BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 2102|
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THIRD READING
Bill No: AB 2102
Author: Ting (D), et al.
Amended: 8/4/14 in Senate
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEVEL. COMM. : 6-2, 6/23/14
AYES: Lieu, Corbett, Galgiani, Hernandez, Hill, Torres
NOES: Wyland, Berryhill
NO VOTE RECORDED: Block
SENATE APPROPRIATIONS COMMITTEE : 5-2, 8/4/14
AYES: De Le�n, Hill, Lara, Padilla, Steinberg
NOES: Walters, Gaines
ASSEMBLY FLOOR : 56-15, 5/15/14 - See last page for vote
SUBJECT : Healing arts: licensees: data collection
SOURCE : California Pan-Ethnic Health Network
Latino Coalition for a Healthy California
DIGEST : This bill requires the Board of Registered Nursing
(BRN), The Physician Assistant Board (PAB), the Respiratory Care
Board (RCB) and the Board of Vocational Nursing and Psychiatric
Technicians (BVNPT) to collect and report specific demographic
data relating to its licensees, subject to a licensee's
discretion to report his/her race or ethnicity, to the Office of
Statewide Health Planning and Development (OSHPD); and requires
the boards to collect this data at least biennially at the time
of issuing an initial license or renewal license.
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ANALYSIS :
Existing law:
1. Establishes (a) the BRN which licenses and regulates the
practices of registered nurses; (b) the PAB to license and
regulate the practice of physician assistants; (c) the RCB to
license and regulate the practice of respiratory care
therapists; and (d) the BVNPT to license and regulate the
practice of vocational nurses and psychiatric technicians.
2. Requires BRN to collect and analyze workforce data from its
licensees for future workforce planning and produce reports
at least biennially.
3. Requires OSHPD to prepare an annual report to the Legislature
that does all of the following:
A. Identify education and employment trends in the
healthcare profession;
B. Report 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
C. Recommend state policy needed to address issues of
workforce shortage and distribution.
This bill:
1. Requires the BRN, PAB, RCB, and BVNPT to collect, at least
biennially, at the time of issuing an initial and a renewal
license, the following data:
A. Location of practice, including city, county and ZIP
code;
B. Race or ethnicity;
C. Gender;
D. Languages spoken; and
E. Educational background.
F. Classification of primary practice site among the types
of practice sites specified by the board, including, but
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not limited to, clinic, hospital, managed care
organization, or private practice.
2. Specifies that a licensee may, but is not required to, report
his/her race or ethnicity to the BRN, PAB, RCB, and BVNPT.
3. Authorizes the BRN to expend $145,000 from the BRN Fund
within the Professions and Vocations Fund in order to
implement the data collection.
Background
Culturally and linguistically appropriate care . For millions of
Californians, comprehensive access to healthcare depends on
professionals who can provide culturally and linguistically
appropriate medical services. California collects data on
healthcare occupations, but current data is insufficient for
determining the state's capacity to address the needs of our
diverse population, in particular, language access.
Research indicates that a failure to provide adequate language
access can result in dire consequences. Language barriers can
contribute to inadequate patient evaluation and diagnosis, lack
of appropriate and/or timely treatment and other medical errors
that can jeopardize patient safety and lead to unnecessary
procedures and costs. Although the state is acutely aware of
its diverse needs, the limited English-proficient enrollees of
the state's seven largest health plans still report more
problems understanding their physician than their English
proficient counterparts (11.2% vs. 2.6%). They are also more
likely to believe they would have received better care if they
were of a different race/ethnicity (14% vs. 3.2%).
OSHPD and The Healthcare Workforce Clearinghouse (HWC) . The
HWC, housed within OSHPD, is tasked with collecting and
analyzing data on health care occupations. However, race,
language capacity and gender demographic information for many
important allied health professions is incomplete or
uncollected. OSHPD does not receive key data from licensees of
the RCB, Physician Assistant Committee (PAC), and the BVNPT.
Health professionals governed by these boards are responsible
for critical patient needs, such as measurement of vital signs
and basic client assessments. They interact with nearly all
patients visiting a physician and often provide care to the most
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sensitive patients in our population.
For 2014, the HWC will produce an in-depth report on physician
assistants based on 2013 survey data collected by the California
Academy of Physician Assistants. This report will be an
expansion of the current Survey Snapshot: Physician Assistants.
It is unclear if this will be a continuing partnership that will
be able to provide annual data. The new report for 2014 will
include race/ethnicity and languages spoken.
Department of Consumer Affairs (DCA) health boards . Several
boards under DCA collect information which is utilized by OSHPD.
For example, the Medical Board and Dental Board already report
languages spoken, race and gender information. However, other
boards collect and report different types of data. Below is a
list of the entities that will be impacted by this bill. The
data that each entity collects is outlined.
