(1)Existing law establishes the California Community Colleges under the administration of the Board of Governors of the California Community Colleges. Existing law requires the board of governors to prescribe minimum standards for the formation and operation of, and to exercise general supervision over, the California Community Colleges.

The bill would require a community college with a limited enrollment course or program, as defined, to ensure that at least 15 percent of the admitted students, but no less than 3 students per incoming cohort, in the course or program are incumbent health care workers, as provided. The bill would require a community college that administers a priority enrollment system to grant priority in that system to students who are incumbent health care workers, as specified. The bill would define incumbent health care worker and health care facility for purposes of these provisions. The bill would repeal these provisions on January 1, 2034.

(2)Existing law authorizes a community college registered nursing program, if it determines that the number of applicants to the program exceeds its capacity, to admit students to the program using a multicriteria screening process, a random selection process, or a blended combination of random selection and a multicriteria screening process, as specified. Existing law repeals these provisions relating to admission to community college registered nursing programs on January 1, 2025.

This bill would extend operation of these provisions indefinitely, indefinitely. The bill, until January 1, 2034, would require at least 15 percent of the admitted students, but no less than 3 students per incoming cohort, in a community college registered nursing program to be incumbent health care workers, as provided, and would define incumbent health care worker and health care facility for purposes of these provisions.

Existing law authorizes a community college registered nursing program, if it determines that the number of applicants to the program exceeds its capacity, to admit students to the program using a multicriteria screening process, a random selection process, or a blended combination of random selection and a multicriteria screening process, as specified. Existing law repeals these provisions relating to admission to community college registered nursing programs on January 1, 2025.

This bill would make nonsubstantive changes to those provisions.

SENATE COMMITTEE ON APPROPRIATIONS

Senator Anthony Portantino, Chair

2023 - 2024 Regular Session

AB 689 (Wendy Carrillo) - Community colleges: enrollment and registration: incumbent health care workers

Bill Summary:

This bill requires California Community Colleges (CCCs), beginning in the 2024-2025 academic year, to set aside 15% of slots in a limited enrollment course or program and registered nursing program for incumbent health care employees. The bill also requires a CCC to provide priority registration to incumbent health care employees when enrolling in community college courses and programs.

Fiscal Impact:

The Chancellor’s Office estimates ongoing Proposition 98 General Fund costs of up to $16.7 million for community colleges to comply with the bill’s requirements. This estimate assumes that each of the 77 colleges with a nursing program would need to hire between 1.5 and and 2 admissions and records (A/R) clerk positions at a cost of $60,000 each, and that the 112 colleges with impacted allied health programs would need to hire 1 to 2 additional A/R clerk positions, depending on the number of programs offered at each college. These positions would primarily be needed for workload relating to application review, employment verification, and application priority workload. The community colleges would incur additional one-time Proposition 98 General Fund costs of $870,000 to update priority enrollment policies and create new policies on program admissions.

The Chancellor’s Office indicates one-time General Fund costs of $184,000 to update Title V regulations on priority enrollment and limited enrollment programs and issue a guidance memo, and $77,000 in ongoing costs to provide technical assistance.

Background:

Existing law authorizes the California State University (CSU) and each community college district, and requests the University of California (UC) to offer priority registration for any existing or former member of the State Guard or a former member of the Armed Forces of the United States who is a California resident and has been honorably discharged, as defined. Existing law also authorizes the CSU and each community college district, and requests the UC to offer priority registration to foster youth, former foster youth, homeless youth, or formerly homeless youth, as defined.

Existing law requires each community college district to offer priority registration to students eligible for disabled student programs and services, students eligible for extended opportunity programs and services, students receiving CalWORKS, and students who receive Tribal Temporary Assistance for Needy Families (TANF),as defined.

Existing law requires, beginning no later than July 1, 2023, each campus of the CSU, and each community college campus, and requests each campus of the UC to offer priority registration to student parents.

Proposed Law:

This bill requires, commencing with the 2024-25 academic year, a CCC with a limited enrollment course or healthcare program to ensure that at least 15 percent of admitted students, but no less than 3 students per incoming cohort, in the course or program are incumbent health care workers. The bill provides that a community college’s limited enrollment course or program is in compliance if, after following the admittance requirement the community college does not receive a sufficient number of incumbent health care workers who apply for admittance into the course or program within 10 business days of the opening of enrollment for the course or program. This provision shall remain in effect only until January 1, 2034.

This bill requires, commencing with the 2024-25 academic year, a community college that administers a priority enrollment system shall grant registration priority, for each term in which the registration priority system is administered, to students who are incumbent health care workers. This provision shall remain in effect only until January 1, 2034.

This bill requires, commencing with the 2024–25 academic year until January 1, 2034, that an impacted CCC registered nursing program described have at least 15 percent of the admitted students, but no less than 3 students per incoming cohort, be incumbent health care workers. The bill also indefinitely extend the multi-criteria screening process authorized in current law for impacted nursing programs.

Related Legislation:

AB 1311 (Soria, 2023) requires the Legislative Analyst's Office (LAO) to conduct an assessment, on or before January 1, 2025, evaluating the efficacy of existing programs in allied health jointly offered between campuses of the CCC, CSU, and UC. AB 1311 has been ordered to Enrollment and Engrossing.

AB 1695 (Gipson, 2023) establishes the Nursing Pathway Pilot program in high schools to create pathways toward associate degrees in nursing at California Community Colleges. AB 1695 is scheduled to be heard in this Committee on August 14, 2023.

AB 255 (Alanis, 2023) requires CCC districts and the CSU, and requests the UC, to grant priority registration to students employed as first responders, including paramedics and emergency medical technicians. AB 255 is on the Suspense File in this Committee.

Staff Comments:

Priority registration decisions are made at the campus level at each segment. The process allows specific students access to classes ahead of the general student population. In addition to priority registration granted by the campuses, existing law requires the CCCs to grant priority enrollment to certain categories of students, including current and former foster youth, any member or former member of the Armed Forces of the United States, as specified, and any student who is a CalWORKs or Tribal TANF recipient. This bill adds incumbent health care workers to this list of groups for which priority registration must be granted. This bill also requires that community colleges with impacted healthcare or nursing programs to set aside 15 percent of slots for incumbent healthcare workers. However, the bill would not increase capacity or add slots for those programs.

