BILL ANALYSIS Ó
SB 98
Page 1
SENATE THIRD READING
SB 98 (Budget and Fiscal Review Committee)
As Amended January 26, 2012
Majority vote. Budget Bill Appropriation Takes Effect
Immediately
SENATE VOTE :Vote not relevant
BUDGET 19-4
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|Ayes:|Blumenfield, Alejo, | | |
| |Allen, Bonilla, Brownley, | | |
| |Buchanan, Butler, | | |
| |Cedillo, Chesbro, | | |
| |Dickinson, Feuer, Gordon, | | |
| |Huffman, Jeffries, Jones, | | |
| |Mitchell, Monning, | | |
| |Nestande, Swanson | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Logue, Mansoor, Morrell, | | |
| |Wagner | | |
| | | | |
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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: four years;
b) Assembly appointment - public member: four years; and,
c) Governor's appointments:
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i) Appointee 1 - public member: one year;
ii) Appointee 2 - public member: five years;
iii) Appointee 3 - RN #1: two years;
iv) Appointee 4 - RN #2: three years;
v) Appointee 5 - nurse educator: four years; and,
vi) Appointee 6 and Appointee 7 - nurse administrator
and advanced practice nurse: Governor's choice on which
one serves two years and which one serves three 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
BRN in the 2011 Budget Act and $1,000 from the Fund for the
purpose of administering the Nursing Practice Act.
4)Declares that it take effect immediately as a bill providing
for appropriations related to the Budget Bill.
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
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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)Specifies 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. The BRN is subject to review by the
Legislature prior to its sunset date. (Repealed).
6)Specifies 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.
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
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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 their ability to interpret the 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 BRN 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 (Price) to extend it to 2016,
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as this bill 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 BRN 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 BRN. Those cases also will
be subject to approval by administrative judges whose decisions
are final if the BRN takes no action in 100 days. The DCA
continues to do the staff work, such as processing licensing
applications and investigating complaints.
Analysis Prepared by : Andrea Margolis / BUDGET / (916)
319-2099
FN: 0003106