BILL ANALYSIS Ó
------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 122|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
UNFINISHED BUSINESS
Bill No: SB 122
Author: Price (D)
Amended: 8/20/12
Vote: 21
SENATE BUSINESS, PROF & ECON DEVELOP COMM : 7-0, 1/9/12
AYES: Price, Emmerson, Corbett, Correa, Hernandez, Negrete
McLeod, Vargas
NO VOTE RECORDED: Walters, Wyland
SENATE APPROPRIATIONS COMMITTEE : 7-0, 1/19/12
AYES: Kehoe, Alquist, Emmerson, Lieu, Pavley, Price,
Steinberg
NO VOTE RECORDED: Walters, Runner
SENATE FLOOR : 30-6, 1/26/12
AYES: Alquist, Berryhill, Blakeslee, Calderon, Cannella,
Corbett, Correa, De León, DeSaulnier, Emmerson, Evans,
Fuller, Hancock, Hernandez, Kehoe, Leno, Lieu, Liu,
Lowenthal, Negrete McLeod, Padilla, Pavley, Price, Rubio,
Simitian, Steinberg, Vargas, Wolk, Wright, Yee
NOES: Anderson, Dutton, Gaines, Huff, La Malfa, Strickland
NO VOTE RECORDED: Harman, Runner, Walters, Wyland
SENATE BUSINESS, PROF & ECON DEVELOP COMM : 8-0, 8/30/12
(pursuant to Senate Rule 29.10)
AYES: Price, Emmerson, Corbett, Correa, Hernandez, Negrete
McLeod, Strickland, Vargas
NO VOTE RECORDED: Wyland
ASSEMBLY FLOOR : 67-9, 8/27/12 - See last page for vote
CONTINUED
SB 122
Page
2
SUBJECT : Nursing
SOURCE : Author
DIGEST : This bill authorizes the Board of Registered
Nursing (BRN) to receive a fee from applicants and for
renewal of a school of nursing's authorization, requires
BRN to enter into a Memorandum of Understanding (MOU) with
the Bureau for Private Postsecondary Education (Bureau) to
delineate the powers of the Bureau related to consumer
protection, as specified, and authorize the California
Medical Board (Board) to determine that an applicant is
eligible for a physician and surgeon's certificate if they
attended a foreign medical school that is not recognized or
has been previously disapproved by the Board if the
applicant meets specified requirements.
Assembly Amendments (1) authorize the Board to determine
that an applicant is eligible for a physician and surgeon's
certificate if they attended a foreign medical school that
is not recognized or has been previously disapproved by the
Board if the applicant meets certain requirements; (2)
require BRN to enter into an MOU with the Bureau for
Private Postsecondary Education (Bureau) to delineate the
powers of the Bureau related to consumer protection, as
specified; and (3) make other technical changes.
ANALYSIS : Existing law, the Business and Professions
Code:
1. Provides for the regulation of various health
professions by regulatory boards within the Department
of Consumer Affairs (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. Specifies that the BRN consists of nine members and
that as of January 1, 2012, the BRN sunsets and its
statutory authorization becomes inoperative and is
CONTINUED
SB 122
Page
3
repealed.
4. Specifies that the provision which provides for the
appointment of the Executive Officer for the BRN is
also repealed as of January 1, 2012.
5. Specifies that an approved school of nursing is one
that has been approved by the BRN, gives the course of
instruction approved by the BRN, covering not less
than two academic years, is affiliated or conducted in
connection with one or more hospitals, and is an
institution of higher education or is affiliated with
an institution of higher education.
6. Defines "institution of higher education" as
community colleges offering an associate of arts or
associate of science degree and private postsecondary
institutions offering an associate of arts or
associate of science degree.
7. Requires that a school of nursing that is not an
"institution of higher education," as defined, shall
make an agreement with an institution of higher
education in the same general location to grant an
associate of arts or associate of science degree to
individuals who graduate from the school of nursing or
to grant a baccalaureate degree with successful
completion of an additional course of study as
approved by the BRN and the institution involved.
8. Provides that the BRN shall determine by regulation
the required subjects of instruction in an approved
school of nursing and the amount of clinical
experience necessary.
9. Specifies that it shall be the duty of the BRN,
through its executive officer, to inspect all schools
of nursing in this state at such times as the BRN
shall deem necessary, and if it is found that a school
is not maintaining the standard(s) required by the
BRN, then the BRN may request the defects to be
corrected and if not corrected then the BRN may remove
them from the approved list.
CONTINUED
SB 122
Page
4
10. Provides that it is unlawful for anyone to conduct
a school of nursing unless the school has been
approved as an accredited school by the BRN, or is
exempt as specified.
Existing law, the Education Code:
1. Establishes the Bureau of Private Postsecondary
Education within the DCA and provides for Bureau
oversight and regulation of California private
postsecondary institutions pursuant to the Private
Postsecondary Education Act of 2009 (PPE Act),
including a school of nursing that is not accredited
by accrediting agencies affiliated with the Western
Association of Schools and Colleges or regional
accrediting agencies recognized by the United States
Department of Education.
2. Establishes numerous unfair business practices for
institutions covered by the PPE Act, including
prohibiting an institution from promising employment
or otherwise overstating the availability of jobs or
making untrue or misleading statements regarding
student completion, placement or expected salary
rates.
3. Sets forth certain disclosure requirements
pertaining to completion, placement, licensure, and
earning potential.
This bill:
1.Subjects a school of nursing or a new nursing program
seeking approval by the BRN to the following fee
schedule:
A. A fee of $5,000 for approval of a nursing program.
B. A fee of $3,500 for continuing approval of a
nursing program established after January 1, 2013.