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SENATE COMMITTEE ON EDUCATION

Senator Josh Newman, Chair

2023 - 2024 Regular

Bill No: AB 689 Hearing Date: July 5, 2023

Subject: Community colleges: enrollment and registration: incumbent health care workers.

SUMMARY

This bill requires a California Community Colleges (CCC), beginning in the 2024-2025 academic year, to set aside 15% of slots in its impacted courses and programs for incumbent health care employees. The bill also requires a CCC to provide priority registration to incumbent health care employees when enrolling in CCC courses and programs.

BACKGROUND

Existing law:

1. Establishes the California Community Colleges (CCC) under the administration of the Board of Governors of the CCC, as one of the segments of public postsecondary education in California. The CCC shall be comprised of CCC districts. (Education Code (EC) § 70900).
2. Authorizes the California State University (CSU) and each CCC district, and requests the University of California (UC) to offer priority registration for any existing or former member of the State Guard or a former member of the Armed Forces of the United States who is a California resident and has been honorably discharged, as defined. (EC § 66025.8).
3. Authorizes the CSU and each CCC district, and requests the UC to offer priority registration to foster youth, former foster youth, homeless youth, or formerly homeless youth, as defined. (EC § 66025.9)
4. Requires each CCC district to offer priority registration to students eligible for disabled student programs and services, students eligible for extended opportunity programs and services, students receiving CalWORKS, and students who receive Tribal Temporary Assistance for Needy Families (TANF),as defined. (EC § 66025.91 and § 66025.92)
5. Requires, beginning no later than July 1, 2023, each campus of the CSU, and each campus within a CCC district, and requests each campus of the UC to offer priority registration to student parents. (EC § 66025.81)
6. Authorizes a CCC registered nursing program that determines that the number of applicants that the program exceeds its capacity to admit students through the administration of multi-criteria screening process, random selection process or a blended combination of random selectin and multi-criteria screening process. Current law requires a CCC that elects to use a multicriteria screening process to evaluate applicants to apply those measures in accordance with all of the following:
   1. The criteria applied in a multicriteria screening process will include, but is not limited to:
      1. Academic degrees or diplomas, held by an applicant.
      2. Grade-point average in relevant coursework.
      3. Any relevant work or volunteer experience.
      4. Life experiences or special circumstances of the applicants as defined.
      5. Proficiency in advance level coursework in languages other than English, as defined.
   2. Additional criteria such as a personal interview, a personal statement, a letter of recommendation, or a number of repetitions of prerequisite classes may be included but are not required.
   3. Additional criteria may include the use of a diagnostic test. (EC § 78261.5 (a) and (b))
7. Requires a CCC that uses a multicriteria screening process to report its nursing program admission policies to the Chancellor annually, in writing. The policy will include how each criteria is factored into the college’s decision in terms of admission.
8. Repeals provisions related to the authorization for a community colleges to admit students using the methods described above on January 1, 2025, unless another statute extends the date. (EC § 78261.5)

ANALYSIS

This bill:

1. Requires, commencing with the 2024-25 academic year, a CCC with a limited enrollment course or program to ensure that at least 15 percent of admitted students, but no less than 3 students per incoming cohort, in the course or program are incumbent health care workers.
2. Requires, commencing with the 2024–25 academic year, that an impacted CCC registered nursing program described have at least 15 percent of the admitted students, but no less than 3 students per incoming cohort, be incumbent health care workers and:
   1. Modifies the multi-criteria screening process authorized in current law for

impacted nursing programs to ensure slots are set aside for incumbent health care workers, other students seeking admittance are subject to a random selection process.

1. States that a CCC is not required to admit any incumbent health care worker into a limited enrollment course or program, including impacted nursing programs, if they would otherwise be ineligible for admittance into the course or program.
2. Deems a community college’s limited enrollment course or program, including impacted nursing programs, in compliance with the 15 percent but no less than 3 students admittance requirement if the CCC does not receive a sufficient number of incumbent health care workers who apply for admittance into the course or program.
3. Requires, commencing with the 2024-25 academic year, that a CCC that administers a priority enrollment system grant registration priority to students who are incumbent health care workers, as prescribed.
4. Defines various terms for purposes of the bill, including:
   1. “Limited enrollment course or program,” to mean a course or programs

that are limited to students meeting pre-requisites and co-requisites, limited due to health and safety considerations, facility limitations, faculty workload, the availability of qualified instructions, funding limitations, the constraints of regional planning, or legal requirements, as specified in regulations.

• 1. “Incumbent health care,” workers to mean a worker who meets all of the

following requirements:

• • 1. The worker is paid to work in a health care facility to directly or

indirectly care for or assist patients. This may include, but is not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, and persons not directly involved in patient care, such as clerical, dietary, environmental services, laundry, security, maintenance, engineering and facilities management, administrative, and billing personnel.

• • 1. The worker has an established employment history with the health

care facility for 6 months or more.

• • 1. The worker meets the necessary pre-requisites and co-requisites

pursuant to regulations.

STAFF COMMENTS

1. Need for the bill. “California is in a health care workforce crisis.

Even before to the COVID-19, California faced a shortage of trained health care employees. In January 2020, Future Health conservatively estimated a shortage of 500,000 allied health employees by 2024. In the aftermath of the pandemic, this workforce shortage has only grown worse. And it is not limited to the allied health professions. According to a recent study by UCSF, California had a deficit of 40,000 registered nurses in 2021, and that number has likely only grown.

These shortages disproportionately impact disadvantaged communities throughout California. Fortunately, there are potential solutions to the state’s health care workforce crisis. One of the most promising areas is in training incumbent workers, which would enable the existing workforce to advance in their careers to earn a higher wage. In health care, this could include training a licensed vocational nurse to become a registered nurse or training an orderly to become a phlebotomist.

