Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided.

This bill would require the office of the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 10 community college districts statewide and would require the chancellors office to identify and select eligible community college districts based on specified criteria. The bill would require the chancellors office to develop a process designed to assist community college districts with nursing programs that are applying for national accreditation for the purpose of qualifying for the pilot program, as provided. The bill would require each participating community college district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district. The bill would require the Legislative Analysts Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified, to be submitted to the Legislature on or before July 1, 2032. The bill would repeal these provisions as of January 1, 2034.

Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided.

This bill would require the office of the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 10 community college districts statewide and would require the chancellors office to identify and select eligible community college districts based on specified criteria. The bill would require the chancellors office to develop a process designed to assist community college districts with nursing programs that are applying for national accreditation for the purpose of qualifying for the pilot program, as provided. The bill would require each participating community college district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district. The bill would require the Legislative Analysts Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified, to be submitted to the Legislature on or before July 1, 2032. The bill would repeal these provisions as of January 1, 2034.

Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided.

This bill would require the office of the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 15 10 community college districts statewide and would require the chancellors office to identify and select eligible community college districts based on specified criteria. The bill would require the chancellors office to develop a process designed to assist community college districts with nursing programs that are applying for national accreditation for the purpose of qualifying for the pilot program, as provided. The bill would require each participating community college district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district. The bill would require the Legislative Analysts Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified, to be submitted to the Legislature on or before July 1, 2032. The bill would repeal these provisions as of January 1, 2034.

Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided.

This bill would require the office of the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 15 community college districts statewide and would require the chancellors office to identify and select eligible community college districts based on specified criteria. The bill would require the chancellors office to develop a process designed to assist community college districts with nursing programs that are applying for national accreditation for the purpose of qualifying for the pilot program, as provided. The bill would require each participating community college district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district. The bill would require the Legislative Analysts Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified, to be submitted to the Legislature on or before July 1, 2032. The bill would repeal these provisions as of January 1, 2034.

Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided.

This bill would require the office of the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 15 community college districts statewide and would require the chancellor chancellors office to identify eligible community college districts based on specified criteria. The bill would require the chancellors office to develop a process designed to assist community college districts with nursing programs that are applying for national accreditation for the purpose of qualifying for the pilot program, as provided. The bill would require each participating community college district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district. The bill would require the Legislative Analysts Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program. program, as specified, to be submitted to the Legislature on or before July 1, 2032. The bill would repeal these provisions as of January 1, 2031. 2034.

Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided.

This bill would require the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 15 community college districts statewide and would require the chancellor to identify eligible community college districts based on specified criteria. The bill would require the Legislative Analysts Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program. The bill would repeal these provisions as of January 1, 2031.

Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided.

This bill would require the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 15 community college districts statewide and would require the chancellor to identify eligible community college districts based on specified criteria. The bill would require the Legislative Analysts Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program. The bill would repeal these provisions as of January 1, 2031.

Existing law establishes the California Community Colleges, under the administration of the Board of Governors of the California Community Colleges. Existing law establishes community college districts throughout the state, under the administration of community college district governing boards, and authorizes these districts to provide instruction at the community college campuses they operate. Existing law establishes a statewide baccalaureate degree program that authorizes up to a total of 30 baccalaureate degree programs at community college districts to be approved per academic year, as provided.

This bill would require the Chancellor of the California Community Colleges to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. The bill would limit the pilot program to 15 community college districts statewide and would require the chancellor to identify eligible community college districts based on specified criteria. The bill would require the Legislative Analysts Office to conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program. The bill would repeal these provisions as of January 1, 2031.

 VETO  

Bill No: SB 895

Author: Roth (D)

Amended: 8/22/24

Vote: 21

SENATE EDUCATION COMMITTEE: 7-0, 4/24/24

AYES: Newman, Ochoa Bogh, Cortese, Glazer, Gonzalez, Smallwood-Cuevas, Wilk

SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/16/24

AYES: Caballero, Jones, Ashby, Becker, Bradford, Seyarto, Wahab

SENATE FLOOR: 38-0, 5/22/24

AYES: Alvarado-Gil, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Min, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk

NO VOTE RECORDED: Allen, Archuleta

SENATE FLOOR: 40-0, 8/29/24

AYES: Allen, Alvarado-Gil, Archuleta, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Min, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk

ASSEMBLY FLOOR: 72-2, 8/28/24 - See last page for vote

SUBJECT: Community colleges: Baccalaureate Degree in Nursing Pilot Program

SOURCE: American Federation of State, County, and Municipal Employees Community College League of California
Los Angeles Community College District
United Nurses Associations of California

DIGEST:

This bill requires the California Community College (CCC) Chancellor’s Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 10 community college districts to offer a Bachelor of Science in Nursing degree.

ANALYSIS:

Existing law:

1. Differentiates the missions and functions of public and independent institutions of higher education. Under these provisions:
   1. The primary mission of the California State University (CSU) is to offer undergraduate and graduate instruction through the master’s degree in the liberal arts and sciences and professional education including teacher education. The CSU is authorized to establish two-year programs only when mutually agreed upon by the Trustees and the CCC Board of Governors. The CSU is also authorized to jointly award the doctoral degree with the University of California (UC) and with one or more independent institutions of higher education.
   2. The UC provides undergraduate and graduate instruction and has exclusive jurisdiction in public higher education over graduate instruction in the professions of law, medicine, dentistry and veterinary medicine. The UC is also the primary state-supported academic agency for research.
   3. The independent institutions of higher education requires undergraduate and graduate instruction and research in accordance with their respective missions.
   4. The mission and function of the CCC offers academic and vocational instruction at the lower division level, and the CCC authorizes to grant the Associate in Arts and the Associate in Science degrees. The community colleges also requires to offer learning supports to close learning gaps, English as a Second Language instruction, and adult noncredit instruction, and support services which help students succeed at the postsecondary level. (Education Code § 66010.4)
2. Authorizes the CCC Board of Governors, in consultation with the CSU and the UC, to establish baccalaureate degree programs that do not duplicate a baccalaureate degree program offered by the CSU or UC. Allows for the approval of 30 community college baccalaureate degree programs per academic year. Current law further requires the CCC Chancellor to consult with and seek feedback from the CSU Chancellor, the UC President and the President of the Association of Independent California Colleges and Universities on proposed baccalaureate degree programs, as specified, and establishes a mechanism for the assessment, consultation, and approval of programs where duplication is identified, as specified. (EC § 78040 et seq.)

This bill:

1. Requires the Chancellor’s Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a Bachelor of Science in Nursing Degree. It provides that the pilot program be limited to 10 community college districts statewide.
2. Requires that the Chancellor identify and select eligible community college districts based on the following criteria:
   1. The Chancellor’s Office is encouraged to ensure there is equitable access between the northern, central, and southern parts of the state to the pilot program.
   2. That priority be given to community college districts in underserved nursing areas.
   3. That the community college districts have a nationally accredited nursing program.
   4. That the Chancellor’s Office give positive consideration to a community college district’s request for participation in the pilot program where the community college district has a successful associate degree in nursing-to-bachelor of science in nursing concurrent enrollment partnership with the CSU, the UC, or an independent institution of higher education, as defined.
3. Provides that a community college district selected for the pilot program continue to offer an associate degree in nursing program.
4. Limits the total number of associate degree in nursing and bachelor of science in nursing students at a community college district to the community college district’s associate degree in nursing class size approved by the board of registered nursing, and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.
5. Allows a community college districts without a nationally accredited nursing program, but are in “candidate” status, be provisionally selected to participate in this pilot program, and commence the program upon final accreditation, as specified. This bill further requires the Chancellor’s Office to develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the pilot program, and that assistance be made available to community college districts upon request.
6. Requires each participating district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district.
7. Requires that the Legislative Analyst’s Office (LAO) conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified. This bill further requires each participating community college district to submit the information necessary for this evaluation, as determined by the LAO, to the Chancellor’s Office.
8. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill’s provision.
9. Sunsets this bill’s provision on January 1, 2031.
10. Makes various findings and declarations relative to this bill’s provisions.
11. States it is the Legislature’s intent that associate degree in nursing-to- bachelor of science in nursing degree concurrent enrollment partnership programs be maintained for the duration of the pilot program and that concurrent enrollment partnership programs be established with CSU, UC, or an independent institution of higher education, as defined.

Comments

1. Need for the bill. According to the author, “For decades, California has suffered from a shortage of registered nurses, and this problem has been exacerbated in recent years due to the pandemic and it’s expected to worsen due to an increase in RN retirements. While the nursing shortage is a national problem, it is particularly acute here in our state,—ranking 40th out of 50 states. A key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. In 2018, more than 85% of hospitals in California reported that the demand for RN’s was greater than the available supply – a situation that has not improved. But there is a path forward to help solve this problem and that path cuts right through our California Community Colleges. Our SB 895 creates a pilot program allowing community colleges to offer a bachelor’s degree in nursing, which is increasingly the industry standard, and a requirement for employment in our hospitals.”

The author further asserts that the goal of this bill is to utilize existing associate degree in nursing program capacity to produce more Bachelor of Science in Nursing degrees. The reason why producing more Bachelor of Science in Nursing degrees is important is because the industry standard in healthcare is changing. Specifically in hospitals and in direct care settings, a Bachelor of Science in Nursing degree is increasingly becoming a requirement for employment. The author argues that CSUs and UCs face challenges in building out additional capacity to produce more nurses with a Bachelor of Science in Nursing, as such it is critical to use the existing community college nursing program structure to assist with meeting these workforce standards.

1. Pushes CCCs from their original mission. The state has four segments of higher education: three public and one private. Each plays a vital and unique role for the state. Their mission statements are outlined in the Master Plan for Higher Education and by state statute. The CCCs are to have an open admission policy and bear the most extensive responsibility for lower-division undergraduate instruction. Its primary areas of mission include instruction leading to associate degrees and university transfer, vocational instruction, and remedial education. Despite the differentiation of mission, the Legislature has authorized the CSU and CCCs to go beyond their original mission to offer doctoral degree and baccalaureate degree programs, respectively, so long as programs do not duplicate those offered by the other segments with primary jurisdiction. Further expansion of CCC baccalaureate degrees as proposed in this bill would signal the legislature’s willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process.
2. Is this the appropriate solution? If it is the desire of the legislature to expand Bachelor of Science in Nursing degree programs, arguably more effective and efficient alternatives do not require a departure from the CCC’s mission to expand and streamline Bachelor of Science in Nursing pathways. In its recommendation for alternatives to the original baccalaureate degree pilot program, the LAO’s analysis notes that some CCCs have agreements with baccalaureate degree-granting institutions. Improving alignment between CCC and the universities could increase the number of CCC students who ultimately obtain a bachelor’s degree and reduce the amount of time students take to obtain their degree. For example, the Tri-County Nursing Pathway is a partnership between Riverside City College and two CSU campuses (Fullerton and San Bernardino) that allows associate degree nursing students to concurrently obtain their bachelor’s degrees. Students can enroll in CSU courses while still completing their associate degree requirements, allowing them to obtain their bachelor’s degree with only six additional months of coursework. The LAO report further asserts that such partnerships could not only be more cost-effective but also benefit more students (including place-bound students), thereby having a more widespread impact.
3. State investment in CCC associate degree in nursing programs. Of California’s three public higher education segments, only the community colleges offer associate degrees in nursing. According to the CCC Chancellor’s Office 2020-2022 legislative report on Community Colleges Nursing Educational Programs, associate degrees in nursing programs account for 55.4% of programs in the state. Numerous legislative efforts and investments have been made to expand community college associate degree in nursing enrollments and improve retention to facilitate the expansion of associate degree in nursing programs. The Budget Act of 2015 provided additional nursing program support to expand community college nursing enrollments and improve student retention in associate degree nursing programs. Since 2009-10, the Legislature has provided ongoing funding ($13.4 million) through grants to CCC associate degree in nursing programs in recognition of the relatively high cost of educating nurses. The Department of Health Care Access and Information, which administers a state program to help, among other things, increase support for nursing education programs, awarded a total of $17 million to 34 nursing programs in 2023, including 17 community college associate degree in nursing programs. These investments demonstrate the state’s willingness to invest in associate degrees and demonstrate a recognition of their value to the state.
4. Tuition costs? Current law allows CCCs to raise tuition for the other CCC baccalaureate degree programs to the same amount as a CSU. This bill, however, makes it clear that those provisions are not applicable to the proposed pilot program but is silent on tuition costs. Tuition fees for CCC courses are currently $46 per credit. Without statutory authorization, it is uncertain if CCC districts can charge higher rates for the more advance degree. If this measure moves forward, the author may wish to clarify the parameters related to program funding and tuition costs.

1. Not all community college nursing programs are nationally accredited. According to the community college chancellor’s office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN) and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have Board of Registered Nursing (BRN) approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs. This bill allows non-nationally accredited community college programs to be provisionally selected as they work toward obtaining accreditation.
2. Nursing programs in California. Graduates of associate and bachelor nursing degree programs may sit for nurse licensure exams and become licensed registered nurses. The state’s BRN approves all of California’s pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 bachelor of science in nursing, and 13 Entry Level Master’s (ELM) programs. According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18 percent increase in student completions since 2012. Associate’s degree completions decreased while bachelor’s degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor’s programs has increased over the last 10 years. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500. www.rn.ca.gov/forms/rnsurvey201718.shtml
3. Enrollment decisions controlled by BRN. The author argues that a key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. As noted in the above comment, the BRN is one of a few licensing boards that continues to actively approve educational programs and make enrollment decisions. According to a recent state audit of the BRN, two of the key factors that should be included in the BRN’s enrollment decisions are the forecasted supply of nurses that the state will need to fulfill demand and the available number of clinical placement slots. The audit found that the BRN has failed to gather and use sufficient data related to both of these factors to appropriately inform its enrollment decisions.
4. Nursing shortage projected to close within a few years. According to a 2022 University of California, San Francisco (UCSF) study, “Forecasts of the Registered Nurse Workforce in California,” data shows consistent employment rates for RNs since 2018, but decreasing rates for older RNs. It further warns that a greater number of RNs plan to retire or quit within two years compared to 2018. The pandemic also had an impact on retention rates. RN education programs experienced fewer enrollments and graduates during the 2018-2019 academic year. Combined, these changes have reduced the supply of RNs relative to previous forecasts. However, circumstances are improving. RN education enrollments are expected to surpass pre-pandemic levels starting with the 2021-22 academic year. It is projected that the supply of new RNs will match demand by 2029, thereby filling unfilled positions. According to UCSF’s updated 2024 forecast (unpublished), there is a statewide supply-demand gap of 17,000 full-time equivalent nurses, which is projected to close within four years (2028), one year earlier than the 2022 report indicated. Notably, retention of new and experienced nurses is key. www.rn.ca.gov/pdfs/forms/forecast2022.pdf
5. Duplication indicates that California needs better higher education coordination. All of California’s public education institutions share a commitment to work together to ensure that parts of the system work for all Californians. Since the defunding of the California Postsecondary Education Commission in 2011, California has not had a statewide coordinating entity for higher education. The absence of a higher education coordinating entity has hindered the state’s ability to review degree programs to align with state and workforce needs. In its place, changes to higher education’s blueprint are being made one legislative proposal at a time in a piecemeal way, which could result in an uncoordinated and fragmented system. Although this bill is limited to one community college baccalaureate degree program, it establishes a precedent for permitting duplication of degree programs and expands CCC’s ability to establish baccalaureate degrees independent from California’s other public universities.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Assembly Appropriations Committee analysis:

• One-time Proposition 98 General Fund costs in the low hundreds of thousands of dollars for up to 15 CCC districts to create and implement a BSN degree program. These costs would encompass updates to the design of new nursing academic standards, updates to existing curriculum that would be needed to satisfy the BSN, implementation of other coursework requirements, and initial accreditation fees. The state has 72 CCC districts consisting of 115 CCCs. The largest CCC district has nine CCCs and the majority of CCC districts have several CCCs.
• Ongoing Proposition 98 General Fund costs, potentially in the hundreds of thousands of dollars annually for up to 15 CCC districts, to offer upper division programing. These costs are associated with increased operational expenses, staff salaries, and annual accreditation fees. Costs associated with staff salaries would be lower to the extent pilot CCC districts can redirect existing nursing faculty to teach upper division curriculum.
• One-time General Fund workload costs between $32,500 and $53,000 for the CCC Chancellor’s Office to develop the application for the pilot program, issue guidance, and provide technical assistance.

SUPPORT: (Verified 10/3/24)

American Federation of State, County, and Municipal Employees (co-source)
Community College League of California (co-source)
Los Angeles Community College District (co-source)
United Nurses Associations of California (co-source)
Adventist Health White Memorial
Alameda Health System
American Federation of State, County and Municipal Employees
Antelope Valley Community College District
Asian American Pacific Islander Trustees and Administrators Caucus of the Community College League of California
Association of California Community College Administrators
Association of California Healthcare Districts
Bakersfield College
Butte-Glenn Community College District
Cabrillo Community College District
California Assisted Living Association
California Association for Health Services at Home
California Association of Health Facilities
California Association of Latino Community College Trustees and Administrators
California Community College Baccalaureate Association
California Community Colleges 
California Community Colleges Chief Instructional Officers
California Hospital Association
California Kidney Care Alliance
California State Association of Counties
Cerritos Community College District
Chabot-Las Positas Community College District
Citrus College
Coast Community College District
Compton Community College District
Contra Costa Community College District
County Health Executives Association of California
County of Los Angeles Board of Supervisors
CPCA Advocates
Desert Community College District
El Camino Community College District
Faculty Association of California Community Colleges
Foothill-De Anza Community College District
Gavilan Joint Community College District
Glendale Community College 
Grossmont College
Grossmont-Cuyamaca Community College District
Health Net 
Kern Community College District
Lassen Community College District
Long Beach City College
Los Angeles Area Chamber of Commerce
Los Angeles Pierce College
Los Angeles Unified School District
Los Angeles Valley College
MiraCosta Community College District
Monterey Peninsula Community College District
Moorpark College
Mt. San Antonio College
Mt. San Jacinto Community College 
North Orange County Community College District
Palo Verde Community College District
Palomar Community College District
Pasadena City College
Peralta Community College District
Providence
Rancho Santiago Community College District
Redwoods Community College District
Rio Hondo College
Riverside Community College District
Rural County Representatives of California
San Diego Community College District
San Diego Unified School District
San Jose-Evergreen Community College District
San Luis Obispo County Community College District / Cuesta College
Santa Clarita Community College District - College of the Canyons
Sharp HealthCare
Sierra Joint Community College District
Siskiyous Joint Community College District
Sonoma County Junior College District
South Orange County Community College District
Southwestern Community College District
Student Senate for California Community Colleges
Sutter Health
TELACU
Urban Counties of California
Ventura County Community College District
Victor Valley College
West Hills College Lemoore
West Hills Community College District
West Kern Community College District
West Valley-Mission Community College District

OPPOSITION: (Verified 10/3/24)

Academic Senate Executive Committee, California State University, Bakersfield

Academic Senate of the California State University

Association of Independent California Colleges and Universities

Azusa Pacific University

California Association of Colleges of Nursing

California Baptist University

California Baptist University College of Nursing

California Faculty Association

California Polytechnic State University, San Luis Obispo

California State Polytechnic University, Humboldt

California State Polytechnic University, Pomona

California State University, Bakersfield

California State University, Chico

California State University, East Bay

California State University, Fresno

California State University, Fullerton

California State University, Long Beach

California State University, Los Angeles

California State University, Monterey Bay

California State University, Northridge

California State University, Office of the Chancellor

California State University, San Bernardino

California State University, San Marcos

Concordia University Irvine

Dominican University of California

San Diego State University

San Francisco State University

San José State University

Sonoma State University

University of San Francisco School of Nursing and Health Professions

ARGUMENTS IN SUPPORT: Community College League (co-sponsors) states, “SB 895 does not intend to create competition between public nursing schools. Currently, when students are not admitted into a public nursing program, they turn to for-profit and private institutions. While this may be a good option for many students, it is an unnecessarily expensive option when the local community college could offer the program at a lower cost. Many capable students are also priced out of the option to attend a private university or are forced to incur tremendous amounts of debt. Those are the students this bill intends to help—students who may otherwise not seek baccalaureate degrees, including working adults, economically disadvantaged students, people of color, and place-bound students. The Community College League further asserts, “California’s nursing shortage cannot be solved by one singular approach but rather requires a collaborative, multi-program solution. SB 895 seeks to address the nursing shortage through California’s community colleges, which have already shown to be successful through ADN-BSN partnerships. As a 6-year pilot program, SB 895 would authorize 15 community college districts with existing ADN infrastructure to begin offering baccalaureate degrees in nursing. Several ADN programs are already well-positioned to take on this next step, and community college leaders across the state are eager and ready to serve their students by educating and training the next generation of nurses.”

ARGUMENTS IN OPPOSITION: The California Association of Colleges of Nursing argues, in part, in their opposition letter, that SB 895 “will not add a single additional nurse to the state workforce beyond the number that would exist under current law. Community colleges lack the infrastructure needed to administer baccalaureate nursing degree programs in accordance with evolving nursing accreditation standards. In fact, we are concerned that the bill will exacerbate existing challenges in hiring nursing faculty, since community college programs will likely need to seek out more faculty, to teach the additional courses required as part of baccalaureate degree programs. CACN additionally stresses that, “while we absolutely concur with the author and proponents on the need to craft policies that increase the number of nurses in the state, we respectfully disagree that this approach will address any of the underlying constraints to that pipeline. CACN believes that we can increase the number of nursing students in our state faster by partnering with our community colleges and not duplicating efforts and competing for limited resources, including clinical placements and qualified faculty.”

GOVERNOR'S VETO MESSAGE:

This bill requires the California Community Colleges (CCC) Chancellor's Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 10 community college districts to offer a Bachelor of Science in Nursing degree.

I appreciate the author's commitment to expanding access to baccalaureate nursing degree programs for community college students. The 2024 Budget Agreement included $60 million per year, from 2025-26 to 2028-29, for the Rebuilding Nursing Infrastructure Grant Program, which may be used to develop or expand Bachelor of Science in Nursing (BSN) partnerships with higher education institutions. These types of partnerships have proven successful in expanding BSN access for community college students and increasing the number of BSN degree recipients. All segments of higher education should continue to focus on building these programs together, and I am concerned this bill could inadvertently undermine that collaboration.

Additionally, in recent years, both the CCC and the CSU have been provided with expanded authority to offer independent programs. Given these major changes, a pause should be taken to understand their full impact before additional authorities are granted.

For these reasons, I cannot sign this bill.

