BILL ANALYSIS �
SENATE COMMITTEE ON EDUCATION
Carol Liu, Chair
2013-2014 Regular Session
BILL NO: AB 548
AUTHOR: Salas
AMENDED: January 7, 2014
FISCAL COMM: Yes HEARING DATE: May 14, 2014
URGENCY: No CONSULTANT: Daniel Alvarez
SUBJECT : Public postsecondary education: community college
registered nursing programs.
SUMMARY
This bill removes the sunset on the California Community
College (CCC) districts' associate degree nursing (ADN)
programs admissions process that must be followed under
Education Code � 78261.5.
BACKGROUND
Current law, allows California Community College (CCC)
districts to use any diagnostic assessment tools that are
commonly used in registered nursing programs and approved
by the CCC Chancellor and, if, after using an approved
diagnostic tool, the CCC registered nursing program
determines that the number of applicants to the program
exceeds its capacity, the program is authorized to use
additional multicriteria screening measures.
Current law also specifies that a CCC district may not:
(a) exclude an applicant to a registered nursing program if
the applicant is not a resident of that district or has not
completed prerequisite courses in that district; and (b)
implement policies, procedures, and systems, including, but
not limited to, priority registration systems, that have
the effect of excluding an applicant or student who is not
a resident of that district from a registered nursing
program of that district. (Education Code � 78261.3)
In addition, current law permits, until January 1, 2016, a
community college to admit students to a registered nursing
program if, for any academic term, there are more
applicants seeking enrollment in that program than may
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reasonably be accommodated using the following procedures:
1) Administration of a multicriteria screening
process, as authorized in EC � 78261.3, that
includes, but is not limited to (1) academic degrees
or diplomas held by the applicant, (2) grade point
average in relevant coursework, (3) any relevant work
or volunteer experience, and (4) life experiences or
circumstances, such as disabilities, income status,
veteran status, proficiency in languages other than
English, and additional criteria - personal
interviews, letters of recommendation, or personal
statements.
2) A random selection process.
3) A blended combination of random selection and
multicriteria screening process. (EC � 78261.5)
ANALYSIS
This bill removes the sunset on the California Community
College (CCC) districts' associate degree nursing (ADN)
programs admissions process that must be followed under
Education Code � 78261.5.
STAFF COMMENTS
1) Need for the bill . According to the author's office,
California suffers from a serious nursing shortage,
there are many individuals seeking admission to the
California Community College nursing programs, and yet
approximately 12,000 applicants are turned away every
year due to lack of space.
2) Nursing shortage . According to the California
Healthcare Foundation, California's registered nurse
(RN) per capita ratio (726 RNs per 100,000) remains
significantly lower than the rest the nation (929 RNs
per 100,000). The California RN workforce is aging.
More RNs are approaching retirement age with fewer RNs
to replace them. Nearly half of the nursing workforce
is over 50 and a recent survey found that 12 percent
are planning to retire over the next 5 years. The
California Board of Registered Nursing forecasts,
accounting for the Affordable Care Act, the total need
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for RNs in 2013 ranged from 234,516 to 286,985, and
that demand in 2030 is forecasted to be between
291,679 and 350,166 total RNs. These lower figures
are not likely to accurately represent total future
demand, because they do not account for additional
demand caused by future population growth and aging.
California's RN workforce has become increasingly
racially/ethnically diverse over the past two decades
-- non-whites grew from 23 percent to 41 percent of
the RN workforce since 1990. Although registered
nurses are one of the more racially/ethnically diverse
health professions in California, Latino RNs remain
substantially underrepresented in relation to the
state's general Latino population. In contrast,
Filipinos account for 18 percent of the RN workforce
but just 3 percent of the general population. Despite
the growth in the number of degree programs, the
demand for nursing education has far exceeded the
number of available spots. In 2009, 60 percent of
applicants meeting the admission criteria were not
accepted. A recent survey found that the most common
barriers to program expansion were lack of clinical
sites, insufficient funding for faculty salaries and
noncompetitive faculty salaries.
Based on a 2011 presentation to the Legislature by the
Legislative Analyst's Office (LAO), it was recommended
that the Legislature should implement additional
measures to reduce CCC attrition rates. During this
same presentation, the LAO also opined that despite
recent efforts to expand access to nursing programs,
the number of applicants to CCC nursing programs far
exceeds available slots. To note, the LAO found that
the CCC is able to accommodate less than 30 percent of
their applications.
3) The measure does not address lack of program capacity,
but rather the preparedness of the applicant pool .
