Is there a nursing shortage in California? Now, yes, though in a few years, probably not.
By 2027, the state is because of a rise in nursing program enrollment, according to UC San Francisco projections compiled for the state agency that regulates nursing programs. The report was published last year.
But there are other sub-shortages in California鈥檚 nursing workforce. Two bills passed by the Legislature last week focus on one of those: nurses with bachelor鈥檚 degrees.
Both target a growing demand for nurses to possess bachelor鈥檚 degrees by allowing some community colleges to issue them. Presently the colleges only provide associate degrees 鈥� generally the needed to be a registered nurse.
The bills are the latest developments in the state鈥檚 ongoing quest to tweak the educational offerings of colleges and universities to address cultural and workforce needs, from to permitting and to issue degrees they haven鈥檛 before. But the bills also underscore the complexity of both identifying a labor force problem 鈥� a nursing shortage 鈥� and the role that community colleges and universities play in graduating skilled workers.
One is Senate Bill 895 by Sen. Richard Roth, a Democrat from Riverside. The other is by Assemblymember Esmeralda Soria, a Democrat from Merced.
The California State University opposes both bills, viewing them as undermining a promise lawmakers made two years ago that community colleges wouldn鈥檛 issue bachelor鈥檚 degrees that duplicate existing Cal State programs, among other worries. Private colleges oppose the bills, as well. The University of California doesn鈥檛 officially oppose the bills but similar .
Understanding the nursing shortages
Even as the state may not have an industry-wide nursing shortage by 2027, there are still stubborn sub-shortages.
While California has seen the number of nursing education program slots grow by , virtually all of that was. Available slots at the more affordable public colleges and universities have remained flat.
There are regional differences, too, with California鈥檚 Central Valley and the Central Coast lacking enough nursing program slots to meet demand. 鈥淭hose would be the regions that I would point to as having the biggest challenges,鈥� said Joanne Spetz, a researcher at UC San Francisco who studies the state鈥檚 nursing sector and co-wrote the projections report
Yet another micro-shortage stems from the fact that more hospitals . That makes sense: Several academic studies concluded that hospitals that increased their share of nurses with bachelor鈥檚 degrees saw .
And an overall shortage may still persist past 2027 due to 鈥渉igh rates of burnout鈥� that 鈥渕ay lead to greater turnover and departures from nursing,鈥� the projections report said.
What the two bills will do
Enter the two bills the Legislature passed in the just-concluded session.
Will they lead to more registered nurses? Speaking Roth said no. But it would help produce more nurses with bachelor鈥檚 degrees 鈥� which more hospitals say they want, he said.
The bill authors 鈥� as well as their community college and 鈥� say some community colleges should be allowed to issue bachelor鈥檚 degrees in nursing for other reasons, too.
Students from a California State University or University of California nursing program could enroll at a community college and avoid long commutes to the public universities or . There are in California that offer associate degrees in nursing and 21 public universities 鈥� mostly through the Cal State system 鈥�. And while some universities offer online programs, not every student has fast-enough internet or enough computing power at home, Roth .
Students with associate and bachelor鈥檚 degrees take the same licensure exam. Typically a bachelor鈥檚 degree in nursing requires about 30 more units of coursework, which takes about a year to complete.
An overall shortage may still persist past 2027 due to 鈥渉igh rates of burnout鈥� that 鈥渕ay lead to greater turnover and departures from nursing.鈥�UC San Francisco projections report
Both bills seek to form pilot programs that each allow just 10 community college districts 鈥� out of 鈥� to offer bachelor鈥檚 degrees in nursing.
But they vary in other ways. Soria鈥檚 bill places , which has a chronic nursing shortage. Roth鈥檚 bill is aimed at the whole state, though it would focus on the Central Valley and other regions by prioritizing pilot programs in underserved communities. Both would require the Legislative Analyst鈥檚 Office to evaluate the pilots, but Roth鈥檚 bill would have the pilot programs last until 2034 while under Soria鈥檚 bill the programs would run until 2031.
Roth鈥檚 bill requires colleges in the pilot to have national accreditation, which can take several years to accomplish. Soria鈥檚 bill doesn鈥檛 specify that. Still, 28 community colleges already have national accreditation, according to a July legislative bill analysis.
The differences raise questions about how Gov. Gavin Newsom may reconcile the two bills.