Unfortunately, the current method of assigning slots within impacted programs at California’s community colleges limits incumbent worker training in the health care industry. This is why I authored AB 689.”

1. Is this the appropriate solution? This bill attempts to address the health care workforce crisis by setting aside slots in impacted community college courses. However, this bill does not increase the number of spaces available rather it limits open slots. The bill’s provisions apply to any person who is paid to work in a health care facility, ranging from physicians to security personnel. Courses or programs do not have to be health-related in order for an incumbent health care worker to receive the benefit provided under this bill. Any impacted course or program, including, for example, a course in criminal justice or history, would have to set aside 15 percent of slots for an incumbent health care worker. Further, the bill is silent on addressing issues affecting course or program impaction, such as the availability of instructors, funding, or facility limitations. If it is the goal of the bill to expand the workforce, is it an effective policy to limit the number of slots available for other students who wish to enroll in the same course or program? How would such a policy impact the overall goal of increasing the number of health care graduates? Would requiring community colleges to reserve 15 percent of limited slots for incumbent health care workers signal that certain groups of students are less worthy of those slots or career path? The committee may wish to consider whether this policy may have unintended consequences, such as discouraging potential students from pursuing a career in health care? Rather than limit the number of slots available to the general student population, why not expand programs or course offerings throughout the system to serve any student who wishes to enroll in those programs?
2. Slippery slope. As outlined in the Master Plan for Higher Education and by state statute, the CCCs are designated to have an open admission policy and bear the most extensive responsibility for lower-division undergraduate instruction. Its three primary areas of mission include education leading to associate degrees and university transfer, career technical education, and basic skills. The community colleges admit any student capable of benefiting from instruction. It is the largest and most diverse system of higher education in the country, with over 69 percent of CCC students coming from diverse ethnic backgrounds and 47 percent of students receiving financial aid to cover tuition fees. The CCC Chancellor’s Office's most recent report (May 2023) on basic needs services concludes that basic needs security remains the top need identified by students that impacts their equitable enrollment, persistence, and completion. It is evident that CCCs serve a vulnerable population within the state and have a critical role in ensuring their academic success. This bill would establish a statutory precedent for setting aside slots within CCCs for specific groups of students based on their employment; it is likely that in future years other worthy groups will request a similar benefit. If the Legislature continues down this path, it could jeopardize the open access mission of the community colleges by limiting the number of open spaces available to the general student population.
3. Priority registration. Priority registration decisions are made at the campus level at each segment. The process allows specific students access to classes ahead of the general student population. For example, continuing students generally are allowed to enroll in courses before new students enroll. As such, students who have priority registration status have an advantage over other students.

In addition to priority registration granted by the campuses, existing law requires the CCCs to grant priority enrollment to the following students:

• 1. Current and former foster youth.
  2. Until January 1, 2020, homeless youth.
  3. Any member or former member of the Armed Forces of the United States,

and who is a resident of California, who has received an honorable discharge, a general discharge, or an other than honorable discharge, and to any member or former member of the State Military Reserve, for any academic term attended at one of these institutions for four academic years after he or she has left state or federal active duty, which he or she shall use within 15 years of leaving state or federal active duty.

• 1. Any student who is a CalWORKs or Tribal TANF recipient.
  2. Students in the CCC Extended Opportunity Programs and Services program, and disabled students who are determined to be eligible for disabled student programs and services.

This bill adds incumbent health care workers to this list of groups for which priority registration must be granted. The Committee may wish to consider at what point priority becomes overprescribed.

1. Other options that address program impaction. To address workforce shortages, previous budgetary and policy efforts aimed to boost enrollment capacity, build educational pipeline programs to improve time to degree, or expand programs and student assistance. The 2015 Budget Act included funding to strengthen enrollment capacity and student assistance for the CCC nursing program, resulting in increased enrollment and lower attrition rates. Furthermore, in response to concerns about managing limited enrollment slots within high-demand nursing programs and student retention, current law established by AB 1559 (Berryhill, Chapter 712, Statues of 2007) requires CCCs that elect to use a multi-criteria screening process to evaluate applicants for admission to nursing programs on specified criteria. Those criteria may relate to the academic performance, work or volunteer experience, foreign language skills, life experiences, and special circumstances of the applicant. AB 1559 authorizes a CCC registered nursing program using a multi-criteria screening process to use an approved diagnostic assessment tool before, during, or after the multi-criteria screening process. It authorized a college to admit students through a random selection process or a multi-criteria screening process. This bill would allow incumbent health care workers to bypass the evaluation process in current law, established by AB 1559.
2. Amendments. The author has agreed to the amending the bill as follows:

• Clarify that the 15% set aside only applies to healthcare programs, not all impacted programs.
• Clarify that incumbent healthcare workers will get first shot at the 15% of set aside slots. If those slots are not filled by incumbent healthcare workers within 10 days of opening enrollment then they can be opened up to everyone.
• Add a 10-year sunset.
• Increase time in employment from 6 months to a 1 year.

1. Related legislation

AB 1311 (Soria, 2023) requires the Legislative Analyst's Office (LAO) to conduct an assessment, on or before January 1, 2025, evaluating the efficacy of existing programs in allied health jointly offered between campuses of the CCC, CSU, and UC. AB 1311 is set to be heard at the same hearing as this bill.

AB 1695 (Gipson, 2023) establishes the Nursing Pathway Pilot program in high schools to create pathways toward associate degrees in nursing at California Community Colleges. AB 1695 was heard and approved by this committee on June 28, 2023.

AB 255 (Alanis, 2023) requires by July 1, 2024, for CCC districts and the CSU and request the UC to grant priority registration to students employed as first responders, including paramedics and emergency medical technicians. AB 255 was approved on consent by this committee on June 21, 2023 and is currently pending in Senate Appropriations Committee.