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| BVNT | Collects: | Current supply of providers by county |
| | | Age |
| | | Educational programs available in the |
| | | state - public and private |
|-------+---------------+-------------------------------------------|
| | Partially | Gender. (Licensed Vocational Nurses |
| | Collects: | (LVNs) and psychiatric technicians are |
| | | not required to report gender. Less |
| | | than 1% of LVNs report their gender and |
| | | 77% of psychiatric technicians did not |
| | | report their gender.) |
|-------+---------------+-------------------------------------------|
| | Does Not | Race/ethnicity |
| | Collect: | Languages spoken |
|-------+---------------+-------------------------------------------|
| RCB | Collects: | Current supply of providers by county |
| | | Age |
| | | Educational programs available in the |
| | | state |
| | | Number of Respiratory Care |
| | | Practitioner (RCP) degrees awarded |
|-------+---------------+-------------------------------------------|
| | Partially | Gender. (39% of RCPs do not report |
| | Collects: | their gender.) |
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|-------+---------------+-------------------------------------------|
| | Does Not | Race/ethnicity |
| | Collect: | Languages spoken |
|-------+---------------+-------------------------------------------|
| PAC | Collects: | Current supply of providers by county |
| | | Age |
| | | Educational programs available in the |
| | | state |
| | | Number of graduates annually |
|-------+---------------+-------------------------------------------|
| | Partially | Gender. (64% of physician assistant's |
| | Collects: | gender is not publicly reported.) |
|-------+---------------+-------------------------------------------|
| | Does Not | Race/ethnicity |
| | Collect: | Languages |
| | |spoken |
|-------+---------------+-------------------------------------------|
| BRN | Collects: | Current supply of providers by county |
| | | Educational programs available in the |
| | | state |
| | | Work setting |
| | | Five-year employment goals |
| | | Gender. (This information is being |
| | | collected as a partnership with UCSF |
| | | Center for Health Professions. The |
| | |survey is not mandatory.) |
|-------+---------------+-------------------------------------------|
| | Unclear if | Race/ethnicity |
| | collected: | Languages spoken |
| | | |
| | |Age |
| | | |
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Comments
According to the author, "With the implementation of the federal
Affordable Care Act, the majority of those newly eligible for
health care coverage will be from communities of color.
Additionally, 35 percent of the newly eligible will be Limited
English Proficient. Currently, the Medical and Dental Boards
collect demographic data on their workforce. AB 2102 expands
that charge to other health care professionals to ensure our
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newly insured communities have access to culturally and
linguistically appropriate services?The experience of stark
racial and ethnic health disparities among communities of color
necessitates a diverse and culturally appropriate
workforce?According to the National Institutes of Health, when
health care is respectful and responsive to diverse patients,
disparities decrease and access to quality care increases.
Other benefits of culturally appropriate care include improved
patient data collection, increased preventative care, increased
cost savings and reduced number of missed medical visits."
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee, one-time costs
of about $130,000 for modifications to the computer software
used to process licensing applications (various special funds).
SUPPORT : (Verified 8/6/14)
California Pan-Ethnic Health Network (co-source)
Latino Coalition for a Healthy California (co-source)
ACCESS Women's Health Justice
ACLU
ACT for Women and Girls
Asian & Pacific Islander American Health Forum
Asian Americans Advancing Justice - Los Angeles
Asian Pacific Policy & Planning Council
Black Women for Wellness
Borrego Community Health Foundation
California Academy of Physician Assistants
California Equity Network
California Immigrant Policy Center
California Latinas for Reproductive Justice
California Partnership
California Rural Legal Assistance Foundation
Cal-Islanders Humanitarian Association
Central Valley Partnership for Citizenship
Centro Binacional para el Desarrollo Ind�gena Oaxaque�o - Fresno
Centro Binacional para el Desarrollo Ind�gena Oaxaque�o -
Greenfield
Centro Binacional para el Desarrollo Ind�gena Oaxaque�o - Los
Angeles
Chinese Progressive Association
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Clinica Msr. Oscar A. Romero
Coalition for Human Immigrant Rights of Los Angeles
Earth Mama Healing
El Quinto Sol
Families in Good Health
Fresno Center for New Americans
Fresno Interdenominational Refugee Ministries
Guam Communications Network
Korean Community Center of the East Bay
Korean Resource Center
Libreria del Pueblo
Madera Coalition
Mid-City CAN
Pacific Islander Cancer Survivors Network
Roots Community Health Center/Roots Community Health Alliance
Services, Immigrant Rights, and Education Network
South Asian Network
Southeast Asia Resource Action Center
SSG/Pals for Health
St. John's Well Child & Family Center
Street Level Health Project
The Council of Mexican Federations
The Greenlining Institute
United Taxi Workers of San Diego
Vision y Compromiso
Young Invisibles
ARGUMENTS IN SUPPORT : Supporters write, "AB 2102 builds upon
previous legislation that established policies for the
collection of demographic data on physician and dentists. This
bill requires boards under the Department of Consumer Affairs to
collect demographic data on registered nurses, nurse
practitioners, vocational nurses, physician assistants,
respiratory care providers and psychiatric technicians. AB 2102
will give California a more accurate picture of the geographic,
cultural and linguistic gaps in the health care workforce. The
data will also inform a more targeted approach to strengthen the
workforce."
ASSEMBLY FLOOR : 56-15, 5/15/14
AYES: Alejo, Ammiano, Bigelow, Bloom, Bocanegra, Bonilla,
Bonta, Bradford, Brown, Buchanan, Ian Calderon, Campos, Chau,
Chesbro, Cooley, Dababneh, Daly, Dickinson, Eggman, Fong, Fox,
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Frazier, Garcia, Gatto, Gomez, Gonzalez, Gordon, Gray, Hall,
Roger Hern�ndez, Holden, Jones-Sawyer, Levine, Lowenthal,
Medina, Mullin, Muratsuchi, Nazarian, Pan, Perea, John A.
P�rez, V. Manuel P�rez, Quirk, Quirk-Silva, Rendon,
Ridley-Thomas, Rodriguez, Salas, Skinner, Stone, Ting, Weber,
Wieckowski, Williams, Yamada, Atkins
NOES: Achadjian, Allen, Conway, Dahle, Donnelly, Beth Gaines,
Grove, Hagman, Harkey, Jones, Logue, Maienschein, Melendez,
Patterson, Wagner
NO VOTE RECORDED: Ch�vez, Gorell, Linder, Mansoor, Nestande,
Olsen, Waldron, Wilk, Vacancy
MW:nl:d 8/6/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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