ASSEMBLY FLOOR: 72-2, 8/28/24

AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Chen, Connolly, Megan Dahle, Davies, Dixon, Flora, Mike Fong, Friedman, Gabriel, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Holden, Hoover, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, Mathis, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Luz Rivas, Rodriguez, Blanca Rubio, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Wicks, Wilson, Wood, Zbur, Robert Rivas

NOES: Essayli, Irwin

NO VOTE RECORDED: Arambula, Cervantes, Ortega, Sanchez, Weber

Prepared by: Olgalilia Ramirez / ED. / (916) 651-4105

10/16/24 14:08:47

**** END ****

 UNFINISHED BUSINESS  

Bill No: SB 895

Author: Roth (D) and Caballero (D), et al.

Amended: 8/22/24

Vote: 21

SENATE EDUCATION COMMITTEE: 7-0, 4/24/24

AYES: Newman, Ochoa Bogh, Cortese, Glazer, Gonzalez, Smallwood-Cuevas, Wilk

SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/16/24

AYES: Caballero, Jones, Ashby, Becker, Bradford, Seyarto, Wahab

SENATE FLOOR: 38-0, 5/22/24

AYES: Alvarado-Gil, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Min, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk

NO VOTE RECORDED: Allen, Archuleta

ASSEMBLY FLOOR: 72-2, 8/28/24 - See last page for vote

SUBJECT: Community colleges: Baccalaureate Degree in Nursing Pilot Program

SOURCE: American Federation of State, County, and Municipal Employees Community College League of California
Los Angeles Community College District
United Nurses Associations of California

DIGEST:

This bill requires the California Community College (CCC) Chancellor’s Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 10 community college districts to offer a Bachelor of Science in Nursing degree.

Assembly Amendments

limit the pilot program to 10 community college districts and add intent language relating to concurrent enrollment partnership programs and requires consideration for priority consideration of those programs.

ANALYSIS:

Existing law:

1. Differentiates the missions and functions of public and independent institutions of higher education. Under these provisions:
   1. The primary mission of the California State University (CSU) is to offer undergraduate and graduate instruction through the master’s degree in the liberal arts and sciences and professional education including teacher education. The CSU is authorized to establish two-year programs only when mutually agreed upon by the Trustees and the CCC Board of Governors. The CSU is also authorized to jointly award the doctoral degree with the University of California (UC) and with one or more independent institutions of higher education.
   2. The UC provides undergraduate and graduate instruction and has exclusive jurisdiction in public higher education over graduate instruction in the professions of law, medicine, dentistry and veterinary medicine. The UC is also the primary state-supported academic agency for research.
   3. The independent institutions of higher education requires undergraduate and graduate instruction and research in accordance with their respective missions.
   4. The mission and function of the CCC offers academic and vocational instruction at the lower division level, and the CCC authorizes to grant the Associate in Arts and the Associate in Science degrees. The community colleges also requires to offer learning supports to close learning gaps, English as a Second Language instruction, and adult noncredit instruction, and support services which help students succeed at the postsecondary level. (Education Code § 66010.4)
2. Authorizes the CCC Board of Governors, in consultation with the CSU and the UC, to establish baccalaureate degree programs that do not duplicate a baccalaureate degree program offered by the CSU or UC. Allows for the approval of 30 community college baccalaureate degree programs per academic year. Current law further requires the CCC Chancellor to consult with and seek feedback from the CSU Chancellor, the UC President and the President of the Association of Independent California Colleges and Universities on proposed baccalaureate degree programs, as specified, and establishes a mechanism for the assessment, consultation, and approval of programs where duplication is identified, as specified. (EC § 78040 et seq.)

This bill:

1. Requires the Chancellor’s Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a Bachelor of Science in Nursing Degree. It provides that the pilot program be limited to 10 community college districts statewide.
2. Requires that the Chancellor identify and select eligible community college districts based on the following criteria:
   1. The Chancellor’s Office is encouraged to ensure there is equitable access between the northern, central, and southern parts of the state to the pilot program.
   2. That priority be given to community college districts in underserved nursing areas.
   3. That the community college districts have a nationally accredited nursing program.
   4. That the Chancellor’s Office give positive consideration to a community college district’s request for participation in the pilot program where the community college district has a successful associate degree in nursing-to-bachelor of science in nursing concurrent enrollment partnership with the CSU, the UC, or an independent institution of higher education, as defined.
3. Provides that a community college district selected for the pilot program continue to offer an associate degree in nursing program.
4. Limits the total number of associate degree in nursing and bachelor of science in nursing students at a community college district to the community college district’s associate degree in nursing class size approved by the board of registered nursing, and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.
5. Allows a community college districts without a nationally accredited nursing program, but are in “candidate” status, be provisionally selected to participate in this pilot program, and commence the program upon final accreditation, as specified. This bill further requires the Chancellor’s Office to develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the pilot program, and that assistance be made available to community college districts upon request.
6. Requires each participating district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district.
7. Requires that the Legislative Analyst’s Office (LAO) conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified. This bill further requires each participating community college district to submit the information necessary for this evaluation, as determined by the LAO, to the Chancellor’s Office.
8. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill’s provision.
9. Sunsets this bill’s provision on January 1, 2031.
10. Makes various findings and declarations relative to this bill’s provisions.
11. States it is the Legislature’s intent that associate degree in nursing-to- bachelor of science in nursing degree concurrent enrollment partnership programs be maintained for the duration of the pilot program and that concurrent enrollment partnership programs be established with CSU, UC, or an independent institution of higher education, as defined.

Comments

1. Need for the bill. According to the author, “For decades, California has suffered from a shortage of registered nurses, and this problem has been exacerbated in recent years due to the pandemic and it’s expected to worsen due to an increase in RN retirements. While the nursing shortage is a national problem, it is particularly acute here in our state,—ranking 40th out of 50 states. A key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. In 2018, more than 85% of hospitals in California reported that the demand for RN’s was greater than the available supply – a situation that has not improved. But there is a path forward to help solve this problem and that path cuts right through our California Community Colleges. Our SB 895 creates a pilot program allowing community colleges to offer a bachelor’s degree in nursing, which is increasingly the industry standard, and a requirement for employment in our hospitals.”

The author further asserts that the goal of this bill is to utilize existing associate degree in nursing program capacity to produce more Bachelor of Science in Nursing degrees. The reason why producing more Bachelor of Science in Nursing degrees is important is because the industry standard in healthcare is changing. Specifically in hospitals and in direct care settings, a Bachelor of Science in Nursing degree is increasingly becoming a requirement for employment. The author argues that CSUs and UCs face challenges in building out additional capacity to produce more nurses with a Bachelor of Science in Nursing, as such it is critical to use the existing community college nursing program structure to assist with meeting these workforce standards.

1. Pushes CCCs from their original mission. The state has four segments of higher education: three public and one private. Each plays a vital and unique role for the state. Their mission statements are outlined in the Master Plan for Higher Education and by state statute. The CCCs are to have an open admission policy and bear the most extensive responsibility for lower-division undergraduate instruction. Its primary areas of mission include instruction leading to associate degrees and university transfer, vocational instruction, and remedial education. Despite the differentiation of mission, the Legislature has authorized the CSU and CCCs to go beyond their original mission to offer doctoral degree and baccalaureate degree programs, respectively, so long as programs do not duplicate those offered by the other segments with primary jurisdiction. Further expansion of CCC baccalaureate degrees as proposed in this bill would signal the legislature’s willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process.
2. Is this the appropriate solution? If it is the desire of the legislature to expand Bachelor of Science in Nursing (BSN) degree programs, arguably more effective and efficient alternatives do not require a departure from the CCC’s mission to expand and streamline BSN pathways. In its recommendation for alternatives to the original baccalaureate degree pilot program, the LAO’s analysis notes that some CCCs have agreements with baccalaureate degree-granting institutions. Improving alignment between CCC and the universities could increase the number of CCC students who ultimately obtain a bachelor’s degree and reduce the amount of time students take to obtain their degree. For example, the Tri-County Nursing Pathway is a partnership between Riverside City College and two CSU campuses (Fullerton and San Bernardino) that allows associate degree nursing students to concurrently obtain their bachelor’s degrees. Students can enroll in CSU courses while still completing their associate degree requirements, allowing them to obtain their bachelor’s degree with only six additional months of coursework. The LAO report further asserts that such partnerships could not only be more cost-effective but also benefit more students (including place-bound students), thereby having a more widespread impact.
3. State investment in CCC associate degree in nursing programs. Of California’s three public higher education segments, only the community colleges offer associate degrees in nursing. According to the CCC Chancellor’s Office 2020-2022 legislative report on Community Colleges Nursing Educational Programs, associate degrees in nursing programs account for 55.4% of programs in the state. Numerous legislative efforts and investments have been made to expand community college associate degree in nursing enrollments and improve retention to facilitate the expansion of associate degree in nursing programs. The Budget Act of 2015 provided additional nursing program support to expand community college nursing enrollments and improve student retention in associate degree nursing programs. Since 2009-10, the Legislature has provided ongoing funding ($13.4 million) through grants to CCC associate degree in nursing programs in recognition of the relatively high cost of educating nurses. The Department of Health Care Access and Information, which administers a state program to help, among other things, increase support for nursing education programs, awarded a total of $17 million to 34 nursing programs in 2023, including 17 community college associate degree in nursing programs. These investments demonstrate the state’s willingness to invest in associate degrees and demonstrate a recognition of their value to the state.
4. Tuition costs? Current law allows CCCs to raise tuition for the other CCC baccalaureate degree programs to the same amount as a CSU. This bill, however, makes it clear that those provisions are not applicable to the proposed pilot program but is silent on tuition costs. Tuition fees for CCC courses are currently $46 per credit. Without statutory authorization, it is uncertain if CCC districts can charge higher rates for the more advance degree. If this measure moves forward, the author may wish to clarify the parameters related to program funding and tuition costs.

1. Not all community college nursing programs are nationally accredited. According to the community college chancellor’s office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN) and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have Board of Registered Nursing (BRN) approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs. This bill allows non-nationally accredited community college programs to be provisionally selected as they work toward obtaining accreditation.
2. Nursing programs in California. Graduates of associate and bachelor nursing degree programs may sit for nurse licensure exams and become licensed registered nurses. The state’s BRN approves all of California’s pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 bachelor of science in nursing, and 13 Entry Level Master’s (ELM) programs. According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18 percent increase in student completions since 2012. Associate’s degree completions decreased while bachelor’s degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor’s programs has increased over the last 10 years. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500. www.rn.ca.gov/forms/rnsurvey201718.shtml
3. Enrollment decisions controlled by BRN. The author argues that a key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. As noted in the above comment, the BRN is one of a few licensing boards that continues to actively approve educational programs and make enrollment decisions. According to a recent state audit of the BRN, two of the key factors that should be included in the BRN’s enrollment decisions are the forecasted supply of nurses that the state will need to fulfill demand and the available number of clinical placement slots. The audit found that the BRN has failed to gather and use sufficient data related to both of these factors to appropriately inform its enrollment decisions.
4. Nursing shortage projected to close within a few years. According to a 2022 University of California, San Francisco (UCSF) study, “Forecasts of the Registered Nurse Workforce in California,” data shows consistent employment rates for RNs since 2018, but decreasing rates for older RNs. It further warns that a greater number of RNs plan to retire or quit within two years compared to 2018. The pandemic also had an impact on retention rates. RN education programs experienced fewer enrollments and graduates during the 2018-2019 academic year. Combined, these changes have reduced the supply of RNs relative to previous forecasts. However, circumstances are improving. RN education enrollments are expected to surpass pre-pandemic levels starting with the 2021-22 academic year. It is projected that the supply of new RNs will match demand by 2029, thereby filling unfilled positions. According to UCSF’s updated 2024 forecast (unpublished), there is a statewide supply-demand gap of 17,000 full-time equivalent nurses, which is projected to close within four years (2028), one year earlier than the 2022 report indicated. Notably, retention of new and experienced nurses is key. www.rn.ca.gov/pdfs/forms/forecast2022.pdf
5. Duplication indicates that California needs better higher education coordination. All of California’s public education institutions share a commitment to work together to ensure that parts of the system work for all Californians. Since the defunding of the California Postsecondary Education Commission (CPEC) in 2011, California has not had a statewide coordinating entity for higher education. The absence of a higher education coordinating entity has hindered the state’s ability to review degree programs to align with state and workforce needs. In its place, changes to higher education’s blueprint are being made one legislative proposal at a time in a piecemeal way, which could result in an uncoordinated and fragmented system. Although this bill is limited to one community college baccalaureate degree program, it establishes a precedent for permitting duplication of degree programs and expands CCC’s ability to establish baccalaureate degrees independent from California’s other public universities.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Assembly Appropriations Committee analysis, this bill would have the following fiscal impact:

• One-time Proposition 98 General Fund costs in the low hundreds of thousands of dollars for up to 15 CCC districts to create and implement a BSN degree program. These costs would encompass updates to the design of new nursing academic standards, updates to existing curriculum that would be needed to satisfy the BSN, implementation of other coursework requirements, and initial accreditation fees. The state has 72 CCC districts consisting of 115 CCCs. The largest CCC district has nine CCCs and the majority of CCC districts have several CCCs.
• Ongoing Proposition 98 General Fund costs, potentially in the hundreds of thousands of dollars annually for up to 15 CCC districts, to offer upper division programing. These costs are associated with increased operational expenses, staff salaries, and annual accreditation fees. Costs associated with staff salaries would be lower to the extent pilot CCC districts can redirect existing nursing faculty to teach upper division curriculum.
• One-time General Fund workload costs between $32,500 and $53,000 for the CCC Chancellor’s Office to develop the application for the pilot program, issue guidance, and provide technical assistance.

SUPPORT: (Verified 8/28/24)

American Federation of State, County, and Municipal Employees (co-source)
Community College League of California (co-source)
Los Angeles Community College District (co-source)
United Nurses Associations of California (co-source)
Adventist Health White Memorial
Alameda Health System
American Federation of State, County and Municipal Employees
Antelope Valley Community College District
Asian American Pacific Islander Trustees and Administrators Caucus of the Community College League of California
Association of California Community College Administrators
Association of California Healthcare Districts
Bakersfield College
Butte-Glenn Community College District
Cabrillo Community College District
California Assisted Living Association
California Association for Health Services at Home
California Association of Health Facilities
California Association of Latino Community College Trustees and Administrators
California Community College Baccalaureate Association
California Community Colleges 
California Community Colleges Chief Instructional Officers
California Hospital Association
California Kidney Care Alliance
California State Association of Counties
Cerritos Community College District
Chabot-Las Positas Community College District
Citrus College
Coast Community College District
Compton Community College District
Contra Costa Community College District
County Health Executives Association of California
County of Los Angeles Board of Supervisors
CPCA Advocates
Desert Community College District
El Camino Community College District
Faculty Association of California Community Colleges
Foothill-De Anza Community College District
Gavilan Joint Community College District
Glendale Community College 
Grossmont College
Grossmont-Cuyamaca Community College District
Health Net 
Kern Community College District
Lassen Community College District
Long Beach City College
Los Angeles Area Chamber of Commerce
Los Angeles Pierce College
Los Angeles Unified School District
Los Angeles Valley College
MiraCosta Community College District
Monterey Peninsula Community College District
Moorpark College
Mt. San Antonio College
Mt. San Jacinto Community College 
North Orange County Community College District
Palo Verde Community College District
Palomar Community College District
Pasadena City College
Peralta Community College District
Providence
Rancho Santiago Community College District
Redwoods Community College District
Rio Hondo College
Riverside Community College District
Rural County Representatives of California
San Diego Community College District
San Diego Unified School District
San Jose-Evergreen Community College District
San Luis Obispo County Community College District / Cuesta College
Santa Clarita Community College District - College of the Canyons
Sharp HealthCare
Sierra Joint Community College District
Siskiyous Joint Community College District
Sonoma County Junior College District
South Orange County Community College District
Southwestern Community College District
Student Senate for California Community Colleges
Sutter Health
TELACU
Urban Counties of California
Ventura County Community College District
Victor Valley College
West Hills College Lemoore
West Hills Community College District
West Kern Community College District
West Valley-Mission Community College District

OPPOSITION: (Verified 8/28/24)

Academic Senate Executive Committee, California State University, Bakersfield
Academic Senate of the California State University
Association of Independent California Colleges and Universities
Azusa Pacific University
California Association of Colleges of Nursing
California Baptist University
California Baptist University College of Nursing
California Faculty Association
California Polytechnic State University, San Luis Obispo
California State Polytechnic University, Humboldt
California State Polytechnic University, Pomona
California State University, Bakersfield
California State University, Chico
California State University, East Bay
California State University, Fresno
California State University, Fullerton
California State University, Long Beach
California State University, Los Angeles
California State University, Monterey Bay
California State University, Northridge
California State University, Office of the Chancellor
California State University, San Bernardino
California State University, San Marcos
Concordia University Irvine
Dominican University of California
San Diego State University
San Francisco State University
San José State University
Sonoma State University
University of San Francisco School of Nursing and Health Professions

ARGUMENTS IN SUPPORT: Community College League (co-sponsors) states, “SB 895 does not intend to create competition between public nursing schools. Currently, when students are not admitted into a public nursing program, they turn to for-profit and private institutions. While this may be a good option for many students, it is an unnecessarily expensive option when the local community college could offer the program at a lower cost. Many capable students are also priced out of the option to attend a private university or are forced to incur tremendous amounts of debt. Those are the students this bill intends to help—students who may otherwise not seek baccalaureate degrees, including working adults, economically disadvantaged students, people of color, and place-bound students. The Community College League further asserts, “California’s nursing shortage cannot be solved by one singular approach but rather requires a collaborative, multi-program solution. SB 895 seeks to address the nursing shortage through California’s community colleges, which have already shown to be successful through ADN-BSN partnerships. As a 6-year pilot program, SB 895 would authorize 15 community college districts with existing ADN infrastructure to begin offering baccalaureate degrees in nursing. Several ADN programs are already well-positioned to take on this next step, and community college leaders across the state are eager and ready to serve their students by educating and training the next generation of nurses.”

ARGUMENTS IN OPPOSITION: The California Association of Colleges of Nursing argues, in part, in their opposition letter, that SB 895 “will not add a single additional nurse to the state workforce beyond the number that would exist under current law. Community colleges lack the infrastructure needed to administer baccalaureate nursing degree programs in accordance with evolving nursing accreditation standards. In fact, we are concerned that the bill will exacerbate existing challenges in hiring nursing faculty, since community college programs will likely need to seek out more faculty, to teach the additional courses required as part of baccalaureate degree programs. CACN additionally stresses that, “while we absolutely concur with the author and proponents on the need to craft policies that increase the number of nurses in the state, we respectfully disagree that this approach will address any of the underlying constraints to that pipeline. CACN believes that we can increase the number of nursing students in our state faster by partnering with our community colleges and not duplicating efforts and competing for limited resources, including clinical placements and qualified faculty.”

ASSEMBLY FLOOR: 72-2, 8/28/24

AYES: Addis, Aguiar-Curry, Alanis, Alvarez, Bains, Bauer-Kahan, Bennett, Berman, Boerner, Bonta, Bryan, Calderon, Juan Carrillo, Wendy Carrillo, Chen, Connolly, Megan Dahle, Davies, Dixon, Flora, Mike Fong, Friedman, Gabriel, Gallagher, Garcia, Gipson, Grayson, Haney, Hart, Holden, Hoover, Jackson, Jones-Sawyer, Kalra, Lackey, Lee, Low, Lowenthal, Maienschein, Mathis, McCarty, McKinnor, Muratsuchi, Stephanie Nguyen, Pacheco, Papan, Jim Patterson, Joe Patterson, Pellerin, Petrie-Norris, Quirk-Silva, Ramos, Rendon, Reyes, Luz Rivas, Rodriguez, Blanca Rubio, Santiago, Schiavo, Soria, Ta, Ting, Valencia, Villapudua, Waldron, Wallis, Ward, Wicks, Wilson, Wood, Zbur, Robert Rivas

NOES: Essayli, Irwin

NO VOTE RECORDED: Arambula, Cervantes, Ortega, Sanchez, Weber

Prepared by: Olgalilia Ramirez / ED. / (916) 651-4105

8/28/24 22:32:22

**** END ****

SENATE THIRD READING

STR Bill Id:SB 895

Author:(Roth and Caballero)

As Amended Ver:August 22, 2024

Majority vote

SUMMARY

Requires the California Community College (CCC) Chancellor's Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 10 community college districts (CCD) to offer a Bachelor of Science in Nursing (BSN) degree.

Major Provisions

1. Requires the CCC Chancellor's Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a BSN degree. It provides that the pilot program be limited to 10 CCDs statewide.
2. Requires that the CCC Chancellor identify and select eligible CCDs based on the following criteria:
   1. The Chancellor's Office is encouraged to ensure there is equitable access between the northern, central, and southern parts of the state to the pilot program.
   2. That priority be given to CCDs in underserved nursing areas.
   3. That the CCDs have a nationally accredited nursing program.
3. Requires the CCC Chancellor's Office to give positive consideration to a community college district's request for participation in the pilot program where the community college district has a successful associate degree in nursing to bachelor of science in nursing (ADN-to-BSN) concurrent enrollment partnership with the California State University, the University of California, or an independent institution of higher education, as specified.
4. Provides that a CCD selected for the pilot program continue to offer an associate degree in nursing program.
5. Limits the total number of associate degree in nursing (ADN) and BSN students at a CCD to the CCD's ADN class size approved by the Board of Registered Nursing (BRN), and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.
6. Allows a CCD without a nationally accredited nursing program, but are in "candidate" status, be provisionally selected to participate in this pilot program, and commence the program upon final accreditation, as specified. This bill further requires the CCC Chancellor's Office to develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the pilot program, and that assistance be made available to CCDs upon request.
7. Requires each participating CCD to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that CCD.
8. Requires that the Legislative Analyst's Office (LAO) conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified. This bill further requires each participating CCD to submit the information necessary for this evaluation, as determined by the LAO, to the CCC Chancellor's Office.
9. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill's provision.
10. Sunsets this bill's provision on January 1, 2034.
11. States various findings and declarations relative to this bill's provisions.

COMMENTS

Master Plan for Higher Education. 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 associates degrees and university transfer, career technical education, and basic skills. The primary mission of the CSU is undergraduate and graduate instruction through the master's degree. The UC was granted the sole authority to independently offer doctoral degrees.

Notwithstanding the differentiation of the mission envisioned by the Master Plan, and as outlined in statute, the Legislature authorized the CSU to go beyond its original mission to offer six professional doctoral degrees which include the Au.D, Ed.D, D.P.T., DNP, OTD, and Dr.PH. Each program was individually approved through legislation. Fees were capped at the rate charged at the UC, no additional funding was provided by the state, and these programs were to be implemented without diminishing or reducing enrollment in undergraduate programs. Additionally, the CSU programs that offer applied doctorates were not duplicative of degrees offered by UC.