C. A fee of $500 for processing authorization of a
substantive change to an approval of a school of
nursing.
CONTINUED
SB 122
Page
5
1.Deletes provisions requiring a school of nursing that is
not affiliated with an institution of higher education to
make an agreement with such an institution for purposes
of awarding nursing degrees and instead authorizes the
BRN to grant approval to these institutions to grant
nursing degrees.
2.Requires the BRN to issue a cease and desist order to a
school of nursing not approved by the BRN and to notify
the Bureau and the Attorney General of such a school.
Makes it unprofessional conduct for any registered nurse
(RN) to violate or attempt to violate or to assist or
abet the violation of this provision.
3.Requires meetings of the BRN to be held in northern and
southern California.
4.Requires the BRN to have a memorandum of understanding
with the Bureau to delineate the powers of the BRN and
the Bureau as related to schools of nursing and the
powers of the Bureau to protect the interest of students
attending institutions governed by the Private
Postsecondary Education Act of 2009.
5.Authorizes the Board to determine that an applicant is
eligible for a physician and surgeon's certificate if
they attended a foreign medical school that is not
recognized or has been previously disapproved by the
Board if the applicant meets the following requirements
and authorizes the Board to adopt regulations, as
specified, for implementing this authority:
A. Successfully completed a resident course of medical
education leading to a degree of medical doctor
equivalent to that specified under current law, as
specified;
B. Holds an unlimited and unrestricted license as a
physician and surgeon in another state or federal
territory and continuously practiced for at least 10
years, as specified, if the applicant acquired any of
his or her education from an unrecognized foreign
medical school;
CONTINUED
SB 122
Page
6
C. Holds an unlimited and unrestricted license as a
physician and surgeon in another state or federal
territory and continuously practiced for at least 20
years, as specified, if the applicant acquired any of
his or her education from a foreign medical school
previously disapproved by the Board;
D. Is certified by a specialty board that is a member
of the American Board of Medical Specialties;
E. Successfully passed specified examinations for
licensure as a physician and surgeon;
F. Has not been the subject of a disciplinary action
by a medical licensing authority or of adverse
judgments or settlements, as specified;
G. Successfully completed three years of approved
postgraduate training, as specified;
H. Is not subject to denial of licensure, as
specified, and;
I. Has not held a healing arts license and been the
subject of disciplinary action by a healing arts board
by any state or federal territory.
1.Prohibits specified persons from participating in this
program.
Background
The BRN is responsible for regulating the practice of 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
CONTINUED
SB 122
Page
7
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:
California Pre-licensure Registered Nursing
Programs.
Nurse-Midwifery Programs.
Nurse Practitioner Programs.
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.
The BRN also recognizes registered nursing is an integral
component of the health care delivery system. The BRN
affects public policy by collaborating and interacting with
legislators, consumers, health care providers, health care
insurers, professional organizations, and other state
agencies. The BRN takes a proactive role in structuring
health care and evaluating nursing trends in order to make
sound policy decisions. According to the BRN, this
enhances the Board's ability to interpret the Nursing
Practice Act and establish policies for its regulatory
CONTINUED
SB 122
Page
8
programs and activities, which are then implemented by the
BRN staff.
Due to the veto of SB 538, and the sunset of the BRN as of
January 1, 2012, the 9 members of the BRN have been
eliminated. The Governor does intend, however, to
immediately reconstitute the BRN in January of 2012. In
the meantime, the Governor, the former BRN and the DCA have
entered into an "Interagency Agreement" for the DCA and its
Director to assume the responsibilities, powers and duties
as permitted by law.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
According to the Assembly Appropriations Committee:
One-time information technology costs of $10,000 to the
BRN to begin collecting nursing program approval and
renewal fee revenue. Increased workload related to
approval and regulation of nursing schools of $100,000
annually, offset by increased revenue in the same amount
to the BRN special fund.
Potential increased staff costs to the Department of
Justice of $80,000 (charged to the BRN special fund) for
approximately 0.5 Deputy Attorneys General to enforce or
defend the BRN's ability to issue cease and desist
letters. These costs can vary depending upon the number
and complexity of cases.
SUPPORT : (Verified 8/28/12)
American Nurses Association of California
Board of Registered Nursing
Medical Board of California
ASSEMBLY FLOOR : 67-9, 8/27/12
AYES: Achadjian, Alejo, Allen, Ammiano, Atkins, Beall,
Bill Berryhill, Block, Blumenfield, Bonilla, Bradford,
Brownley, Buchanan, Butler, Charles Calderon, Campos,
Carter, Cedillo, Chesbro, Conway, Davis, Dickinson, Eng,
CONTINUED
SB 122
Page
9
Feuer, Fletcher, Fong, Fuentes, Furutani, Galgiani,
Gatto, Gordon, Gorell, Grove, Hagman, Hall, Hayashi,
Roger Hernández, Hill, Huber, Hueso, Huffman, Lara,
Logue, Bonnie Lowenthal, Ma, Mendoza, Miller, Mitchell,
Monning, Nestande, Norby, Olsen, Pan, Perea, V. Manuel
Pérez, Portantino, Skinner, Smyth, Solorio, Swanson,
Torres, Valadao, Wagner, Wieckowski, Williams, Yamada,
John A. Pérez
NOES: Donnelly, Beth Gaines, Garrick, Halderman, Jeffries,
Jones, Mansoor, Morrell, Nielsen
NO VOTE RECORDED: Cook, Harkey, Knight, Silva
JJA:n 8/31/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED