BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1677
                                                                  Page  1

          Date of Hearing:   April 1, 2014

                       ASSEMBLY COMMITTEE ON HIGHER EDUCATION
                                 Das Williams, Chair
                    AB 1677 (Gomez) - As Amended:  March 17, 2014
           
          SUBJECT  :   Nursing education: service in public hospitals and  
          veterans' facilities.

           SUMMARY  :   Establishes a loan assumption program for employees  
          of eligible public facilities, as defined; specifies that the  
          California Student Aid Commission (CSAC) shall award no more  
          than the number of warrants that are authorized in the Budget  
          Act for that fiscal year for the assumption of the loans; and,  
          appropriates 48 million dollars from the General Fund (GF) to  
          CSAC to be expended for the purposes of CSAC issuing loan  
          assumption awards beginning with the 2015-2016 fiscal year to  
          the 2021-22 fiscal year, as specified.  Specifically,  this bill  :  
           

          1)Specifies that any person enrolled in an eligible institution,  
            or any person who agrees to work full time as a registered  
            nurse or a licensed vocational nurse in an eligible public  
            facility that employs registered nurses or licensed vocational  
            nurses, may be eligible to enter into an agreement for loan  
            assumption, to be redeemed, as specified, upon becoming  
            employed as a clinical registered nurse or licensed vocational  
            nurse in an eligible public facility that employs registered  
            nurses or licensed vocational nurses. 

          2)Stipulates that in order to be eligible to enter into an  
            agreement for a loan assumption, an applicant shall satisfy  
            all of the following conditions:

             a)   The applicant has been admitted to, or is enrolled in,  
               or has successfully completed, an accredited program of  
               professional preparation for licensing as a registered  
               nurse or vocational nurse in California;

             b)   The applicant is currently enrolled, or has been  
               admitted to a program in which he or she will be enrolled,  
               on a full-time basis, as determined by the participating  
               institution and the applicant shall agree to maintain  
               satisfactory academic progress and a minimum of full-time  
               enrollment, as defined by the participating eligible  








                                                                  AB 1677
                                                                  Page  2

               institution;

             c)   The applicant has been judged by his or her  
               postsecondary educational institution to have outstanding  
               ability on the basis of criteria that may include, but need  
               not be limited to, any of the following:

               i)     Grade point average;

               ii)    Test scores;

               iii)   Faculty evaluations;

               iv)    Interviews; and

               v)     Other recommendations.

             d)   The applicant has received, or is approved to receive, a  
               loan under one or more of the following designated loan  
               programs:

               i)     The federal Family Education Loan Program; and,

               ii)    Any loan program approved by CSAC.

             e)   The Applicant has agreed to work full time for at least  
               four consecutive years as a clinical registered nurse or  
               licensed vocational nurse in an eligible public facility  
               that employs registered nurses or licensed vocational  
               nurses.

          3)Stipulates that no applicant who has completed few than 60  
            semester units, or the equivalent, shall be eligible to  
            participate in the loan assumption program as established by  
            this measure. 

          4)Defines "eligible institution" to mean a postsecondary  
            institution that is determined by CSAC to meet both of the  
            following requirements:

             a)   The institution is eligible to participate in state and  
               federal financial aid programs; and,

             b)   The institution maintains an accredited program of  
               professional preparation for licensing as a registered  








                                                                 AB 1677
                                                                  Page  3

               nurse or vocational nurse in California.

          5)Defines "eligible public facility" to mean any of the  
            following:

             a)   A state hospital administered by the State Department of  
               State Hospitals (DSH);

             b)   A state veterans' home, as defined in existing law;

             c)   A public hospital that is a member of the California  
               Association of Public Hospitals and Health Systems (CAPH);   


             d)   A facility administered by the federal Veterans Health  
               Administration and located in California; and, 

             e)   A health care district located in California.

          6)Stipulates that a person participating in the program shall  
            not enter into more than one agreement.

          7)Specifies that a person who is currently employed as a  
            registered nurse or licensed vocational nurse in an eligible  
            public facility may be eligible to enter into an agreement for  
            loan assumption under existing law, but is not eligible to  
            enter into an agreement for loan assumption under this  
            measure.

          8)Authorizes CSAC to issue loan assumption payments, as  
            specified, upon verification that the applicant has fulfilled  
            all of the following:

             a)   The applicant has become a registered nurse or  
               vocational nurse licensed to practice in California;
             b)   The applicant is working full time as a clinical  
               registered nurse or licensed vocational nurse in an  
               eligible public facility that employs registered nurses or  
               licensed vocational nurses; and,

             c)   The applicant has met the requirements of the agreement  
               and all other pertinent conditions, as specified.