Parallel expansion. SB 850 (Block), Chapter 747, Statutes of 2014, authorized the CCC BOG, in consultation with the CSU and the UC, to establish a baccalaureate degree pilot program. The pilot program allowed up to 15 participating community college districts to offer one baccalaureate degree program each to meet local workforce needs as long as it was not duplicating a baccalaureate degree program already offered by the CSU or the UC. The LAO conducted interim and final evaluations of the pilot program.

Assembly Bill 927 (Medina and Choi), Chapter 565, Statutes of 2021 made the SB 850 (Block) pilot program permanent, perpetually approving the original pilot programs and authorizing as many as 30 new baccalaureate degrees per year. As of publication of this analysis there are a total of 39 approved programs. Most participating campuses currently offer one program, while seven campus offer two baccalaureate degree programs. Consistent with the provisions of SB 850 (Block), AB 927 (Medina and Choi) mandates that none of the CCC baccalaureate degree programs can duplicate programs offered by the CSU or UC.

AB 656 (McCarty), Chapter 663, Statutes of 2023, authorizes the CSU to award professional or applied doctoral degrees statewide that do not duplicate UC doctoral degrees and satisfy certain requirements.

Nursing programs in California. Graduates of associate and BSN degree programs may sit for nurse licensure exams and become licensed registered nurses. The state's BRN approves all of California's pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 BSN, and 13 Entry Level Master's (ELM) programs.

According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18% increase in student completions since 2012. Associate's degree completions decreased while bachelor's degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor's programs has increased over the last 10 years. The time it takes a student to graduate from a program varies by degree. An associate degree in nursing prepares students for registered nursing care in a variety of settings in two-three years, whereas a bachelor's degree takes about four years to train students for registered nursing care as well as administrative and leadership positions. An ELM is a one- to two- year program for baccalaureate degree holders in other fields seeking to become registered nurses. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500.

Not all community college nursing programs are nationally accredited. According to the CCC Chancellor's Office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN), and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have BRN approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs. This bill allows non-nationally accredited community college programs to be provisionally selected as they work toward obtaining accreditation.

To note, further expansion of CCC baccalaureate degrees as proposed in this bill would signal the Legislature's willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process. SB 895 (Roth) does not specifically require the pilot programs to be bridge programs (ADN to BSN) – though it does require that each participating CCD to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that CCD.

According to the Author

According to the author, "For over 40 years, the community college ADN has been the basic credential requirement for employment as a registered nurse in a health care facility. However, due to a push by credentialing organizations to increase the percentage of nurses holding BSN degrees to 80 percent of those employed in health care facilities, the BSN degree is now becoming the new industry standard for employment in California hospitals. BSN degreed nurses are qualified to become supervisors and managers in healthcare facilities, become Master's or Doctorate degreed nurse practitioners in independent practice settings, and become members of nursing school faculty – which are sorely needed to continue to expand our healthcare workforce."

"However, the demand for production of BSN credentialed [registered nurses] continues to increase without a corresponding increase in the capacity to train them at our public nursing schools. This bill proposes to utilize existing ADN programs at our underutilized community colleges on a limited basis to supplement the work of our public and private BSN programs to meet this demand."

"Given our current and future budget challenges and the high cost of setting up and expanding undergraduate nursing programs—both in terms of the cost of the equipment and brick-and-mortar facilities and the low student-to-faculty ratios required—why not try using the underutilized team member with campuses most accessible to students—one with a cadre of fully trained and licensed ADN's ready to earn the relatively few humanities and leadership course units remaining for the BSN credential at their local community college as they perform critical health care delivery duties in our local communities. It is critical that we use all the tools in our tool chest to address the need. The time to try it is now."

Arguments in Support

According to the Community College League of California, "SB 895 is a direct response to a national trend of hospitals requiring and preferring to hire BSN educated nurses, which disadvantages community college nursing students. A 2021 Health Impact report found that 18% of California hospitals surveyed stated that a BSN was required for employment – double the percentage from 2017 – and 54.3% reported a preference for hiring BSN nurses. Additionally, 31.5% of nurses with an Associate Degree in Nursing (ADN) stated that the lack of a BSN degree was given as the reason for their failure to be hired. SB 895 utilizes California's community colleges to create an affordable and accessible pathway towards a BSN degree, leading to advanced career opportunities for the state's most diverse students, and an increased pool of BSN-educated nurses for the state's healthcare workforce."

"Under SB 895, community college students seeking a BSN will not be competing for additional clinical placements. Currently, upon completing an ADN program, community college students can take a licensing exam, become a Registered Nurse (RN), and apply for employment. SB 895 works within the current ADN infrastructure; for instance, in a cohort of 100 ADN students, 35 of those students would be eligible to pursue their BSN degrees. By utilizing an existing framework, students entering the BSN program would've already completed their hospital clinical placements in the AND portion of their education. Students in the BSN program would not be competing for clinical placements since they already completed that requirement. These students would only be required to conduct post-licensure clinical work in Leadership and Community Health, which are structured as independent projects with individual nurses or in the community and are not competitive hospital clinical slots."

"The BSN programs established by SB 895 will maintain the highest standards of quality. Baccalaureate-level education is not foreign to California's community colleges, which currently offer over 30 baccalaureate degree programs ranging from Dental Hygiene and Respiratory Care to Biomanufacturing. Several parameters ensure BSN programs established by SB 895 are of the highest quality, including that each participating community college must have a nationally accredited nursing program and that all programs must be approved by the Board of Registered Nursing, the same standard for existing nursing schools."

Arguments in Opposition

The CSU Chancellor's Office argues that "SB 895 is intended to allow licensed ADN holders to earn a BSN at a community college. CSU can, and does, fulfill this role. 20 CSU universities offer ADN-to-BSN degree programs, with the majority offering hybrid and online programs. These CSU nursing programs have open enrollment slots available to qualified applicants. Community colleges desiring to offer BSN degrees are already partnering with CSU universities to offer students streamlined BSN pathways, which can reduce the time to graduation from an average of five to six years to three to four years. 37 community colleges have concurrent enrollment nursing partnership programs with 15 CSU universities, and CSU is seeking to add more. These joint programs have helped community colleges become nationally accredited and have increased opportunities for clinical coordination."

"Of the 77 community college campuses offering the ADN, only 33 programs are nationally accredited. Several community college nursing programs are on probationary status with the California Board of Registered Nursing this year because they fell below the state's National Council Licensure Exam (NCLEX) minimal pass rates of 75%. Conversely, the CSU provides excellent (BSN) programs at 20 of our universities, all of which are nationally accredited. NCLEX passage rates for CSU nursing graduates are consistently high. The latest BRN data show that all CSU universities reported pass rates of over 85%. Seven CSU nursing programs and three UC programs are rated as the top ten nursing programs in California. Students within CSU partnership programs often complete their ADN and BSN degrees faster than students at a community college completing their ADN degree because of high quality academics and student supportive services."

The Association for Independent California Colleges and Universities (AICCU) wrote that "in October 2021, Governor Gavin Newsom signed AB 927 (Medina) into law. That bill granted permanent authority for the California Community Colleges to offer baccalaureate degrees within certain parameters, including a clear restriction that 'a baccalaureate degree program shall not offer a baccalaureate degree program or program curricula already offered by the California State University or the University of California.' That restriction was repeatedly acknowledged by proponents throughout the legislative process, and following the bill's enactment the chairs of the Assembly Higher Education Committee and Senate Education Committee sent a joint letter on April 18, 2023 affirming this restriction. Respectfully, we view this proposal to be a significant shift away from that recently agreed upon framework that made the authority permanent."

FISCAL COMMENTS

According to the Assembly Committee on Appropriations:

1. One-time Proposition 98 General Fund costs in the low hundreds of thousands of dollars for up to 10 CCC districts to create and implement a BSN degree program. These costs would encompass updates to the design of new nursing academic standards, updates to existing curriculum that would be needed to satisfy the BSN, implementation of other coursework requirements, and initial accreditation fees.
2. Ongoing Proposition 98 General Fund costs, potentially in the hundreds of thousands of dollars annually, for up to 10 CCC districts to offer upper division programing. These costs are associated with increased operational expenses, staff salaries, and annual accreditation fees. Costs associated with staff salaries would be lower to the extent pilot CCC districts can redirect existing nursing faculty to teach upper division curriculum.
3. One-time General Fund workload costs between $32,500 and $53,000 for the CCC Chancellor's Office to develop the application for the pilot program, issue guidance, and provide technical assistance.

According to the Legislative Analyst's Office, the General Fund faces a structural deficit in the tens of billions of dollars over the next several fiscal years.

VOTES

SENATE FLOOR: 38-0-2

YES: Alvarado-Gil, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Min, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk

ABS, ABST OR NV: Allen, Archuleta

ASM HIGHER EDUCATION: 9-1-1

YES: Mike Fong, Ta, Arambula, Boerner, Chen, Jackson, Low, Muratsuchi, Quirk-Silva

NO: Essayli

ABS, ABST OR NV: Irwin

ASM APPROPRIATIONS: 11-0-4

YES: Wicks, Arambula, Bryan, Calderon, Wendy Carrillo, Mike Fong, Grayson, Haney, Hart, Pellerin, Villapudua

ABS, ABST OR NV: Sanchez, Dixon, Jim Patterson, Ta

UPDATED

VERSION: August 22, 2024

CONSULTANT: Kevin J. Powers / HIGHER ED. / (916) 319-3960 FN: 0004516

SENATE THIRD READING

STR Bill Id:SB 895

Author:(Roth and Caballero)

As Amended Ver:August 19, 2024

Majority vote

SUMMARY

Requires the California Community College (CCC) Chancellor's Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 10 community college districts (CCD) to offer a Bachelor of Science in Nursing (BSN) degree.

Major Provisions

1. Requires the Chancellor's Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a BSN degree. It provides that the pilot program be limited to 10 CCDs statewide.
2. Requires that the Chancellor identify and select eligible CCDs based on the following criteria:
   1. The Chancellor's Office is encouraged to ensure there is equitable access between the northern, central, and southern parts of the state to the pilot program.
   2. That priority be given to CCDs in underserved nursing areas.
   3. That the CCDs have a nationally accredited nursing program.
3. Provides that a CCD selected for the pilot program continue to offer an associate degree in nursing program.
4. Limits the total number of associate degree in nursing (ADN) and BSN students at a CCD to the CCD's ADN class size approved by the Board of Registered Nursing (BRN), and further limits the total number of participants in a pilot program to 25% of that class size or 35 students, whichever is greater.
5. Allows a CCD without a nationally accredited nursing program, but are in "candidate" status, be provisionally selected to participate in this pilot program, and commence the program upon final accreditation, as specified. This bill further requires the CCC Chancellor's Office to develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the pilot program, and that assistance be made available to CCDs upon request.
6. Requires each participating CCD to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that CCD.
7. Requires that the Legislative Analyst's Office (LAO) conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified. This bill further requires each participating CCD to submit the information necessary for this evaluation, as determined by the LAO, to the CCC Chancellor's Office.
8. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill's provision.
9. Sunsets this bill's provision on January 1, 2034.
10. States various findings and declarations relative to this bill's provisions.

COMMENTS

Master Plan for Higher Education. 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 associates degrees and university transfer, career technical education, and basic skills. The primary mission of the CSU is undergraduate and graduate instruction through the master's degree. The UC was granted the sole authority to independently offer doctoral degrees.

Notwithstanding the differentiation of the mission envisioned by the Master Plan, and as outlined in statute, the Legislature authorized the CSU to go beyond its original mission to offer six professional doctoral degrees which include the Au.D, Ed.D, D.P.T., DNP, OTD, and Dr.PH. Each program was individually approved through legislation. Fees were capped at the rate charged at the UC, no additional funding was provided by the state, and these programs were to be implemented without diminishing or reducing enrollment in undergraduate programs. Additionally, the CSU programs that offer applied doctorates were not duplicative of degrees offered by UC.

Parallel expansion. SB 850 (Block), Chapter 747, Statutes of 2014, authorized the CCC BOG, in consultation with the CSU and the UC, to establish a baccalaureate degree pilot program. The pilot program allowed up to 15 participating community college districts to offer one baccalaureate degree program each to meet local workforce needs as long as it was not duplicating a baccalaureate degree program already offered by the CSU or the UC. The LAO conducted interim and final evaluations of the pilot program.

Assembly Bill 927 (Medina and Choi), Chapter 565, Statutes of 2021 made the SB 850 (Block) pilot program permanent, perpetually approving the original pilot programs and authorizing as many as 30 new baccalaureate degrees per year. As of publication of this analysis there are a total of 39 approved programs. Most participating campuses currently offer one program, while seven campus offer two baccalaureate degree programs. Consistent with the provisions of SB 850 (Block), AB 927 (Medina and Choi) mandates that none of the CCC baccalaureate degree programs can duplicate programs offered by the CSU or UC.

AB 656 (McCarty), Chapter 663, Statutes of 2023, authorizes the CSU to award professional or applied doctoral degrees statewide that do not duplicate UC doctoral degrees and satisfy certain requirements.

Nursing programs in California. Graduates of associate and BSN degree programs may sit for nurse licensure exams and become licensed registered nurses. The state's BRN approves all of California's pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 BSN, and 13 Entry Level Master's (ELM) programs.

According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18% increase in student completions since 2012. Associate's degree completions decreased while bachelor's degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor's programs has increased over the last 10 years. The time it takes a student to graduate from a program varies by degree. An associate degree in nursing prepares students for registered nursing care in a variety of settings in two-three years, whereas a bachelor's degree takes about four years to train students for registered nursing care as well as administrative and leadership positions. An ELM is a one- to two- year program for baccalaureate degree holders in other fields seeking to become registered nurses. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500.

Not all community college nursing programs are nationally accredited. According to the CCC Chancellor's Office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN), and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have BRN approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs. This bill allows non-nationally accredited community college programs to be provisionally selected as they work toward obtaining accreditation.

To note, further expansion of CCC baccalaureate degrees as proposed in this bill would signal the Legislature's willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process. SB 895 (Roth) does not specifically require the pilot programs to be bridge programs (ADN to BSN) – though it does require that each participating CCD to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that CCD.

According to the Author

According to the author, "For over 40 years, the community college ADN has been the basic credential requirement for employment as a registered nurse in a health care facility. However, due to a push by credentialing organizations to increase the percentage of nurses holding BSN degrees to 80% of those employed in health care facilities, the BSN degree is now becoming the new industry standard for employment in California hospitals. BSN degreed nurses are qualified to become supervisors and managers in healthcare facilities, become Master's or Doctorate degreed nurse practitioners in independent practice settings, and become members of nursing school faculty – which are sorely needed to continue to expand our healthcare workforce."

"However, the demand for production of BSN credentialed [registered nurses] continues to increase without a corresponding increase in the capacity to train them at our public nursing schools. This bill proposes to utilize existing ADN programs at our underutilized community colleges on a limited basis to supplement the work of our public and private BSN programs to meet this demand."

"Given our current and future budget challenges and the high cost of setting up and expanding undergraduate nursing programs—both in terms of the cost of the equipment and brick-and-mortar facilities and the low student-to-faculty ratios required—why not try using the underutilized team member with campuses most accessible to students—one with a cadre of fully trained and licensed ADN's ready to earn the relatively few humanities and leadership course units remaining for the BSN credential at their local community college as they perform critical health care delivery duties in our local communities. It is critical that we use all the tools in our tool chest to address the need. The time to try it is now."

Arguments in Support

According to the Community College League of California, "SB 895 is a direct response to a national trend of hospitals requiring and preferring to hire BSN educated nurses, which disadvantages community college nursing students. A 2021 Health Impact report found that 18% of California hospitals surveyed stated that a BSN was required for employment – double the percentage from 2017 – and 54.3% reported a preference for hiring BSN nurses. Additionally, 31.5% of nurses with an Associate Degree in Nursing (ADN) stated that the lack of a BSN degree was given as the reason for their failure to be hired. SB 895 utilizes California's community colleges to create an affordable and accessible pathway towards a BSN degree, leading to advanced career opportunities for the state's most diverse students, and an increased pool of BSN-educated nurses for the state's healthcare workforce."

"Under SB 895, community college students seeking a BSN will not be competing for additional clinical placements. Currently, upon completing an ADN program, community college students can take a licensing exam, become a Registered Nurse (RN), and apply for employment. SB 895 works within the current ADN infrastructure; for instance, in a cohort of 100 ADN students, 35 of those students would be eligible to pursue their BSN degrees. By utilizing an existing framework, students entering the BSN program would've already completed their hospital clinical placements in the AND portion of their education. Students in the BSN program would not be competing for clinical placements since they already completed that requirement. These students would only be required to conduct post-licensure clinical work in Leadership and Community Health, which are structured as independent projects with individual nurses or in the community and are not competitive hospital clinical slots."

"The BSN programs established by SB 895 will maintain the highest standards of quality. Baccalaureate-level education is not foreign to California's community colleges, which currently offer over 30 baccalaureate degree programs ranging from Dental Hygiene and Respiratory Care to Biomanufacturing. Several parameters ensure BSN programs established by SB 895 are of the highest quality, including that each participating community college must have a nationally accredited nursing program and that all programs must be approved by the Board of Registered Nursing, the same standard for existing nursing schools."

Arguments in Opposition

The CSU Chancellor's Office argues that "SB 895 is intended to allow licensed ADN holders to earn a BSN at a community college. CSU can, and does, fulfill this role. 20 CSU universities offer ADN-to-BSN degree programs, with the majority offering hybrid and online programs. These CSU nursing programs have open enrollment slots available to qualified applicants. Community colleges desiring to offer BSN degrees are already partnering with CSU universities to offer students streamlined BSN pathways, which can reduce the time to graduation from an average of five to six years to three to four years. 37 community colleges have concurrent enrollment nursing partnership programs with 15 CSU universities, and CSU is seeking to add more. These joint programs have helped community colleges become nationally accredited and have increased opportunities for clinical coordination."

"Of the 77 community college campuses offering the ADN, only 33 programs are nationally accredited. Several community college nursing programs are on probationary status with the California Board of Registered Nursing this year because they fell below the state's National Council Licensure Exam (NCLEX) minimal pass rates of 75%. Conversely, the CSU provides excellent (BSN) programs at 20 of our universities, all of which are nationally accredited. NCLEX passage rates for CSU nursing graduates are consistently high. The latest BRN data show that all CSU universities reported pass rates of over 85%. Seven CSU nursing programs and three UC programs are rated as the top ten nursing programs in California. Students within CSU partnership programs often complete their ADN and BSN degrees faster than students at a community college completing their ADN degree because of high quality academics and student supportive services."

The Association for Independent California Colleges and Universities (AICCU) wrote that "in October 2021, Governor Gavin Newsom signed AB 927 (Medina) into law. That bill granted permanent authority for the California Community Colleges to offer baccalaureate degrees within certain parameters, including a clear restriction that 'a baccalaureate degree program shall not offer a baccalaureate degree program or program curricula already offered by the California State University or the University of California.' That restriction was repeatedly acknowledged by proponents throughout the legislative process, and following the bill's enactment the chairs of the Assembly Higher Education Committee and Senate Education Committee sent a joint letter on April 18, 2023 affirming this restriction. Respectfully, we view this proposal to be a significant shift away from that recently agreed upon framework that made the authority permanent."

FISCAL COMMENTS

According to the Assembly Committee on Appropriations:

1. One-time Proposition 98 General Fund costs in the low hundreds of thousands of dollars for up to 10 CCC districts to create and implement a BSN degree program. These costs would encompass updates to the design of new nursing academic standards, updates to existing curriculum that would be needed to satisfy the BSN, implementation of other coursework requirements, and initial accreditation fees.
2. Ongoing Proposition 98 General Fund costs, potentially in the hundreds of thousands of dollars annually, for up to 10 CCC districts to offer upper division programing. These costs are associated with increased operational expenses, staff salaries, and annual accreditation fees. Costs associated with staff salaries would be lower to the extent pilot CCC districts can redirect existing nursing faculty to teach upper division curriculum.
3. One-time General Fund workload costs between $32,500 and $53,000 for the CCC Chancellor's Office to develop the application for the pilot program, issue guidance, and provide technical assistance.

According to the Legislative Analyst's Office, the General Fund faces a structural deficit in the tens of billions of dollars over the next several fiscal years.

VOTES

SENATE FLOOR: 38-0-2

YES: Alvarado-Gil, Ashby, Atkins, Becker, Blakespear, Bradford, Caballero, Cortese, Dahle, Dodd, Durazo, Eggman, Glazer, Gonzalez, Grove, Hurtado, Jones, Laird, Limón, McGuire, Menjivar, Min, Newman, Nguyen, Niello, Ochoa Bogh, Padilla, Portantino, Roth, Rubio, Seyarto, Skinner, Smallwood-Cuevas, Stern, Umberg, Wahab, Wiener, Wilk

ABS, ABST OR NV: Allen, Archuleta

ASM HIGHER EDUCATION: 9-1-1

YES: Mike Fong, Ta, Arambula, Boerner, Chen, Jackson, Low, Muratsuchi, Quirk-Silva

NO: Essayli

ABS, ABST OR NV: Irwin

ASM APPROPRIATIONS: 11-0-4

YES: Wicks, Arambula, Bryan, Calderon, Wendy Carrillo, Mike Fong, Grayson, Haney, Hart, Pellerin, Villapudua

ABS, ABST OR NV: Sanchez, Dixon, Jim Patterson, Ta

UPDATED

VERSION: August 19, 2024

CONSULTANT: Kevin J. Powers / HIGHER ED. / (916) 319-3960 FN: 0004101

Date of Hearing: August 7, 2024

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Buffy Wicks, Chair

SBPCA Bill Id:SB 895

Author:(Roth) – As Amended Ver:May 16, 2024

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

SUMMARY:

This bill requires the California Community College (CCC) Chancellor to develop a Baccalaureate Degree in Nursing (BSN) Pilot Program at up to 15 CCC districts statewide. The bill repeals its provisions January 1, 2034.

Specifically, this bill requires the CCC Chancellor’s Office to give priority for pilot participation to CCC districts located in underserved nursing areas. To be eligible as a pilot, a CCC district must have a nationally accredited CCC nursing program. However, this bill allows non-nationally accredited CCC programs to be provisionally selected as they work toward obtaining accreditation. Once selected, each participating CCC district is to give priority registration for enrollment in the pilot program to students with an associate degree in nursing (ADN) from that CCC district.

The bill also requires that the total number of ADN students and BSN students at selected CCC districts be limited to the CCC district’s ADN class size approved by the Board of Registered Nursing (BRN). In addition, the total number of participants in a pilot program is to be limited to 25% of that class size, or 35 students, whichever is greater. The bill further specifies a pilot CCC district may not charge a per-unit tuition fee rate higher than the rate it charges for lower-division course work.

Lastly, the Legislative Analyst’s Office (LAO), by July 1, 2032, is to conduct an evaluation of the pilot program, which is to include recommendations on whether and how the authorization establishing the pilot program should be extended.

