.  The JRCNMT holds 
               recognition from the Council for Higher Education 
               Accreditation.

               The Radiologic Health Branch (RHB) within DPH is 
               responsible for the inspection of RT schools.  However, the 








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               three branches of the military have programs for RTs and 
               NMTs.  These programs are accredited by the Joint Review 
               Committee on Education in Radiologic Technology (JRCERT), a 
               private accrediting organization recognized by the U.S. 
               Department of Education for the accreditation of 
               educational programs in the radiological sciences.  The 
               American Registry of Radiologic Technologists (ARRT) is a 
               private certifying organization that accepts graduates from 
               schools accredited by JRCERT.  A Radiologic Technologist or 
               Nuclear Medicine Technologist completing the military's 
               programs is qualified to take ARRT's examination.  If a 
               veteran takes and passes the ARRT's examination, the 
               veteran can then apply to DPH-RHB to obtain the applicable 
               authorization without taking the DPH examination, since 
               they have already passed the ARRT's examination.  The 
               veteran is not required to attend an RHB-approved school 
               since they completed the required training program in the 
               military.  Therefore, schools do not need to have a 
               procedure to accept an already qualified veteran who 
               participated in and passed a military RT or NMT program.  
               This bill could apply if someone from the military, who had 
               been attending a JRCERT accredited program, left service 
               before completing the program.  If he/she were to apply to 
               finish his/her RT courses, all 41 schools have procedures 
               in place to assess out of state, out of country, and 
               military education received to identify what classes would 
               be needed in order to graduate and become certified.  

               DPH has no record of any applicants for licensure or 
               certification for any of the professions specified in the 
               bill being denied because DPH did not accept the 
               applicant's military education, training or practical 
               experience toward the requirements for licensure or 
               certification.  

               Similar, comprehensive information for DCA's health care 
               boards was not available at the time this analysis was 
               written.  However, according to the Medical Board of 
               California (MBC), the MBC does not accredit U.S. medical 
               schools.  The requirement is that applicants must be 
               graduates of a medical school accredited by the Liaison 
               Committee on Medical Education (LCME), which is the 
               nationally recognized accrediting authority for medical 
               education programs leading to the MD degree in U.S. and 
               Canadian medical schools.  The LCME is sponsored by the 








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               Association of American Medical Colleges and the American 
               Medical Association.

               DCA's boards and bureaus that would be affected by this 
               bill include the Acupuncture Board, the Board of Behavioral 
               Sciences, the Board of Occupational Therapy, the Board of 
               Optometry, the Board of Pharmacy, the Board of Podiatric 
               Medicine, the Board of Psychology, the Board of Registered 
               Nursing, the Board of Vocational Nursing and Psychiatric 
               Technicians, the Dental Board, the MBC, the Osteopathic 
               Medical Board, the Physical Therapy Board, the Respiratory 
               Care Board, the Speech-Language Pathology and Audiology 
               Board, and the Veterinary Medical Board.

          According to "U.S. Military and California Health Personnel: 
          Select Comparisons,"
          a 2008 report by the Center for the Health Professions at the 
          University of California, San Francisco, "As California faces 
          workforce shortages and geographic mal-distribution in many of 
          the health care professions, policy makers are looking to 
          expanding educational programs, rethinking practice models and 
          improving recruitment and retention efforts among existing and 
          new pools of workers.  One potential pool of health care workers 
          includes former military personnel returning from active duty or 
          retiring with years available for service in the civilian labor 
          force.

          "Individuals with military training or experience in health care 
          may be well-positioned to meet civilian health care needs upon 
          their separation from service.  Most of the military training is 
          nationally accredited and/or of documented high quality, and a 
          serviceperson retiring from military duty may still want to work 
          for many years in the civilian sector.  However, current rules 
          and regulations may present unnecessary challenges.  To 
          facilitate smooth transitions between military and civilian 
          work, civilian policy makers and educators might want to explore 
          better alignment of accreditation, certification and licensure 
          standards."

          Veterans of the United States Armed Forces and the National 
          Guard gain invaluable education, training and practical 
          experience through their military service.  Yet, while the 
          national unemployment rate is approximately 8.3% as of June 
          2011, one million veterans were unemployed nationally and the 
          unemployment rate for post 9/11 veterans was 13.3% with young 








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          (18-24) male veterans experiencing an unemployment rate of 21.9 
          %.

          Reducing barriers to unemployment for these veterans, 
          particularly in light of their training and experience.  
          President Obama and the United States Department of Veterans 
          Affairs have multiple initiatives aimed at reducing veteran 
          unemployment.  The proposed policy of this bill is aligned with 
          national policy.

           Related legislation  .  AB 1932 (Cook) requires healing arts 
          boards within DCA to issue a written report to CDVA detailing 
          the methods of evaluating the education, training, and 
          experience obtained in military service and whether that 
          education, training, and experience is applicable to the boards' 
          requirements for licensure, by January 1, 2014.  

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California State Rural Health Association (sponsor)
          American Legion - Department of California
          AMVETS - Department of California
          California Association of County Veterans Service Officers
          California State Commanders Veterans Council
          Vietnam Veterans of America - California State Council
           
          Opposition 
           
          None on file.
           
          Analysis Prepared by  :    John Spangler / V. A. / (916) 319-3550