          9)States the terms of a loan assumption shall be as follows,  
            subject to the specific terms of each agreement:








                                                                  AB 1677
                                                                  Page  4


             a)   After a program participant has completed one year of  
               full-time employment, as specified, CSAC shall assume up to  
               $15,000.00 of the participant's outstanding liability under  
               one or more of the designated loan programs;

             b)   After a program participant has completed two years of  
               full-time employment, as specified, CSAC shall assume up to  
               an additional $15,000.00 of the participant's outstanding  
               liability under one or more of the designated loan  
               programs, for a total loan assumption of up to $30,000.00;

             c)   After a program participant has completed three years of  
               full-time employment, as specified, CSAC shall assume  up  
               to an additional $15,000.00 of the participant's  
               outstanding liability under one or more of the designated  
               loan programs, for a total loan assumption of up to  
               $45,000.00; and,

             d)   After a program participant has completed four years of  
               full-time employment, as specified, CSAC shall assume up to  
               an additional $15,000.00 of the participant's outstanding  
               liability under one or more of the designated loan  
               programs, for a total loan assumption of up to $60,000.00.

          10)Stipulates that if a program participant fails to complete a  
            minimum of four consecutive years of full time employment as  
            required under the terms of the agreement, the participant  
            shall retain full liability for all student loan obligations  
            remaining after CSAC's assumption of loan liability for the  
            last year of qualifying clinical registered nursing or  
            licensed vocational nursing service.

          11)Specifies that if a program participant becomes unable to  
            complete one of the four consecutive years of qualifying  
            clinical registered nursing or licensed vocational nursing  
            service due to serious illness, pregnancy, or other natural  
            causes, the term of the loan assumption agreement shall be  
            extended for a period not to exceed one year; and, that CSAC   
            shall make no further payments under the loan assumption  
            agreement until the applicable work requirements have been  
            satisfied.

          12)Specifies that if a natural disaster prevents a program  
            participant from completing one of the required years of work  








                                                                  AB 1677
                                                                 Page  5

            due to the interruption of employment at the employing  
            eligible public facility, the term of the loan assumption  
            agreement shall be extended for the period of time equal to  
            the period from the interruption of employment at the  
            employing eligible public facility until the resumption of  
            employment; and, that CSAC shall make no further payments  
            under the loan assumption agreement until the applicable  
            employment requirements have been satisfied.

          13)Authorizes CSAC to administer this loan assumption program  
            and to adopt rules and regulations for the purposes of  
            administering the program; and, specifies that the rules and  
            regulations shall include, but need not be limited to,  
            provisions regarding the period of time during which an  
            agreement shall remain valid, the reallocation of resources in  
            light of agreements that are not used by program participants,  
            the failure, for any reason, of a program participant to  
            complete a minimum of four consecutive years of qualifying  
            clinical registered nursing or licensed vocational nursing  
            service, and the development of projections for funding  
            purposes.

          14) Specifies that if a provision is added to this article and  
            CSAC deems it necessary to adopt a rule or regulation in order  
            to implement the new provision, that CSAC shall develop and  
            adopt that rule or regulation no later than six months after  
            the operative date of the statute that adds the provision.

          15) Requires CSAC, on or before January 31, 2016, and on or  
            before each January 31 thereafter until, and including January  
            31, 2020, to report annually to the Legislature regarding both  
            the following, on the basis of sex, age, and ethnicity:

             a)   The total number of program participants and the type of  
               program of professional preparation they are attending or  
               have attended; and,

             b)   The number of participants who complete one, two, three,  
               or four years of qualifying clinical registered nursing or  
               licensed vocational nursing service, respectively.  

          16)Requires the Legislative Analyst's Office, on or before May  
            1, 2019, to submit a report to the Legislature that includes  
            the finding and recommendations of the Legislative Analyst  
            with respect to the efficacy of the program.








                                                                  AB 1677
                                                                  Page  6


          17)Specifies that the required reports shall be submitted  
            pursuant to existing law.

          18)Authorizes CSAC, when selecting participants in this program,  
            to grant priority to applicants who, in the determination of  
            CSAC, are included in any of the following categories:

             a)   Persons who possess a baccalaureate degree at the time  
               of initial application;

             b)   Persons who are enrolled in an accelerated program of  
               professional preparation for licensing as a registered  
               nurse or vocational nurse in California; and,

             c)   Persons who are recipients of federally subsidized  
               student loans or other need-based student loans.

          19)Specifies that in any fiscal year, CSAC shall award no more  
            than the number of warrants that are authorized in the annual  
            Budget Act for that fiscal year for the assumption of loans.

          20)Appropriates 48 million dollars from the GF to CSAC to be  
            expended for the purposes of CSAC issuing loan assumption  
            awards beginning with the 2015-16 fiscal year (FY) to the  
            2021-22 FY, inclusive, as follows:

             a)   For the 2015-16 FY, CSAC may expend up to three million  
               dollars to award up to 200 awards as specified;

             b)   For the 2016-17 FY, CSAC may expend up to six million  
               dollars to award up to 400 awards as specified;

             c)   For the 2017-18 FY, CSAC may expend up to nine million  
               dollars to award up to 600 awards as specified;

             d)   For the 2018-19 FY, CSAC may expend up to 12 million  
               dollars to award up to 800 awards as specified;

             e)   For the 2019-20 FY, CSAC may expend up to nine million  
               dollars to award up to 600 awards as specified;

             f)   For the 2020-21 FY, CSAC may expend up to six million  
               dollars to award up to 400 awards as specified; and,









                                                                  AB 1677
                                                                  Page  7

             g)   For the 2021-22 FY, CSAC may expend up to three million  
               dollars to award up to 200 awards.

