BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1028
                                                                  Page  1

          Date of Hearing:   April 16, 2013

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER  
                                     PROTECTION
                              Richard S. Gordon, Chair
                   AB 1028 (Patterson) - As Amended:  April 3, 2013
           
          SUBJECT  :   Vocational nursing: interim permits.

           SUMMARY  :   Authorizes an applicant for licensure as a vocational  
          nurse (VN) to submit an application for an interim permit (IP)  
          at the same time as the applicant submits his or her application  
          for licensure by examination, and requires the Board of  
          Vocational Nursing and Psychiatric Technicians (BVNPT) to  
          immediately issue the IP after both the IP application and the  
          application for licensure by examination have been processed.

           EXISTING LAW  :

          1)Provides for the licensure and regulation of 92,271 licensed  
            VNs and 10,101 psychiatric technicians by BVNPT. (Business and  
            Professions Code (BPC) Section 2849 et seq.)   

          2)States that if BVNPT receives an application for VN licensure  
            no later than four months after completion of a BVNPT-approved  
            nursing program, BVNPT may issue an IP authorizing the  
            applicant to practice vocational nursing pending the results  
            of the first licensing examination, or for a period of nine  
            months, whichever occurs first. (BPC 2872.2) 

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   

           1)Purpose of this bill  . This bill seeks to expedite the issuance  
            of a vocational nursing IP by allowing applicants to submit an  
            IP application simultaneously with his or her application for  
            licensure by examination.  It is unclear whether this will  
            make permit issuance more efficient because the primary cause  
            of application processing delays appears to be a shortage of  
            staff to process the applications.  This bill is author  
            sponsored.    

           2)Author's statement.   According to the author, "Vocational  
            nursing applicants are currently experiencing extraordinary  








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            delays with application processing times. AB 1028 aims to  
            ensure that these critical health care providers can begin  
            working in a timely manner once they have finished schooling  
            and have entered the licensing process with BVNPT by speeding  
            up the process by which they can apply for and receive an IP  
            while they complete all board exams. 

            "This bill would not be altering the process already in code  
            regarding the interim permits that can be issued to these  
            nursing graduates, but it would be allowing the application  
            process for the interim permits to begin simultaneously with  
            the general application process, so that once all the  
            currently required information has been processed-including  
            fingerprinting and background check-the interim permit can be  
            issued immediately."

           3)Interim permits  . To obtain an IP, a VN candidate must be  
            approved to take the VN licensure exam.  An IP allows a VN  
            candidate to practice vocational nursing under the supervision  
            of a licensed VN or registered nurse while the candidate waits  
            for his or her first examination results (up to nine months).   
            If the candidate passes the exam, the IP continues to be valid  
            until BVNPT issues the VN license (up to six months).  An IP  
            is terminated upon notice that the candidate has failed the  
            exam. 

            BVNPT last received a request for an IP in 2010; this may be  
            due in part to the fact that BVNPT does not promote IPs --  
            there is no mention of the availability of an IP on BVNPT's  
            Web site under "licensing", nor does BVNPT offer an IP  
            application online as it does for its application for  
            licensure by examination.    

           4)Processing delays  .  Although BVNPT's Web site states that  
            applications for licensure by examination take 4-5 weeks to  
            process, BVNPT acknowledges that it currently takes 8-12  
            weeks.  This is due primarily to staffing shortages; there are  
            presently eight vacancies in their licensing division.  BVNPT  
            reports that an IP generally takes 3-4 weeks to process, but  
            this is not a current figure because they have not received a  
            request for an IP in over two years.

           5)Questions for the committee  . It is unclear to what extent this  
            bill would speed the ability of VN candidates to work, either  
            under an IP or full license, because the underlying problem is  








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            a shortage of staff to process applications and this bill  
            would increase the total number of applications to be  
            processed.  Presumably, if more candidates requested an IP,  
            BVNPT's processing times would fall farther behind for both  
            the IP and licensure by examination because of the additional  
            staff time required to process the new IP applications.  

            Furthermore, there is nothing presently in law that prohibits  
            an applicant from filing an application for an IP  
            simultaneously with his or her application for licensure by  
            examination.  In fact, current law does not even specify that  
            an additional application is necessary. This raises the  
            question as to whether or not a separate IP application should  
            even be required.

            BVNPT reports that candidates typically take their  
            examinations before an IP is needed because testing is now  
            done year-round.  However, even if a candidate successfully  
            takes the licensed VN exam immediately after receiving  
            approval from BVNPT, it takes 2-3 weeks for the results to be  
            processed, after which the candidate has to wait for BVNPT to  
            send a form for the applicant to complete and return by mail,  
            and then it takes another 3-4 weeks for the license to be  
            issued.  The VN candidate could be working during this time,  
            and the IP was originally designed to facilitate that purpose.  
               

            The Committee may wish to inquire of the author and BVNPT as  
            to whether or not it would be more efficient to grant IPs  
            automatically to all licensure exam applicants upon receipt  
            and processing of a single application.  

           6)Arguments in support  .  The California Hospital Association  
            writes, "CHA supports AB 1028 for several reasons.  First, as  
            a result of the implementation of the Affordable Care Act  
            (ACA), about 4.7 million Californians will be eligible for  
            health insurance starting in 2014.  The newly insured, with  
            increased demand for health care on an already strained  
            system, will need increased providers to provide primary care  
            and preventive services?.

            "Presently, registered nurses (RNs) are permitted to operate  
            with an interim permit which affords organizations the ability  
            to employ RNs and inculcate them into introductory practice in  
            a safe environment, enhancing their skills and increasing  








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            retention rates in their facilities.  Organizations could use  
            the same principles to apply the interim permittee program to  
            vocational nurses.  This could be a very positive opportunity  
            for our California hospitals and health systems to grow and  
            expand the use of vocational nurses in the new delivery team  
            models."

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Hospital Association

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Sarah Huchel / B.,P. & C.P. / (916)  
          319-3301