That鈥檚 one reason why the California Community Colleges Chancellor鈥檚 Office is 鈥渞ecommending the governor sign SB 895鈥� over Soria鈥檚 bill, wrote Melissa Villarin, a spokesperson for the California Community Colleges Chancellor鈥檚 Office, in an email Wednesday. She also noted that either bill getting Newsom鈥檚 signature would be a 鈥渕ajor victory.鈥�
The chancellor鈥檚 office prefers Roth鈥檚 bill because it was sponsored by statewide groups close to the central office, including the Community College League of California, which represents community college administrators and trustees. Roth鈥檚 legislation is also a 鈥渂ill where more attention and efforts (in terms of negotiating amendments) have been focused throughout the legislative process,鈥� she wrote.
Why Cal State opposes bachelors degrees at community colleges聽
Both bills are creating a panic for Cal State leadership and the system鈥檚 nursing programs. There鈥檚 the fear that the community colleges will eat Cal State鈥檚 enrollment lunch by offering bachelor鈥檚 degrees that are cheaper than what Cal States charge.
Roth鈥檚 bill 鈥渨ill siphon off the students鈥� who鈥檇 鈥渙therwise come to a CSU nursing degree program,鈥� , director of health care workforce development at the Cal States, during a July legislative hearing. He said the .
Forming new bachelor鈥檚 programs at community colleges is expensive, he argued. Cal State鈥檚 online bachelor鈥檚 programs and the system鈥檚 fast-track bachelor鈥檚 degree programs with 37 existing community colleges can meet the bills鈥� goals, he said in an interview. More of these partnership programs are pending, .
There鈥檚 also a philosophical battle brewing over the distinct roles of each higher education segment in California. For decades, the state鈥檚 1960 Master Plan for Higher Education stipulated that the community colleges offer certificates and associate degrees; Cal States chiefly provide bachelor鈥檚 degrees and master鈥檚 degrees; and the UCs focus on research by offering bachelor鈥檚, master鈥檚 and doctoral degrees.
But in recent years, the Legislature has permitted the community colleges to award bachelor鈥檚 degrees, with the proviso that those degrees don鈥檛 duplicate the degrees already offered at Cal States. Both systems have , but the bills proposed by Roth and Soria would knowingly blow up that public policy peace by allowing the community colleges to offer the same nursing bachelor鈥檚 degrees the Cal States already provide.
鈥淥ur overall opposition is, of course, we鈥檙e opposed to duplication,鈥� Attar said in an interview.
Both bills received wide bipartisan support. However, a few Democrats 鈥� who have a supermajority in the Legislature 鈥� expressed reservations about the emerging mission creep of the community colleges.
Among those is Sen. Josh Newman, a Democrat from Fullerton who is chair of the Senate鈥檚 education committee. , he said that the master plan assumed a 鈥渄ivision of labor, if you will, between the segments. And largely because of geographical and workforce needs, we鈥檙e seeing that erode. I believe that is problematic.鈥�
Roth鈥檚 bill would also create new layers of pricing. It would cap tuition for the pilot nursing bachelor鈥檚 degrees to be no more expensive than other community college courses 鈥� $46 a unit 鈥� wrote Villarin.
鈥淭he only way to pursue a bachelor鈥檚 degree, if you鈥檙e in some of those communities, is to either do an online program, some of which are excellent and some of which are not so good, or to relocate to do a bachelor鈥檚 degree.鈥�Joanne Spetz, researcher at UCSF
Existing bachelor鈥檚 degrees at community colleges have tuition charges that are capped at $10,560, excluding course and campus fees, so Roth鈥檚 bill would make a nursing bachelor鈥檚 roughly half that. Meanwhile, Cal State systemwide tuition, excluding fees, is now more than $6,000 a year and will grow .
Spetz of UC San Francisco said the lack of public bachelor鈥檚 degree programs in nursing is a real barrier to Californians in remote parts of the state where there鈥檚 no nearby university.
鈥淭he only way to pursue a bachelor鈥檚 degree, if you鈥檙e in some of those communities, is to either do an online program, some of which are excellent and some of which are not so good, or to relocate to do a bachelor鈥檚 degree, which just seems kind of silly and isn鈥檛 possible for many people,鈥� she said.
She鈥檇 recommend limiting the pilot programs to community colleges that are particularly far from a public university with a nursing program. 鈥淚 think having a distance threshold and really focusing on regions where there is not a public bachelor鈥檚 degree opportunity for folks 鈥s a reasonable thing to test.鈥�
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