FISCAL EFFECT:

1. One-time Proposition 98 General Fund costs in the low hundreds of thousands of dollars for up to 15 CCC districts to create and implement a BSN degree program. These costs would encompass updates to the design of new nursing academic standards, updates to existing curriculum that would be needed to satisfy the BSN, implementation of other coursework requirements, and initial accreditation fees. The state has 72 CCC districts consisting of 115 CCCs. The largest CCC district has nine CCCs and the majority of CCC districts have several CCCs.
2. Ongoing Proposition 98 General Fund costs, potentially in the hundreds of thousands of dollars annually for up to 15 CCC districts, to offer upper division programing. These costs are associated with increased operational expenses, staff salaries, and annual accreditation fees. Costs associated with staff salaries would be lower to the extent pilot CCC districts can redirect existing nursing faculty to teach upper division curriculum.
3. One-time General Fund workload costs between $32,500 and $53,000 for the CCC Chancellor’s Office to develop the application for the pilot program, issue guidance, and provide technical assistance.

According to the Legislative Analyst’s Office, the General Fund faces a structural deficit in the tens of billions of dollars over the next several fiscal years.

COMMENTS:

1. Background.

ADNs and BSNs. The state has 152 registered nursing programs. Of these, 101 are offered by public institutions of higher education and the remainder by private institutions. Of these 152 programs, 91 are ADNs and 48 are BSNs. 77 CCCs offer ADN programs and 20 CSUs offer BSN programs. CSU also offers 13 of its programs online. All nursing programs are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. In addition, to become a registered nurse, students must pass a national licensure examination.

While an ADN was once the standard degree for a registered nurse, hospitals are increasingly requiring a nurse to hold a BSN for employment. To address this, CSU and UC are increasingly partnering with CCCs to transition CCC students with an ADN to a UC or CSU to complete their BSN. According to CSU, 37 CCCs have partnership programs with 15 CSUs and are working to add more. Recent legislation provided funding for these partnership efforts and other CCC nursing programs. Specifically, the adopted 2024-25 budget act provides $60 million one-time Proposition 98 General Fund per year for five years to support the Rebuilding Nursing Infrastructure Grant Program to expand ADN programs at CCCs and BSN partnerships between CCCs and four-year institutions, among other purposes. The higher education budget trailer bill establishes parameters for these funds. (SB 155 (Committee on Budget and Fiscal Review), Chapter 71, Statutes of 2024.)

Baccalaureate Degree Pilot Program. SB 850 (Block), Chapter 747, Statutes of 2014, authorized the CCC Board of Governors, in consultation with the CSU and UC to establish a baccalaureate degree pilot program. AB 927 (Medina), Chapter 565, Statutes of 2021, made the CCC baccalaureate program permanent. Statute requires baccalaureate degree programs to be approved by the CCC Chancellor’s Office and specifies the programs are not to duplicate existing UC or CSU baccalaureate programs. Currently, CCCs operate 39 approved baccalaureate programs.

1. Support and Opposition. This bill is supported by many CCC districts, the CCC Chancellor’s Office, the United Nurses Associations of California/Union of Health Care Professionals, and others. Among other arguments, supporters argue this bill will produce more BSN registered nurses in underserved areas, will allow more students who are turned away due to impaction at four-year institutions to enroll in CCC BSN programs, and will cost a student less than attending a four-year institutions to earn their BSN.

This bill is opposed by many CSUs, the CSU Chancellor’s Office, the Association of Independent California Colleges and Universities, and others. Among other arguments, opponents argue this bill will not produce more BSN registered nurses because the issue is not lack of space in BSN programs, but instead the lack of clinical placements opportunities for nurse candidates. Opponents also argue enacting this measure undermines CCC baccalaureate degree pilot program statute, which restricts CCC baccalaureate programs to those that do not duplicate degrees already offered by UC and CSU. Opponents, namely the CSU Chancellor’s Office, additionally argue that CCC BSN programs may not necessarily result in lower costs to students because, while the bill contains restrictions on costs per unit, the bill does not restrict the additional fees a CCC may charge.

1. Related Legislation. AB 1311 (Soria), Chapter 126, Statutes of 2023, requires the LAO, January 1, 2025, to conduct an assessment evaluating the efficacy of existing programs in allied health jointly offered between campuses of the CCC, UC, and CSU.

AB 2104 (Soria), is very similar to this bill and authorizes 10 CCC districts to offer a BSN degree. The bill is pending in the Senate Appropriations Committee.

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

Date of Hearing: July 2, 2024

ASSEMBLY COMMITTEE ON HIGHER EDUCATION

Mike Fong, Chair

SBPCA Bill Id:SB 895

Author:(Roth) – As Amended Ver:May 16, 2024

SENATE VOTE: 38-0

SUBJECT: Community colleges: Baccalaureate Degree in Nursing Pilot Program

SUMMARY: Requires the California Community College (CCC) Chancellor’s Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 15 community college districts (CCD) to offer a Bachelor of Science in Nursing (BSN) degree. Specifically, this bill:

1. Requires the Chancellor’s Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a BSN degree. It provides that the pilot program be limited to 15 CCDs statewide.
2. Requires that the Chancellor identify and select eligible CCDs based on the following criteria:
   1. The Chancellor’s Office is encouraged to ensure there is equitable access between the northern, central, and southern parts of the state to the pilot program.
   2. That priority be given to CCDs in underserved nursing areas.
   3. That the CCDs have a nationally accredited nursing program.
3. Provides that a CCD selected for the pilot program continue to offer an associate degree in nursing program.
4. Limits the total number of associate degree in nursing (ADN) and BSN students at a CCD to the CCD’s ADN class size approved by the Board of Registered Nursing (BRN), and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.
5. Allows a CCD without a nationally accredited nursing program, but are in “candidate” status, be provisionally selected to participate in this pilot program, and commence the program upon final accreditation, as specified. This bill further requires the CCC Chancellor’s Office to develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the pilot program, and that assistance be made available to CCDs upon request.
6. Requires each participating CCD to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that CCD.
7. Requires that the Legislative Analyst’s Office (LAO) conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified. This bill further requires each participating CCD to submit the information necessary for this evaluation, as determined by the LAO, to the CCC Chancellor’s Office.
8. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill’s provision.
9. Sunsets this bill’s provision on January 1, 2034.
10. States various findings and declarations relative to this bill’s provisions.

EXISTING LAW:

1. Differentiates the missions and functions of public and independent institutions of higher education. Under these provisions:
   1. The primary mission of the California State University (CSU) is to offer undergraduate and graduate instruction through the master’s degree in the liberal arts and sciences and professional education including teacher education. The CSU is authorized to establish two-year programs only when mutually agreed upon by the Trustees and the CCC Board of Governors. The CSU is also authorized to jointly award the doctoral degree with the University of California (UC) and with one or more independent institutions of higher education;
   2. The UC provides undergraduate and graduate instruction and has exclusive jurisdiction in public higher education over graduate instruction in the professions of law, medicine, dentistry and veterinary medicine. The UC is also the primary state-supported academic agency for research;
   3. The independent institutions of higher education requires undergraduate and graduate instruction and research in accordance with their respective missions; and,
   4. The mission and function of the CCC offers academic and vocational instruction at the lower division level, and the CCC authorizes to grant the Associate in Arts and the Associate in Science degrees. The community colleges also requires to offer learning supports to close learning gaps, English as a Second Language instruction, and adult noncredit instruction, and support services which help students succeed at the postsecondary level. (Education Code (EDC) Section 66010.4)
2. Authorizes the BOG of the CCC to establish permanent district baccalaureate degree programs, and provided that only 15 baccalaureate degree programs are approved during each application period allowing for a total of 30 baccalaureate degree programs per academic year. Additionally, existing law:
   1. Specifies that CCDs, as part of the baccalaureate degree program, will have the additional mission to provide high-quality undergraduate education at an affordable price for students and the state.
   2. Requires the Chancellor of the CCC to consult with and seek feedback from the Chancellor of the CSU, the President of the University of California (UC), and the President of the Association of Independent California Colleges and Universities (AICCU) on proposed baccalaureate degree programs, as specified, and establishes a mechanism for the assessment, consultation, and approval of programs where duplication is identified, as specified;
   3. Requires a CCD to continue to offer an associate degree program in the same academic subject for which baccalaureate degree program has been approved, unless the CCD has received approval from the CCC Chancellor to eliminate the associate degree program, and requires the CCC Chancellor to evaluate both changes to the labor market viability of an associate degree and changes to the minimum education required to maintain program accreditation when making a decision to authorize the elimination of an associate degree program; and,
   4. Specifies that the total number of baccalaureate degree programs offered by a CCD, at any time, does not exceed 25% of the total number of associate degree programs offered by the CCD, including associate degrees for transfer. (EDC Section 78040, et seq.)
3. Authorizes the CSU to award professional or applied doctoral degrees statewide that do not duplicate University of California (UC) doctoral degrees and satisfy certain requirements. Requires a CSU campus seeking authorization to offer a professional or applied doctoral degree to submit specified information on the proposed doctoral degree for review by the office of the Chancellor of the CSU, and approval by the CSU Board of Trustees (BOT), as provided. Authorizes a proposed doctoral degree that is approved for implementation by the BOT to be implemented at the CSU systemwide, but would limit the number of doctoral degree programs that may be offered at a California State University campus. (EDC Section 66046)
4. Authorizes the CSU to independently award the Doctor of Education (Ed.D.) degree focused solely on preparing administrative leaders for California public elementary and secondary schools and community colleges and on the knowledge and skills needed by administrators to be effective leaders in California public schools and community colleges. (EDC Section 66040, et seq.)
5. Authorizes the CSU to offer the Doctor of Audiology (Au.D) degree; and, specifies that the Au.D degree programs at the CSU will focus on preparing audiologists to provide health care services and shall be consistent with the standards for accreditation set forth by the Council on Academic Accreditation in Audiology and Speech-Language Pathology. (EDC Section 66041, et seq.)
6. Authorizes the CSU to offer the Doctor of Physical Therapy (D.P.T.) degree, and specifies that the D.P.T. degree programs at the CSU will focus on preparing physical therapists to provide health care services, and be consistent with meeting the requirements of the Commission on Accreditation in Physical Therapy Education. (EDC Section 66042, et seq.)
7. Authorizes CSU to offer the Doctor of Nursing Practice (DNP) degree programs, and specifies that the DNP offered by the CSU will focus on the preparation of nursing faculty to teach in postsecondary nursing education programs and may also train nurses for advanced nursing practice or nurse leadership. (EDC Section 89280, et seq.)
8. Authorizes CSU to offer the Doctor of Occupational Therapy (OTD) degree, and specifies that OTD degree programs offered by the CSU will focus on preparing occupational therapists to provide health care services and to be consistent with the standards for accreditation set forth by the appropriate accrediting body. (EDC Section 66043, et seq.)
9. Authorizes CSU to offer the Doctor of Public Health (Dr.PH) degree, and specifies that DrPH degree programs offered by the CSU will focus on health and scientific knowledge translation and transformative community leadership, and will be designed to address the community public health workforce needs of California and prepare qualified professionals to be leaders and experienced practitioners who apply their advanced knowledge in service to California’s diverse communities in areas such as community health administration, health education and promotion, and public health advocacy. (EDC Section 66044, et seq.)

FISCAL EFFECT: According to the Senate Committee on Appropriations, while there could be one-time Proposition 98 General Fund costs for each pilot district to create and implement a Bachelor of Science of Nursing degree program, the CCCCO indicates that these initial start-up costs could be absorbable within existing resources. The costs would encompass any updates to the design of new nursing academic standards, student learning outcomes, updates to existing curriculum that would be needed to satisfy the program, and implementation of other coursework. The CCCCO believes these costs are consistent with recent state budget actions to implement new academic programs and curriculum. The Chancellor’s office estimates one-time General Fund workload costs of between $33,000 and $53,000 to develop the application for the pilot program, issue guidance, and provide technical assistance.

COMMENTS: Purpose. According to the author, “For over 40 years, the community college ADN has been the basic credential requirement for employment as a registered nurse in a health care facility. However, due to a push by credentialing organizations to increase the percentage of nurses holding BSN degrees to 80 percent of those employed in health care facilities, the BSN degree is now becoming the new industry standard for employment in California hospitals. BSN degreed nurses are qualified to become supervisors and managers in healthcare facilities, become Master’s or Doctorate degreed nurse practitioners in independent practice settings, and become members of nursing school faculty – which are sorely needed to continue to expand our healthcare workforce.”

“However, the demand for production of BSN credentialed [registered nurses] continues to increase without a corresponding increase in the capacity to train them at our public nursing schools. This bill proposes to utilize existing ADN programs at our underutilized community colleges on a limited basis to supplement the work of our public and private BSN programs to meet this demand.”

“Given our current and future budget challenges and the high cost of setting up and expanding undergraduate nursing programs—both in terms of the cost of the equipment and brick-and-mortar facilities and the low student-to-faculty ratios required—why not try using the underutilized team member with campuses most accessible to students—one with a cadre of fully trained and licensed ADN’s ready to earn the relatively few humanities and leadership course units remaining for the BSN credential at their local community college as they perform critical health care delivery duties in our local communities. It is critical that we use all the tools in our tool chest to address the need. The time to try it is now.”

Master Plan for Higher Education. 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 associates degrees and university transfer, career technical education, and basic skills. The primary mission of the CSU is undergraduate and graduate instruction through the master’s degree. The UC was granted the sole authority to independently offer doctoral degrees.

Notwithstanding the differentiation of the mission envisioned by the Master Plan, and as outlined in statute, the Legislature authorized the CSU to go beyond its original mission to offer six professional doctoral degrees which include the Au.D, Ed.D, D.P.T., DNP, OTD, and Dr.PH. Each program was individually approved through legislation. Fees were capped at the rate charged at the UC, no additional funding was provided by the state, and these programs were to be implemented without diminishing or reducing enrollment in undergraduate programs. Additionally, the CSU programs that offer applied doctorates were not duplicative of degrees offered by UC.

Parallel expansion. SB 850 (Block), Chapter 747, Statutes of 2014, authorized the CCC BOG, in consultation with the CSU and the UC, to establish a baccalaureate degree pilot program. The pilot program allowed up to 15 participating community college districts to offer one baccalaureate degree program each to meet local workforce needs as long as it was not duplicating a baccalaureate degree program already offered by the CSU or the UC. The LAO conducted interim and final evaluations of the pilot program.

Assembly Bill 927 (Medina and Choi), Chapter 565, Statutes of 2021 made the SB 850 (Block) pilot program permanent, perpetually approving the original pilot programs and authorizing as many as 30 new baccalaureate degrees per year. As of publication of this analysis there are a total of 39 approved programs. Most participating campuses currently offer one program, while seven campus offer two baccalaureate degree programs. Consistent with the provisions of SB 850 (Block), AB 927 (Medina and Choi) mandates that none of the CCC baccalaureate degree programs can duplicate programs offered by the CSU or UC.

AB 656 (McCarty), Chapter 663, Statutes of 2023, authorizes the CSU to award professional or applied doctoral degrees statewide that do not duplicate UC doctoral degrees and satisfy certain requirements.

Nursing programs in California. Graduates of associate and BSN degree programs may sit for nurse licensure exams and become licensed registered nurses. The state’s BRN approves all of California’s pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 BSN, and 13 Entry Level Master’s (ELM) programs.

According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18% increase in student completions since 2012. Associate’s degree completions decreased while bachelor’s degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor’s programs has increased over the last 10 years. The time it takes a student to graduate from a program varies by degree. An associate degree in nursing prepares students for registered nursing care in a variety of settings in two-three years, whereas a bachelor’s degree takes about four years to train students for registered nursing care as well as administrative and leadership positions. An ELM is a one- to two- year program for baccalaureate degree holders in other fields seeking to become registered nurses. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500.

Budget Support. The Budget Act of 2024, through SB 155 (Committee on Budget and Fiscal Review), establishes the Rebuilding Nursing Infrastructure Grant Program to expand nursing programs and partnerships, address nursing shortages, and increase, educate, and maintain the next generation of registered nurses through the community college system. This grant program will receive $60 million Proposition 98 General Fund per year for five years, starting in 2024-25, with CCC Strong Workforce Program funding. This program would specifically be used for developing or expanding BSN in nursing partnerships, including established partnerships with the CSU, the UC, or independent institutions of higher education or developing or expanding associate degree in nursing programs (or a combination thereof, amongst other purposes).

It is presently unclear what the impacts of this funding would be on this proposed pilot program.

Not all community college nursing programs are nationally accredited. According to the CCC Chancellor’s Office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN), and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have BRN approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs. This bill allows non-nationally accredited community college programs to be provisionally selected as they work toward obtaining accreditation.

Arguments in support. According to the Community College League of California, “SB 895 is a direct response to a national trend of hospitals requiring and preferring to hire BSN educated nurses, which disadvantages community college nursing students. A 2021 Health Impact report found that 18% of California hospitals surveyed stated that a BSN was required for employment – double the percentage from 2017 – and 54.3% reported a preference for hiring BSN nurses. Additionally, 31.5% of nurses with an Associate Degree in Nursing (ADN) stated that the lack of a BSN degree was given as the reason for their failure to be hired. SB 895 utilizes California’s community colleges to create an affordable and accessible pathway towards a BSN degree, leading to advanced career opportunities for the state’s most diverse students, and an increased pool of BSN-educated nurses for the state’s healthcare workforce.”

“Under SB 895, community college students seeking a BSN will not be competing for additional clinical placements. Currently, upon completing an ADN program, community college students can take a licensing exam, become a Registered Nurse (RN), and apply for employment. SB 895 works within the current ADN infrastructure; for instance, in a cohort of 100 ADN students, 35 of those students would be eligible to pursue their BSN degrees. By utilizing an existing framework, students entering the BSN program would’ve already completed their hospital clinical placements in the AND portion of their education. Students in the BSN program would not be competing for clinical placements since they already completed that requirement. These students would only be required to conduct post-licensure clinical work in Leadership and Community Health, which are structured as independent projects with individual nurses or in the community and are not competitive hospital clinical slots.”

“The BSN programs established by SB 895 will maintain the highest standards of quality. Baccalaureate-level education is not foreign to California’s community colleges, which currently offer over 30 baccalaureate degree programs ranging from Dental Hygiene and Respiratory Care to Biomanufacturing. Several parameters ensure BSN programs established by SB 895 are of the highest quality, including that each participating community college must have a nationally accredited nursing program and that all programs must be approved by the Board of Registered Nursing, the same standard for existing nursing schools.”

Arguments in opposition. The CSU Chancellor’s Office argues that “SB 895 is intended to allow licensed ADN holders to earn a BSN at a community college. CSU can, and does, fulfill this role. 20 CSU universities offer ADN-to-BSN degree programs, with the majority offering hybrid and online programs. These CSU nursing programs have open enrollment slots available to qualified applicants. Community colleges desiring to offer BSN degrees are already partnering with CSU universities to offer students streamlined BSN pathways, which can reduce the time to graduation from an average of five to six years to three to four years. 37 community colleges have concurrent enrollment nursing partnership programs with 15 CSU universities, and CSU is seeking to add more. These joint programs have helped community colleges become nationally accredited and have increased opportunities for clinical coordination.”

“Of the 77 community college campuses offering the ADN, only 33 programs are nationally accredited. Several community college nursing programs are on probationary status with the California Board of Registered Nursing this year because they fell below the state’s National Council Licensure Exam (NCLEX) minimal pass rates of 75%. Conversely, the CSU provides excellent (BSN) programs at 20 of our universities, all of which are nationally accredited. NCLEX passage rates for CSU nursing graduates are consistently high. The latest BRN data show that all CSU universities reported pass rates of over 85%. Seven CSU nursing programs and three UC programs are rated as the top ten nursing programs in California. Students within CSU partnership programs often complete their ADN and BSN degrees faster than students at a community college completing their ADN degree because of high quality academics and student supportive services.”

The Association for Independent California Colleges and Universities (AICCU) wrote that “in October 2021, Governor Gavin Newsom signed AB 927 (Medina) into law. That bill granted permanent authority for the California Community Colleges to offer baccalaureate degrees within certain parameters, including a clear restriction that ‘a baccalaureate degree program shall not offer a baccalaureate degree program or program curricula already offered by the California State University or the University of California.’ That restriction was repeatedly acknowledged by proponents throughout the legislative process, and following the bill’s enactment the chairs of the Assembly Higher Education Committee and Senate Education Committee sent a joint letter on April 18, 2023 affirming this restriction. Respectfully, we view this proposal to be a significant shift away from that recently agreed upon framework that made the authority permanent.”

Committee staff notes that further expansion of CCC baccalaureate degrees as proposed in this bill would signal the Legislature’s willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process.

Committee staff further notes that SB 895 (Roth) does not specifically require the pilot programs to be bridge programs (ADN to BSN) – though it does require that each participating CCD to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that CCD.

Moving forward, the author may wish to consider amending the bill to specify that the pilot program is specifically for ADN-to-BSN bridge programs.

If it is the desire of the Committee to expand BSN degree programs, arguably more effective and efficient alternatives do not require a departure from the CCC’s mission to expand and streamline BSN pathways. For example, the Tri-County Nursing Pathway is a partnership between Riverside City College and two CSU campuses (Fullerton and San Bernardino) that allows associate degree nursing students to concurrently obtain their bachelor’s degrees. Students can enroll in CSU courses while still completing their associate degree requirements, allowing them to obtain their bachelor’s degree with only six additional months of coursework. Improving alignment between CCC and the universities could increase the number of CCC students who ultimately obtain a bachelor’s degree and reduce the amount of time students take to obtain their degree.

Related and prior legislation. AB 2104 (Soria), requires the Chancellor of the California Community Colleges (CCC) to develop a Baccalaureate Degree in Nursing (BSN) Pilot Program that authorizes select community college districts to offer a BSN degree. AB 2104 (Soria) is scheduled to be heard on July 3^rd, 2024 in the Senate Committee on Education.

AB 656 (McCarty), Chapter 663, Statutes of 2023, authorized the CSU to award professional or applied doctoral degrees statewide that do not duplicate UC doctoral degrees and satisfy certain requirements. Required a CSU campus seeking authorization to offer a professional or applied doctoral degree to submit specified information on the proposed doctoral degree for review by the office of the Chancellor of the CSU, and approval by the CSU Board of Trustees, as provided.

AB 1311 (Soria), Chapter 126, Statutes of 2023, required the 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 California Community Colleges, the California State University, and the University of California. Required the final assessment to be reported, in writing, to the Legislature and the Governor on or before January 1, 2025, as specified.

SB 684 (Hueso), Chapter 936, Statutes of 2022, authorized CSU to offer the DrPH degree, and specified that DrPH degree programs offered by the CSU will focus on health and scientific knowledge translation and transformative community leadership.

