BILL ANALYSIS Ó 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 AB 1028 Page 2 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 AB 1028 Page 3 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 AB 1028 Page 4 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