SUPPORT

California Hospital Association (Co-Sponsor)

California Association of Public Hospitals & Health Systems

CaliforniaHealth+Advocates

Community Clinic Association of Los Angeles County

OPPOSITION

Community College League of California

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ASSEMBLY THIRD READING

ATR Bill Id:AB 689

Author:(Wendy Carrillo)

As Amended Ver:March 23, 2023

Majority vote

SUMMARY

Establishes a requirement beginning in the 2024-2025 academic year, for limited enrollment course or programs and nursing programs offered at community colleges to reserve placements for incumbent health care workers and requires community colleges to provide priority registration for incumbent health care workers.

Major Provisions

1. Authorizes a community college, beginning in the 2024-25 academic year, to require the enrollment of incumbent health care workers to be at least 15% but no less than three students for each limited enrollment course or program. Does not require a community college to admit incumbent health care workers if the worker is otherwise ineligible for admission to the course or program and permits a community college to enroll students at will if the community college after initial admissions there is an insufficient number of incumbent health care workers who applied for admission to the limited enrollment course or program.
2. Requires a community college, beginning with the 2024-2025 academic year, to provide priority registration to students who are incumbent health care workers, if the community college has a priority enrollment system in place.
3. Stipulates when a community college registered nursing program has more applicants than capacity the community college may use a multicriteria screening process, a random selection process, or a combination of both; however, for any of the methods employed the community college must adhere to the following:
   1. Beginning in the 2024-2025 academic year, community college registered nursing programs are required to admit at least 15%, but not less than three students, who identify as incumbent health care workers. Does not require a community college to admit incumbent health care workers if the worker is otherwise ineligible for admission to the course or program and permits a community college to enroll students at will if the community college determines there is an insufficient number of incumbent health care workers who applied for admission to the registered nursing program described in (4).
4. Repeals a sunset date for the procedures on how community colleges may screen applicants to be admitted to nursing programs where applicants outnumber the capacity of the nursing programs. Extends the screening processes indefinitely.

COMMENTS

California Community Colleges (CCC). The CCC is the only open-access public college system in California. The CCC accepts 100% of applicants and provides education to all students regardless of academic or socioeconomic background. However, being open access does not infer that courses are readily available to any one student. Just like their four-year university counterparts, the CCC has prerequisites and corequisites for specified courses. Such as the prerequisite of having to have completed trigonometry before enrolling in calculus. The CCC also has limited enrollment or impaction. The California Code of Regulations, Title 5, Section 58106, explains limited enrollment may be provided for specific courses through the following methods:

1. Limiting enrollment to students who meet designated prerequisites and corequisites;
2. Limiting enrollment due to health and safety considerations, facility limitations, faculty workload, the availability of qualified instructors, funding limitations, constraints of regional planning, or legal requirements imposed by statutes, regulations, or contracts. When limiting enrollment for the above circumstances, the governing board of the community college may adopt policies that consist of one or more of the following:
   1. Limiting enrollment on a first-come, first-served basis;
   2. Limiting enrollment using a registration procedure that includes priority enrollment;
   3. Allocate available seats to students judged most qualified (this is limited to courses of intercollegiate competition, honors courses, or public performance courses); and,
   4. Limiting enrollment using any selection procedure expressly authorized by statute.

According to the Chancellor's Office, limited enrollment courses are courses that have limited enrollment capacity either due to the teaching method (limited lab placements or equipment) or due to limited qualified faculty. These courses are typically Career Technical Education courses or nursing courses. When a course has limited enrollment or impactions, a wait list ensues which can result in students waiting a semester, or even up to an entire year, before placement in the course. This measure provides priority placement for health care workers and therein, guarantees these students a seat in "impacted" or limited courses.

Nursing programs at community colleges. The California Registered Board of Nursing stipulates in order to be a registered nurse in the State of California, a nurse must complete a pre-licensure registered nursing program that is approved by the board and pass the National Council Licensing Examination. The minimum education requirement for a registered nurse is an associate degree in nursing. According to the California Registered Board of Nursing, 79 community colleges offer an associate's degree in nursing. CCCs offer three different types of nursing programs: Certifications as nursing assistants, licensed vocational nursing (LVN), and registered nursing (RN) degrees. Each year the Chancellor's Office is statutorily required to publish a report on the state of nursing at the community colleges. The most recent report was published in 2019, and the report provides various data points from the 2017-2018 academic year on the state of nursing programs. The report included the following data points:

1. 12,960 full-time equivalent students enrolled in 77 community college nursing programs;
2. 4,541 students graduated with an RN and the CCC National Council Licensing Exam pass rate was 91.58%; and,
3. 47 colleges used multicriteria screening in selecting applicants due to limited capacity or limited enrollment.

One of the criteria used in the multicrieria screening process to provide priority for nursing applicants to a CCC program is vocational work. Technically health care workers are supposed to be given priority placement over other applicants if the college is using a multicriteria screening process. However, colleges are also permitted the ability to use a random selection process when a nursing program is impacted and the colleges are not required to report whether they use this process for selecting nursing applicants. Therefore, it is entirely possible that the other 30 community college use random selection thereby not providing a priority for incumbent health workers for the impacted nursing programs.

This measure would add an additional requirement for nursing programs to prioritize the placement of health care workers in nursing programs above other nursing applicants and builds upon existing law by requiring health care workers to comprise of at least 15%, but not less than three student placements, in nursing program cohorts beginning in the 2024-25 academic year.

Please see the policy committee analysis for a full discussion of this bill.

According to the Author

As delineated by the author, "California is in a health care workforce crisis. Even before the COVID-19 pandemic, California faced a shortage of trained health care employees. In January 2020, Futuro Health conservatively estimated a shortage of 500,000 allied health employees by 2024. In the aftermath of the pandemic, this workforce shortage has only grown worse. And it is not limited to the allied health professions. According to a recent study by UCSF, California had a deficit of 40,000 registered nurses in 2021, and that number has likely only grown. These shortages disproportionately impact disadvantaged communities throughout California. Fortunately, there are potential solutions to the state's health care workforce crisis. One of the most promising areas is in training incumbent workers, which would enable the existing workforce to advance in their careers to earn a higher wage. In health care, this could include training a licensed vocational nurse to become a registered nurse or training an orderly to become a phlebotomist. Unfortunately, the current method of assigning seats within impacted programs at California's community colleges limits incumbent worker training in the health care industry. This is why I authored AB 689."