AB 927 (Medina and Choi), Chapter 565, Statutes of 2021, removed the cap on the total number of baccalaureate degree programs allowed within the CCC system and eliminates the January 1, 2027, sunset date of the statewide baccalaureate degree pilot program, thereby permanently authorizing the offering of baccalaureate degree programs at CCCs.

SB 874 (Hill) of 2020, would have extended the operation of the statewide baccalaureate degree pilot program indefinitely. The bill would have removed the requirements that the program consist of a maximum of 15 community college district programs and for a student to commence a program by the end of the 2022–23 academic year. SB 874 was held in the Senate Committee on Education due to bill restrictions from COVID-19.

AB 829 (Bloom), Chapter 183, Statutes of 2019, authorized CSU to offer the OTD degree, and specifies that OTD degree programs offered by the CSU will focus on preparing occupational therapists to provide health care services and to be consistent with the standards for accreditation set forth by the appropriate accrediting body.

SB 577 (Dodd), Chapter 603, Statutes of 2018, established the CCC Teacher Credentialing Partnership Pilot Program, awarding grants to collaboratives of one or more teacher-credentialing higher education institutions partnering with one or more community colleges for the purpose of offering teacher credentialing programs at community colleges.

AB 422 (Arambula), Chapter 702, Statutes of 2017, authorized CSU to offer the DNP degree programs, and specified that the DNP offered by the CSU shall focus on the preparation of nursing faculty to teach in postsecondary nursing education programs and may also train nurses for advanced nursing practice or nurse leadership.

SB 769 (Hill) of 2017, would have extended the operation of the statewide baccalaureate degree pilot program until July 1, 2028. SB 769 was held in the Assembly Committee on Appropriations.

AB 2317 (Mullin), Chapter 267, Statutes of 2016, authorized the CSU to offer the Au.D degree, and specifies that the Au.D degree programs at the CSU shall be focused on preparing audiologists to provide health care services and shall be consistent with the standards for accreditation set forth by the Council on Academic Accreditation in Audiology and Speech-Language Pathology.

SB 850 (Block), Chapter 747, Statutes of 2014, authorized the CCC BOG, in consultation with the CSU and the UC, to establish a baccalaureate degree pilot program. The pilot program allows up to 15 participating community college districts to offer one baccalaureate degree program each to meet local workforce needs as long as it does not duplicate a baccalaureate degree program already offered by the CSU or the UC.

AB 661 (Block, 2011) authorized Grossmont-Cuyamaca and the San Mateo Community College districts to offer one baccalaureate degree pilot program per campus. AB 661 was heard and passed in the Assembly Higher Education Committee by a vote of 6-0 but was moved to the inactive file on the Assembly Floor.

AB 2400 (Block, 2010) authorized the San Diego, Grossmont-Cuyamaca and San Mateo Community College districts to establish baccalaureate degree pilot programs. No vote was taken and AB 2400 was held in the Assembly Higher Education Committee.

AB 2382 (Blumenfield), Chapter 425, Statutes of 2010, authorized the CSU to offer the D.P.T. degree, and specified that the D.P.T. degree programs at the CSU shall be focused on preparing physical therapists to provide health care services, and shall be consistent with meeting the requirements of the Commission on Accreditation in Physical Therapy Education.

SB 724 (Scott), Chapter 269, Statutes of 2005, authorized the CSU to independently award the Ed.D degree focused solely on preparing administrative leaders for California public K-14 schools.

REGISTERED SUPPORT / OPPOSITION:

Support

Academic Senate for California Community Colleges

Adventist Health White Memorial

Alameda Health System

Alianza

American Federation of State, County and Municipal Employees

American Federation of State, County and Municipal Employees, Afl-cio

American Federation of State, County, and Municipal Employees

American Nurses Association/california

Antelope Valley College

Antelope Valley Community College District

Asian American Pacific Islander Trustees and Administrators Caucus of The Community College League of California

Association of California Community College Administrators

Association of California Healthcare Districts

Bakersfield College

Board of Registered Nursing

Butte-glenn Community College District

Cabrillo Community College District

California Assisted Living Association

California Association for Health Services At Home

California Association of Health Facilities

California Association of Latino Community College Trustees and Administrators

California Community College Baccalaureate Association

California Community Colleges Chancellor's Office

California Community Colleges Chief Instructional Officers

California Hospital Association

California Kidney Care Alliance

California School Nurses Organization

California State Association of Counties (CSAC)

Cerritos College

Chabot Las Positas Community College District

Citrus College

City of Los Angeles

Coast Community College District

Community College League of California

Compton Community College District

Contra Costa Community College District

County Health Executives Association of California (CHEAC)

County of Los Angeles Board of Supervisors

Cpca Advocates

Deputy Sheriffs' Association of Monterey County

Desert Community College District

El Camino Community College District

Faculty Association of California Community Colleges

Faculty Association of California's Community Colleges

Foothill-de Anza Community College District

Fresno City College

Gavilan Joint Community College District

Glendale Community College District

Grossmont College

Grossmont-cuyamaca Community College District

Hartnell College

Health Net

Individual (8)

Kern Community College District

Lassen Community College District

Long Beach Community College Distict

Los Angeles Area Chamber of Commerce

Los Angeles Community College District

Los Angeles Pierce College

Los Angeles Regional Consortium

Los Angeles Unified School District

Los Angeles Valley College

Memorialcare, Orange Coast Medical Center

Merced Community College District

Miracosta Community College District

Monterey Peninsula Community College District

Moorpark College

Mt. San Antonio College

Mt. San Jacinto Community College District

North Orange County Community College District

Ohlone Community College District

Palo Verde Community College District

Palomar Community College District

Pasadena Area Community College District

Peralta Community College District

Placer County Deputy Sheriffs' Assocation

Providence

Rancho Santiago Community College District

Redwoods Community College District

Rio Hondo College

Riverside Community College District

Riverside Sheriffs' Association

Rural County Representatives of California (RCRC)

San Bernardino Community College District

San Diego Community College District

San Diego Unified School District

San Jose-evergreen Community College District

San Luis Obispo County Community College District / Cuesta College

San Mateo County Community College District

Santa Ana College

Santa Clarita Community College District - College of The Canyons

Santa Rosa Junior College

Sharp Healthcare

Sierra Community College District

Sierra Joint Community College District

Siskiyous Joint Community College District

South Orange County Community College District

Southwest California Legislative Council

Southwestern Community College District

Student Senate for California Community Colleges

Sutter Health

Telacu

Tri County Chamber Alliance

United Nurses Associations of California/union of Health Care Professionals

Urban Counties of California (UCC)

Ventura County Community College District

Victor Valley College

West Hills College Lemoore

West Hills Community College District

West Kern Community College District

West Valley-mission Community College District

Westhillscollege.com

Opposition

Academic Senate Executive Committee, California State University, Bakersfield

Academic Senate of The California State University

Association of Independent California Colleges & Universities (AICCU)

Azusa Pacific University

Bakersfield, California State University

Cal Poly Humboldt Nursing

California Association of Colleges of Nursing

California Baptist University

California Baptist University College of Nursing

California Faculty Association

California Polytechnic State University, San Luis Obispo

California State Polytechnic University, Humboldt

California State Polytechnic University, Pomona

California State University Alumni Council

California State University Long Beach

California State University, Los Angeles

California State University, Office of The Chancellor

Channel Islands, California State University

Chico, California State University

Concordia University Irvine

Csu Dominguez Hills

Csulb School of Nursing

Dominguez Hills, California State University

Dominican University of California

East Bay, California State University

Fresno, California State University

Fullerton, California State University

Individual (9)

Long Beach, California State University

Monterey Bay, California State University

Northridge, California State University

Sacramento, California State University

San Bernardino, California State University

San Diego State University

San Francisco State University

San José State University

San Marcos, California State University

School of Nursing, Sacramento State University

Sonoma State University

Stanislaus, California State University

University of San Francisco School of Nursing and Health Professions

Analysis Prepared by: Kevin J. Powers / HIGHER ED. / (916) 319-3960

 THIRD READING  

Bill No: SB 895

Author: Roth (D) and Caballero (D), et al.

Amended: 5/16/24

Vote: 21

SENATE EDUCATION COMMITTEE: 7-0, 4/24/24

AYES: Newman, Ochoa Bogh, Cortese, Glazer, Gonzalez, Smallwood-Cuevas, Wilk

SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/16/24

AYES: Caballero, Jones, Ashby, Becker, Bradford, Seyarto, Wahab

SUBJECT: Community colleges: Baccalaureate Degree in Nursing Pilot Program

SOURCE: American Federation of State, County, and Municipal Employees Community College League of California

Los Angeles Community College District

United Nurses Associations of California

DIGEST:

This bill requires the California Community College (CCC) Chancellor’s Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 15 community college districts to offer a Bachelor of Science in Nursing degree.

ANALYSIS:

Existing law:

1. Differentiates the missions and functions of public and independent institutions of higher education. Under these provisions:
   1. The primary mission of the California State University (CSU) is to offer undergraduate and graduate instruction through the master’s degree in the liberal arts and sciences and professional education including teacher education. The CSU is authorized to establish two-year programs only when mutually agreed upon by the Trustees and the CCC Board of Governors. The CSU is also authorized to jointly award the doctoral degree with the University of California (UC) and with one or more independent institutions of higher education.
   2. The UC provides undergraduate and graduate instruction and has exclusive jurisdiction in public higher education over graduate instruction in the professions of law, medicine, dentistry and veterinary medicine. The UC is also the primary state-supported academic agency for research.
   3. The independent institutions of higher education requires undergraduate and graduate instruction and research in accordance with their respective missions.
   4. The mission and function of the CCC offers academic and vocational instruction at the lower division level, and the CCC authorizes to grant the Associate in Arts and the Associate in Science degrees. The community colleges also requires to offer learning supports to close learning gaps, English as a Second Language instruction, and adult noncredit instruction, and support services which help students succeed at the postsecondary level. (Education Code § 66010.4)
2. Authorizes the CCC Board of Governors, in consultation with the CSU and the UC, to establish baccalaureate degree programs that do not duplicate a baccalaureate degree program offered by the CSU or UC. Allows for the approval of 30 community college baccalaureate degree programs per academic year. Current law further requires the CCC Chancellor to consult with and seek feedback from the CSU Chancellor, the UC President and the President of the Association of Independent California Colleges and Universities on proposed baccalaureate degree programs, as specified, and establishes a mechanism for the assessment, consultation, and approval of programs where duplication is identified, as specified. (EC § 78040 et seq.)

This bill:

1. Requires the Chancellor’s Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a Bachelor of Science in Nursing Degree. It provides that the pilot program be limited to 15 community college districts statewide.
2. Requires that the Chancellor identify and select eligible community college districts based on the following criteria:
   1. The Chancellor’s Office is encouraged to ensure there is equitable access between the northern, central, and southern parts of the state to the pilot program.
   2. That priority be given to community college districts in underserved nursing areas.
   3. That the community college districts have a nationally accredited nursing program.
3. Provides that a community college district selected for the pilot program continue to offer an associate degree in nursing program.
4. Limits the total number of associate degree in nursing and bachelor of science in nursing students at a community college district to the community college district’s associate degree in nursing class size approved by the board of registered nursing, and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.
5. Allows a community college districts without a nationally accredited nursing program, but are in “candidate” status, be provisionally selected to participate in this pilot program, and commence the program upon final accreditation, as specified. This bill further requires the Chancellor’s Office to develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the pilot program, and that assistance be made available to community college districts upon request.
6. Requires each participating district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district.
7. Requires that the Legislative Analyst’s Office (LAO) conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified. This bill further requires each participating community college district to submit the information necessary for this evaluation, as determined by the LAO, to the Chancellor’s Office.
8. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill’s provision.
9. Sunsets this bill’s provision on January 1, 2031.
10. States various findings and declarations relative to this bill’s provisions.

Comments

1. Need for the bill. According to the author:

“For decades, California has suffered from a shortage of registered nurses, and this problem has been exacerbated in recent years due to the pandemic and it’s expected to worsen due to an increase in RN retirements. While the nursing shortage is a national problem, it is particularly acute here in our state,—ranking 40th out of 50 states. A key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. In 2018, more than 85% of hospitals in California reported that the demand for RN’s was greater than the available supply – a situation that has not improved. But there is a path forward to help solve this problem and that path cuts right through our California Community Colleges. Our SB 895 creates a pilot program allowing community colleges to offer a bachelor’s degree in nursing, which is increasingly the industry standard, and a requirement for employment in our hospitals.”

The author further asserts that the goal of this bill is to utilize existing associate degree in nursing program capacity to produce more Bachelor of Science in Nursing degrees. The reason why producing more Bachelor of Science in Nursing degrees is important is because the industry standard in healthcare is changing. Specifically in hospitals and in direct care settings, a Bachelor of Science in Nursing degree is increasingly becoming a requirement for employment. The author argues that CSUs and UCs face challenges in building out additional capacity to produce more nurses with a Bachelor of Science in Nursing, as such it is critical to use the existing community college nursing program structure to assist with meeting these workforce standards.

1. Pushes CCCs from their original mission. The state has four segments of higher education: three public and one private. Each plays a vital and unique role for the state. Their mission statements are outlined in the Master Plan for Higher Education and by state statute. The CCCs are to have an open admission policy and bear the most extensive responsibility for lower-division undergraduate instruction. Its primary areas of mission include instruction leading to associate degrees and university transfer, vocational instruction, and remedial education. Despite the differentiation of mission, the Legislature has authorized the CSU and CCCs to go beyond their original mission to offer doctoral degree and baccalaureate degree programs, respectively, so long as programs do not duplicate those offered by the other segments with primary jurisdiction. Further expansion of CCC baccalaureate degrees as proposed in this bill would signal the legislature’s willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process.
2. Is this the appropriate solution? If it is the desire of the legislature to expand Bachelor of Science in Nursing (BSN) degree programs, arguably more effective and efficient alternatives do not require a departure from the CCC’s mission to expand and streamline BSN pathways. In its recommendation for alternatives to the original baccalaureate degree pilot program, the LAO’s analysis notes that some CCCs have agreements with baccalaureate degree-granting institutions. Improving alignment between CCC and the universities could increase the number of CCC students who ultimately obtain a bachelor’s degree and reduce the amount of time students take to obtain their degree. For example, the Tri-County Nursing Pathway is a partnership between Riverside City College and two CSU campuses (Fullerton and San Bernardino) that allows associate degree nursing students to concurrently obtain their bachelor’s degrees. Students can enroll in CSU courses while still completing their associate degree requirements, allowing them to obtain their bachelor’s degree with only six additional months of coursework. The LAO report further asserts that such partnerships could not only be more cost-effective but also benefit more students (including place-bound students), thereby having a more widespread impact.
3. State investment in CCC associate degree in nursing programs. Of California’s three public higher education segments, only the community colleges offer associate degrees in nursing. According to the CCC Chancellor’s Office 2020-2022 legislative report on Community Colleges Nursing Educational Programs, associate degrees in nursing programs account for 55.4% of programs in the state. Numerous legislative efforts and investments have been made to expand community college associate degree in nursing enrollments and improve retention to facilitate the expansion of associate degree in nursing programs. The Budget Act of 2015 provided additional nursing program support to expand community college nursing enrollments and improve student retention in associate degree nursing programs. Since 2009-10, the Legislature has provided ongoing funding ($13.4 million) through grants to CCC associate degree in nursing programs in recognition of the relatively high cost of educating nurses. The Department of Health Care Access and Information, which administers a state program to help, among other things, increase support for nursing education programs, awarded a total of $17 million to 34 nursing programs in 2023, including 17 community college associate degree in nursing programs. These investments demonstrate the state’s willingness to invest in associate degrees and demonstrate a recognition of their value to the state.
4. Tuition costs? Current law allows CCCs to raise tuition for the other CCC baccalaureate degree programs to the same amount as a CSU. This bill, however, makes it clear that those provisions are not applicable to the proposed pilot program but is silent on tuition costs. Tuition fees for CCC courses are currently $46 per credit. Without statutory authorization, it is uncertain if CCC districts can charge higher rates for the more advance degree. If this measure moves forward, the author may wish to clarify the parameters related to program funding and tuition costs.

1. Not all community college nursing programs are nationally accredited. According to the community college chancellor’s office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN) and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have Board of Registered Nursing (BRN) approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs. This bill allows non-nationally accredited community college programs to be provisionally selected as they work toward obtaining accreditation.
2. Nursing programs in California. Graduates of associate and bachelor nursing degree programs may sit for nurse licensure exams and become licensed registered nurses. The state’s BRN approves all of California’s pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 bachelor of science in nursing, and 13 Entry Level Master’s (ELM) programs. According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18 percent increase in student completions since 2012. Associate’s degree completions decreased while bachelor’s degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor’s programs has increased over the last 10 years. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500. www.rn.ca.gov/forms/rnsurvey201718.shtml
3. Enrollment decisions controlled by BRN. The author argues that a key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. As noted in the above comment, the BRN is one of a few licensing boards that continues to actively approve educational programs and make enrollment decisions. According to a recent state audit of the BRN, two of the key factors that should be included in the BRN’s enrollment decisions are the forecasted supply of nurses that the state will need to fulfill demand and the available number of clinical placement slots. The audit found that the BRN has failed to gather and use sufficient data related to both of these factors to appropriately inform its enrollment decisions.
4. Nursing shortage projected to close within a few years. According to a 2022 University of California, San Francisco (UCSF) study, “Forecasts of the Registered Nurse Workforce in California,” data shows consistent employment rates for RNs since 2018, but decreasing rates for older RNs. It further warns that a greater number of RNs plan to retire or quit within two years compared to 2018. The pandemic also had an impact on retention rates. RN education programs experienced fewer enrollments and graduates during the 2018-2019 academic year. Combined, these changes have reduced the supply of RNs relative to previous forecasts. However, circumstances are improving. RN education enrollments are expected to surpass pre-pandemic levels starting with the 2021-22 academic year. It is projected that the supply of new RNs will match demand by 2029, thereby filling unfilled positions. According to UCSF’s updated 2024 forecast (unpublished), there is a statewide supply-demand gap of 17,000 full-time equivalent nurses, which is projected to close within four years (2028), one year earlier than the 2022 report indicated. Notably, retention of new and experienced nurses is key. www.rn.ca.gov/pdfs/forms/forecast2022.pdf
5. Duplication indicates that California needs better higher education coordination. All of California’s public education institutions share a commitment to work together to ensure that parts of the system work for all Californians. Since the defunding of the California Postsecondary Education Commission (CPEC) in 2011, California has not had a statewide coordinating entity for higher education. The absence of a higher education coordinating entity has hindered the state’s ability to review degree programs to align with state and workforce needs. In its place, changes to higher education’s blueprint are being made one legislative proposal at a time in a piecemeal way, which could result in an uncoordinated and fragmented system. Although this bill is limited to one community college baccalaureate degree program, it establishes a precedent for permitting duplication of degree programs and expands CCC’s ability to establish baccalaureate degrees independent from California’s other public universities.

FISCAL EFFECT: Appropriation: No Fiscal Com.: Yes Local: No

According to the Senate Appropriation Committee:

While there could be one-time Proposition 98 General Fund costs for each pilot district to create and implement a Bachelor of Science of Nursing degree program, the Chancellor’s Office indicates that these initial start-up costs could be absorbable within existing resources. The costs would encompass any updates to the design of new nursing academic standards, student learning outcomes, updates to existing curriculum that would be needed to satisfy the program, and implementation of other coursework. The Chancellor’s Office believes these costs are consistent with recent state budget actions to implement new academic programs and curriculum. The Chancellor’s office estimates one-time General Fund workload costs of between $33,000 and $53,000 to develop the application for the pilot program, issue guidance, and provide technical assistance.

SUPPORT: (Verified 5/15/24)

American Federation of State, County, and Municipal Employees (co-source)

Community College League of California (co-source)

Los Angeles Community College District (co-source)

United Nurses Associations of California (co-source)

Adventist Health White Memorial

Alameda Health System

Antelope Valley Community College District

Asian American Pacific Islander Trustees and Administrators Caucus of the Community College League of California

Association of California Community College Administrators

Association of California Healthcare Districts

Bakersfield College

Butte-Glenn Community College District

Cabrillo Community College District

California Assisted Living Association

California Association for Health Services at Home

California Association of Health Facilities

California Association of Latino Community College Trustees and Administrators

California Community College Baccalaureate Association

California Community Colleges

California Community Colleges Chief Instructional Officers

California Hospital Association

Cerritos Community College District

Chabot-Las Positas Community College District

Citrus College

Coast Community College District

Compton Community College District

Contra Costa Community College District

County Health Executives Association of California

County of Los Angeles Board of Supervisors

CPCA Advocates

Desert Community College District

El Camino Community College District

Faculty Association of California Community Colleges

Foothill-De Anza Community College District

Gavilan Joint Community College District

Glendale Community College

Grossmont College

Grossmont-Cuyamaca Community College District

Health Net

Kern Community College District

Lassen Community College District

Long Beach City College

Los Angeles Area Chamber of Commerce

Los Angeles Pierce College

Los Angeles Unified School District

Los Angeles Valley College

MiraCosta Community College District

Monterey Peninsula Community College District

Moorpark College

Mt. San Antonio College

Mt. San Jacinto Community College

North Orange County Community College District

Palo Verde Community College District

Palomar Community College District

Pasadena City College

Peralta Community College District

Providence

Rancho Santiago Community College District

Redwoods Community College District

Rio Hondo College

Riverside Community College District

San Diego Community College District

San Diego Unified School District

San Jose-Evergreen Community College District

San Luis Obispo County Community College District / Cuesta College

Santa Clarita Community College District - College of the Canyons

Sharp HealthCare

Sierra Joint Community College District

Siskiyous Joint Community College District

Sonoma County Junior College District

South Orange County Community College District

Southwestern Community College District

Student Senate for California Community Colleges

Sutter Health

TELACU

Ventura County Community College District

Victor Valley College

West Hills College Lemoore

West Hills Community College District

West Kern Community College District

West Valley-mission Community College District

OPPOSITION: (Verified 5/15/24)

Academic Senate of the California State University

Association of Independent California Colleges and Universities

Azusa Pacific University

California Association of Colleges of Nursing

California Baptist University

California Faculty Association

California Polytechnic State University, San Luis Obispo

California State Polytechnic University, Pomona

California State University, Bakersfield

California State University, Chico

California State University, East Bay

California State University, Fresno

California State University, Fullerton

California State University, Long Beach

California State University, Los Angeles

California State University, Monterey Bay

California State University, Northridge

California State University, Office of the Chancellor

California State University, San Bernardino

California State University, San Marcos

Concordia University Irvine

Dominican University of California

San Diego State University

San Francisco State University

San José State University

Sonoma State University

University of San Francisco School of Nursing and Health Professions

ARGUMENTS IN SUPPORT: Community College League (co-sponsors) states: “SB 895 does not intend to create competition between public nursing schools. Currently, when students are not admitted into a public nursing program, they turn to for-profit and private institutions. While this may be a good option for many students, it is an unnecessarily expensive option when the local community college could offer the program at a lower cost. Many capable students are also priced out of the option to attend a private university or are forced to incur tremendous amounts of debt. Those are the students this bill intends to help—students who may otherwise not seek baccalaureate degrees, including working adults, economically disadvantaged students, people of color, and place-bound students. The Community College League further asserts, “California’s nursing shortage cannot be solved by one singular approach but rather requires a collaborative, multi-program solution. SB 895 seeks to address the nursing shortage through California’s community colleges, which have already shown to be successful through ADN-BSN partnerships. As a 6-year pilot program, SB 895 would authorize 15 community college districts with existing ADN infrastructure to begin offering baccalaureate degrees in nursing. Several ADN programs are already well-positioned to take on this next step, and community college leaders across the state are eager and ready to serve their students by educating and training the next generation of nurses.”

