BILL ANALYSIS                                                                                                                                                                                                    �






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

          BILL NO:       AB 2214
          AUTHOR:        Monning
          AMENDED:       June 20, 2012
          HEARING DATE:  June 27, 2012
          CONSULTANT:    Moreno

           SUBJECT  :  Health workforce development.
           
          SUMMARY  :  Requires certified radiologic technologist and limited 
          radiologic technology permit holders, nuclear medicine 
          technologists, and all clinical laboratory licensees, including 
          medical laboratory technicians, to report to the Department of 
          Public Health (DPH), immediately upon issuance of an initial 
          certificate or permit and at the time of renewal, their practice 
          status designated, as specified. Requires the California 
          Workforce Investment Board (CWIB), until January 1, 2019, to 
          establish a special committee known as the Health Workforce 
          Development Council (Council) to help expand the state's health 
          workforce in order to provide access to quality health care for 
          all Californians. 

          Existing law:
          1.Establishes CWIB within the California Labor and Workforce 
            Development Agency to assist the Governor in the development, 
            oversight, and continuous improvement of California's 
            workforce investment system.

          2.Establishes the Health Care Workforce Clearinghouse 
            (Clearinghouse) under Office of Statewide Health Planning and 
            Development (OSHPD) to serve as the central source of health 
            care workforce and educational data in the state. Requires the 
            Clearinghouse to be responsible for the collection, analysis, 
            and distribution of information on the educational and 
            employment trends for health care occupations in the state.

          3.Requires OSHPD to prepare an annual report to the Legislature 
            that identifies education and employment trends in the health 
            care profession, reports on the current supply and demand for 
            health care workers in California and gaps in the educational 
            pipeline producing workers in specific occupations and 
            geographic areas, and recommends state policy needed to 
            address issues of workforce shortage and distribution.
          
                                                         Continued---



          AB 2214 | Page 2




          This bill:
          1.Requires certified radiologic technologists, limited 
            radiologic technology permit holders, nuclear medicine 
            technologists, and all clinical laboratory licensees, 
            including medical laboratory technicians, to report to DPH, 
            immediately upon issuance of an initial certificate or permit 
            and at the time of renewal, their practice status designated 
            as one of the following: full-time practice in California, 
            part-time practice in California, full-time practice outside 
            of California, retired, or other practice status, as may be 
            defined by DPH.  

          2.Requires the licensees above to report to DPH, immediately 
            upon issuance of an initial license and upon renewal, 
            information regarding his or her cultural background and 
            foreign language proficiency. Requires DPH to provide an 
            option for a licensee to decline to state his or her cultural 
            background and foreign language proficiency.

          3.Requires DPH to collect the above information, and permits DPH 
            to aggregate and post this information on its website.

          4.Prohibits a failure to report under this bill from 
            constituting a violation within the meaning of existing law 
            that provides for enforcement of licensing requirements.

          5.Requires CWIB, until January 1, 2019, to establish a special 
            committee known as the Council to help expand the state's 
            health workforce in order to provide access to quality health 
            care for all Californians. 

          6.Requires the Council membership to consist of the appropriate 
            representatives from CWIB's existing membership, as well as 
            representatives from other state agencies and departments, 
            higher education, labor, the health care industry, workforce 
            groups, philanthropic and nongovernmental entities, and other 
            appropriate health advocates. Requires the CWIB representative 
            on the Council to be the chair.

          7.Requires the Council to:
             a.   Develop a comprehensive statewide plan and 
               implementation strategy for health workforce development 
               through strategic partnerships;
             b.   Examine proven strategies and policies to increase 
               health workforce supply that can be replicated and deployed 
               through sector strategy and other models;




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             c.   Provide guidance on the development and maturation of 
               regional health workforce partnerships to address regional 
               health care and delivery system needs;
             d.   Use regional partnerships to identify and inform 
               regional and statewide health workforce development 
               priorities; and
             e.   Seek expertise from multisector representatives to 
               enhance the understanding of the issues and policies needed 
               to ensure that California has the necessary workforce to 
               provide access to quality, and culturally and 
               linguistically appropriate, health care.

          8.Requires the Council to provide the Legislature with a copy of 
            the CWIB's annual report to the federal Department of Labor, 
            as specified.

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee analysis of a previous version of this bill, which 
          only contained the Council provisions:
          1.Costs of an unknown amount, but likely less than $100,000, to 
            complete the study as described.  To the extent these costs 
            exceed the conservancies existing budget resources, this 
            funding would come from voluntary private and nonprofit 
            resources, as specified in the bill.  

          2.Cost pressure of an unknown amount, but potentially in 
            millions of dollars, to fund development of the greenbelt and 
            other recreational uses of the wash that are the focus of the 
            study.  (Bond funds or private funds.)
           
          PRIOR VOTES  :  
          Assembly Health:    13- 6
          Assembly Appropriations:12- 5
          Assembly Floor:     52- 26
           COMMENTS  :  
           1.Author's statement.  To assist in the implementation of 
            federal health care reform and support the expansion of 
            insurance coverage, there is a need for an adequate health 
            care workforce with the necessary skills. AB 2214 will 
            establish within the CWIB the Council to help expand 
            California's healthcare workforce. The Council would provide a 
            forum for broad stakeholder agreement and allows for the 
            collaboration of various public, private, non-profit and 
            non-governmental groups to assist in developing a statewide 
            plan and implementation strategy for addressing the health 




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            workforce needs of Californians, especially in primary care.  
            This bill ensures that healthcare workforce is a priority for 
            the state.
          