The author further contends, "simply put, AB 689 does two things: First, AB 689 provides health care employees with priority registration when enrolling in community college courses. This would ensure that health care workers have access to the courses they need. Second, AB 689 would require that community colleges set aside at least 15% of the slots in their impacted courses for health care workers, ensuring they have full access to the impacted courses that will assist them in their training."

Arguments in Support

As contextualized by the California Hospital Association and the California State Council of Service Employees International Union, "fortunately, there are potential solutions to the state's health care workforce crisis. One of the most promising areas is in training incumbent workers, which would enable the existing workforce to advance in their careers to earn a higher wage. In health care, this could include training a licensed vocational nurse to become a registered nurse or training an orderly to become a phlebotomist. However, there are fundamental barriers to health care workers accessing appropriate training. This is why – in the face of such a profound crisis — the California Hospital Association and the Service Employees International Union (SEIU) have come together to co-sponsor Assembly Bill (AB) 689, which would address some of the challenges."

"First, AB 689 would provide health care employees with priority registration when enrolling in community college courses. This would ensure that health care workers have access to the courses they need. Second, AB 689 would require that community colleges set aside at least 15% of the slots in their impacted courses for health care workers, ensuring they have full access to the impacted courses that will assist them in their training."

"Because many health care workers already have commitments on the job as well as personal responsibilities that necessitate juggling multiple responsibilities, community colleges are the simplest and most affordable way to access academic prerequisites and training programs. Unfortunately, community college classes and programs are generally impacted, or there is more student demand than available space, and this places health care workers at a disadvantage. Not only are they limited in what courses they can sign up for due to their work schedules, but the seats that are available are apportioned by either a "first come, first served" or lottery system. Neither option assists health care workers in receiving the training they need to increase their earnings or career options. Eliminating these barriers to training would result in a "win-win" situation – the community receives an additional trained health care worker, and the employee sees increased wages for an in-demand field."

Arguments in Opposition

None on file.

FISCAL COMMENTS

According to the Assembly Committee on Appropriations, one-time and ongoing Proposition 98 General Fund costs, in the high hundreds of thousands of dollars across 115 CCCs, to update priority enrollment policies, create a new policy on program admissions, potential costs related to workload increases for administrative staff to review application and verify employment. In addition, though the bill does not require it, the CCC Chancellor's Office that it would be a best practice to collect data on incumbent health care workers and include it in the CCC data system, which would result in additional costs.

VOTES

ASM HIGHER EDUCATION: 11-0-1

YES: Mike Fong, Ta, Addis, Arambula, Gabriel, Irwin, Low, Ortega, Santiago, Wallis, Weber

ABS, ABST OR NV: Sanchez

ASM APPROPRIATIONS: 12-0-4

YES: Holden, Bryan, Calderon, Wendy Carrillo, Mike Fong, Hart, Lowenthal, Mathis, Papan, Pellerin, Weber, Ortega

ABS, ABST OR NV: Megan Dahle, Dixon, Robert Rivas, Sanchez

UPDATED

VERSION: March 23, 2023

CONSULTANT: Ellen Cesaretti-Monroy / HIGHER ED. / (916) 319-3960 FN: 0000789

Date of Hearing: May 10, 2023

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Chris Holden, Chair

ABPCA Bill Id:AB 689

Author:(Wendy Carrillo) – As Amended Ver:March 23, 2023

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

SUMMARY:

This bill requires a California Community Colleges (CCC), beginning in the 2024-2025 academic year, to set aside 15% of slots in its impacted courses and programs for incumbent health care employees. The bill also requires a CCC to provide priority registration to incumbent health care employees when enrolling in CCC courses and programs.

The bill defines “incumbent health care employee” as a worker who:

1. Is paid to care for or assist patients in a health care facility, either directly or indirectly. This includes, nurses, nursing assistants, technicians, clerical, laundry, security and administrative personnel, among others.
2. Has established employment history with the health care facility for six months or more.
3. Has met the necessary prerequisites and corequisites for enrollment in certain CCC courses.

FISCAL EFFECT:

One-time and ongoing Proposition 98 General Fund costs, in the high hundreds of thousands of dollars across 115 CCCs, to update priority enrollment policies, create a new policy on program admissions, potential costs related to workload increases for administrative staff to review application and verify employment. In addition, though the bill does not require it, the CCC Chancellor’s Office that it would be a best practice to collect data on incumbent health care workers and include it in the CCC data system, which would result in additional costs.

COMMENTS:

1. Purpose. According to the author:

California is in a health care workforce crisis…One of the most promising areas is in training incumbent workers, which would enable the existing workforce to advance in their careers to earn a higher wage. In health care, this could include training a licensed vocational nurse to become a registered nurse or training an orderly to become a phlebotomist. Unfortunately, the current method of assigning seats within impacted programs at California’s community colleges limits incumbent worker training in the health care industry.

1. Background. In order to receive state funding for offering a course or program, a CCC must open enrollment to any student who has been admitted to the college. However, certain courses and programs may limit enrollment if they are “impacted.” Subdivision (b) of Section 58106 of Title 5 of the California Code of Regulations specifies when a program or course may be limited. Specifically, enrollment may be limited due to health and safety considerations, facility limitations, faculty workload, the availability of qualified instructors, funding limitations, the constraints of regional planning or legal requirements imposed by statutes, regulations, or contracts. The code requires a CCC governing board to adopt policies identifying any such limitations and requires fair and equitable procedures for determining who may enroll in affected courses or programs.

This bill requires all CCCs to set aside 15% of slots in impacted courses for incumbent healthcare workers.

Priority registration is the opportunity for certain students to enroll in courses and programs before the general public. Current law provides priority enrollment at any CCC campus to members, or former members of the United States Armed Forces, members, or former members of the State Guard, current, or former foster youth, current, or formerly homeless youth, students who identify as student-parents (beginning July 1, 2023), students who participate in Extended Opportunity Programs and Service programs, disabled students, and students who participate in the CalWORKs program.

This bill would also grant priority registration to incumbent health care employees.