ARGUMENTS IN OPPOSITION: The California Association of Colleges of Nursing argues, in part, in their opposition letter, that SB 895 “will not add a single additional nurse to the state workforce beyond the number that would exist under current law. Community colleges lack the infrastructure needed to administer baccalaureate nursing degree programs in accordance with evolving nursing accreditation standards. In fact, we are concerned that the bill will exacerbate existing challenges in hiring nursing faculty, since community college programs will likely need to seek out more faculty, to teach the additional courses required as part of baccalaureate degree programs. CACN additionally stresses that, “while we absolutely concur with the author and proponents on the need to craft policies that increase the number of nurses in the state, we respectfully disagree that this approach will address any of the underlying constraints to that pipeline. CACN believes that we can increase the number of nursing students in our state faster by partnering with our community colleges and not duplicating efforts and competing for limited resources, including clinical placements and qualified faculty.”

Prepared by: Olgalilia Ramirez / ED. / (916) 651-4105

5/20/24 18:52:10

**** END ****

SENATE COMMITTEE ON

Senator Anna Caballero, Chair

2023 - 2024 Regular Session

SB 895 (Roth) - Community colleges: Baccalaureate Degree in Nursing Pilot Program

Bill Summary:

This bill requires the California Community College (CCC) Chancellor’s Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 15 community college districts to offer a Bachelor of Science in nursing degree.

*********** ANALYSIS ADDENDUM – SUSPENSE FILE ***********

The following information is revised to reflect amendments

adopted by the committee on May 16, 2024

Fiscal Impact:

• While there could be one-time Proposition 98 General Fund costs for each pilot district to create and implement a Bachelor of Science of Nursing degree program, the Chancellor’s Office indicates that these initial start-up costs could be absorbable within existing resources. The costs would encompass any updates to the design of new nursing academic standards, student learning outcomes, updates to existing curriculum that would be needed to satisfy the program, and implementation of other coursework. The Chancellor’s Office believes these costs are consistent with recent state budget actions to implement new academic programs and curriculum.
• The Chancellor’s office estimates one-time General Fund workload costs of between $33,000 and $53,000 to develop the application for the pilot program, issue guidance, and provide technical assistance.

Author Amendments:

Make clarifying changes for the Chancellor’s Office to select eligible community college districts for the pilot program and add coauthors.

-- END --

SENATE COMMITTEE ON APPROPRIATIONS

Senator Anna Caballero, Chair

2023 - 2024 Regular Session

SB 895 (Roth) - Community colleges: Baccalaureate Degree in Nursing Pilot Program

Bill Summary:

This bill requires the California Community College (CCC) Chancellor’s Office to establish a Community College Baccalaureate Degree in Nursing Pilot Program that would authorize 15 community college districts to offer a Bachelor of Science in nursing degree.

Fiscal Impact:

• While the Chancellor’s Office indicates that there could be one-time Proposition 98 General Fund costs for each pilot district to create and implement a Bachelor of Science of Nursing degree program, these initial start-up costs could be absorbable within existing resources. The costs would encompass any updates to the design of new nursing academic standards, student learning outcomes, updates to existing curriculum that would be needed to satisfy the program, and implementation of other coursework. The Chancellor’s Office believes these costs are consistent with recent state budget actions to implement new academic programs and curriculum.
• The Chancellor’s office estimates one-time General Fund workload costs of between $33,000 and $53,000 to develop the application for the pilot program, issue guidance, and provide technical assistance.

Background:

Under existing law, the primary mission of the California State University (CSU) is to offer undergraduate and graduate instruction through the master’s degree in the liberal arts and sciences and professional education including teacher education. The CSU is authorized to establish two-year programs only when mutually agreed upon by the Trustees and the CCC Board of Governors. The CSU is also authorized to jointly award the doctoral degree with the University of California (UC) and with one or more independent institutions of higher education.

The UC is authorized to provide undergraduate and graduate instruction and has exclusive jurisdiction in public higher education over graduate instruction in the professions of law, medicine, dentistry and veterinary medicine. The UC is also the primary state-supported academic agency for research.

Under existing law, the mission and function of the CCC is the offering of academic and vocational instruction at the lower division level, and the CCC are authorized to grant the Associate in Arts and the Associate in Science degrees. The community colleges are also required to offer learning supports to close learning gaps, English as a Second Language instruction, and adult noncredit instruction, and support services which help students succeed at the postsecondary level.

Proposed Law:

This bill requires the Chancellor’s Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a Bachelor of Science in Nursing Degree. It provides that the pilot program be limited to 15 community college districts statewide.

This bill requires that the Chancellor identify eligible community college districts based on the following criteria:

1. The Chancellor’s Office is encouraged to ensure there is equitable access between the northern, central, and southern parts of the state to the pilot program.
2. Priority shall be given to community college districts in underserved nursing areas.
3. The community college districts shall have a nationally accredited nursing program.

This bill provides that a community college district selected for the pilot program shall continue to offer an associate degree in nursing program.

This bill limits the total number of associate degree in nursing and bachelor of science in nursing students at a community college district to the community college district’s associate degree in nursing class size approved by the board of registered nursing, and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.

This bill provides that community college districts without a nationally accredited nursing program, but are in “candidate” status, may be provisionally selected to participate in this pilot program, and may commence the program upon final accreditation, as specified. The Chancellor’s Office shall develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the pilot program, and that assistance shall be made available to community college districts upon request. This bill also requires each participating district to give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district.

This bill requires that the LAO conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program, as specified. Each participating community college district shall submit the information necessary for this evaluation, as determined by the LAO, to the Chancellor’s Office.

The bill’s provisions would sunset on January 1, 2034.

Related Legislation:

AB 2104 (Soria, 2024) would require the CCC Chancellor’s office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. AB 2104 has been referred to the Assembly Committee on Higher Education.

Staff Comments:

The Chancellor’s Office indicates there could be one-time Proposition 98 General Fund costs for each pilot district to create and implement a Bachelor of Science of Nursing degree program. The costs would encompass any updates to the design of new nursing academic standards, student learning outcomes, any updates to existing curriculum that would be needed to satisfy the program, and implement other coursework. However, the Chancellor’s Office indicates that these costs are consistent with recent state budget actions to implement new academic programs and curriculum and could be absorbable. For example, the 2021 State Budget included $5.6 million for the California Community Colleges to implement the California State University ethnic studies graduation requirement and 115 colleges received an allocation of approximately $48,000.

The Chancellor’s Office also indicates that the bill’s costs could be lower if the pilot districts can develop a shared BSN curriculum that is consistent with the Bureau of Registered Nursing (BSN) standards. Additionally, because class sizes are limited and based on existing Associate Degree for Nursing (ADN) enrollment, the pilot colleges will not need to hire new faculty for this program and can instead redirect existing nursing faculty to teach the required curriculum (75 percent of nursing students will be enrolled in the ADN program, and 25 percent of nursing students will be enrolled in the BSN).

-- END --

SENATE COMMITTEE ON EDUCATION

Senator Josh Newman, Chair

2023 - 2024 Regular

Bill No: SB 895 Hearing Date: April 24, 2024

Subject: Community colleges: Baccalaureate Degree in Nursing Pilot Program.

SUMMARY

This bill requires the California Community College (CCC) Chancellor’s Office to establish, until January 1, 2031, a Community College Baccalaureate Degree in Nursing Pilot Program for purposes of authorizing 15 community college districts with nationally accredited nursing programs selected by the CCC Chancellor’s office to offer a Bachelor of Science in nursing degree. The bill further requires the Legislative Analyst’s Office to conduct and submit to the legislature an evaluation of the pilot program, as specified.

BACKGROUND

Existing law:

1. Differentiates the missions and functions of public and independent institutions of higher education. Under these provisions:
   1. The primary mission of the California State University (CSU) is to offer undergraduate and graduate instruction through the master’s degree in the liberal arts and sciences and professional education including teacher education. The CSU is authorized to establish two-year programs only when mutually agreed upon by the Trustees and the CCC Board of Governors. The CSU is also authorized to jointly award the doctoral degree with the University of California (UC) and with one or more independent institutions of higher education.
   2. The UC is authorized to provide undergraduate and graduate instruction and has exclusive jurisdiction in public higher education over graduate instruction in the professions of law, medicine, dentistry and veterinary medicine. The UC is also the primary state-supported academic agency for research.
   3. The independent institutions of higher education are required to provide undergraduate and graduate instruction and research in accordance with their respective missions.
   4. The mission and function of the CCC is the offering of academic and vocational instruction at the lower division level, and the CCC are authorized to grant the Associate in Arts and the Associate in Science degrees. The community colleges are also required to offer learning supports to close learning gaps, English as a Second Language instruction, and adult noncredit instruction, and support services which help students succeed at the postsecondary level. (Education Code § 66010.4)
2. Authorizes the CCC Board of Governors, in consultation with the CSU and the UC, to establish baccalaureate degree programs that do not duplicate a baccalaureate degree program offered by the CSU or UC. Allows for the approval of 30 community college baccalaureate degree programs per academic year. Current law further requires the CCC Chancellor to consult with and seek feedback from the CSU Chancellor, the UC President and the President of the Association of Independent California Colleges and Universities on proposed baccalaureate degree programs, as specified, and establishes a mechanism for the assessment, consultation, and approval of programs where duplication is identified, as specified. (EC § 78040 et seq.)

ANALYSIS

This bill:

1. Requires the CCC Chancellor’s Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a Bachelor of Science in Nursing Degree.
2. Provides that the pilot program be limited to 15 community college districts statewide.
3. Requires that the Chancellor identify eligible community college districts that apply based on the following criteria:
   1. There is equitable access between the northern, central, and southern

parts of the state to the pilot program.

• 1. Priority is given to community college districts in underserved nursing

areas.

• 1. The community college district has a nationally accredited nursing

program.

1. Limits the total number of associate degree in nursing and bachelor of science in nursing students at a community college district to the community college district’s associate degree in nursing class size approved by the board of registered nursing, and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.
2. Requires that the LAO conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program.
3. Requires that the evaluation be submitted to the legislature as specified.
4. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill’s provision.
5. Sunsets the bill’s provision on January 1, 2031.
6. States various findings and declarations relative to the bill’s provisions.

STAFF COMMENTS

1. Need for the bill. According to the author, “For decades, California has suffered from a shortage of registered nurses, and this problem has been exacerbated in recent years due to the pandemic and it’s expected to worsen due to an increase in RN retirements. While the nursing shortage is a national problem, it is particularly acute here in our state,—ranking 40th out of 50 states. A key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. In 2018, more than 85% of hospitals in California reported that the demand for RN’s was greater than the available supply – a situation that has not improved. But there is a path forward to help solve this problem and that path cuts right through our California Community Colleges. Our SB 895 creates a pilot program allowing community colleges to offer a bachelor’s degree in nursing, which is increasingly the industry standard, and a requirement for employment in our hospitals.”

The author further asserts that the goal of the bill is to utilize existing associate degree in nursing program capacity to produce more Bachelor of Science in Nursing degrees. The reason why producing more Bachelor of Science in Nursing degrees is important is because the industry standard in healthcare is changing. Specifically in hospitals and in direct care settings, a Bachelor of Science in nursing degree is increasingly becoming a requirement for employment. The author argues that CSUs and UCs face challenges in building out additional capacity to produce more nurses with a Bachelor of Science in Nursing, as such it is critical to use the existing community college nursing program structure to assist with meeting these workforce standards.

1. Pushes CCCs from their original mission. The state has four segments of higher education: three public and one private. Each plays a vital and unique role for the state. Their mission statements are outlined in the Master Plan for Higher Education and by state statute. The CCCs are to have an open admission policy and bear the most extensive responsibility for lower-division undergraduate instruction. Its primary areas of mission include instruction leading to associate degrees and university transfer, vocational instruction, and remedial education. Despite the differentiation of mission, the Legislature has authorized the CSU and CCCs to go beyond their original mission to offer doctoral degree and baccalaureate degree programs, respectively, so long as programs do not duplicate those offered by the other segments with primary jurisdiction. Further expansion of CCC baccalaureate degrees as proposed in this bill would signal the legislature’s willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process.
2. Is this the appropriate solution? If it is the desire of the legislature to expand Bachelor of Science in Nursing (BSN) degree programs, arguably more effective and efficient alternatives do not require a departure from the CCC’s mission to expand and streamline BSN pathways. In its recommendation for alternatives to the original baccalaureate degree pilot program, the LAO’s analysis notes that some CCCs have agreements with baccalaureate degree-granting institutions. Improving alignment between CCC and the universities could increase the number of CCC students who ultimately obtain a bachelor’s degree and reduce the amount of time students take to obtain their degree. For example, the Tri-County Nursing Pathway is a partnership between Riverside City College and two CSU campuses (Fullerton and San Bernardino) that allows associate degree nursing students to concurrently obtain their bachelor’s degrees. Students can enroll in CSU courses while still completing their associate degree requirements, allowing them to obtain their bachelor’s degree with only six additional months of coursework. The LAO report further asserts that such partnerships could not only be more cost-effective but also benefit more students (including place-bound students), thereby having a more widespread impact. The committee may wish to consider all of the following:

• Could this bill undermine any incentives for similar collaborations across the public higher education segments to address regional workforce needs like nursing?
• Can the process for developing collaborative efforts to address workforce needs be modified to facilitate greater proliferation of these programs?
• Should a community college be required to demonstrate that existing avenues for partnership with other institutions are not possible or viable before seeking authorization to offer an independent baccalaureate degree?
• Should additional support be provided to the other segments with primary jurisdiction for granting baccalaureate degrees to increase the number of degree slots available in high-demand areas?

1. State investment in CCC associate degree in nursing programs. Of California’s three public higher education segments, only the community colleges offer associate degrees in nursing. According to the CCC Chancellor’s Office 2020-2022 legislative report on Community Colleges Nursing Educational Programs, associate degrees in nursing programs account for 55.4% of programs in the state. Numerous legislative efforts and investments have been made to expand community college associate degree in nursing enrollments and improve retention to facilitate the expansion of associate degree in nursing programs. The Budget Act of 2015 provided additional nursing program support to expand community college nursing enrollments and improve student retention in associate degree nursing programs. Since 2009-10, the Legislature has provided ongoing funding ($13.4 million) through grants to CCC associate degree in nursing programs in recognition of the relatively high cost of educating nurses. The Department of Health Care Access and Information, which administers a state program to help, among other things, increase support for nursing education programs, awarded a total of $17 million to 34 nursing programs in 2023, including 17 community college associate degree in nursing programs. These investments demonstrate the state’s willingness to invest in associate degrees and demonstrate a recognition of their value to the state.
2. Tuition costs. Current law allows CCCs to raise tuition for the other CCC baccalaureate degree programs to the same amount as a CSU. This bill, however, makes it clear that those provisions are not applicable to the proposed pilot program but is silent on tuition costs. Tuition fees for CCC courses are currently $46 per credit. Without statutory authorization, it is uncertain if CCC districts can charge higher rates for the more advance degree. If this measure moves forward, the author may wish to clarify the parameters related to program funding and tuition costs.

1. Not all community college nursing programs are nationally accredited. According to the community college chancellor’s office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN) and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have Board of Registered Nursing (BRN) approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs.
2. Nursing programs in California. Graduates of associate and bachelor nursing degree programs may sit for nurse licensure exams and become licensed registered nurses. The state’s BRN approves all of California’s pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 bachelor of science in nursing, and 13 Entry Level Master’s (ELM) programs. According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18 percent increase in student completions since 2012. Associate’s degree completions decreased while bachelor’s degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor’s programs has increased over the last 10 years. The time it takes a student to graduate from a program varies by degree. An associate degree in nursing prepares students for registered nursing care in a variety of settings in two-three years, whereas a bachelor’s degree takes about four years to train students for registered nursing care as well as administrative and leadership positions. An ELM is a one- to two-year program for baccalaureate degree holders in other fields seeking to become registered nurses. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500. www.rn.ca.gov/forms/rnsurvey201718.shtml
3. Enrollment decisions controlled by BRN. The author argues that a key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. As noted in the above comment, the BRN is one of a few licensing boards that continues to actively approve educational programs and make enrollment decisions. According to a recent state audit of the BRN, two of the key factors that should be included in the BRN’s enrollment decisions are the forecasted supply of nurses that the state will need to fulfill demand and the available number of clinical placement slots. The audit found that the BRN has failed to gather and use sufficient data related to both of these factors to appropriately inform its enrollment decisions. Should the BRN continue to approve RN educational programs? Shouldn’t institutions play a greater role in determining enrollment decisions?
4. Nursing shortage projected to close within a few years. According to a 2022 University of California, San Francisco (UCSF) study, “Forecasts of the Registered Nurse Workforce in California,” data shows consistent employment rates for RNs since 2018, but decreasing rates for older RNs. It further warns that a greater number of RNs plan to retire or quit within two years compared to 2018. The pandemic also had an impact on retention rates. RN education programs experienced fewer enrollments and graduates during the 2018-2019 academic year. Combined, these changes have reduced the supply of RNs relative to previous forecasts. However, circumstances are improving. RN education enrollments are expected to surpass pre-pandemic levels starting with the 2021-22 academic year. It is projected that the supply of new RNs will match demand by 2029, thereby filling unfilled positions. According to UCSF’s updated 2024 forecast (unpublished), there is a statewide supply-demand gap of 17,000 full-time equivalent nurses, which is projected to close within four years (2028), one year earlier than the 2022 report indicated. Notably, retention of new and experienced nurses is key. Below is a graph from the UCSF 2022 forecast report. www.rn.ca.gov/pdfs/forms/forecast2022.pdf

1. Duplication indicates that California needs better higher education coordination. All of California’s public education institutions share a commitment to work together to ensure that parts of the system work for all Californians. Since the defunding of the California Postsecondary Education Commission (CPEC) in 2011, California has not had a statewide coordinating entity for higher education. Prior to its demise, the role of the CPEC included academic program review to coordinate the long-range planning of the state’s public higher education systems as a means to ensure that the segments were working together to carry out their individual missions while serving the state’s long-range workforce and economic needs. The absence of a higher education coordinating entity has hindered the state’s ability to review degree programs to align with state and workforce needs. In its place, changes to higher education’s blueprint are being made one legislative proposal at a time in a piecemeal way, which could result in an uncoordinated and fragmented system. Although this bill is limited to one community college baccalaureate degree program, it establishes a precedent for permitting duplication of degree programs and expands CCC’s ability to establish baccalaureate degrees independent from California’s other public universities. The committee may wish to consider all of the following:

• What relationship is there among the different missions of California’s higher education segments and their differential ways in which they offer education?
• Is it appropriate to rely solely on the legislative process to implement significant programmatic changes to higher education without any coordination or long-range plan to guide the conversation? Does the legislative process allow for consideration of priority relative to other demands in higher education?
• How should the legislature leverage the strength of each segment to address regional or statewide workforce needs? What is the expectation for collaboration among the segments?
• The delineation of missions serves as a guide for how and where to allocate state resources. If there is a lack of clarity about institutional missions, what will guide the future of higher education?

1. Arguments in support. According to the letter of support submitted to the committee from the Community College League, co-sponsors of the bill, it states in part, “SB 895 does not intend to create competition between public nursing schools. Currently, when students are not admitted into a public nursing program, they turn to for-profit and private institutions. While this may be a good option for many students, it is an unnecessarily expensive option when the local community college could offer the program at a lower cost. Many capable students are also priced out of the option to attend a private university or are forced to incur tremendous amounts of debt. Those are the students this bill intends to help—students who may otherwise not seek baccalaureate degrees, including working adults, economically disadvantaged students, people of color, and place-bound students. The Community College League further asserts, “California’s nursing shortage cannot be solved by one singular approach but rather requires a collaborative, multi-program solution. SB 895 seeks to address the nursing shortage through California’s community colleges, which have already shown to be successful through ADN-BSN partnerships. As a 6-year pilot program, SB 895 would authorize 15 community college districts with existing ADN infrastructure to begin offering baccalaureate degrees in nursing. Several ADN programs are already well-positioned to take on this next step, and community college leaders across the state are eager and ready to serve their students by educating and training the next generation of nurses.”
2. Arguments in opposition. The California Association of Colleges of Nursing argues, in part, in their opposition letter, that SB 895 “will not add a single additional nurse to the state workforce beyond the number that would exist under current law. Community colleges lack the infrastructure needed to administer baccalaureate nursing degree programs in accordance with evolving nursing accreditation standards. In fact, we are concerned that the bill will exacerbate existing challenges in hiring nursing faculty, since community college programs will likely need to seek out more faculty, to teach the additional courses required as part of baccalaureate degree programs. CACN additionally stresses that, “while we absolutely concur with the author and proponents on the need to craft policies that increase the number of nurses in the state, we respectfully disagree that this approach will address any of the underlying constraints to that pipeline. CACN believes that we can increase the number of nursing students in our state faster by partnering with our community colleges and not duplicating efforts and competing for limited resources, including clinical placements and qualified faculty.”
3. Amendments.

The author wishes, and committee staff agrees, that the bill be amended as follows:

Legislative findings and declarations

• Modify the legislative findings and declarations to better reflect the intent of the bill.

Equitable access across the state

• Clarifies that the Community College Chancellor’s Office is encouraged to ensure equitable access between the northern, central, and southern parts of the state to the pilot program.

Provisional approval for unaccredited programs

• Allow community college districts without a nationally accredited nursing program, which are in “Candidate” status, to be provisionally selected to participate in this pilot program, and may commence the program upon final accreditation. With regard to this provision, require that priority be given to community college districts located in the Central Valley. If a district that is provisionally selected is found to be making untimely progress toward accreditation, after notice and opportunity to cure, allow the Chancellor of the California Community Colleges to withdraw the provisional selection and select a different community college district to participate in the pilot program.
• Require the California Community College Chancellor’s Office to develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the Baccalaureate Degree in Nursing pilot program, such assistance shall be made available to community college districts upon request.

