BILL ANALYSIS                                                                                                                                                                                                    Ó


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                                    THIRD READING

          Bill No:  AB 1028
          Author:   Patterson (D)
          Amended:  6/10/13 in Senate
          Vote:     21

           SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE  :  10-0, 6/17/13
          AYES:  Lieu, Emmerson, Block, Corbett, Galgiani, Hernandez,  
            Hill, Padilla, Wyland, Yee
          AYES:  De León, Walters, Gaines, Hill, Lara, Steinberg
          NO VOTE RECORDED:  Padilla
          ASSEMBLY FLOOR  :  75-0, 5/9/13 - See last page for vote

           SUBJECT  :    Vocational nursing:  interim permits

           SOURCE  :     Author

           DIGEST  :    This bill permits an applicant for a vocational  
          nursing license to submit an application for an interim permit  
          (IP) at the same time they submit an application for the  
          required licensing examination and requires the Board of  
          Vocational Nursing and Psychiatric Technicians (BVNPT) to decide  
          whether to issue the permit and, if the BVNPT deems to, issue  
          the IP within 60 days of receiving the application.

           ANALYSIS  :    Existing law:

          1. Provides for the licensure and regulation of Licensed  


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             Vocational Nurses (LVNs) and psychiatric technicians by the  

          2. Defines the scope of practice for LVNs.

          3. Outlines the requirements that an applicant for a license as  
             a vocational nurse must meet in order to be granted an IP by  
             the BVNPT.  

          4. Specifies that if the BVNPT receives an application for  
             licensure as a vocational nurse, no later than four months  
             after completion of a the BVNPT approved nursing program, the  
             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  

          5. Specifies that the fee to be paid for an IP shall be in an  
             amount no less than $40 and may be fixed by the BVNPT at an  
             amount no more than $50.  

          This bill:

          1. Specifies that an applicant may submit an application for an  
             IP at the same time the applicant submits their application  
             for the licensing examination.

          2. Indicates that the BVNPT shall make a decision whether to  
             issue the IP, and if the BVNPT decides to issue the IP, they  
             will issue the IP within 60 days of receiving the completed  

          Currently, a vocational nursing student who has completed their  
          training program may apply to take the licensing examination.   
          Provided that the application for licensure is received by the  
          BVNPT no later than four months after completion of a  
          board-approved nursing program and clearance from the Department  
          of Justice, the BVNPT may issue an IP authorizing the applicant  
          to practice vocational nursing, pending the results of the  
          licensing examination, or for a period of nine months, whichever  
          occurs first.  If the applicant passes the examination, the IP  
          shall remain in effect until the license is issued by the BVNPT  



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          or for a maximum period of six months after passing the  
          examination, whichever occurs first.  If the applicant fails the  
          examination, the IP shall terminate upon notice by certified  
          mail, return receipt requested, or if the applicant fails to  
          receive the notice, upon the date specified in the IP, whichever  
          occurs first.  An interim permittee shall not use any title or  
          designation other than "vocational nurse interim permittee."

          A permittee shall function under the supervision of an LVN or a  
          registered nurse (RN), who shall be present and available on the  
          premises during the time the permittee is rendering professional  
          services.  The LVN or RN may delegate to the permittee any  
          function taught in the permittee's basic nursing program.

          According to the BVNPT Web site, it takes approximately three to  
          four weeks to process an IP.  However, the BVNPT acknowledges  
          that it currently takes eight to 12 weeks.  This is due  
          primarily to staffing shortages.  

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

          According to the Senate Appropriations Committee:

             Potential one-time costs up to $75,000 for the amendment of  
             existing regulations by the BVNPT (Vocational Nursing and  
             Psychiatric Technicians Fund).

             Potential ongoing costs in the tens of thousands, up to  
             about $150,000 for additional interim permit application  
             review, offset by fee revenues (Vocational Nursing and  
             Psychiatric Technicians Fund).

          The BVNPT indicates that it has not issued an interim permit in  
          more than two years, in part because staff limitations lead to  
          long processing times.  The increased workload to the BVNPT will  
          depend on how many license applicants also apply for an interim  
          permit.  If half of the licensing applicants also apply for an  
          interim permit, the BVNPT estimates that it will experience  
          costs of about $75,000 per year, offset by fee revenues.

           SUPPORT  :   (Verified  7/2/13)

          Association of California Healthcare Districts



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          California Association for Health Services at Home
          California Hospital Association
          Hospital Corporation of America

           ARGUMENTS IN SUPPORT  :    According to the author, vocational  
          nursing applicants are currently experiencing extraordinary  
          delays with application processing times.  "The current wait  
          time [for an interim permit] is actually 8 to12 weeks?The BVNPT  
          states that there would then be an additional 4-5 weeks  
          processing time before the IP could be issued.  As a result of  
          this lengthy process, the BVNPT has also stated that they have  
          not actually issued any of these interim permits in over 2  
          years.  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  
          the BVNPT by speeding up the process by which they can apply for  
          and receive an interim permit while they complete all board  

          The California Association for Health Services at Home, the  
          California Hospital Association and the Hospital Corporation of  
          America write, "The Affordable Care Act?emphasizes allowing all  
          providers to function at the top of their education and  
          training, and delivering care in teams. The ability for  
          vocational nurses to work under an interim permit could enhance  
          this access."  They also add, "While the supply of registered  
          nurses is presently stable, 50 percent of California's RN's with  
          active licensees are over the age of 50 and are predicted to  
          retire or reduce hours as the economy improves?Therefore,  
          introducing vocational nurse into the workforce as interim  
          permittees to maximize their availability and increase their  
          significance in the care of Californians is crucial." 

          The Association of California Healthcare Districts (ACHD)  
          states, "The majority of California's Healthcare Districts are  
          located in rural areas, and many have a difficult time  
          recruiting qualified individuals into their workforce.  By  
          increasing the prospective workforce, Healthcare Districts will  
          be able to offer their communities increased patient care.  As  
          ACHD supports long-term solutions to increase the potential  
          workforce for healthcare professionals within all areas of  
          California to ease workforce shortages, we strongly urge your  
          support of this important measure."



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           ASSEMBLY FLOOR  :  75-0, 5/9/13
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Bigelow, Bloom,  
            Blumenfield, Bocanegra, Bonilla, Bonta, Bradford, Brown,  
            Buchanan, Ian Calderon, Campos, Chau, Chávez, Chesbro, Conway,  
            Cooley, Dahle, Daly, Dickinson, Eggman, Fong, Fox, Frazier,  
            Beth Gaines, Garcia, Gatto, Gomez, Gordon, Gorell, Gray,  
            Grove, Hagman, Hall, Harkey, Roger Hernández, Jones,  
            Jones-Sawyer, Levine, Linder, Lowenthal, Maienschein, Mansoor,  
            Medina, Melendez, Mitchell, Morrell, Mullin, Muratsuchi,  
            Nazarian, Nestande, Olsen, Pan, Patterson, Perea, V. Manuel  
            Pérez, Quirk, Quirk-Silva, Rendon, Salas, Skinner, Stone,  
            Ting, Torres, Wagner, Weber, Wieckowski, Wilk, Williams,  
            Yamada, John A. Pérez
          NO VOTE RECORDED:  Donnelly, Holden, Logue, Waldron, Vacancy

          MW:k  7/2/13   Senate Floor Analyses 

                           SUPPORT/OPPOSITION:  SEE ABOVE

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