BILL NUMBER: SB 747	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  AUGUST 26, 2011
	AMENDED IN ASSEMBLY  JUNE 13, 2011
	AMENDED IN SENATE  APRIL 25, 2011
	AMENDED IN SENATE  APRIL 4, 2011

INTRODUCED BY   Senator Kehoe

                        FEBRUARY 18, 2011

   An act to amend Sections 2190.1, 2811.5, 2892.5, 2915, 3524.5,
4517, 4980.54, and 4996.22 of the Business and Professions Code, and
to amend Section 1337.3 of the Health and Safety Code, relating to
healing arts.



	LEGISLATIVE COUNSEL'S DIGEST


   SB 747, as amended, Kehoe. Continuing education: lesbian, gay,
bisexual, and transgender patients.
   Existing law provides for licensing and regulation of various
healing arts professions and generally requires licensees to complete
continuing education courses in order to remain eligible to renew
their licenses or certifications. Existing law imposes various
training requirements for certified nurse assistants regulated by the
State Department of Public Health.
   This bill would require physicians and surgeons, physician
assistants, registered nurses, licensed vocational nurses, nurse
practitioners, psychologists, marriage and family therapists,
licensed clinical social workers, psychiatric technicians, and
certified nurse assistants to complete at least one course of 2 to 5
hours in duration that provides instruction on cultural competency,
sensitivity, and best practices for providing adequate care to
lesbian, gay, bisexual, and transgender persons, as specified  ,
  with certain exceptions  . The bill would 
generally  require the applicable licensing or certifying entity
to enforce these requirements  , with certain exceptions  .
The new requirements would become effective on January 1, 2013.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 2190.1 of the Business and Professions Code is
amended to read:
   2190.1.  (a) The continuing medical education standards of Section
2190 may be met by educational activities that meet the standards of
the board and serve to maintain, develop, or increase the knowledge,
skills, and professional performance that a physician and surgeon
uses to provide care, or improve the quality of care provided for
patients, including, but not limited to, educational activities that
meet any of the following criteria:
   (1) Have a scientific or clinical content with a direct bearing on
the quality or cost-effective provision of patient care, community
or public health, or preventive medicine.
   (2) Concern quality assurance or improvement, risk management,
health facility standards, or the legal aspects of clinical medicine.

   (3) Concern bioethics or professional ethics.
   (4) Are designed to improve the physician-patient relationship.
   (b) (1) On and after July 1, 2006, all continuing medical
education courses shall contain curriculum that includes cultural and
linguistic competency in the practice of medicine.
   (2) Notwithstanding the provisions of paragraph (1), a continuing
medical education course dedicated solely to research or other issues
that does not include a direct patient care component and a course
offered by a continuing medical education provider that is not
located in this state are not required to contain curriculum that
includes cultural and linguistic competency in the practice of
medicine.
   (3) Associations that accredit continuing medical education
courses shall develop standards before July 1, 2006, for compliance
with the requirements of paragraph (1). The associations may develop
these standards in conjunction with an advisory group that has
expertise in cultural and linguistic competency issues.
   (4) A physician and surgeon who completes a continuing education
course meeting the standards developed pursuant to paragraph (3)
satisfies the continuing education requirement for cultural and
linguistic competency.
   (c) In order to satisfy the requirements of subdivision (b),
continuing medical education courses shall address at least one or a
combination of the following:
   (1) Cultural competency. For the purposes of this section,
"cultural competency" means a set of integrated attitudes, knowledge,
and skills that enables a health care professional or organization
to care effectively for patients from diverse cultures, groups, and
communities. At a minimum, cultural competency is recommended to
include the following:
   (A) Applying linguistic skills to communicate effectively with the
target population.
   (B) Utilizing cultural information to establish therapeutic
relationships.
   (C) Eliciting and incorporating pertinent cultural data in
diagnosis and treatment.
   (D) Understanding and applying cultural and ethnic data to the
process of clinical care.
   (2) Linguistic competency. For the purposes of this section,
"linguistic competency" means the ability of a physician and surgeon
to provide patients who do not speak English or who have limited
ability to speak English, direct communication in the patient's
primary language.
   (3) A review and explanation of relevant federal and state laws
and regulations regarding linguistic access, including, but not
limited to, the federal Civil Rights Act (42 U.S.C. Sec. 1981, et
seq.), Executive Order 13166 of August 11, 2000, of the President of
the United States, and the Dymally-Alatorre Bilingual Services Act
(Chapter 17.5 (commencing with Section 7290) of Division 7 of Title 1
of the Government Code).
