Existing law establishes a State Department of Public Health within the California Health and Human Services Agency. Existing law requires the department to license and regulate clinical laboratories and various clinical laboratory personnel, including medical laboratory technicians. Existing law prohibits a person from operating a school, as defined, or conducting any course for the purpose of training or preparing persons to perform duties subject to those provisions, as specified, without having first secured the approval of the department. Existing law imposes on the department specified duties related to the approval and regulation of schools and clinical laboratory scientist programs for instruction in clinical laboratory technique.

This bill would authorize the department, upon appropriation by the Legislature, to establish a grant program to provide funding to schools training programs that both offer training programs for clinical laboratory scientists or medical laboratory technicians, and are approved by the department or accredited by a recognized accrediting program approved by the department. The bill would also authorize the department to award grants to those schools training programs in the amount of no more than $600,000, to be used within 3 years of receiving a grant.

Existing law establishes a State Department of Public Health within the California Health and Human Services Agency. Existing law requires the department to license and regulate clinical laboratories and various clinical laboratory personnel, including medical laboratory technicians. Existing law prohibits a person from operating a school, as defined, or conducting any course for the purpose of training or preparing persons to perform duties subject to those provisions, as specified, without having first secured the approval of the department. Existing law imposes on the department specified duties related to the approval and regulation of schools and clinical laboratory scientist programs for instruction in clinical laboratory technique.

This bill would authorize the department, upon appropriation by the Legislature, to establish a grant program to provide funding to schools that both offer training programs for clinical laboratory scientists or medical laboratory technicians, and are approved by the department or accredited by a recognized accrediting program approved by the department. The bill would also authorize the department to award grants to those schools in the amount of no more than $600,000, to be used within 3 years of receiving a grant.

Date of Hearing: May 15, 2024

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

ABPCA Bill Id:AB 2702

Author:(Chen) – As Amended Ver:March 14, 2024

Urgency: No State Mandated Local Program: No Reimbursable: No

SUMMARY:

This bill authorizes the California Department of Public Health (CDPH) to establish a grant program to provide funding to approved training programs for clinical laboratory scientists (CLSs) and medical laboratory technicians (MLTs). This bill is contingent on an appropriation by the Legislature.

Specifically, this bill:

1. Upon an appropriation by the Legislature, authorizes CDPH to establish a grant program to provide funding to training programs that meet both of the following criteria:
   1. Offer CLS or MLT training programs.
   2. Are approved by CDPH or accredited by a recognized accrediting program approved by CDPH.
2. Limits the amount of the grants from CDPH to no more than $600,000 each.
3. Requires CLS or MLT training programs to use grant funds within three years of receipt.

FISCAL EFFECT:

Cost pressure of an unknown amount, potentially in the millions of dollars annually, depending on the size and number of grants distributed (General Fund).

COMMENTS:

1. Purpose. This bill is sponsored by the California Association for Medical Lab Technology. According to the author:

The need for clinical laboratory scientists and medical laboratory technicians has grown in recent years at a rate severely disproportionate to the growth rate of educational training program opportunities for up and coming lab professionals. With state law requiring that each clinical laboratory scientist or medical laboratory technician have experience in such programs, the process of students becoming professionals must be streamlined and provided for by the state.

1. Implementation Concern. According to the Assembly Business and Professions Committee and the Assembly Higher Education Committee analyses of this bill, CDPH does not currently administer training grant programs. Other entities might be more appropriate choices to administer a clinical laboratory training grant program.
   
2. Support. The San Francisco State University (SFSU) Clinical Lab Science Program writes in support:

At hospitals all over California, lab staff are experiencing burn-out from working overtime or having a second job. Understaffing means poor turn-around-times for lab results or an increase in errors…

The most obvious solution would be to recruit and train more Clinical Lab Scientists and Medical Technicians to fulfill the need. However, schools are running on tight budgets. The SFSU Clinical Lab Science program has difficulty recruiting instructors due to salaries that are far below the market rate for lab scientists. To teach students lab skills, we must modify our lessons to only need the most inexpensive equipment, and we must accept donations from hospitals for lab items that are old or expired.

Analysis Prepared by: Allegra Kim / APPR. / (916) 319-2081

Date of Hearing: April 16, 2024

ASSEMBLY COMMITTEE ON HIGHER EDUCATION

Mike Fong, Chair

ABPCA Bill Id:AB 2702 (

Author:Chen) – As Amended Ver:March 14, 2024

SUBJECT: Training programs for clinical laboratory scientists and medical laboratory technicians: grants.

SUMMARY: Authorizes the California Department of Public Health (CDPH) to, upon appropriation by the Legislature, establish a grant program to provide funding to approved training programs for clinical laboratory scientists (CLS) and medical laboratory technicians (MLT). Specifically, this bill:

1. Authorizes the CDPH to, upon appropriation by the Legislature, establish a grant program to provide funding to training programs that meet both of the following criteria:
   1. Offer training programs for CLS or MLT; and,
   2. Are approved by the CDPH or accredited by a recognized accrediting program approved by the CDPH.
2. Limits the amount of the grants, as enumerated in (1) above, to no more than $600,000.
3. Requires the funds provided to CLS or MLT training programs to be used within three years of receiving a grant.

EXISTING LAW:

1. Establishes the Donahoe Higher Education Act, setting forth the mission of the UC, CSU, and CCC; and, defines "independent institutions of higher education" as nonpublic higher education institutions that grant undergraduate degrees, graduate degrees, or both, and that are formed as nonprofit corporations in California and are accredited by an agency recognized by the United States Department of Education (Education Code Section 66010, et seq.).
2. Regulates clinical laboratories and the performance of clinical laboratory tests through the licensing of clinical laboratories and laboratory directors, scientists, and other laboratory personnel under the CDPH and Clinical Laboratory Improvement Amendments of 1988 (CLIA) (Business and Professions Code (BPC) Sections 1200 - 1327).
3. Defines “CLS” as a person who is licensed to engage in clinical laboratory practice under the overall operation and administration of a laboratory director, unless serving as a director of specified laboratories (BPC Section 1204).
4. Requires the CDPH to issue a CLS or a limited CLS license to applicants who hold a bachelor’s or an equivalent or higher degree and the qualifications established by CDPH, as specified (BPC Section 1261(a)(1) and California Code of Regulations (CCR), Title 17, Section 1030.7).
5. Requires the CDPH to establish an “MLT-to-CLS” pathway program by January 1, 2022, that authorizes a licensed MLT to apply their work experience and training from a CDPH-approved MLT training program towards the completion of a CLS training program. The work experience and training may only be eligible for the pathway program upon approval by the CDPH (BPC Section 1261(b)).
6. Requires the CDPH to issue an MLT license to applicants who have completed specified MLT training programs and the qualifications established by the CDPH (BPC Section 1260.3, CCR, Title 17, Section 1030.6).

FISCAL EFFECT: Unknown

COMMENTS: Double referral. This measure was heard by the Assembly Committee on Business and Professions, on April 2, 2024, where it passed out with a vote of 18 – 0.

Purpose of the measure. According to the author, “the U.S. Department of Health and Human Services, Human Resources and Service Administration estimates an increase in demand [of CLS and MLT) by nearly a quarter for medical and clinical lab technicians by 2025. The need for lab professionals greatly exceeds the current employment vacancy rates, which is 7.2% on average according to a survey conducted by the American Society for Clinical Pathology.”

The author contends that, “the need for CLS and MLT has grown in recent years at a rate severely disproportionate to the growth rate of educational training program opportunities for up and coming lab professionals. With state law requiring that each clinical laboratory scientist or medical laboratory technician have experience in such programs, the process of students becoming professionals must be streamlined and provided for by the state.”

Further, the author states that, “by expanding the number of students that Clinical Laboratory Science educational programs accept, AB 2702 would make it more likely for underrepresented individuals to get the experience required to become a clinical laboratory scientist or medical lab technician.”

This measure authorizes the CDPH to award grants of no more than $600,000 to schools who provide CLS and MLT laboratory training programs.

Clinical laboratory scientists and medical laboratory technicians. CLS and MLT are highly skilled professionals who work in lab settings. They are responsible for performing complex assessments to assist medical professionals diagnose and treat diseases. Common job duties for these job titles include:

• Preparing test samples of blood, tissue, and fluids
• Ensuring specimens and test samples match
• Collecting and updating patient data
• Evaluating samples, slides, and cultures with microscopes
• Troubleshooting issues that occur with equipment

The only difference between a CLS and a MLS is the actual job title. The two professions involve the same training, job duties, and credentials. The main difference is what job title an employer chooses to use. Employers may also refer to these professionals as medical technologists. However, there is a difference between said job titles and a medical technician, the latter not requiring as much education and has less job responsibilities. But it is common for both professionals to work together in the same job settings.

In order to become a medical technologist, CLS or MLS, one needs to earn a bachelor's degree. Common majors for individuals interested in becoming a CLS and MLT, include biology, biochemistry, or microbiology. Another requirement for this career path is completing a medical technologist program. It is accredited by the National Accrediting Agency of Clinical Laboratory Science (NAA-CLS). During the program, students learn about organic chemistry, microbiology and biology. Students may also participate in clinical rotations, gaining hands-on instruction from experienced technologists.

Before getting their first medical technologist, clinical laboratory scientist, or medical laboratory scientist job, individuals need to complete a pathology lab internship; whereby they gain hands-on experience and work with professionals in this field.

The California Association for Medical Laboratory Technology in their support of this measure, state that, “there has been a long-standing shortage of training opportunities for qualified candidates to receive the clinical experience required by law to fulfill the requirements necessary to become a CLS/MLT. There are estimated to be over 1,200 vacant CLS/MLT positions currently and the number is expanding every year, compounded by the aging demographics of the profession and an increase in retirements. Our healthcare system is built on the foundation of clinical laboratory testing and diagnostics, and the COVID-19 crisis has clearly revealed the cracks in that foundation. Millions of diagnostic tests are performed each year in California, influencing approximately 70% of medical decisions.”

According to the U. S. Bureau of Labor Statistics, the job outlook for CLS and MLT is forecasted to grow from 7% from 2019 to 2029. This is faster than the average growth rate for all occupations, which is 4%. As the population continues to increase, there will be a greater need for professionals who can help with the process of diagnosing diseases through lab procedures and tests.

CLS and MLT Programs and Schools. As referenced above, in order to become a CLS or MLT, an individual must earn, at a minimum, a bachelor’s degree. At the time this analysis was published, Committee Staff was not able to ascertain the exact number of institutions of higher education (IHE) in the State that offer degrees and/or training programs in CLS and/or MLT. However, the chart below, lists the top California IHEs that offer degrees and/or training program in CLS and/or MLT and the type of institution:

Committee comments. Currently, this measure requires the CDPH to establish and administer a grant program to provide funding to approved CLS and MLT training programs; however, Committee Staff understands that the CDPH does not currently administer any training grant programs.

Moving forward, the author may wish to work with the appropriate stakeholders in order to determine if the CDPH is the best entity to establish and administer the grant program, or if there is a better suited entity.

Arguments in support. San Francisco State University (SFSU) states that, “at hospitals all over California, lab staff are experiencing burn-out from working overtime or having a second job. Understaffing means poor turn-around-times for lab results or an increase in errors. Automation has not sufficiently alleviated this need since people are still required to run and troubleshoot the instruments. In addition, many tests are still done manually since it takes time to develop an automated method.”

Further, SFSU states that, “the most obvious solution would be to recruit and train more Clinical Lab Scientists and Medical Technicians to fulfill the need. However, schools are running on tight budgets. The SFSU Clinical Lab Science program has difficulty recruiting instructors due to salaries that are far below the market rate for lab scientists. To teach students lab skills, we must modify our lessons to only need the most inexpensive equipment, and we must accept donations from hospitals for lab items that are old or expired. Despite our struggles, we continue to fight to keep the program open, however we would like to do better for our students.”

SFSU concludes that, “we support AB 2702 as this will increase much needed funding for clinical lab training schools.”

REGISTERED SUPPORT / OPPOSITION:

Support

American Society for Clinical Pathology
California Association for Medical Laboratory Technology
California Association of Medical Laboratory Technology
California Clinical Laboratory Association
California Life Sciences
Engineers and Scientists of California, IFPTE Local 20, AFL-CIO
Quest Diagnostics Incorporated
San Francisco State University

Opposition

None on file.

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

Date of Hearing: April 2, 2024

ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS

Marc Berman, Chair

ABPCA Bill Id:AB 2702

Author:(Chen) – As Amended Ver:March 14, 2024

NOTE: This bill is double referred and if passed by this Committee will be re-referred to the Assembly Higher Education Committee.

SUBJECT: Training programs for clinical laboratory scientists and medical laboratory technicians: grants.

SUMMARY: Authorizes the California Department of Public Health (CDPH) to, upon appropriation by the Legislature, establish a grant program to provide funding to approved training programs for clinical laboratory scientists (CLSs) and medical laboratory technicians (MLTs).

EXISTING LAW:

1. Regulates clinical laboratories and the performance of clinical laboratory tests through the licensing of clinical laboratories and laboratory directors, scientists, and other laboratory personnel under the CDPH and CLIA. (BPC §§ 1200-1327)
2. Defines “clinical laboratory scientist” as a person who is licensed to engage in clinical laboratory practice under the overall operation and administration of a laboratory director, unless serving as a director of specified laboratories. (BPC § 1204)
3. Requires the CDPH to issue a CLS or a limited CLS license to applicants who hold a baccalaureate or an equivalent or higher degree and the qualifications established by CDPH, as specified. (BPC § 1261(a)(1), California Code of Regulations (CCR), Title 17, § 1030.7)
4. Requires the CDPH to establish an “MLT-to-CLS” pathway program by January 1, 2022, that would authorize a licensed MLT to apply their work experience and training from a CDPH-approved MLT training program towards the completion of a CLS training program. The work experience and training may only be eligible for the pathway program upon approval by the CDPH. (BPC § 1261(b))
5. Requires the CDPH to issue an MLT license to applicants who have completed specified MLT training programs and the qualifications established by the CDPH. (BPC § 1260.3, CCR, tit. 17, § 1030.6)

THIS BILL:

1. Authorizes the CDPH to, upon appropriation by the Legislature, establish a grant program to provide funding to schools training programs that meet both of the following criteria:
   1. Offer training programs for clinical laboratory scientists or medical laboratory technicians.
   2. Are approved by the CDPH or accredited by a recognized accrediting program approved by the CDPH.
2. Limits the amount of the grants to no more than $600,000.
3. Require the funds to be used within three years of receiving a grant.

FISCAL EFFECT: Unknown. This bill is keyed fiscal by the Legislative Counsel.

COMMENTS:

Purpose. This bill is sponsored by the California Association for Medical Laboratory Technology. According to the author, “The need for clinical laboratory scientists and medical laboratory technicians has grown in recent years at a rate severely disproportionate to the growth rate of educational training program opportunities for up and coming lab professionals. With state law requiring that each clinical laboratory scientist or medical laboratory technician have experience in such programs, the process of students becoming professionals must be streamlined and provided for by the state.”

Background. At both the federal and state level, a facility or location where people perform laboratory tests on human specimens for diagnostic or assessment purposes must be certified under CLIA. The federal CLIA law establishes minimum standards but allows states to establish more stringent requirements. The purpose of CLIA and the state requirements is to minimize the risk of incorrect or unreliable results, patient harm during testing, and improper diagnoses, among other things. Laboratories are licensed and regulated by the CDPH.

In California, two of the licensed personnel authorized to work in clinical laboratories are MLTs and CLSs. MLTs are personnel that are authorized to perform laboratory tests that are classified as “waived” (low complexity) and certain tests classified as “moderate complexity” under CLIA. To become licensed as an MLT, applicants must have a minimum of an associate degree with specified coursework in physical or biological sciences, chemistry, and biology. They must also complete a training program or obtain specified on the job experience and pass a CDPH-approved examination.

Similarly, CLS are personnel that are generally authorized to perform any work in a laboratory that they are trained to perform. To become licensed as a CLS, applicants must have a minimum of a bachelor degree with specified coursework in clinical chemistry or analytical and biochemistry, hematology, immunology, medical microbiology, and physics, except that the CDPH can make exceptions for military applicants. They must also complete at least one year of post-graduate training or experience as a licensed CLS trainee and pass a CDPH-approved examination.

ARGUMENTS IN SUPPORT:

The California Association for Medical Laboratory Technology (CAMLT) (sponsor) writes in support, “Passage of this bill may finally provide funding to Clinical Laboratory Science educational programs to expand the number of students these programs accept. This funding must be flexible enough to be used to fund laboratory preceptorships as that is a clear chokepoint for the laboratory workforce pipeline. As you are aware, there has been a long-standing shortage of training opportunities for qualified candidates to receive the clinical experience required by law to fulfill the requirements necessary to become a CLS/MLT. There are estimated to be over 1,200 vacant (CLS/MLT) positions currently and the number is expanding every year, compounded by the aging demographics of the profession and an increase in retirements. Our healthcare system is built on the foundation of clinical laboratory testing and diagnostics, and the COVID-19 crisis has clearly revealed the cracks in that foundation. Millions of diagnostic tests are performed each year in California, influencing approximately 70 percent of medical decisions.”

The San Francisco State University Clinical Lab Science Program writes in support:

At hospitals all over California, lab staff are experiencing burn-out from working overtime or having a second job. Understaffing means poor turn-around-times for lab results or an increase in errors. Automation has not sufficiently alleviated this need since people are still required to run and troubleshoot the instruments. In addition, many tests are still done manually since it takes time to develop an automated method.

The most obvious solution would be to recruit and train more Clinical Lab Scientists and Medical Technicians to fulfill the need. However, schools are running on tight budgets. The SFSU Clinical Lab Science program has difficulty recruiting instructors due to salaries that are far below the market rate for lab scientists. To teach students lab skills, we must modify our lessons to only need the most inexpensive equipment, and we must accept donations from hospitals for lab items that are old or expired. Despite our struggles, we continue to fight to keep the program open, however we would like to do better for our students.

ARGUMENTS IN OPPOSITION:

None on file

IMPLEMENTATION ISSUES:

Proper Entity. The CDPH does not currently administer training grant programs. If this bill passes this committee, the author may wish to determine if there is a more appropriate entity to administer the program.

REGISTERED SUPPORT:

California Association for Medical Laboratory Technology (sponsor)
San Francisco State University Clinical Laboratory Science Program

REGISTERED OPPOSITION:

None on file

Analysis Prepared by: Vincent Chee / B. & P. / (916) 319-3301