          2.The Council.  According to CWIB, the Council was established 
            in August 2010 to help alleviate workforce shortages in 
            California's health sector. The Council will be a broad 
            partnership consisting of industry representatives, education, 
            economic development, elected officials, the public workforce 
            system, philanthropic organizations, community-based 
            organizations, health professionals, advocacy organizations, 
            and organized labor. Its mission is to help expand 
            California's health workforce in order to provide access to 
            quality healthcare for all Californians. This includes the 
            objective of expanding California's full-time, primary care 
            workforce by 10 to 25 percent over 10 years.



          The Council is tasked with understanding the current and future 
            health workforce needs of California and with developing a 
            comprehensive strategy to meet those needs. Health workforce 
            development issues will be addressed by the Council through 
            strategic actions at the state, regional, and local levels by 
            understanding, assessing and acting on the training and 
            education, skill development, and capacity and expansion needs 
            of the health sector. The Council functions as a special 
            committee of the State Board and staff support for the Council 
            will be provided by CWIB and OSHPD. Council meetings, the 
            first of which is anticipated to occur in early to mid-October 
            in Sacramento, will be open to the public along with agendas, 
            presentations, and other materials presented.
          3.Workforce shortages.  In March 2012, the Senate Health 
            Committee held two initial hearings in a series on 
            California's health care workforce. The background paper, 
            prepared by the Senate Office of Research (SOR), stated that 
            statewide shortages of health care providers currently exist 
            in several major health professions. Additionally, health care 
            workforce needs are projected to increase dramatically due to 
            the aging of the general population as well as health care 
            providers, population growth, expanding diversity and 
            implementation of the federal Patient Protection and 
            Affordable Care Act (ACA). Recent health care workforce 
            research indicates that health professional shortage, 
            distribution, and diversity issues impact access to primary, 
            allied, mental, and dental health care in California today. 




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          5


          

            The demand for these health care professions is also 
            forecasted to grow faster than professions in other 
            industries. According to the SOR paper, the scale and scope of 
            the problem is not well understood because data on the supply 
            and demand of health professions are incomplete and not 
            systematically or regularly updated.  

          4.Current data.  The Center for Health Professions at UCSF, in 
            its report entitled "California's Health Care Workforce: 
            Readiness for the ACA Era", indicated that California lags the 
            nation on employment of imaging professionals per capita, and 
            that California hospitals are concerned about the supply of 
            imaging professionals, as vacancies in these areas have a 
            significant impact on care delivery and hospital efficiency. 
            Many experts predict that demand for imaging professionals 
            will continue to increase, driven by an aging population and 
            by the development of new imaging technologies and protocols. 
            In the same manner, there are also shortages for clinical 
            laboratory scientists and medical lab technologists. The 
            report also pointed out California-specific data on these 
            practitioners are lacking because DPH does not collect any 
            demographic information and information about these licensees 
            are often unavailable or difficult to track.
            
          5.Prior legislation.  AB 2375 (Hernandez) of 2008 would have 
            required OSHPD to establish the Health Professions Workforce 
            Task Force, as specified, to assist in the development of a 
            health professions workforce master plan. AB 2375 died on 
            suspense in the Senate Appropriations Committee.

            SB 139 (Scott), Chapter 522, Statutes of 2007, established the 
            Clearinghouse under OSHPD to serve as the central source of 
            health care workforce and educational data in the state.

            AB 269 (Eng), Chapter 262, Statutes of 2007, creates new 
            reporting requirements for dentists and dental auxiliaries 
            upon their application for initial licensure and renewal, 
            including reporting their completion of any advanced 
            educational program and their current employment status. AB 
            269 also requires the Dental Board of California and the 
            Committee on Dental Auxiliaries to collect and aggregate 
            information received from dentists and dental auxiliaries 
            relating to cultural background and foreign language 
            proficiency. 





          AB 2214 | Page 6




            AB 2283 (Oropeza), Chapter 612, Statutes of 2006, requires the 
            Medical Board to annually aggregate existing data reported to 
            it by physicians on their cultural background and foreign 
            language proficiency, as specified, and report that 
            information on their website. 
            
          6.Support.  According to the California Hospital Association, 
            establishing the Council within CWIB, and requiring the 
            Council to develop a comprehensive statewide plan and 
            implementation strategy for health workforce development 
            through strategic partnerships will lead to increased 
            coordination and collaboration around the issue, resulting in 
            the development of solutions that are responsive to regional 
            and statewide demand for health professionals. The California 
            Society of Health-System Pharmacists states that this bill 
            would improve the quality of life in California by ensuring 
            that there is adequate access to healthcare providers in the 
            near future.
          
           SUPPORT AND OPPOSITION  :
          Support:  American Cancer Society
                    American Federation of State, County and Municipal 
                              Employees, AFL-CIO
                    California Academy of Physician Assistants
                    California Commission on Aging
                    California Hospital Association
                    California Pan-Ethnic Health Network
                    California Psychological Association
                    California Society of Health-System Pharmacists
                    Kaiser Permanente
                    Los Angeles County Board of Supervisors

          Oppose:   None received.

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