   (d)  (1)    On and after January 1, 2013, the
board shall require all of its licensees under this chapter to take
at least one continuing education course that provides instruction on
cultural competency, sensitivity, and best practices for providing
adequate care to lesbian, gay, bisexual, and transgender persons.
Persons licensed by the board before January 1, 2013, shall complete
the course no later than January 1, 2017. Persons who are newly
licensed by the board on and after January 1, 2013, shall complete
the course within four years of their initial license issuance date
or their second license renewal date, whichever occurs first. The
course shall be between two and five hours in duration and shall
contain content similar to the content described in the publication
of the Gay and Lesbian Medical Association entitled "Guidelines for
Care of Lesbian, Gay, Bisexual, and Transgender Patients." The board
may specify the required contents of the course by regulation
consistent with this subdivision. The board shall enforce this
requirement in the same manner as it enforces other required
continuing education requirements. 
   (2) By regulatory action the board may exempt physicians and
surgeons by practice status category from the requirements of this
subdivision if the physician and surgeons does not engage in direct
patient care, does not provide patient consultations, or does not
reside in the State of California.  
   (3) This subdivision shall not apply to physicians and surgeons
practicing in pathology or radiology specialty areas. 
   (e) Notwithstanding subdivision (a), educational activities that
are not directed toward the practice of medicine, or are directed
primarily toward the business aspects of medical practice, including,
but not limited to, medical office management, billing and coding,
and marketing shall not be deemed to meet the continuing medical
education standards for licensed physicians and surgeons.
   (f) Educational activities that meet the content standards set
forth in this section and are accredited by the California Medical
Association or the Accreditation Council for Continuing Medical
Education may be deemed by the Division of Licensing to meet its
continuing medical education standards.
  SEC. 2.  Section 2811.5 of the Business and Professions Code is
amended to read:
   2811.5.  (a) Each person renewing his or her license under Section
2811 shall submit proof satisfactory to the board that, during the
preceding two-year period, he or she has been informed of the
developments in the registered nurse field or in any special area of
practice engaged in by the licensee, occurring since the last renewal
thereof, either by pursuing a course or courses of continuing
education in the registered nurse field or relevant to the practice
of the licensee, and approved by the board, or by other means deemed
equivalent by the board.
   (b) For purposes of this section, the board shall, by regulation,
establish standards for continuing education. The standards shall be
established in a manner to ensure that a variety of alternative forms
of continuing education are available to licensees, including, but
not limited to, academic studies, in-service education, institutes,
seminars, lectures, conferences, workshops, extension studies, and
home study programs. The standards shall take cognizance of
specialized areas of practice. The continuing education standards
established by the board shall not exceed 30 hours of direct
participation in a course or courses approved by the board, or its
equivalent in the units of measure adopted by the board.
   (c) The board shall encourage continuing education in spousal or
partner abuse detection and treatment. In the event the board
establishes a requirement for continuing education coursework in
spousal or partner abuse detection or treatment, that requirement
shall be met by each licensee within no more than four years from the
date the requirement is imposed.
   (d) In establishing standards for continuing education, the board
shall consider including a course in the special care needs of
individuals and their families facing end-of-life issues, including,
but not limited to, all of the following:
   (1) Pain and symptom management.
   (2) The psycho-social dynamics of death.
   (3) Dying and bereavement.
   (4) Hospice care.
   (e) In establishing standards for continuing education, the board
may include a course on pain management.
   (f) This section shall not apply to licensees during the first two
years immediately following their initial licensure in California or
any other governmental jurisdiction.
   (g) On and after January 1, 2013,  the board shall require
all of its licensees to   all persons licensed by the
board shall  take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2013, shall complete the course no later than January 1, 2018.
Persons who are newly licensed by the board on and after January 1,
2013, shall complete the course before their third license renewal
date. The course shall be between two and five hours in duration and
shall contain content similar to the content described in the
publication of the Gay and Lesbian Medical Association entitled
"Guidelines for Care of Lesbian, Gay, Bisexual, and Transgender
Patients." The board may specify the required contents of the course
by regulation consistent with this subdivision. The board shall not
enforce this requirement in the same manner as it enforces
other required continuing education requirements, and shall instead
request all persons licensed by the board to disclose on the renewal
form or a supplemental form whether they have complied with this
requirement.   nor shall the board ensure compliance of
licensees except to inform licensees that this requirement exists and
that proof of compliance must be submitted during the license
renewal process. 