1. Related Legislation. AB 1965 (Gipson) would allocate funding to dual enrollment programs for the development of career pathways toward an associate degree in nursing and provide priority enrollment at CCCs for these students. The bill is pending in this committee.

Analysis Prepared by: Natasha Collins / APPR. / (916) 319-2081

Date of Hearing: April 25, 2023

ASSEMBLY COMMITTEE ON HIGHER EDUCATION

Mike Fong, Chair

ABPCA Bill Id:AB 689 (

Author:Wendy Carrillo) – As Amended Ver:March 23, 2023

SUBJECT: Community colleges: enrollment and registration: incumbent health care workers

SUMMARY: Establishes a requirement beginning in the 2024-2025 academic year, for limited enrollment course or programs and nursing programs offered at community colleges to reserve placements for incumbent health care workers and requires community colleges to provide priority registration for incumbent health care workers. Specifically, this bill:

1. Authorizes a community college, beginning in the 2024-25 academic year, to require the enrollment of incumbent health care workers to be at least 15% but no less than three students for each limited enrollment course or program. Does not require a community college to admit incumbent health care workers if the worker is otherwise ineligible for admission to the course or program and permits a community college to enroll students at will if the community college after initial admissions there is an insufficient number of incumbent health care workers who applied for admission to the limited enrollment course or program.
2. Requires a community college, beginning with the 2024-2025 academic year, to provide priority registration to students who are incumbent health care workers, if the community college has a priority enrollment system in place.
3. Stipulates when a community college registered nursing program has more applicants than capacity the community college may use a multicriteria screening process, a random selection process, or a combination of both; however, for any of the methods employed the community college must adhere to the following:
   1. Beginning in the 2024-2025 academic year, community college registered nursing programs are required to admit at least 15%, but not less than three students, who identify as incumbent health care workers. Does not require a community college to admit incumbent health care workers if the worker is otherwise ineligible for admission to the course or program and permits a community college to enroll students at will if the community college determines there is an insufficient number of incumbent health care workers who applied for admission to the registered nursing program described in (4).
4. Repeals a sunset date for the procedures on how community colleges may screen applicants to be admitted to nursing programs where applicants outnumber the capacity of the nursing programs. Extends the screening processes indefinitely.
5. Defines for purposes of the measure the following:
   1. “Health care facility” as any of the following:
      1. A general acute care hospital, as defined;
      2. An acute psychiatric hospital, as defined;
      3. A skilled nursing facility, as defined;
      4. A clinic, as defined;
      5. A physician organization that is part of a fully integrated delivery system that includes a physician organization, health facility or health system, and a nonprofit health care service plan that provides medical services to enrollees in a specific geographic region of the state through an affiliate hospital system and an exclusive contract between the nonprofit health care service plan and a single physician organization in each geographic region to provide those medical services; and,
      6. A designated public hospital system, as defined, and its affiliated governmental health and behavioral health provider entities;
   2. “Incumbent health care worker” means a worker who meets all the following requirements:
      1. The worker is paid to work in a health care facility to directly, or indirectly, care for or assist patients. Provides examples of direct care as including but not limited to: nurses and doctors and indirect care as including, but not limited to clerical services, dietary services, environmental services, and laundry services;
      2. The worker has an employment history with the health care facility for six months or more; and,
      3. The worker has met the necessary perquisites and corequisite, as defined; and,
   3. “Limited enrollment course or program” as a course or program with limited enrollment, as defined.

EXISTING LAW: State law listed below is pertaining to the jurisdiction of the Assembly Committee on Higher Education as it relates to the community colleges.

1. Establishes the California Community Colleges (CCC) under the administration of the Board of Governors of the CCC, as one of the segments of public postsecondary education in California. The CCC shall be comprised of community college districts (Education Code (EDC) Section 70900).
2. Authorizes the CSU and each community college district, and requests the UC to offer priority registration for any existing or former member of the State Guard or a former member of the Armed Forces of the United States who is a California resident and has been honorably discharged, as defined (EDC Section 66025.8).
3. Authorizes the CSU and each community college district, and requests the UC to offer priority registration to foster youth, former foster youth, homeless youth, or formerly homeless youth, as defined (EDC Section 66025.9).
4. Requires each community college district to offer priority registration to students eligible for disabled student programs and services, students eligible for extended opportunity programs and services, students receiving CalWORKS, and students who receive Tribal Temporary Assistance for Needy Families as defined (EDC Section 66025.91 and 66025.92).
5. Requires, beginning no later than July 1, 2023, each campus of the CSU, and each campus within a community college district, and requests each campus of the UC to offer priority registration to student parents. Encourages the CCC, the CSU, and the UC to utilize data from the Free Application for Federal Student Aid, the California Dream Act Application, the application to receive a fee waiver at the CCC, and any campus form or document that identifies student parents. Student parents for purposes of priority enrollment are defined as a student who has a child or children under 18 years of age who will receive more than half of their support from the student (EDC Section 66025.81).
6. Stipulates should a community college registered nursing program determine that the number of applicants to that program exceeds its capacity, the nursing program may admit students through the following methods:
   1. Administer a multicriteria screening process to evaluate applicants will apply measures of evaluation in accordance with the following:
      1. The criteria applied in a multicriteria screening process will include, but is not limited to:
         1. Academic degrees or diplomas, held by an applicant;
         2. Grade-point average in relevant coursework;
         3. Any relevant work or volunteer experience;
         4. Life experiences or special circumstances of the applicants as defined;
         5. Proficiency in advance level coursework in languages other than English, as defined;
      2. Additional criteria such as a personal interview, a personal statement, a letter of recommendation, or a number of repetitions of prerequisite classes may be included but are not required; and,
      3. Additional criteria may include the use of a diagnostic test.
   2. A random selection process; and,
   3. A blend of a random selection process or a multicriteria screening process.

Requires a community college that uses a multicriteria screening process to report its nursing program admission policies to the Chancellor annually, in writing. The policy will include how each criteria is factored into the college’s decision in terms of admission.

