Community College Nursing Programs

Chapter 712, Statutes of 2007 (AB 1559, Berryhill), sought to improve completion rates at community college nursing programs by permitting campuses to select students for these programs based on academic qualifications, as well as other skills and circumstances. Chapter 712 also requires the Legislative Analyst’s Office to report on CCC’s use of the new admissions process. This section fulfills this requirement.

Background on CCC Nursing Programs. As of fall 2008, 75 community colleges offer programs leading to an associate’s degree in nursing. The number of programs has increased considerably in recent years in response to concerns about a statewide nursing shortfall. In addition, the Legislature has funded a number of grants designed to increase the number of enrollment slots at existing programs, particularly in the CCC system.

Despite these expansion efforts, the number of applicants to nursing programs continues to far exceed the number of available slots. According to a 2008 Board of Registered Nursing study, for example, CCC nursing programs received a total of 18,530 eligible applications for just 8,135 first–year slots for the 2006–07 school year. (Eligibility is based on criteria such as applicants successfully completing certain prerequisite science courses.) This means there was capacity to accommodate less than 45 percent of applications.

About one–fifth of each year’s incoming students fail to complete their degree. As we discussed in Ensuring an Adequate Health Workforce: Improving State Nursing Programs (May 2007), this is likely due in part to CCC’s admissions policies. Prior to enactment of Chapter 712, CCC regulations prohibited programs from choosing from among eligible applicants based on merit (such as their grades in prerequisite classes). Instead, community colleges could use only nonevaluative admissions strategies (such as random selection) when selecting students for oversubscribed programs. (This policy stemmed from a decades–old lawsuit settlement.) As a result of this requirement, nursing programs could not choose the most qualified or best prepared students from among of the pool of applications they received.

New Law Allows Comprehensive Merit–Based Admissions Approach. Effective January 1, 2008, Chapter 712 changed this policy by permitting nursing–program admissions committees to select students based on multiple factors, including grades in prerequisite coursework, relevant work experience, and proficiency in languages such as Spanish. Alternatively, programs can continue using a nonevaluative process (or some combination of a merit–based approach and random selection). Pursuant to separate legislation, every program—regardless of its admissions process—also is permitted to administer a diagnostic assessment test to admitted students before they start a nursing program. Students who are unable to obtain a passing score must demonstrate readiness for the program by, for example, passing remedial courses (such as English or math) or receiving tutorial services from CCC staff.

Mixed Interest in Evaluative Admissions Option So Far. In fall 2008, a CCC nursing advisory committee surveyed all 75 nursing program directors on their admissions policies in light of Chapter 712. Twenty–nine campuses responded to the survey. Of this number, six indicated that they planned to implement a merit–based policy by spring or fall 2009. Another nine programs reported that their districts were still in the process of deciding which approach to use (but expected a decision to be made later this year). The remaining 14 programs indicated that they do not have plans to move to an evaluative system in the foreseeable future. For this final group, the most common reasons given were that the programs do not have the resources to evaluate applicants based on multiple criteria (random selection is less labor intensive) or that attrition rates were already relatively low using their current nonevaluative selection process. Others indicated that they had recently made changes to their admissions process (such as requiring students to take the diagnostic assessment test) and needed time to fully evaluate the impact on student success before considering any further changes.

Recommend Linking Future Grant Funding to Attrition Rates and Admissions Process. As noted earlier, systemwide attrition (drop out) rates at CCC nursing programs are about 20 percent. There is a large disparity among programs, however. For example, in 2006–07, there were 19 programs with attrition rates below 10 percent, and another 19 programs with attrition over 25 percent. Attrition rates ranged between 0 percent to 59 percent. Chapter 712 allows community colleges the authority and flexibility to use the admissions model of their choice. We are concerned, however, about nursing programs with high attrition rates that refuse to switch to a merit–based system. It is reasonable to believe that attrition rates would decline if these programs made the effort to select the most–qualified applicants. In order to create an incentive for these programs to change their admissions policy, we recommend the Legislature condition continued receipt of enrollment–expansion grant funding on a district either (1) keeping attrition rates below a specified level (such as 15 percent), or (2) implementing a multi–criteria selection process as authorized by Chapter 712. (Virtually all nursing programs receive this grant funding.) Under our recommendation, successful programs with relatively low attrition rates would continue to receive grant funding regardless of their admissions policy.