   (h) The board may, in accordance with the intent of this section,
make exceptions from continuing education requirements for licensees
residing in another state or country, or for reasons of health,
military service, or other good cause.
   (i) This section shall apply to all persons licensed under this
chapter, including nurse practitioners.
  SEC. 3.  Section 2892.5 of the Business and Professions Code is
amended to read:
   2892.5.  (a) Each person renewing his or her license under the
provisions of this chapter shall submit proof satisfactory to the
board that, during the preceding two-year period, he or she has
informed himself or herself of developments in the vocational nurse
field or in any special area of vocational nurse practice, occurring
since the issuance of his or her certificate, or the last renewal
thereof, whichever last occurred, either by pursuing a course or
courses of continuing education approved by the board in the
vocational nurse field or relevant to the practice of such licensee,
and approved by the board; or by other means deemed equivalent by the
board.
   (b) For purposes of this section, the board shall, by regulation,
establish standards for continuing education. The standards shall be
established in a manner to ensure that a variety of alternative forms
of continuing education are available to licensees including, but
not limited to, academic studies, in-service education, institutes,
seminars, lectures, conferences, workshops, extension studies, and
home study programs. The standards shall take cognizance of
specialized areas of practice. The continuing education standards
established by the board shall not exceed 30 hours of direct
participation in a course or courses approved by the board, or its
equivalent in the units of measure adopted by the board.
   (c) This section shall not apply to the first license renewal
following the initial issuance of a license.
   (d) On and after January 1, 2013, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2013, shall complete the course no later than January 1, 2017.
Persons who are newly licensed by the board on and after January 1,
2013, shall complete the course within four years of their initial
license issuance date or their second license renewal date, whichever
occurs first. The course shall be between two and five hours in
duration and shall contain content similar to the content described
in the publication of the Gay and Lesbian Medical Association
entitled "Guidelines for Care of Lesbian, Gay, Bisexual, and
Transgender Patients." The board may specify the required contents of
the course by regulation consistent with this subdivision. The board
shall enforce this requirement in the same manner as it enforces
other required continuing education requirements.
   (e) The board may, in accordance with the intent of this section,
make exceptions from continuing education for licensees residing in
another state or country, or for reasons of health, military service,
or other good cause.
  SEC. 4.  Section 2915 of the Business and Professions Code is
amended to read:
   2915.  (a) Except as provided in this section, on or after January
1, 1996, the board shall not issue any renewal license unless the
applicant submits proof that he or she has completed no less than 18
hours of approved continuing education in the preceding year. On or
after January 1, 1997, except as provided in this section, the board
shall issue renewal licenses only to those applicants who have
completed 36 hours of approved continuing education in the preceding
two years.
   (b) Each person renewing his or her license issued pursuant to
this chapter shall submit proof of compliance with this section to
the board. False statements submitted pursuant to this section shall
be a violation of Section 2970.
   (c) A person applying for relicensure or for reinstatement to an
active license status shall certify under penalty of perjury that he
or she is in compliance with this section.
   (d) (1) The continuing education requirement shall include, but
shall not be limited to, courses required pursuant to Sections 25 and
28. The requirement may include courses pursuant to Sections 32 and
2914.1.
   (2) (A) The board shall require a licensed psychologist who began
graduate study prior to January 1, 2004, to take a continuing
education course during his or her first renewal period after the
operative date of this section in spousal or partner abuse
assessment, detection, and intervention strategies, including
community resources, cultural factors, and same gender abuse
dynamics. Equivalent courses in spousal or partner abuse assessment,
detection, and intervention strategies taken prior to the operative
date of this section or proof of equivalent teaching or practice
experience may be submitted to the board and at its discretion, may
be accepted in satisfaction of this requirement.
   (B) Continuing education courses taken pursuant to this paragraph
shall be applied to the 36 hours of approved continuing education
required under subdivision (a).
   (C) A licensed psychologist whose practice does not include the
direct provision of mental health services may apply to the board for
an exemption from the requirements of this paragraph.
   (3) Continuing education instruction approved to meet the
requirements of this section shall be completed within the State of
California, or shall be approved for continuing education credit by
the American Psychological Association or its equivalent as approved
by the board.
   (e) The board may establish a policy for exceptions from the
continuing education requirement of this section.
   (f) The board may recognize continuing education courses that have
been approved by one or more private nonprofit organizations that
have at least 10 years' experience managing continuing education
programs for psychologists on a statewide basis, including, but not
limited to:
   (1) Maintaining and managing related records and data.
   (2) Monitoring and approving courses.
   (g) The board shall adopt regulations as necessary for
implementation of this section.
   (h) A licensed psychologist shall choose continuing education
instruction that is related to the assessment, diagnosis, and
intervention for the client population being served or to the fields
of psychology in which the psychologist intends to provide services,
that may include new theoretical approaches, research, and applied
techniques. Continuing education instruction shall include required
courses specified in subdivision (d).
   (i) A psychologist shall not practice outside his or her
particular field or fields of competence as established by his or her
education, training, continuing education, and experience.
   (j) On and after January 1, 2013, the board shall require every
person licensed under this chapter to take at least one continuing
education course that provides instruction on cultural competency,
sensitivity, and best practices for providing adequate care to
lesbian, gay, bisexual, and transgender persons. Persons licensed by
the board before January 1, 2013, shall complete the course no later
than January 1, 2017. Persons who are newly licensed by the board
under this chapter on and after January 1, 2013, shall complete the
course within four years of their initial license issuance date or
their second license renewal date, whichever occurs first. The course
shall be between two and five hours in duration and shall contain
content similar to the content described in the publication of the
Gay and Lesbian Medical Association entitled "Guidelines for Care of
Lesbian, Gay, Bisexual, and Transgender Patients." The board may
specify the required contents of the course by regulation consistent
with this subdivision. The board shall enforce this requirement in
the same manner as it enforces other required continuing education
requirements.
   (k) The administration of this section may be funded through
professional license fees and continuing education provider and
course approval fees, or both. The fees related to the administration
of this section shall not exceed the costs of administering the
corresponding provisions of this section.
   (l) Continuing education credit may be approved for those
licensees who serve as commissioners on any examination pursuant to
Section 2947, subject to limitations established by the board.
  SEC. 5.  Section 3524.5 of the Business and Professions Code is
amended to read:
   3524.5.  (a) The committee may require a licensee to complete
continuing education as a condition of license renewal under Section
3523 or 3524. The committee shall not require more than 50 hours of
continuing education every two years. The committee shall, as it
deems appropriate, accept certification by the National Commission on
Certification of Physician Assistants (NCCPA), or another qualified
certifying body, as determined by the committee, as evidence of
compliance with continuing education requirements.
   (b) On and after January 1, 2013, the board shall require all of
its licensees under this chapter to take at least one continuing
education course that provides instruction on cultural competency,
sensitivity, and best practices for providing adequate care to
lesbian, gay, bisexual, and transgender persons. Persons licensed by
the board before January 1, 2013, shall complete the course no later
than January 1, 2017. Persons who are newly licensed by the board on
and after January 1, 2013, shall complete the course within four
years of their initial license issuance date or their second license
renewal date, whichever occurs first. The course shall be between two
and five hours in duration and shall contain content similar to the
content described in the publication of the Gay and Lesbian Medical
Association entitled "Guidelines for Care of Lesbian, Gay, Bisexual,
and Transgender Patients." The board may specify the required
contents of the course by regulation consistent with this
subdivision. The board shall enforce this requirement in the same
manner as it enforces other required continuing education
requirements.
  SEC. 6.  Section 4517 of the Business and Professions Code is
amended to read:
   4517.  (a) The board may, in its discretion, provide for a
continuing education program in connection with the professional
functions and courses described in this chapter. The number of course
hours that the board may require in a continuing education program
shall not exceed the number of course hours prescribed for licensed
vocational nurses pursuant to Section 2892.5.
   (b) On and after January 1, 2013, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2013, shall complete the course no later than January 1, 2017.
Persons who are newly licensed by the board on and after January 1,
2013, shall complete the course within four years of their initial
license issuance date or their second license renewal date, whichever
occurs first. The course shall be between two and five hours in
duration and shall contain content similar to the content described
in the publication of the Gay and Lesbian Medical Association
entitled "Guidelines for Care of Lesbian, Gay, Bisexual, and
Transgender Patients." The board may specify the required contents of
the course by regulation consistent with this subdivision. The board
shall enforce this requirement in the same manner as it enforces
other required continuing education requirements.
