BILL ANALYSIS Ó
SB 98
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Date of Hearing: January 31, 2012
ASSEMBLY COMMITTEE ON BUDGET
Bob Blumenfield, Chair
SB 98 (Committee on Budget and Fiscal Review) - As Amended:
January 26, 2012
SUBJECT : Board of Registered Nursing
SUMMARY : This bill restores the Board of Registered Nursing
until 2016. Specifically, this bill :
1)Restores the Board of Registered Nursing (BRN) and establishes
a new sunset date of January 1, 2016;
2)Establishes the BRN within the Department of Consumer Affairs
(DCA);
3)Re-establishes the terms of office for the nine members of the
BRN at four years, but with staggered initial appointments in
order to have staggered terms going forward, as follows:
a) Senate appointment - public member: 4 years
b) Assembly appointment - public member: 4 years
c) Governor's appointments:
d) #1 - public member: 1 year
e) #2 - public member: 5 years
f) #3 - RN #1: 2 years
g) #4 - RN #2: 3 years
h) #5 - nurse educator: 4 years
i) #6 and #7 - nurse administrator and advanced practice
nurse: Governor's choice on which one serves 2 years and
which one serves 3 years for their initial terms
1)Ratifies the interagency agreement between the BRN and the
Director of Consumer Affairs;
2)Provides for an interim executive officer until the board
appoints a permanent executive officer, and deems that interim
executive officer to be the same person who was serving as
executive officer before the board expired;
3)Appropriates to the BRN unencumbered funds in the Board of
Registered Nursing Fund (Fund) that were appropriated to the
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BRN in the 2011 Budget Act and $1,000 from the Fund for the
purpose of administering the Nursing Practice Act.
EXISTING LAW:
1)Provides for the regulation of various health professions by
regulatory boards within the DCA.
2)Establishes the Nursing Practice Act, which provides for the
certification and regulation of registered nurses, nurse
practitioners, and advanced practice nurses by the BRN within
the DCA.
3)Establishes within the DCA, the Division of Investigation
(DOI), to investigate alleged misconduct by licensees of
boards. Allows the Director of the DCA to employ such
investigators, inspectors, and deputies as are necessary to
investigate and prosecute all violations of any law. States
Legislative intent that inspectors used by boards are not
required to be employees of the DOI, but may be either
employees or under contract to the boards.
4)Provides that investigators of the DOI and the Medical Board
of California and Dental Board of California have the
authority of peace officers and that those entities are also
authorized to employ individuals who are not peace officers to
provide investigative services.
5)(Repealed) Specified that the BRN consisted of nine members
and that as of January 1, 2012, the BRN would sunset (and be
repealed), unless a later enacted statute were to be enacted
prior to January 1, 2012. This did not occur. The BRN is
subject to review by the Legislature prior to its sunset date.
6)Specified that the provision, which provided for the
appointment of the Executive Officer for the BRN would be
repealed as of January 1, 2012, unless a later enacted statute
was enacted before January 1, 2012.
FISCAL EFFECT : Approximately $30 million (BRN Fund) annually
in regulatory costs will continue to be incurred as a result of
extending the sunset on the BRN. The BRN is fully-funded with
fee revenue.
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COMMENTS : The BRN is responsible for regulating the practice of
registered nurses (RNs) in California. Currently, there are
almost 380,000 licensed RNs in California, with over 23,000 new
licenses issued annually, and more than 170,000 licenses renewed
annually. The BRN also regulates interim permittees, i.e.,
applicants who are pending licensure by examination, and
temporary licensees, i.e., out-of-state applicants who are
pending licensure by endorsement. The interim permit allows the
applicant to practice while under the supervision of an RN while
awaiting examination results. Similarly, the temporary license
enables the applicant to practice registered nursing pending a
final decision on the licensure application. The BRN also
issues certificates to Clinical Nurse Specialists, Nurse
Anesthetists, Nurse Practitioners, Nurse-Midwives and Public
Health Nurses. These titles are those most commonly used by the
California RNs and use of the titles is protected under the
Business and Professions Code. The BRN also issues furnishing
numbers to nurse practitioners and nurse midwives to administer
prescriptions and lists psychiatric/mental health nurses. In
addition to its licensing and certification functions, the BRN
also regulates and approves the following entities: 1)
California Pre-licensure Registered Nursing Programs; 2)
Nurse-Midwifery Programs; 3) Nurse Practitioner Programs; and,
4) Registered Nursing Continuing Education Providers.
The BRN is responsible for implementation and enforcement of the
Nursing Practice Act -- the laws and regulations related to
nursing education, licensure, practice, and discipline. The BRN
implements regulatory programs and performs a variety of
activities to protect the public. These programs and activities
include, setting registered nurse educational standards for
pre-licensure and advanced practice nursing programs, issuing
and renewing registered nurse licenses, issuing certificates for
advanced practice nurses and public health nurses, taking
disciplinary action for violation of the Nursing Practice Act,
and managing a Diversion Program for registered nurses whose
practice may be impaired due to chemical dependency or mental
illness.
Recognizing that registered nursing is an integral component of
the health care delivery system, the BRN seeks to affect public
policy by collaborating and interacting with legislators,
consumers, health care providers, health care insurers,
professional organizations, and other state agencies. According
to the BRN, this enhances the Board's ability to interpret the
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Nursing Practice Act and establish policies for its regulatory
programs and activities, which are then implemented by the BRN
staff.
The former composition of the BRN included seven members who
were appointed by the Governor, one by the Senate Rules
Committee and one by the Assembly Speaker. The Board included
four public members, two registered nurses in direct patient
care practice, an advanced practice registered nurse, a
registered nurse educator, and a registered nurse administrator.
The former statute included a sunset on the BRN of January 1,
2012 and no subsequent legislation was passed and signed to
extend the sunset. This is due in part to the fact that there
was legislation last year (SB 538) to extend it to 2016, as SB
98 does, however SB 538 contained additional provisions that
made changes to the operation of the BRN, related to pension
benefits, which the Governor objected to and therefore vetoed
the bill. In his veto message, the Governor asked the
Legislature to send him legislation to restore the BRN as soon
as possible.
The dissolution of the BRN means that substantial work in the
area of licensing, disciplinary action, and general nursing
practice oversight cannot continue. The BRN adopts, amends or
rejects proposed decisions by administrative law judges who hear
cases on nurse discipline. Now, judges' decisions will
automatically take effect if no board action is taken in 100
days. The BRN also approves or rejects settlements reached
between attorneys representing nurses accused of misconduct and
deputy attorneys general representing the board. Those cases
also will be subject to approval by administrative judges whose
decisions are final if the board takes no action in 100 days.
The DCA continues to do the staff work, such as processing
licensing applications and investigating complaints.
REGISTERED SUPPORT / OPPOSITION :
Support
None on file.
Opposition
None on file.
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Analysis Prepared by : Andrea Margolis / BUDGET / (916)
319-2099