Is there a nursing shortage in California? Now, yes, though in a few years, probably not.

By 2027, the state is projected to have as many nurses as it needs 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’s nursing workforce. Two bills passed by the Legislature last week focus on one of those: nurses with bachelor’s degrees.

Both target a growing demand for nurses to possess bachelor’s degrees by allowing some community colleges to issue them. Presently the colleges only provide associate degrees — generally the minimum degree needed to be a registered nurse.

The bills are the latest developments in the state’s ongoing quest to tweak the educational offerings of colleges and universities to address cultural and workforce needs, from requiring ethnic studies courses to permitting colleges and universities to issue degrees they haven’t before. But the bills also underscore the complexity of both identifying a labor force problem — a nursing shortage — 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 Assembly Bill 2104 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’t issue bachelor’s degrees that duplicate existing Cal State programs, among other worries. Private colleges oppose the bills, as well. The University of California doesn’t officially oppose the bills but raised similar concerns.

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 3,000 between 2018 and 2023, virtually all of that was at private nonprofit and for-profit campuses. Available slots at the more affordable public colleges and universities have remained flat.

There are regional differences, too, with California’s Central Valley and the Central Coast lacking enough nursing program slots to meet demand. “Those would be the regions that I would point to as having the biggest challenges,” said Joanne Spetz, a researcher at UC San Francisco who studies the state’s nursing sector and co-wrote the projections report

Yet another micro-shortage stems from the fact that more hospitals prefer — or require — hiring nurses with bachelor’s degrees. That makes sense: Several academic studies concluded that hospitals that increased their share of nurses with bachelor’s degrees saw lower rates of patient death and shorter hospital stays.

And an overall shortage may still persist past 2027 due to​​ “high rates of burnout” that “may lead to greater turnover and departures from nursing,” the projections report said.

What the two bills will do

Enter the two bills the Legislature passed last week.

Will they lead to more registered nurses? Speaking of his bill in July, Roth said no. But it would help produce more nurses with bachelor’s degrees — which more hospitals say they want, he said.

The bill authors — as well as their community college and hospital backers — say some community colleges should be allowed to issue bachelor’s degrees in nursing for other reasons, too.

Students who live too far 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 much more expensive private colleges. There are more than 70 community colleges in California that offer associate degrees in nursing and 21 public universities — mostly through the Cal State system — that award bachelor’s degrees in nursing. And while some universities offer online programs, not every student has fast-enough internet or enough computing power at home, Roth told lawmakers.

Students with associate and bachelor’s degrees take the same licensure exam. Typically a bachelor’s 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​​ “high rates of burnout” that “may lead to greater turnover and departures from nursing.”
— UC San Francisco projections report

Both bills seek to form pilot programs that each allow just 10 community college districts — out of the state’s 73 — to offer bachelor’s degrees in nursing.

But they vary in other ways. Soria’s bill places an emphasis on pilots in the Central Valley, which has a chronic nursing shortage. Roth’s 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’s Office to evaluate the pilots, but Roth’s bill would have the pilot programs last until 2034 while under Soria’s bill the programs would run until 2031.

Roth’s bill requires colleges in the pilot to have national accreditation, which can take several years to accomplish. Soria’s bill doesn’t 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’s one reason why the California Community Colleges Chancellor’s Office is “recommending the governor sign SB 895” over Soria’s bill, wrote Melissa Villarin, a spokesperson for the California Community Colleges Chancellor’s Office, in an email Wednesday. She also noted that either bill getting Newsom’s signature would be a “major victory.”

The chancellor’s office prefers Roth’s 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’s legislation is also a “bill where more attention and efforts (in terms of negotiating amendments) have been focused throughout the legislative process,” she wrote.

Why Cal State opposes bachelors degrees at community colleges

Both bills are creating a panic for Cal State leadership and the system’s nursing programs. There’s the fear that the community colleges will eat Cal State’s enrollment lunch by offering bachelor’s degrees that are cheaper than what Cal States charge.

Roth’s bill “will siphon off the students” who’d “otherwise come to a CSU nursing degree program,” said Rehman Attar, director of health care workforce development at the Cal States, during a July legislative hearing. He said the same about Soria’s bill.

Forming new bachelor’s programs at community colleges is expensive, he argued. Cal State’s online bachelor’s programs and the system’s fast-track bachelor’s degree programs with 37 existing community colleges can meet the bills’ goals, he said in an interview. More of these partnership programs are pending, he added.

There’s also a philosophical battle brewing over the distinct roles of each higher education segment in California. For decades, the state’s 1960 Master Plan for Higher Education stipulated that the community colleges offer certificates and associate degrees; Cal States chiefly provide bachelor’s degrees and master’s degrees; and the UCs focus on research by offering bachelor’s, master’s and doctoral degrees.

But in recent years, the Legislature has permitted the community colleges to award bachelor’s degrees, with the proviso that those degrees don’t duplicate the degrees already offered at Cal States. Both systems have fought over the practicalities of that détente, 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’s degrees the Cal States already provide.

“Our overall opposition is, of course, we’re opposed to duplication,” Attar said in an interview. Both bills received wide bipartisan support. However, a few Democrats — who have a supermajority in the Legislature — expressed reservations about the emerging mission creep of the community colleges.

Among those is Assemblymember Josh Newman, a Democrat from Fullerton who is chair of the Senate’s education committee. During a hearing on Soria’s bill, he said that the master plan assumed a “division of labor, if you will, between the segments. And largely because of geographical and workforce needs, we’re seeing that erode. I believe that is problematic.”

Roth’s bill would also create new layers of pricing. It would cap tuition for the pilot nursing bachelor’s degrees to be no more expensive than other community college courses — $46 a unit — wrote Villarin.

“The only way to pursue a bachelor’s degree, if you’re 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’s degree.”
— Joanne Spetz, researcher at UCSF

Existing bachelor’s degrees at community colleges have tuition charges that are capped at $10,560, excluding course and campus fees, so Roth’s bill would make a nursing bachelor’s roughly half that. Meanwhile, Cal State systemwide tuition, excluding fees, is now more than $6,000 a year and will grow by 5% annually through 2028-29.

Spetz of UC San Francisco said the lack of public bachelor’s degree programs in nursing is a real barrier to Californians in remote parts of the state where there’s no nearby university.

“The only way to pursue a bachelor’s degree, if you’re 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’s degree, which just seems kind of silly and isn’t possible for many people,” she said.

She’d recommend limiting the pilot programs to community colleges that are particularly far from a public university with a nursing program. “I think having a distance threshold and really focusing on regions where there is not a public bachelor’s degree opportunity for folks …is a reasonable thing to test.”

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