  SEC. 7.  Section 4980.54 of the Business and Professions Code is
amended to read:
   4980.54.  (a) The Legislature recognizes that the education and
experience requirements in this chapter constitute only minimal
requirements to ensure that an applicant is prepared and qualified to
take the licensure examinations as specified in subdivision (d) of
Section 4980.40 and, if he or she passes those examinations, to begin
practice.
   (b) In order to continuously improve the competence of licensed
marriage and family therapists and as a model for all
psychotherapeutic professions, the Legislature encourages all
licensees to regularly engage in continuing education related to the
profession or scope of practice as defined in this chapter.
   (c) Except as provided in subdivision (e), the board shall not
renew any license pursuant to this chapter unless the applicant
certifies to the board, on a form prescribed by the board, that he or
she has completed not less than 36 hours of approved continuing
education in or relevant to the field of marriage and family therapy
in the preceding two years, as determined by the board.
   (d) The board shall have the right to audit the records of any
applicant to verify the completion of the continuing education
requirement. Applicants shall maintain records of completion of
required continuing education coursework for a minimum of two years
and shall make these records available to the board for auditing
purposes upon request.
   (e) The board may establish exceptions from the continuing
education requirements of this section for good cause, as defined by
the board.
   (f) The continuing education shall be obtained from one of the
following sources:
   (1) An accredited school or state-approved school that meets the
requirements set forth in Section 4980.36 or 4980.37. Nothing in this
paragraph shall be construed as requiring coursework to be offered
as part of a regular degree program.
   (2) Other continuing education providers, including, but not
limited to, a professional marriage and family therapist association,
a licensed health facility, a governmental entity, a continuing
education unit of an accredited four-year institution of higher
learning, or a mental health professional association, approved by
the board.
   (g) The board shall establish, by regulation, a procedure for
approving providers of continuing education courses, and all
providers of continuing education, as described in paragraphs (1) and
(2) of subdivision (f), shall adhere to procedures established by
the board. The board may revoke or deny the right of a provider to
offer continuing education coursework pursuant to this section for
failure to comply with the requirements of this section or any
regulation adopted pursuant to this section.
   (h) Training, education, and coursework by approved providers
shall incorporate one or more of the following:
   (1) Aspects of the discipline that are fundamental to the
understanding or the practice of marriage and family therapy.
   (2) Aspects of the discipline of marriage and family therapy in
which significant recent developments have occurred.
   (3) Aspects of other disciplines that enhance the understanding or
the practice of marriage and family therapy.
   (i) A system of continuing education for licensed marriage and
family therapists shall include courses directly related to the
diagnosis, assessment, and treatment of the client population being
served.
   (j) On and after January 1, 2013, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2013, shall complete the course no later than January 1, 2017.
Persons who are newly licensed by the board on and after January 1,
2013, shall complete the course within four years of their initial
license issuance date or their second license renewal date, whichever
occurs first. The course shall be between two and five hours in
duration and shall contain content similar to the content described
in the publication of the Gay and Lesbian Medical Association
entitled "Guidelines for Care of Lesbian, Gay, Bisexual, and
Transgender Patients." The board may specify the required contents of
the course by regulation consistent with this subdivision. The board
shall enforce this requirement in the same manner as it enforces
other required continuing education requirements.
   (k) The board shall, by regulation, fund the administration of
this section through continuing education provider fees to be
deposited in the Behavioral Sciences Fund. The fees related to the
administration of this section shall be sufficient to meet, but shall
not exceed, the costs of administering the corresponding provisions
of this section. For purposes of this subdivision, a provider of
continuing education                                           as
described in paragraph (1) of subdivision (f) shall be deemed to be
an approved provider.
   (l) The continuing education requirements of this section shall
comply fully with the guidelines for mandatory continuing education
established by the Department of Consumer Affairs pursuant to Section
166.
  SEC. 8.  Section 4996.22 of the Business and Professions Code is
amended to read:
   4996.22.  (a) (1) Except as provided in subdivision (c), the board
shall not renew any license pursuant to this chapter unless the
applicant certifies to the board, on a form prescribed by the board,
that he or she has completed not less than 36 hours of approved
continuing education in or relevant to the field of social work in
the preceding two years, as determined by the board.