Extend the sunset date and set the report submission deadline

• Set July 1, 2032, as the LAO report submission deadline.
• Extend the pilot program to January 1, 2034.

Committee staff recommends, and the author agrees, that the bill be further amended as follows:

Continue associate degree programs

• Require districts selected for the pilot program to continue offering an associate degree in nursing program.
• Require that each participating community college district give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district.

Define underserved nursing area

• Define underserved nursing area to mean registered nurse shortage areas designated at a high, medium, or low severity level as identified by the California Department of Health Care Access and Information.

Information included in the LAO report

• Require that LAO report include, but not be limited to, all of the following:
  • How many, and which specific, districts applied for a BSN pilot program.
  • The number of BSN pilot programs implemented, including information identifying the number of enrollments and degree recipients.
  • Which of the selected districts developed a BSN pilot program in an underserved nursing area.
  • Which districts were selected and why they were selected.
  • BSN degree pilot program costs and the funding sources that were used to finance these programs.
  • The cost charged to students including tuition and any additional fees.
  • The extent to which instruction was provided in-person or online.
  • Current completion rates, if available, for each cohort of students participating in the BSN degree pilot program.
  • Time-to-degree rates and completion rates for the BSN pilot programs.
  • The extent to which the BSN pilot programs established by the bill’s provisions are in compliance with the requirements with the bill’s provisions.
  • Other factors to consider when expanding BSN opportunities across the state.
  • Recommendations on whether and how the authorization establishing the pilot program should be extended.

Submit information to LAO

• Require that districts submit the information necessary to conduct the evaluations required in the bill, as determined by the Legislative Analyst’s Office, to the Chancellor of the California Community Colleges, who shall provide the information to the Legislative Analyst’s Office upon request.

1. Related and prior legislation.

AB 2104 (Soria, 2024) would require the CCC Chancellor’s office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. AB 2104 has been referred to the Assembly Committee on Higher Education.

SB 1183 (Hurtado, 2024) would add living in a medically underserved area or population as a factor for consideration in the multicriteria screening tool used for admission into an impacted registered nursing program at a CCC. It also extends the sunset date by five years. SB 1183 was approved by this committee on April 3.

AB 1311 (Soria, Chapter 126, Statutes of 2023) required the 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 1695 (Gipson, 2023) would establish the Nursing Pathway Pilot program in high schools to create pathways toward associate degrees in nursing at CCC. AB 1695 was heard and approved by this committee on June 28, 2023 and held on the Senate floor.

SUPPORT

American Federation of State, County, and Municipal Employees (co-sponsor)
Community College League of California (co-sponsor)
Los Angeles Community College District (co-sponsor)
United Nurses Associations of California (co-sponsor)
Adventist Health White Memorial
Alameda Health System
Antelope Valley Community College District
Asian Pacific Islander Trustees and Administrators Caucus of the Community College

League of California
Association of California Community College Administrators
Association of California Healthcare Districts
Bakersfield College
Butte-Glenn Community College District
Cabrillo Community College District
California Assisted Living Association
California Association for Health Services at Home
California Association of Health Facilities
California Association of Latino Community College Trustees and Administrators
California Community College Baccalaureate Association
California Community Colleges
California Community Colleges Chief Instructional Officers
California Hospital Association
Cerritos Community College District
Chabot-Las Positas Community College District
Citrus College
Coast Community College District
Compton Community College District
Contra Costa Community College District
County Health Executives Association of California
County of Los Angeles Board of Supervisors

Cuesta College
Desert Community College District
El Camino Community College District
Faculty Association of California Community Colleges
Foothill-De Anza Community College District
Gavilan Joint Community College District
Glendale Community College 
Grossmont College
Grossmont-Cuyamaca Community College District
HealthNet
Kern Community College District
Lassen Community College District
Long Beach City College
Los Angeles Area Chamber of Commerce
Los Angeles Pierce College
Los Angeles Valley College
MiraCosta Community College District
Monterey Peninsula Community College District
Moorpark College
Mt. San Antonio College
Mt. San Jacinto Community College
North Orange County Community College District
Palo Verde Community College District
Palomar Community College District
Pasadena City College
Peralta Community College District
Providence
Rancho Santiago Community College District
Redwoods Community College District
Rio Hondo College
Riverside Community College District
San Diego Community College District
San Diego Unified School District
San Jose-Evergreen Community College District
San Luis Obispo County Community College District
Santa Clarita Community College District - College of the Canyons
Sharp HealthCare
Sierra Joint Community College District
Siskiyous Joint Community College District
Sonoma County Junior College District

South Orange County Community College District
Southwestern Community College District
Student Senate for California Community Colleges
Sutter Health
TELACU

Union of Health Care Professionals
Ventura County Community College District
Victor Valley College
West Hills College Lemoore
West Hills Community College District
West Kern Community College District

9 individuals

OPPOSITION

Association of Independent California Colleges and Universities
Azusa Pacific University
California Association of Colleges of Nursing
California Baptist University
California Faculty Association
California State University, Office of the Chancellor
Concordia University Irvine
Dominican University of California
University of San Francisco School of Nursing and Health Professions

1 individual

-- END --

SENATE COMMITTEE ON EDUCATION

Senator Josh Newman, Chair

2023 - 2024 Regular

Bill No: Hearing Date: April 24, 2024

Subject:

SUMMARY

This bill requires the California Community College (CCC) Chancellor’s Office to establish, until January 1, 2031, a Community College Baccalaureate Degree in Nursing Pilot Program for purposes of authorizing 15 community college districts with nationally accredited nursing programs selected by the CCC Chancellor’s office to offer a Bachelor of Science in nursing degree. The bill further requires the Legislative Analyst’s Office to conduct and submit to the legislature an evaluation of the pilot program, as specified.

BACKGROUND

Existing law:

1. Differentiates the missions and functions of public and independent institutions of higher education. Under these provisions:
   1. The primary mission of the California State University (CSU) is to offer undergraduate and graduate instruction through the master’s degree in the liberal arts and sciences and professional education including teacher education. The CSU is authorized to establish two-year programs only when mutually agreed upon by the Trustees and the CCC Board of Governors. The CSU is also authorized to jointly award the doctoral degree with the University of California (UC) and with one or more independent institutions of higher education.
   2. The UC is authorized to provide undergraduate and graduate instruction and has exclusive jurisdiction in public higher education over graduate instruction in the professions of law, medicine, dentistry and veterinary medicine. The UC is also the primary state-supported academic agency for research.
   3. The independent institutions of higher education are required to provide undergraduate and graduate instruction and research in accordance with their respective missions.
   4. The mission and function of the CCC is the offering of academic and vocational instruction at the lower division level, and the CCC are authorized to grant the Associate in Arts and the Associate in Science degrees. The community colleges are also required to offer learning supports to close learning gaps, English as a Second Language instruction, and adult noncredit instruction, and support services which help students succeed at the postsecondary level. (Education Code § 66010.4)
2. Authorizes the CCC Board of Governors, in consultation with the CSU and the UC, to establish baccalaureate degree programs that do not duplicate a baccalaureate degree program offered by the CSU or UC. Allows for the approval of 30 community college baccalaureate degree programs per academic year. Current law further requires the CCC Chancellor to consult with and seek feedback from the CSU Chancellor, the UC President and the President of the Association of Independent California Colleges and Universities on proposed baccalaureate degree programs, as specified, and establishes a mechanism for the assessment, consultation, and approval of programs where duplication is identified, as specified. (EC § 78040 et seq.)

ANALYSIS

This bill:

1. Requires the CCC Chancellor’s Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a Bachelor of Science in Nursing Degree.
2. Provides that the pilot program be limited to 15 community college districts statewide.
3. Requires that the Chancellor identify eligible community college districts that apply based on the following criteria:
   1. There is equitable access between the northern, central, and southern

parts of the state to the pilot program.

• 1. Priority is given to community college districts in underserved nursing

areas.

• 1. The community college district has a nationally accredited nursing

program.

1. Limits the total number of associate degree in nursing and bachelor of science in nursing students at a community college district to the community college district’s associate degree in nursing class size approved by the board of registered nursing, and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.
2. Requires that the LAO conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program.
3. Requires that the evaluation be submitted to the legislature as specified.
4. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill’s provision.
5. Sunsets the bill’s provision on January 1, 2031.
6. States various findings and declarations relative to the bill’s provisions.

STAFF COMMENTS

1. Need for the bill. According to the author, “For decades, California has suffered from a shortage of registered nurses, and this problem has been exacerbated in recent years due to the pandemic and it’s expected to worsen due to an increase in RN retirements. While the nursing shortage is a national problem, it is particularly acute here in our state,—ranking 40th out of 50 states. A key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. In 2018, more than 85% of hospitals in California reported that the demand for RN’s was greater than the available supply – a situation that has not improved. But there is a path forward to help solve this problem and that path cuts right through our California Community Colleges. Our SB 895 creates a pilot program allowing community colleges to offer a bachelor’s degree in nursing, which is increasingly the industry standard, and a requirement for employment in our hospitals.”

The author further asserts that the goal of the bill is to utilize existing associate degree in nursing program capacity to produce more Bachelor of Science in Nursing degrees. The reason why producing more Bachelor of Science in Nursing degrees is important is because the industry standard in healthcare is changing. Specifically in hospitals and in direct care settings, a Bachelor of Science in nursing degree is increasingly becoming a requirement for employment. The author argues that CSUs and UCs face challenges in building out additional capacity to produce more nurses with a Bachelor of Science in Nursing, as such it is critical to use the existing community college nursing program structure to assist with meeting these workforce standards.

1. Pushes CCCs from their original mission. The state has four segments of higher education: three public and one private. Each plays a vital and unique role for the state. Their mission statements are outlined in the Master Plan for Higher Education and by state statute. The CCCs are to have an open admission policy and bear the most extensive responsibility for lower-division undergraduate instruction. Its primary areas of mission include instruction leading to associate degrees and university transfer, vocational instruction, and remedial education. Despite the differentiation of mission, the Legislature has authorized the CSU and CCCs to go beyond their original mission to offer doctoral degree and baccalaureate degree programs, respectively, so long as programs do not duplicate those offered by the other segments with primary jurisdiction. Further expansion of CCC baccalaureate degrees as proposed in this bill would signal the legislature’s willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process.
2. Is this the appropriate solution? If it is the desire of the legislature to expand Bachelor of Science in Nursing (BSN) degree programs, arguably more effective and efficient alternatives do not require a departure from the CCC’s mission to expand and streamline BSN pathways. In its recommendation for alternatives to the original baccalaureate degree pilot program, the LAO’s analysis notes that some CCCs have agreements with baccalaureate degree-granting institutions. Improving alignment between CCC and the universities could increase the number of CCC students who ultimately obtain a bachelor’s degree and reduce the amount of time students take to obtain their degree. For example, the Tri-County Nursing Pathway is a partnership between Riverside City College and two CSU campuses (Fullerton and San Bernardino) that allows associate degree nursing students to concurrently obtain their bachelor’s degrees. Students can enroll in CSU courses while still completing their associate degree requirements, allowing them to obtain their bachelor’s degree with only six additional months of coursework. The LAO report further asserts that such partnerships could not only be more cost-effective but also benefit more students (including place-bound students), thereby having a more widespread impact. The committee may wish to consider all of the following:

• Could this bill undermine any incentives for similar collaborations across the public higher education segments to address regional workforce needs like nursing?
• Can the process for developing collaborative efforts to address workforce needs be modified to facilitate greater proliferation of these programs?
• Should a community college be required to demonstrate that existing avenues for partnership with other institutions are not possible or viable before seeking authorization to offer an independent baccalaureate degree?
• Should additional support be provided to the other segments with primary jurisdiction for granting baccalaureate degrees to increase the number of degree slots available in high-demand areas?

1. State investment in CCC associate degree in nursing programs. Of California’s three public higher education segments, only the community colleges offer associate degrees in nursing. According to the CCC Chancellor’s Office 2020-2022 legislative report on Community Colleges Nursing Educational Programs, associate degrees in nursing programs account for 55.4% of programs in the state. Numerous legislative efforts and investments have been made to expand community college associate degree in nursing enrollments and improve retention to facilitate the expansion of associate degree in nursing programs. The Budget Act of 2015 provided additional nursing program support to expand community college nursing enrollments and improve student retention in associate degree nursing programs. Since 2009-10, the Legislature has provided ongoing funding ($13.4 million) through grants to CCC associate degree in nursing programs in recognition of the relatively high cost of educating nurses. The Department of Health Care Access and Information, which administers a state program to help, among other things, increase support for nursing education programs, awarded a total of $17 million to 34 nursing programs in 2023, including 17 community college associate degree in nursing programs. These investments demonstrate the state’s willingness to invest in associate degrees and demonstrate a recognition of their value to the state.
2. Tuition costs. Current law allows CCCs to raise tuition for the other CCC baccalaureate degree programs to the same amount as a CSU. This bill, however, makes it clear that those provisions are not applicable to the proposed pilot program but is silent on tuition costs. Tuition fees for CCC courses are currently $46 per credit. Without statutory authorization, it is uncertain if CCC districts can charge higher rates for the more advance degree. If this measure moves forward, the author may wish to clarify the parameters related to program funding and tuition costs.

1. Not all community college nursing programs are nationally accredited. According to the community college chancellor’s office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN) and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have Board of Registered Nursing (BRN) approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs.
2. Nursing programs in California. Graduates of associate and bachelor nursing degree programs may sit for nurse licensure exams and become licensed registered nurses. The state’s BRN approves all of California’s pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 bachelor of science in nursing, and 13 Entry Level Master’s (ELM) programs. According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18 percent increase in student completions since 2012. Associate’s degree completions decreased while bachelor’s degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor’s programs has increased over the last 10 years. The time it takes a student to graduate from a program varies by degree. An associate degree in nursing prepares students for registered nursing care in a variety of settings in two-three years, whereas a bachelor’s degree takes about four years to train students for registered nursing care as well as administrative and leadership positions. An ELM is a one- to two-year program for baccalaureate degree holders in other fields seeking to become registered nurses. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500. www.rn.ca.gov/forms/rnsurvey201718.shtml

1. Enrollment decisions controlled by BRN. The author argues that a key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. As noted in the above comment, the BRN is one of a few licensing boards that continues to actively approve educational programs and make enrollment decisions. According to a recent state audit of the BRN, two of the key factors that should be included in the BRN’s enrollment decisions are the forecasted supply of nurses that the state will need to fulfill demand and the available number of clinical placement slots. The audit found that the BRN has failed to gather and use sufficient data related to both of these factors to appropriately inform its enrollment decisions. Should the BRN continue to approve RN educational programs? Shouldn’t institutions play a greater role in determining enrollment decisions?
2. Nursing shortage projected to close within a few years. According to a 2022 University of California, San Francisco (UCSF) study, “Forecasts of the Registered Nurse Workforce in California,” data shows consistent employment rates for RNs since 2018, but decreasing rates for older RNs. It further warns that a greater number of RNs plan to retire or quit within two years compared to 2018. The pandemic also had an impact on retention rates. RN education programs experienced fewer enrollments and graduates during the 2018-2019 academic year. Combined, these changes have reduced the supply of RNs relative to previous forecasts. However, circumstances are improving. RN education enrollments are expected to surpass pre-pandemic levels starting with the 2021-22 academic year. It is projected that the supply of new RNs will match demand by 2029, thereby filling unfilled positions. According to UCSF’s updated 2024 forecast (unpublished), there is a statewide supply-demand gap of 17,000 full-time equivalent nurses, which is projected to close within four years (2028), one year earlier than the 2022 report indicated. Notably, retention of new and experienced nurses is key. Below is a graph from the UCSF 2022 forecast report. www.rn.ca.gov/pdfs/forms/forecast2022.pdf
3. Duplication indicates that California needs better higher education coordination. All of California’s public education institutions share a commitment to work together to ensure that parts of the system work for all Californians. Since the defunding of the California Postsecondary Education Commission (CPEC) in 2011, California has not had a statewide coordinating entity for higher education. Prior to its demise, the role of the CPEC included academic program review to coordinate the long-range planning of the state’s public higher education systems as a means to ensure that the segments were working together to carry out their individual missions while serving the state’s long-range workforce and economic needs. The absence of a higher education coordinating entity has hindered the state’s ability to review degree programs to align with state and workforce needs. In its place, changes to higher education’s blueprint are being made one legislative proposal at a time in a piecemeal way, which could result in an uncoordinated and fragmented system. Although this bill is limited to one community college baccalaureate degree program, it establishes a precedent for permitting duplication of degree programs and expands CCC’s ability to establish baccalaureate degrees independent from California’s other public universities. The committee may wish to consider all of the following:

• What relationship is there among the different missions of California’s higher education segments and their differential ways in which they offer education?
• Is it appropriate to rely solely on the legislative process to implement significant programmatic changes to higher education without any coordination or long-range plan to guide the conversation? Does the legislative process allow for consideration of priority relative to other demands in higher education?
• How should the legislature leverage the strength of each segment to address regional or statewide workforce needs? What is the expectation for collaboration among the segments?
• The delineation of missions serves as a guide for how and where to allocate state resources. If there is a lack of clarity about institutional missions, what will guide the future of higher education?

1. Arguments in support. According to the letter of support submitted to the committee from the Community College League, co-sponsors of the bill, it states in part, “SB 895 does not intend to create competition between public nursing schools. Currently, when students are not admitted into a public nursing program, they turn to for-profit and private institutions. While this may be a good option for many students, it is an unnecessarily expensive option when the local community college could offer the program at a lower cost. Many capable students are also priced out of the option to attend a private university or are forced to incur tremendous amounts of debt. Those are the students this bill intends to help—students who may otherwise not seek baccalaureate degrees, including working adults, economically disadvantaged students, people of color, and place-bound students. The Community College League further asserts, “California’s nursing shortage cannot be solved by one singular approach but rather requires a collaborative, multi-program solution. SB 895 seeks to address the nursing shortage through California’s community colleges, which have already shown to be successful through ADN-BSN partnerships. As a 6-year pilot program, SB 895 would authorize 15 community college districts with existing ADN infrastructure to begin offering baccalaureate degrees in nursing. Several ADN programs are already well-positioned to take on this next step, and community college leaders across the state are eager and ready to serve their students by educating and training the next generation of nurses.”
2. Arguments in opposition. The California Association of Colleges of Nursing argues, in part, in their opposition letter, that SB 895 “will not add a single additional nurse to the state workforce beyond the number that would exist under current law. Community colleges lack the infrastructure needed to administer baccalaureate nursing degree programs in accordance with evolving nursing accreditation standards. In fact, we are concerned that the bill will exacerbate existing challenges in hiring nursing faculty, since community college programs will likely need to seek out more faculty, to teach the additional courses required as part of baccalaureate degree programs. CACN additionally stresses that, “while we absolutely concur with the author and proponents on the need to craft policies that increase the number of nurses in the state, we respectfully disagree that this approach will address any of the underlying constraints to that pipeline. CACN believes that we can increase the number of nursing students in our state faster by partnering with our community colleges and not duplicating efforts and competing for limited resources, including clinical placements and qualified faculty.”
3. Amendments.

The author wishes, and committee staff agrees, that the bill be amended as follows:

Legislative findings and declarations

• Modify the legislative findings and declarations to better reflect the intent of the bill.

Equitable access across the state

• Clarifies that the Community College Chancellor’s Office is encouraged to ensure equitable access between the northern, central, and southern parts of the state to the pilot program.

Provisional approval for unaccredited programs

• Allow community college districts without a nationally accredited nursing program, which are in “Candidate” status, to be provisionally selected to participate in this pilot program, and may commence the program upon final accreditation. With regard to this provision, require that priority be given to community college districts located in the Central Valley. If a district that is provisionally selected is found to be making untimely progress toward accreditation, after notice and opportunity to cure, allow the Chancellor of the California Community Colleges to withdraw the provisional selection and select a different community college district to participate in the pilot program.
• Require the California Community College Chancellor’s Office to develop a process designed to assist community college nursing programs applying for national accreditation for the purpose of qualifying for the Baccalaureate Degree in Nursing pilot program, such assistance shall be made available to community college districts upon request.

Extend the sunset date and set the report submission deadline

• Set July 1, 2032, as the LAO report submission deadline.
• Extend the pilot program to January 1, 2034.

Committee staff recommends, and the author agrees, that the bill be further amended as follows:

Continue associate degree programs

• Require districts selected for the pilot program to continue offering an associate degree in nursing program.
• Require that each participating community college district give priority registration for enrollment in the pilot program to students with an associate degree in nursing from that community college district.

Define underserved nursing area

• Define underserved nursing area to mean registered nurse shortage areas designated at a high, medium, or low severity level as identified by the California Department of Health Care Access and Information.

Information included in the LAO report

• Require that LAO report include, but not be limited to, all of the following:
  • How many, and which specific, districts applied for a BSN pilot program.
  • The number of BSN pilot programs implemented, including information identifying the number of enrollments and degree recipients.
  • Which of the selected districts developed a BSN pilot program in an underserved nursing area.
  • Which districts were selected and why they were selected.
  • BSN degree pilot program costs and the funding sources that were used to finance these programs.
  • The cost charged to students including tuition and any additional fees.
  • The extent to which instruction was provided in-person or online.
  • Current completion rates, if available, for each cohort of students participating in the BSN degree pilot program.
  • Time-to-degree rates and completion rates for the BSN pilot programs.
  • The extent to which the BSN pilot programs established by the bill’s provisions are in compliance with the requirements with the bill’s provisions.
  • Other factors to consider when expanding BSN opportunities across the state.
  • Recommendations on whether and how the authorization establishing the pilot program should be extended.

Submit information to LAO

• Require that districts submit the information necessary to conduct the evaluations required in the bill, as determined by the Legislative Analyst’s Office, to the Chancellor of the California Community Colleges, who shall provide the information to the Legislative Analyst’s Office upon request.

1. Related and prior legislation.

AB 2104 (Soria, 2024) would require the CCC Chancellor’s office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. AB 2104 has been referred to the Assembly Committee on Higher Education.

SB 1183 (Hurtado, 2024) would add living in a medically underserved area or population as a factor for consideration in the multicriteria screening tool used for admission into an impacted registered nursing program at a CCC. It also extends the sunset date by five years. SB 1183 was approved by this committee on April 3.

AB 1311 (Soria, Chapter 126, Statutes of 2023) required the 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 1695 (Gipson, 2023) would establish the Nursing Pathway Pilot program in high schools to create pathways toward associate degrees in nursing at CCC. AB 1695 was heard and approved by this committee on June 28, 2023 and held on the Senate floor.