          21) Sunsets on July 1, 2022, and, as of January 1, 2023, is  
            repealed, unless a later enacted statute, that becomes  
            operative on or before January 1, 2023, deletes or extends the  
            dates on which it becomes inoperative and is repealed.

          EXISTING LAW  :

          1)Establishes CSAC as the primary state agency to administer  
            state-authorized student financial aid programs available to  
            eligible students attending all eligible segments of  
            postsecondary education (Education Code � 69510, et seq.).

          2)Authorizes CSAC to administer the State Nursing Assumption  
            Program of Loans for Education (SNAPLE); lists specific  
            eligibility requirements for participation in SNAPLE; and,  
            specifies the terms of the loan assumptions granted (EC �  
            70100, et seq.).

           FISCAL EFFECT  :   Unknown beyond the 48 million dollars  
          appropriated from the GF to CSAC to administer the loan  
          assumption program.

          COMMENTS  :    Background  .  According to CSAC, recognizing the  
          growing need for new faculty members in the nursing field at  
          California's colleges and universities, the Legislature found  
          that "the rising costs of higher education, coupled with a shift  
          in available financial aid from scholarships and grants to  
          loans, made loan repayment options an important consideration in  
          a student's decision to pursue a graduate degree in nursing  
          education."  With that in mind,  Senate Bill 63 (Senate Budget  
          and Fiscal Review Committee, Chapter 73, Statutes of 2005),  
          enacted SNAPLE.  

          This program authorized CSAC to make payments for student loans  
          on behalf of program participants who took out those loans to  
          finance their graduate nursing education.  The loan payments  
          would begin only after those program participants obtained their  
          graduate nursing degrees and after they complete an academic  
          year of full-time, or the part-time equivalent, teaching nursing  
          in an accredited California college or university.  The students  
          were obligated to teach for three consecutive academic years of  
          full-time teaching, or five consecutive years of part-time  








                                                                  AB 1677
                                                                  Page  8

          teaching, to receive up to $25,000 in loan payments.  CSAC was  
          required to select participants in the program from nominees  
          submitted by accredited colleges and universities.  

          SNAPLE went into effect on July 19, 2005 with a January 1, 2013  
          sunset; the 2012-13 Budget Act did not authorize any new SNAPLE  
          allocations for applicants.  

           Nursing shortage  .  The U. S. Department of Health and Human  
          Services has projected that by 2015, 400,000 new nurses will be  
          needed just to fill the vacancies left by retirees.   
          Additionally, by 2020, the U. S. Bureau of Labor Statistics  
          predicts that it will be short between 800,000 and one million  
          new and replacement nurses, including being short close to  
          117,000 in California alone.

          According to a recent study by the University of California, San  
          Francisco, the supply and demand for nurses in California varies  
          by region.  The report found that the Inland Empire region is  
          experiencing the hardest difficulties in their ability to hire  
          trained nurses.  However, the San Francisco Bay region is  
          expected to have the largest regional decrease in overall hiring  
          of trained nurses.  Additionally, the report found that many new  
          nurses in California are finding it more and more challenging to  
          find hospital nursing jobs.

           Purpose of the bill  .  According to the author, veterans return  
          from duty with various needs.  Two of the more prevalent needs  
          are access to quality medical care and jobs.  The author states,  
          "In California, we have veterans' homes with nursing shortages  
          and, in 2012 California had an unemployment rate for veterans  
          that was 8.9%.  With a population of more than 1.7 million  
          veterans in California, we need to increase our efforts to  
          provide quality medical care and jobs for our servicemen."

          AB 1677 creates a loan assumption program for licensed  
          registered and vocational nurses who commit to working for four  
          years in a state hospital operated by the DSH, a state operated  
          veterans' home, a public hospital that is a member of CAPH,  
          and/or a California facility operated by the federal Veterans  
          Health Administration.

           Eligible health institutions  .  It is presently unclear as to the  
          exact numbers of nursing shortfalls faced by the eligible health  
          institutions (that licensed registered and vocational nurses  








                                                                  AB 1677
                                                                  Page  9

          would have to commit to four years of full time employment in  
          order to participate in the loan assumption program), but  
          anecdotally, these institutions, which are located throughout  
          the entire state, including rural areas, are experiencing some  
          of the highest demands for licensed registered and vocational  
          nurses.

          This measure would allow up to 800 participants in the loan  
          assumption program.

           Related legislation  .  AB 697 (Gomez of 2013), which died in the  
          Assembly Health Committee, was similar in nature to this  
          measure.

          SB 63 (Senate Budget and Fiscal Review Committee), Chapter 73,  
          Statutes of 2005, as described in the "background" section of  
          this analysis.  
           
           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          None on file.

           Opposition 
           
          None on file.

           
          Analysis Prepared by  :    Jeanice Warden / HIGHER ED. / (916)  
          319-3960