   (2) The board shall not renew any license of an applicant who
began graduate study prior to January 1, 2004, pursuant to this
chapter unless the applicant certifies to the board that during the
applicant's first renewal period after the operative date of this
section, he or she completed a continuing education course in spousal
or partner abuse assessment, detection, and intervention strategies,
including community resources, cultural factors, and same gender
abuse dynamics. On and after January 1, 2005, the course shall
consist of not less than seven hours of training. Equivalent courses
in spousal or partner abuse assessment, detection, and intervention
strategies taken prior to the operative date of this section or proof
of equivalent teaching or practice experience may be submitted to
the board and at its discretion, may be accepted in satisfaction of
this requirement. Continuing education courses taken pursuant to this
paragraph shall be applied to the 36 hours of approved continuing
education required under paragraph (1).
   (b) The board shall have the right to audit the records of any
applicant to verify the completion of the continuing education
requirement. Applicants shall maintain records of completion of
required continuing education coursework for a minimum of two years
and shall make these records available to the board for auditing
purposes upon request.
   (c) The board may establish exceptions from the continuing
education requirement of this section for good cause as defined by
the board.
   (d) The continuing education shall be obtained from one of the
following sources:
   (1) An accredited school of social work, as defined in Section
4991.2, or a school or department of social work that is a candidate
for accreditation by the Commission on Accreditation of the Council
on Social Work Education. Nothing in this paragraph shall be
construed as requiring coursework to be offered as part of a regular
degree program.
   (2) Other continuing education providers, including, but not
limited to, a professional social work association, a licensed health
facility, a governmental entity, a continuing education unit of an
accredited four-year institution of higher learning, and a mental
health professional association, approved by the board.
   (e) The board shall establish, by regulation, a procedure for
approving providers of continuing education courses, and all
providers of continuing education, as described in paragraphs (1) and
(2) of subdivision (d), shall adhere to the procedures established
by the board. The board may revoke or deny the right of a provider to
offer continuing education coursework pursuant to this section for
failure to comply with the requirements of this section or any
regulation adopted pursuant to this section.
   (f) Training, education, and coursework by approved providers
shall incorporate one or more of the following:
   (1) Aspects of the discipline that are fundamental to the
understanding, or the practice, of social work.
   (2) Aspects of the social work discipline in which significant
recent developments have occurred.
   (3) Aspects of other related disciplines that enhance the
understanding, or the practice, of social work.
   (g) A system of continuing education for licensed clinical social
workers shall include courses directly related to the diagnosis,
assessment, and treatment of the client population being served.
   (h) The continuing education requirements of this section shall
comply fully with the guidelines for mandatory continuing education
established by the Department of Consumer Affairs pursuant to Section
166.
   (i) On and after January 1, 2013, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2013, shall complete the course no later than January 1, 2017.
Persons who are newly licensed by the board on and after January 1,
2013, shall complete the course within four years of their initial
license issuance date or their second license renewal date, whichever
occurs first. The course shall be between two and five hours in
duration and shall contain content similar to the content described
in the publication of the Gay and Lesbian Medical Association
entitled "Guidelines for Care of Lesbian, Gay, Bisexual, and
Transgender Patients." The board may specify the required contents of
the course by regulation consistent with this subdivision. The board
shall enforce this requirement in the same manner as it enforces
other required continuing education requirements.
   (j) The board may adopt regulations as necessary to implement this
section.
   (k) The board shall, by regulation, fund the administration of
this section through continuing education provider fees to be
deposited in the Behavioral Science Examiners Fund. The fees related
to the administration of this section shall be sufficient to meet,
but shall not exceed, the costs of administering the corresponding
provisions of this section. For purposes of this subdivision, a
provider of continuing education as described in paragraph (1) of
subdivision (d) shall be deemed to be an approved provider.
  SEC. 9.  Section 1337.3 of the Health and Safety Code is amended to
read:
   1337.3.  (a) The state department shall prepare and maintain a
list of approved training programs for nurse assistant certification.
The list shall include training programs conducted by skilled
nursing or intermediate care facilities, as well as local agencies
and education programs. In addition, the list shall include
information on whether a training center is currently training nurse
assistants, their competency test pass rates, and the number of nurse
assistants they have trained. Clinical portions of the training
programs may be obtained as on-the-job training, supervised by a
qualified director of staff development or licensed nurse.