SUPPORT

American Federation of State, County, and Municipal Employees (co-sponsor)
Community College League of California (co-sponsor)
Los Angeles Community College District (co-sponsor)
United Nurses Associations of California (co-sponsor)
Adventist Health White Memorial
Alameda Health System
Antelope Valley Community College District
Asian Pacific Islander Trustees and Administrators Caucus of the Community College

League of California
Association of California Community College Administrators
Association of California Healthcare Districts
Bakersfield College
Butte-Glenn Community College District
Cabrillo Community College District
California Assisted Living Association
California Association for Health Services at Home
California Association of Health Facilities
California Association of Latino Community College Trustees and Administrators
California Community College Baccalaureate Association
California Community Colleges
California Community Colleges Chief Instructional Officers
California Hospital Association
Cerritos Community College District
Chabot-Las Positas Community College District
Citrus College
Coast Community College District
Compton Community College District
Contra Costa Community College District
County Health Executives Association of California
County of Los Angeles Board of Supervisors

Cuesta College
Desert Community College District
El Camino Community College District
Faculty Association of California Community Colleges
Foothill-De Anza Community College District
Gavilan Joint Community College District
Glendale Community College 
Grossmont College
Grossmont-Cuyamaca Community College District
HealthNet
Kern Community College District
Lassen Community College District
Long Beach City College
Los Angeles Area Chamber of Commerce
Los Angeles Pierce College
Los Angeles Valley College
MiraCosta Community College District
Monterey Peninsula Community College District
Moorpark College
Mt. San Antonio College
Mt. San Jacinto Community College
North Orange County Community College District
Palo Verde Community College District
Palomar Community College District
Pasadena City College
Peralta Community College District
Providence
Rancho Santiago Community College District
Redwoods Community College District
Rio Hondo College
Riverside Community College District
San Diego Community College District
San Diego Unified School District
San Jose-Evergreen Community College District
San Luis Obispo County Community College District
Santa Clarita Community College District - College of the Canyons
Sharp HealthCare
Sierra Joint Community College District
Siskiyous Joint Community College District
Sonoma County Junior College District

South Orange County Community College District
Southwestern Community College District
Student Senate for California Community Colleges
Sutter Health
TELACU

Union of Health Care Professionals
Ventura County Community College District
Victor Valley College
West Hills College Lemoore
West Hills Community College District
West Kern Community College District

9 individuals

OPPOSITION

Association of Independent California Colleges and Universities
Azusa Pacific University
California Association of Colleges of Nursing
California Baptist University
California Faculty Association
California State University, Office of the Chancellor
Concordia University Irvine
Dominican University of California
University of San Francisco School of Nursing and Health Professions

1 individual

-- END --

SENATE COMMITTEE ON EDUCATION

Senator Josh Newman, Chair

2023 - 2024 Regular

Bill No: SB 895 Hearing Date: April 10, 2024

Subject: Community colleges: Baccalaureate Degree in Nursing Pilot Program.

SUMMARY

This bill requires the California Community College (CCC) Chancellor’s Office to establish, until January 1, 2031, a Community College Baccalaureate Degree in Nursing Pilot Program for purposes of authorizing 15 community college districts with nationally accredited nursing programs selected by the CCC Chancellor’s office to offer a Bachelor of Science in nursing degree. The bill further requires the Legislative Analyst’s Office to conduct and submit to the legislature an evaluation of the pilot program, as specified.

BACKGROUND

Existing law:

1. Differentiates the missions and functions of public and independent institutions of higher education. Under these provisions:
   1. The primary mission of the California State University (CSU) is to offer undergraduate and graduate instruction through the master’s degree in the liberal arts and sciences and professional education including teacher education. The CSU is authorized to establish two-year programs only when mutually agreed upon by the Trustees and the CCC Board of Governors. The CSU is also authorized to jointly award the doctoral degree with the University of California (UC) and with one or more independent institutions of higher education.
   2. The UC is authorized to provide undergraduate and graduate instruction and has exclusive jurisdiction in public higher education over graduate instruction in the professions of law, medicine, dentistry and veterinary medicine. The UC is also the primary state-supported academic agency for research.
   3. The independent institutions of higher education are required to provide undergraduate and graduate instruction and research in accordance with their respective missions.
   4. The mission and function of the CCC is the offering of academic and vocational instruction at the lower division level, and the CCC are authorized to grant the Associate in Arts and the Associate in Science degrees. The community colleges are also required to offer learning supports to close learning gaps, English as a Second Language instruction, and adult noncredit instruction, and support services which help students succeed at the postsecondary level. (Education Code § 66010.4)
2. Authorizes the CCC Board of Governors, in consultation with the CSU and the UC, to establish baccalaureate degree programs that do not duplicate a baccalaureate degree program offered by the CSU or UC. Allows for the approval of 30 community college baccalaureate degree programs per academic year. Current law further requires the CCC Chancellor to consult with and seek feedback from the CSU Chancellor, the UC President and the President of the Association of Independent California Colleges and Universities on proposed baccalaureate degree programs, as specified, and establishes a mechanism for the assessment, consultation, and approval of programs where duplication is identified, as specified. (EC § 78040 et seq.)

ANALYSIS

This bill:

1. Requires the CCC Chancellor’s Office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community colleges to offer a Bachelor of Science in Nursing Degree.
2. Provides that the pilot program be limited to 15 community college districts statewide.
3. Requires that the Chancellor identify eligible community college districts that apply based on the following criteria:
   1. There is equitable access between the northern, central, and southern

parts of the state to the pilot program.

• 1. Priority is given to community college districts in underserved nursing

areas.

• 1. The community college district has a nationally accredited nursing

program.

1. Limits the total number of associate degree in nursing and bachelor of science in nursing students at a community college district to the community college district’s associate degree in nursing class size approved by the board of registered nursing, and further limits the total number of participants in a pilot program to 25 percent of that class size or 35 students, whichever is greater.
2. Requires that the LAO conduct an evaluation of the pilot program to determine the effectiveness of the program and the need to continue or expand the program.
3. Requires that the evaluation be submitted to the legislature as specified.
4. States that the existing CCC baccalaureate degree authorization does not apply to programs created under this bill’s provision.
5. Sunsets the bill’s provision on January 1, 2031.
6. States various findings and declarations relative to the bill’s provisions.

STAFF COMMENTS

1. Need for the bill. According to the author, “For decades, California has suffered from a shortage of registered nurses, and this problem has been exacerbated in recent years due to the pandemic and it’s expected to worsen due to an increase in RN retirements. While the nursing shortage is a national problem, it is particularly acute here in our state,—ranking 40th out of 50 states. A key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. In 2018, more than 85% of hospitals in California reported that the demand for RN’s was greater than the available supply – a situation that has not improved. But there is a path forward to help solve this problem and that path cuts right through our California Community Colleges. Our SB 895 creates a pilot program allowing community colleges to offer a bachelor’s degree in nursing, which is increasingly the industry standard, and a requirement for employment in our hospitals.”

The author further asserts that the goal of the bill is to utilize existing associate degree in nursing program capacity to produce more Bachelor of Science in Nursing degrees. The reason why producing more Bachelor of Science in Nursing degrees is important is because the industry standard in healthcare is changing. Specifically in hospitals and in direct care settings, a Bachelor of Science in nursing degree is increasingly becoming a requirement for employment. The author argues that CSUs and UCs face challenges in building out additional capacity to produce more nurses with a Bachelor of Science in Nursing, as such it is critical to use the existing community college nursing program structure to assist with meeting these workforce standards.

1. Pushes CCCs from their original mission. The state has four segments of higher education: three public and one private. Each plays a vital and unique role for the state. Their mission statements are outlined in the Master Plan for Higher Education and by state statute. The CCCs are to have an open admission policy and bear the most extensive responsibility for lower-division undergraduate instruction. Its primary areas of mission include instruction leading to associate degrees and university transfer, vocational instruction, and remedial education. Despite the differentiation of mission, the Legislature has authorized the CSU and CCCs to go beyond their original mission to offer doctoral degree and baccalaureate degree programs, respectively, so long as programs do not duplicate those offered by the other segments with primary jurisdiction. Further expansion of CCC baccalaureate degrees as proposed in this bill would signal the legislature’s willingness to allow CCCs to deviate further from their institutional mission, duplicate programs offered by the other segments with primary jurisdiction, and bypass the existing CCC baccalaureate approval process.
2. Is this the appropriate solution? If it is the desire of the legislature to expand Bachelor of Science in Nursing (BSN) degree programs, arguably more effective and efficient alternatives do not require a departure from the CCC’s mission to expand and streamline BSN pathways. In its recommendation for alternatives to the original baccalaureate degree pilot program, the LAO’s analysis notes that some CCCs have agreements with baccalaureate degree-granting institutions. Improving alignment between CCC and the universities could increase the number of CCC students who ultimately obtain a bachelor’s degree and reduce the amount of time students take to obtain their degree. For example, the Tri-County Nursing Pathway is a partnership between Riverside City College and two CSU campuses (Fullerton and San Bernardino) that allows associate degree nursing students to concurrently obtain their bachelor’s degrees. Students can enroll in CSU courses while still completing their associate degree requirements, allowing them to obtain their bachelor’s degree with only six additional months of coursework. The LAO report further asserts that such partnerships could not only be more cost-effective but also benefit more students (including place-bound students), thereby having a more widespread impact. The committee may wish to consider all of the following:

• Could this bill undermine any incentives for similar collaborations across the public higher education segments to address regional workforce needs like nursing?
• Can the process for developing collaborative efforts to address workforce needs be modified to facilitate greater proliferation of these programs?
• Should a community college be required to demonstrate that existing avenues for partnership with other institutions are not possible or viable before seeking authorization to offer an independent baccalaureate degree?
• Should additional support be provided to the other segments with primary jurisdiction for granting baccalaureate degrees to increase the number of degree slots available in high-demand areas?

1. State investment in CCC associate degree in nursing programs. Of California’s three public higher education segments, only the community colleges offer associate degrees in nursing. According to the CCC Chancellor’s Office 2020-2022 legislative report on Community Colleges Nursing Educational Programs, associate degrees in nursing programs account for 55.4% of programs in the state. Numerous legislative efforts and investments have been made to expand community college associate degree in nursing enrollments and improve retention to facilitate the expansion of associate degree in nursing programs. The Budget Act of 2015 provided additional nursing program support to expand community college nursing enrollments and improve student retention in associate degree nursing programs. Since 2009-10, the Legislature has provided ongoing funding ($13.4 million) through grants to CCC associate degree in nursing programs in recognition of the relatively high cost of educating nurses. The Department of Health Care Access and Information, which administers a state program to help, among other things, increase support for nursing education programs, awarded a total of $17 million to 34 nursing programs in 2023, including 17 community college associate degree in nursing programs. These investments demonstrate the state’s willingness to invest in associate degrees and demonstrate a recognition of their value to the state.
2. Tuition costs. Current law allows CCCs to raise tuition for the other CCC baccalaureate degree programs to the same amount as a CSU. This bill, however, makes it clear that those provisions are not applicable to the proposed pilot program but is silent on tuition costs. Tuition fees for CCC courses are currently $46 per credit. Without statutory authorization, it is uncertain if CCC districts can charge higher rates for the more advance degree. If this measure moves forward, the author may wish to clarify the parameters related to program funding and tuition costs.

1. Not all community college nursing programs are nationally accredited. According to the community college chancellor’s office, of the 77 associate degree for nursing programs, 28 are nationally accredited 27 by the Accreditation Commission for Education on Nursing (ACEN) and one by the Commission for Nursing Education Accreditation. Nine are candidates for national accreditation by ACEN. All programs have Board of Registered Nursing (BRN) approval. BRN approval ensures compliance with statutory and regulatory requirements whereas accreditation provides a baseline measure of program quality and supports transferability of credits for students seeking an advanced degree. This bill restricts participation in the pilot program to nationally accredited community college nursing programs.
2. Nursing programs in California. Graduates of associate and bachelor nursing degree programs may sit for nurse licensure exams and become licensed registered nurses. The state’s BRN approves all of California’s pre-licensure nursing programs offered by public and private colleges and makes decisions about the number of students that new and existing nursing programs are allowed to enroll. The number of nursing programs in the state totals 152, with 101 public, 91 associate degrees in nursing, 48 bachelor of science in nursing, and 13 Entry Level Master’s (ELM) programs. According to the most recent BRN annual school report (2021-2022), California graduated about 13,300 students in 2021-22 from registered nursing programs, which represents an 18 percent increase in student completions since 2012. Associate’s degree completions decreased while bachelor’s degrees and ELM nursing completions increased. The number of joint associate degrees in nursing and bachelor’s programs has increased over the last 10 years. The time it takes a student to graduate from a program varies by degree. An associate degree in nursing prepares students for registered nursing care in a variety of settings in two-three years, whereas a bachelor’s degree takes about four years to train students for registered nursing care as well as administrative and leadership positions. An ELM is a one- to two-year program for baccalaureate degree holders in other fields seeking to become registered nurses. All schools are required to provide clinical instruction with clinical placement in a health care facility in each phase of the educational process. Students must pass a national licensure examination to earn a license. The BRN projects enrollment to increase for the 2023-2024 academic year to about 18,500. www.rn.ca.gov/forms/rnsurvey201718.shtml

1. Enrollment decisions controlled by BRN. The author argues that a key factor contributing to this crisis is that California’s nursing school capacity has not been able to keep up with demand. As noted in the above comment, the BRN is one of a few licensing boards that continues to actively approve educational programs and make enrollment decisions. According to a recent state audit of the BRN, two of the key factors that should be included in the BRN’s enrollment decisions are the forecasted supply of nurses that the state will need to fulfill demand and the available number of clinical placement slots. The audit found that the BRN has failed to gather and use sufficient data related to both of these factors to appropriately inform its enrollment decisions. Should the BRN continue to approve RN educational programs? Shouldn’t institutions play a greater role in determining enrollment decisions?
2. Nursing shortage projected to close within a few years. According to a 2022 University of California, San Francisco (UCSF) study, “Forecasts of the Registered Nurse Workforce in California,” data shows consistent employment rates for RNs since 2018, but decreasing rates for older RNs. It further warns that a greater number of RNs plan to retire or quit within two years compared to 2018. The pandemic also had an impact on retention rates. RN education programs experienced fewer enrollments and graduates during the 2018-2019 academic year. Combined, these changes have reduced the supply of RNs relative to previous forecasts. However, circumstances are improving. RN education enrollments are expected to surpass pre-pandemic levels starting with the 2021-22 academic year. It is projected that the supply of new RNs will match demand by 2029, thereby filling unfilled positions. According to UCSF’s updated 2024 forecast (unpublished), there is a statewide supply-demand gap of 17,000 full-time equivalent nurses, which is projected to close within four years (2028), one year earlier than the 2022 report indicated. Notably, retention of new and experienced nurses is key. Below is a graph from the UCSF 2022 forecast report. www.rn.ca.gov/pdfs/forms/forecast2022.pdf
3. Duplication indicates that California needs better higher education coordination. All of California’s public education institutions share a commitment to work together to ensure that parts of the system work for all Californians. Since the defunding of the California Postsecondary Education Commission (CPEC) in 2011, California has not had a statewide coordinating entity for higher education. Prior to its demise, the role of the CPEC included academic program review to coordinate the long-range planning of the state’s public higher education systems as a means to ensure that the segments were working together to carry out their individual missions while serving the state’s long-range workforce and economic needs. The absence of a higher education coordinating entity has hindered the state’s ability to review degree programs to align with state and workforce needs. In its place, changes to higher education’s blueprint are being made one legislative proposal at a time in a piecemeal way, which could result in an uncoordinated and fragmented system. Although this bill is limited to one community college baccalaureate degree program, it establishes a precedent for permitting duplication of degree programs and expands CCC’s ability to establish baccalaureate degrees independent from California’s other public universities. The committee may wish to consider all of the following:

• What relationship is there among the different missions of California’s higher education segments and their differential ways in which they offer education?
• Is it appropriate to rely solely on the legislative process to implement significant programmatic changes to higher education without any coordination or long-range plan to guide the conversation? Does the legislative process allow for consideration of priority relative to other demands in higher education?
• How should the legislature leverage the strength of each segment to address regional or statewide workforce needs? What is the expectation for collaboration among the segments?
• The delineation of missions serves as a guide for how and where to allocate state resources. If there is a lack of clarity about institutional missions, what will guide the future of higher education?

1. Arguments in support. According to the letter of support submitted to the committee from the Community College League, co-sponsors of the bill, it states in part, “SB 895 does not intend to create competition between public nursing schools. Currently, when students are not admitted into a public nursing program, they turn to for-profit and private institutions. While this may be a good option for many students, it is an unnecessarily expensive option when the local community college could offer the program at a lower cost. Many capable students are also priced out of the option to attend a private university or are forced to incur tremendous amounts of debt. Those are the students this bill intends to help—students who may otherwise not seek baccalaureate degrees, including working adults, economically disadvantaged students, people of color, and place-bound students. The Community College League further asserts, “California’s nursing shortage cannot be solved by one singular approach but rather requires a collaborative, multi-program solution. SB 895 seeks to address the nursing shortage through California’s community colleges, which have already shown to be successful through ADN-BSN partnerships. As a 6-year pilot program, SB 895 would authorize 15 community college districts with existing ADN infrastructure to begin offering baccalaureate degrees in nursing. Several ADN programs are already well-positioned to take on this next step, and community college leaders across the state are eager and ready to serve their students by educating and training the next generation of nurses.”
2. Arguments in opposition. The California Association of Colleges of Nursing argues, in part, in their opposition letter, that SB 895 “will not add a single additional nurse to the state workforce beyond the number that would exist under current law. Community colleges lack the infrastructure needed to administer baccalaureate nursing degree programs in accordance with evolving nursing accreditation standards. In fact, we are concerned that the bill will exacerbate existing challenges in hiring nursing faculty, since community college programs will likely need to seek out more faculty, to teach the additional courses required as part of baccalaureate degree programs. CACN additionally stresses that, “while we absolutely concur with the author and proponents on the need to craft policies that increase the number of nurses in the state, we respectfully disagree that this approach will address any of the underlying constraints to that pipeline. CACN believes that we can increase the number of nursing students in our state faster by partnering with our community colleges and not duplicating efforts and competing for limited resources, including clinical placements and qualified faculty.”
3. Amendments. In order to incentivize intersegmental collaboration and ensure programs offered under the pilot program are established in underserved areas of the state, staff recommends that the bill be amended as follows:

Applicant eligibility:

• Modify applicant eligibility criteria in EC Section 78045(b)(1)(B) of the bill so that pilot program eligibility is only available to community college districts physically located in underserved nursing areas as determined by the California Department of Health Care Access and Information.
• Give priority to community college districts that are physically located 100 miles or more from a California State University’s Bachelor of Science in Nursing degree program.
• Clarify in EC Section 78045(b)(1)(A) that the Community College Chancellor’s office is encouraged to ensure that there is equitable access among the northern, central, and southern parts of the state to the pilot program.

Define underserved nursing areas:

• Define underserved nursing areas to mean registered nurse shortage areas designated at a high, medium or low severity level as identified by the California Department of Health Care Access and Information.

Divide pilot program into independent and partnership programs

• Add: The CCC BSN pilot program shall be subject to the following limitations:
  • Only eight shall be granted the authority to develop an independent CCC bachelor of science in nursing degree.
  • Seven shall be selected to establish partnerships with a campus of a California State University, University of California, or independent institutions of higher education as defined in EC § 66010 (b) for purposes of developing concurrent enrollment programs that allow community college students who are enrolled in an associate degree in nursing program to concurrently earn a bachelor of science in nursing degree from a partner institution.
    • Specify that a community college district without a nationally accredited nursing program may be selected to establish a partnership (as described) under the pilot program.

Maintain existing associate degree program

• Districts selected for the pilot program shall continue to offer an associate

degree in nursing program.

Reporting requirement

• Set December 1, 2029 as the deadline for submission of the Legislative

Analyst’s office report.

1. Related and prior legislation.

AB 2104 (Soria, 2024) would require the CCC Chancellor’s office to develop a Baccalaureate Degree in Nursing Pilot Program that authorizes select community college districts to offer a Bachelor of Science in Nursing degree. AB 2104 has been referred to the Assembly Committee on Higher Education.

SB 1183 (Hurtado, 2024) would add living in a medically underserved area or population as a factor for consideration in the multicriteria screening tool used for admission into an impacted registered nursing program at a CCC. It also extends the sunset date by five years. SB 1183 was approved by this committee on April 3.

AB 1311 (Soria, Chapter 126, Statutes of 2023) required the 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 1695 (Gipson, 2023) would establish the Nursing Pathway Pilot program in high schools to create pathways toward associate degrees in nursing at CCC. AB 1695 was heard and approved by this committee on June 28, 2023 and held on the Senate floor.

SUPPORT

American Federation of State, County, and Municipal Employees (co-sponsor)

Community College League of California (co-sponsor)

Los Angeles Community College District (co-sponsor)

United Nurses Associations of California (co-sponsor)

Adventist Health White Memorial

Antelope Valley Community College District

Association of California Community College Administrators

Association of California Healthcare Districts; the

Bakersfield College

Butte College

California Assisted Living Association

California Association for Health Services At Home

California Association of Health Facilities

California Association of Latino Community College Trustees and Administrators

California Community College Baccalaureate Association

California Community Colleges Chief Instructional Officers

California Hospital Association

Cerritos Community College District

Chabot-Las Positas Community College District

Citrus College

Coast Community College District

Compton Community College District

Contra Costa Community College District

County Health Executives Association of California

County of Los Angeles Board of Supervisors

Desert Community College District

El Camino Community College District

Faculty Association of California Community Colleges

Foothill-De Anza Community College District

Gavilan College

Glendale Community College

Grossmont College

Grossmont-Cuyamaca Community College District

Kern Community College District

Lassen Community College District

Long Beach Community College District

Los Angeles Area Chamber of Commerce

Los Angeles Pierce College

Los Angeles Valley College

MiraCosta Community College District

Monterey Peninsula Community College District

Mt. San Antonio College

Mt. San Jacinto Community College District

North Orange County Community College District

Palo Verde Community College District

Palomar Community College District

Pasadena Area Community College District

Peralta Community College District

Providence

Rancho Santiago Community College District

Redwoods Community College District

Rio Hondo College

Riverside Community College District

San Diego Community College District

San Diego Unified School District

San Jose-Evergreen Community College District

San Luis Obispo County Community College District / Cuesta College

Santa Clarita Community College District - College of the Canyons

Sharp Healthcare

Sierra Community College District

Siskiyous Joint Community College District

South Orange County Community College District

Southwestern Community College District

Student Senate for California Community Colleges

Sutter Health

TELACU

The Community College League of California Asian Pacific Islander Trustee and Administrator Caucus

Ventura County Community College District

Victor Valley College

West Hills College Lemoore

West Hills Community College District

West Kern Community College District

Several individuals

OPPOSITION

Association of Independent California Colleges and Universities

California Association of Colleges of Nursing

California Baptist University

California State University

Concordia University Irvine

Dominican University of California

University of San Francisco School of Nursing and Health Professions

One individual

-- END --