Requires the Chancellor’s Office of the CCC to submit a report on or before March 1, 2015, and by March 1 each year thereafter that examines the following:

• 1. The participation, retention, and completion rates in a community college registered nursing program of students admitted through a multicriteria screening process as described, disaggregated by the age, gender, ethnicity, and language spoken at the home of the students admitted;
  2. Information on the annual impact, if any, of the Seymour-Campbell Student Success Act had on the matriculation services for students, admitted through the multicriteria screening process.

Permits the above report to be submitted annually in conjunction with another report on nursing programs.

Repeals all of the above on January 1, 2025, unless another statute extends the date (EDC Section 78261.5).

FISCAL EFFECT: Unknown

COMMENTS: Need for the measure. As delineated by the author, “California is in a health care workforce crisis. Even before the COVID-19 pandemic, California faced a shortage of trained health care employees. In January 2020, Futuro Health conservatively estimated a shortage of 500,000 allied health employees by 2024. In the aftermath of the pandemic, this workforce shortage has only grown worse. And it is not limited to the allied health professions. According to a recent study by UCSF, California had a deficit of 40,000 registered nurses in 2021, and that number has likely only grown. These shortages disproportionately impact disadvantaged communities throughout California. Fortunately, there are potential solutions to the state’s health care workforce crisis. One of the most promising areas is in training incumbent workers, which would enable the existing workforce to advance in their careers to earn a higher wage. In health care, this could include training a licensed vocational nurse to become a registered nurse or training an orderly to become a phlebotomist. Unfortunately, the current method of assigning seats within impacted programs at California’s community colleges limits incumbent worker training in the health care industry. This is why I authored AB 689.”

The author further contends, “simply put, AB 689 does two things: First, AB 689 provides health care employees with priority registration when enrolling in community college courses. This would ensure that health care workers have access to the courses they need. Second, AB 689 would require that community colleges set aside at least 15% of the slots in their impacted courses for health care workers, ensuring they have full access to the impacted courses that will assist them in their training.”

California Community Colleges (CCC). The publication and adoption of the 1960 Master Plan for Higher Education established the three-part higher education system, with each public higher education system serving a distinct purpose on behalf of the State of California. The CCC system is the largest college system in the United States and is home to 116 unique community colleges throughout the State. Each of the 58 counties in California has at least one community college and collectively these colleges educate 1.8 million students. The mission of the CCC as outlined in the Education Code is to provide academic and vocational instruction in certificates, associate degrees, and associate degrees for transfer.

The CCC is also the only open-access public college system in California. The CCC accepts 100% of applicants and provides education to all students regardless of academic or socioeconomic background. However, being open access does not infer that courses are readily available to any one student. Just like their four-year university counterparts, the CCC has prerequisites and corequisites for specified courses. Such as the prerequisite of having to have completed trigonometry before enrolling in calculus. The CCC also has limited enrollment or impaction. The California Code of Regulations, Title 5, Section 58106, explains limited enrollment may be provided for specific courses through the following methods:

1. Limiting enrollment to students who meet designated prerequisites and corequisites;
2. Limiting enrollment due to health and safety considerations, facility limitations, faculty workload, the availability of qualified instructors, funding limitations, constraints of regional planning, or legal requirements imposed by statutes, regulations, or contracts. When limiting enrollment for the above circumstances, the governing board of the community college may adopt policies that consist of one or more of the following:
   1. Limiting enrollment on a first-come, first-served basis;
   2. Limiting enrollment using a registration procedure that includes priority enrollment;
   3. Allocate available seats to students judged most qualified (this is limited to courses of intercollegiate competition, honors courses, or public performance courses); and,
   4. Limiting enrollment using any selection procedure expressly authorized by statute.

According to the Chancellor’s Office, limited enrollment courses are courses that have limited enrollment capacity either due to the teaching method (limited lab placements or equipment) or due to limited qualified faculty. These courses are typically Career Technical Education courses or nursing courses. When a course has limited enrollment or impactions, a wait list ensues which can result in students waiting a semester, or even up to an entire year, before placement in the course. AB 689 (Carrillo) provides priority placement for health care workers and therein, guarantees these students a seat in “impacted” or limited courses.

Healthcare vocational education. Healthcare vocational education offered by the CCC are known as stackable credentials or as defined by the U.S. Department of Labor, “a sequence of credentials that can be accumulated over time to build up an individual’s qualification and help them move along a career pathway.” As recorded by the CCC Chancellor’s Office Management Information Systems Data Mart, the CCC system awarded 25,571 health-related degrees and certificates in the 2021-22 academic year. The most common healthcare vocation program is the nursing program offered at the CCC. Stackable credentials mean a student could earn a sequence of credentials or a single credential before entering the workforce. Each credential would provide additional skill sets that would lead to a student being promoted or offered different job opportunities depending on the skills attained.

However, according to a report published by the Public Policy Institute of California (PPIC), “Health Training Pathways at the CCC,” only 1/5 of students embark on nursing-related pathways, the majority of students in health sciences are in other training programs such as medical assistance, and emergency medical services programs. Furthermore, the PPIC determined less than 6% of students obtain a secondary credential in the health sciences. If California is to maintain an educated workforce, ensuring students have access to stackable health credentials is one step in preserving a pipeline for highly-skilled health care workers. This bill seeks to provide this pathway by providing priority enrollment and securing placement for existing health care workers in courses that are considered impacted.

However, implied within this bill is the assumption that health care workers are returning to the CCC for a health science vocational credential. However, the measure does not restrict enrollment in “limited enrollment” courses to just those in the health sciences. While any additional vocational training is admirable for health care workers and could result in higher wages, the vocational training at the CCC is not limited to the health sciences and therefore could result in health care workers leaving the health care profession.

Moving forward, the author may wish to consider limiting the “limited course enrollment” course to those in the health sciences.