   (b) It shall be the duty of the state department to inspect a
representative sample of training programs. The state department
shall protect consumers and students in any training program against
fraud, misrepresentation, or other practices that may result in
improper or excessive payment of funds paid for training programs. In
evaluating a training center's training program, the state
department shall examine each training center's trainees' competency
test passage rate, and require each program to maintain an average 60
percent test score passage rate to maintain its participation in the
program. The average test score passage rate shall be calculated
over a two-year period. If the state department determines that any
training program is not complying with regulations or is not meeting
the competency passage rate requirements, notice thereof in writing
shall be immediately given to the program. If the program has not
been brought into compliance within a reasonable time, the program
may be removed from the approved list and notice thereof in writing
given to it. Programs removed under this article shall be afforded an
opportunity to request reinstatement of program approval at any
time. The state department's district offices shall inspect
facility-based centers as part of their annual survey.
   (c) Notwithstanding Section 1337.1, the approved training program
shall consist of at least the following:
   (1) A 16-hour orientation program to be given to newly employed
nurse assistants prior to providing direct patient care, and
consistent with federal training requirements for facilities
participating in the Medicare or Medicaid programs.
   (2) (A) A certification training program consisting of at least 60
classroom hours of training on basic nursing skills, patient safety
and rights, the social and psychological problems of patients, and
elder abuse recognition and reporting pursuant to subdivision (e) of
Section 1337.1. The 60 classroom hours of training may be conducted
within a skilled nursing facility, an intermediate care facility, or
an educational institution.
   (B) In addition to the 60 classroom hours of training required
under subparagraph (A), the certification program shall also consist
of 100 hours of supervised and on-the-job training clinical practice.
The 100 hours may consist of normal employment as a nurse assistant
under the supervision of either the director of staff development or
a licensed nurse qualified to provide nurse assistant training who
has no other assigned duties while providing the training.
   (3) At least two hours of the 60 hours of classroom training and
at least four hours of the 100 hours of the supervised clinical
training shall address the special needs of persons with
developmental and mental disorders, including mental retardation,
Alzheimer's disease, cerebral palsy, epilepsy, dementia, Parkinson's
disease, and mental illness.
   (4) On and after January 1, 2013, at least two, but not more than
five, hours of the classroom training shall provide instruction on
cultural competency, sensitivity, and best practices for providing
adequate care to lesbian, gay, bisexual, and transgender persons.
Persons certified by the state department under this article before
January 1, 2013, shall complete the course no later than January 1,
2017. Persons who are newly certified by the state department under
this article on and after January 1, 2013, shall complete the course
within four years of their initial certificate issuance date or their
second certificate renewal date, whichever occurs first. The
instruction shall contain content similar to the content described in
the publication of the Gay and Lesbian Medical Association entitled
"Guidelines for Care of Lesbian, Gay, Bisexual, and Transgender
Patients." The state department may specify the required contents of
the course by regulation consistent with this paragraph. The state
department shall enforce this requirement in the same manner as it
enforces other required training requirements.
   (d) The state department, in consultation with the State
Department of Education and other appropriate organizations, shall
develop criteria for approving training programs, that includes
program content for orientation, training, inservice, and the
examination for testing knowledge and skills related to basic patient
care services and shall develop a plan that identifies and
encourages career ladder opportunities for certified nurse
assistants. This group shall also recommend, and the department shall
adopt, regulation changes necessary to provide for patient care when
facilities utilize noncertified nurse assistants who are performing
direct patient care. The requirements of this subdivision shall be
established by January 1, 1989.
   (e) On or before January 1, 2004, the state department, in
consultation with the State Department of Education, the American Red
Cross, and other appropriate organizations, shall do the following:
   (1) Review the current examination for approved training programs
for certified nurse assistants to ensure the accurate assessment of
whether a nurse assistant has obtained the required knowledge and
skills related to basic patient care services.
   (2) Develop a plan that identifies and encourages career ladder
opportunities for certified nurse assistants, including the
application of on-the-job post-certification hours to educational
credits.
   (f) A skilled nursing or intermediate care facility shall
determine the number of specific clinical hours within each module
identified by the state department required to meet the requirements
of subdivision (d), subject to subdivisions (b) and (c). The facility
shall consider the specific hours recommended by the state
department when adopting the certification training program required
by this chapter.
   (g) This article shall not apply to a program conducted by any
church or denomination for the purpose of training the adherents of
the church or denomination in the care of the sick in accordance with
its religious tenets.
   (h) The Chancellor of the California Community Colleges shall
provide to the state department a standard process for approval of
college credit. The state department shall make this information
available to all training programs in the state.