Notwithstanding the need for nurses, this measure
deals only with maintaining the ability of community
colleges to utilize multiple criteria for enrollment
purposes in its nursing programs, in those instances
where student interest and applicants exceed the
supply of slots for programs. It is clear that more
slots for nursing programs is critical, but that
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entails a greater commitment of fiscal and
infrastructure resources on an on-going basis - well
beyond the scope of this measure. So insuring
retention and completion of nursing programs by
current and future students, while minimizing
attrition in the high cost academically challenging
program like nursing is critical. Part of this
approach also needs to be balanced in a fair and
equitable manner that reviews the preparedness of
students that may be highly motivated and experienced,
but lack some requisite preparatory coursework.
This bill insures the continued option of reviewing
multiple aspects of an applicant's background and
merit in relation to enrollment in a nursing program -
and not solely relying on strict course or diagnostic
requirements, coupled with a possible lottery of slots
when demand exceeds program capacity. However, at
this point in time, there is no thorough reporting on
whether the use of multicriteria is (1) achieving its
intended goal of maintaining a diverse student
population and balancing the concept of "open access"
with student academic preparedness for the rigorous
subject matter, (2) whether retention and completion
is occurring at similar or different rates when
compared to the strict language of EC section
78261.3, (3) whether the alternative approach of using
multicriteria continues to be necessary in light of
state grants targeted for both slots and diagnostic
and support services to reduce student attrition, and
(4) whether the Student Success Act has provided
supplemental assistance in assessing and assisting
students in nursing programs. Some survey information
was presented to the committee, but this information
was not as thorough in answering the four points
above.
As such, staff recommends amendments that (1) extend
the sunset until January 1, 2020 (this will provide
the Chancellor's office an ability to gather
information from at least two cohorts of nursing
students (a typical ADN program is two years in
length) enrolled using multiple criteria and; (2)
require an annual report beginning in 2015, by the
Chancellor's Office that thoroughly examines and
includes, but is not limited to (a) the participation,
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retention, and completion rates in its nursing
programs of students admitted using the multicriteria
entailed in Education Code section 78261.5; (b)
presents information disaggregated by age, gender,
ethnicity, and language spoken at home; and (c)
provides information on what impact, if any, has the
Seymour-Campbell Student Success Act had on the
matriculation of services for students admitted using
the multicriteria approach in Education Code 78261.5.
Finally, allow the required report to be provided in
conjunction with the report on nursing educational
programs required pursuant to Education Code 78261.
4) Background . According to the Assembly Higher
Education analysis, in the early 1990s, a controversy
arose over merit-based or competitive admissions to
associate degree nursing (ADN) programs. The
Mexican-American Legal Defense and Education Fund
(MALDEF) threatened a lawsuit because students of
color were being disproportionately denied admission
to impacted programs. In the negotiations that
ensued, MALDEF agreed not to bring suit, and the CCC
Board of Governors (BOG) agreed to develop program
admissions criteria that would be validated as
relevant to future performance. BOG regulations in
the mid- 1990s prohibited ADN programs from using
evaluative mechanisms---usually grade point average
(GPA) - unless the district could validate its
practices in a complex research initiative, a
requirement that proved too difficult for colleges
without sufficient research staff. CCC districts were
told to undertake the research or rely on lottery or
other non-evaluative mechanisms. Lotteries and wait
lists were instituted; completion rates fell.
The California Community College Chancellor's Office
(CCCCO) then began a project (as a district grant) to
research a full range of variables, seeking those that
would be statistically correlated with nursing program
student success in the hopes of finding six colleges
for which validation could be achieved. In 2002, the
CCCCO announced results, finding that four factors
best predict student success in completing nursing
programs: Overall college GPA, English GPA, Core
Biology GPA (Anatomy, Physiology, Microbiology), and
Core Biology course repetitions. (Students with fewer
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repetitions have a higher probability of success.)
CCC districts were then advised in an October 2002
memo that they could begin using these criteria, but
in order to do so, local research must first be
performed, "?If the decision is made to adopt the
measures as a prerequisite, and to set cut scores that
will result in defined program completion rates, then
districts must analyze and monitor the possibility of
disproportionate impact on particular groups of
students defined in terms of race, ethnicity, gender,
age, or disability."
The districts were also warned, "?It is appropriate to
consider potential risks of implementing this
research. The adoption of the prerequisite measures
and the implementation of the composite formula could
result in rationing access. Unless the implementation
of these measures is done carefully according to the
guidelines discussed later in this memo, it could
conflict with the requirement for open access."
At that time, the CCCCO acknowledged the severity of
the nursing shortage and asserted to its ADN program
directors, "The biggest part of the solution is in
increasing the number of spaces; ?the lesser part of
the solution is in improving success rates."
SUPPORT
California Hospital Association
Kern Community College District (CCD)
Los Angeles CCD
Los Rios CCD
Mt. San Jacinto CCD
Rio Hondo CCD
South Orange County CCD
United Nurses Associations of California / Union of Health
Care Professionals
Yosemite CCD
OPPOSITION
None on file.
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