Nursing programs at community colleges. The California Registered Board of Nursing stipulates in order to be a registered nurse in the State of California, a nurse must complete a pre-licensure registered nursing program that is approved by the board and pass the National Council Licensing Examination. The minimum education requirement for a registered nurse is an associate degree in nursing. According to the California Registered Board of Nursing, 79 community colleges offer an associate’s degree in nursing. CCCs offer three different types of nursing programs: Certifications as nursing assistants, licensed vocational nursing (LVN), and registered nursing (RN) degrees. Each year the Chancellor’s Office is statutorily required to publish a report on the state of nursing at the community colleges. The most recent report was published in 2019, and the report provides various data points from the 2017-2018 academic year on the state of nursing programs. The report included the following data points:

1. 12,960 full-time equivalent students enrolled in 77 community college nursing programs;
2. 4,541 students graduated with an RN and the CCC National Council Licensing Exam pass rate was 91.58%; and,
3. 47 colleges used multicriteria screening in selecting applicants due to limited capacity or limited enrollment.

As featured in the existing language section of this analysis, one of the criteria used in the multicrieria screening process to provide priority for nursing applicants to a CCC program is vocational work. Technically health care workers are supposed to be given priority placement over other applicants if the college is using a multicriteria screening process. However, colleges are also permitted the ability to use a random selection process when a nursing program is impacted and the colleges are not required to report whether they use this process for selecting nursing applicants. Therefore, it is entirely possible that the other 30 community college use random selection thereby not providing a priority for incumbent health workers for the impacted nursing programs.

This bill would add an additional requirement for nursing programs to prioritize the placement of health care workers in nursing programs above other nursing applicants and builds upon existing law by requiring health care workers to comprise of at least 15%, but not less than three student placements, in nursing program cohorts beginning in the 2024-25 academic year.

Priority enrollment at the CCC. Per requirements delineated in the Education Code, the CCCs are required to provide priority registration to: members, or former members of the United States Armed Forces, members, or former members of the State Guard, current, or former foster youth, current, or formerly homeless youth, students who identify as student-parents (by July 1, 2023), students who participate in Extended Opportunity Programs and Service programs (EOPS), disabled students (DSP), and students who participate in the CalWORKs program. According to the CCC Chancellor’s Office, community college districts can also add additional groups of students who can receive priority registration. Athletes, graduating/transferring students, students who participate in TRIO Programs, Puente Project, MESA, UMOJA, and students who participate in Student Success programs (those who attend orientation) or in the California Promise program are also granted priority registration.

Due to the increase in student populations who receive priority enrollment, the CCC has adopted regulations around the order in which priority registration will be provided. Specifically, the California Code of Regulations under Title 5, Section 5, arranges the multitude of priority registrations offered by the CCC into three groups: Tier 1, or statutorily required priority registration, Tier 2, or other priority registrations the community college system has adopted, and Tier 3, or the priority registration provided to students on a district by district basis. Tier 2 consists of students who receive priority enrollment due to their continuation status as students of the college and are not on academic probation. Tier 2 is also provided to first-time students who have completed orientation and have developed a student education plan. Tier 3 is anyone else the community college wishes to provide priority registration to or in most cases the general population left to register.

The CCC enrolls the largest population of students in California, and therefore, has the largest population of students receiving priority enrollment. In fall 2022, the total number of students who identified as being one of the six legislatively required populations for priority enrollment was 174,291 out of 1,267,628, or 13.7% of the student population. In the current legislative session, the Assembly Committee on Higher Education reviewed and passed out two bills with language altering the priority registration requirements for community colleges:

1. AB 255 (Alanis, 2023), currently in the Assembly Committee on Appropriations, would provide priority registration to first responders, as defined; and,
2. AB 368 (Holden, 2023), currently in the Assembly Committee on Appropriations, would provide Tier 3 priority registration to high school students who participate in specified courses as designated by the College and Career Access Pathways Program.

Neither AB 255 (Alanis, 2023) nor AB 689 (Carillo) provide specificities around the type of priority enrollment the students are to receive. The governing boards of each community college could potentially determine priority enrollment for these occupations, first responders and health care workers are either Tier 1, Tier 2, or Tier 3 since both measures are silent on the specificities of the placement of priority enrollment.

Arguments in support. As contextualized by the California Hospital Association and the California State Council of Service Employees International Union, “fortunately, there are potential solutions to the state’s health care workforce crisis. One of the most promising areas is in training incumbent workers, which would enable the existing workforce to advance in their careers to earn a higher wage. In health care, this could include training a licensed vocational nurse to become a registered nurse or training an orderly to become a phlebotomist. However, there are fundamental barriers to health care workers accessing appropriate training. This is why — in the face of such a profound crisis — the California Hospital Association and the Service Employees International Union (SEIU) have come together to co-sponsor Assembly Bill (AB) 689, which would address some of the challenges.”

“First, AB 689 would provide health care employees with priority registration when enrolling in community college courses. This would ensure that health care workers have access to the courses they need. Second, AB 689 would require that community colleges set aside at least 15% of the slots in their impacted courses for health care workers, ensuring they have full access to the impacted courses that will assist them in their training.”

“Because many health care workers already have commitments on the job as well as personal responsibilities that necessitate juggling multiple responsibilities, community colleges are the simplest and most affordable way to access academic prerequisites and training programs. Unfortunately, community college classes and programs are generally impacted, or there is more student demand than available space, and this places health care workers at a disadvantage. Not only are they limited in what courses they can sign up for due to their work schedules, but the seats that are available are apportioned by either a “first come, first served” or lottery system. Neither option assists health care workers in receiving the training they need to increase their earnings or career options. Eliminating these barriers to training would result in a “win-win” situation — the community receives an additional trained health care worker, and the employee sees increased wages for an in-demand field.”

Similar legislation. AB 1695 (Gipson), which is scheduled to be heard by this Committee on April 25, 2023, in part, establishes the Nursing Pathway Pilot Program in high schools to create pathways toward associate degrees in nursing at California Community Colleges (CCC), subject to an appropriation.

REGISTERED SUPPORT / OPPOSITION:

Support

California Hospital Association

California State Council of Service Employees International Union (SEIU California)

Stanford Health Care

Opposition

None on file.

Analysis Prepared by: Ellen Cesaretti-Monroy / HIGHER ED. / (916) 319-3960