BILL NUMBER: SB 466 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 23, 2015
AMENDED IN SENATE APRIL 20, 2015
INTRODUCED BY Senator Hill
FEBRUARY 25, 2015
An act to amend Sections 2736.5, 2786,
2786 and 2786.6 of, to add Section 2736.7 to,
and to add and repeal Section
Sections 2711 and 2736.7 of, the Business and
Professions Code, relating to nursing.
LEGISLATIVE COUNSEL'S DIGEST
SB 466, as amended, Hill. Nursing: Board of Registered Nursing.
The Nursing Practice Act provides for the licensure and regulation
of registered nurses by the Board of Registered Nursing within the
Department of Consumer Affairs, and requires the board to appoint an
executive officer to perform duties delegated by the board. The act
authorizes the board to take disciplinary action against a certified
or licensed nurse or to deny an application for a certificate or
license for certain reasons, including unprofessional conduct.
This bill would require the Director of the Department of Consumer
Affairs to appoint a board enforcement program monitor no later than
March 31, 2016, as specified. The bill would require the enforcement
program monitor to monitor and evaluate the nursing disciplinary
system and procedures and specifically concentrate on improving the
overall efficiency and consistency of the enforcement program,
including, but not limited to, assuring consistency in the
application of sanctions or discipline imposed on licensees. The bill
would make these provisions inoperative on March 31, 2018, and would
repeal these provisions on January 1, 2019.
The act authorizes any person who has served on active duty in the
medical corps of the Armed Forces of the United States and who
successfully completed the course of instruction to qualify him or
her for rating as a medical service technician--independent duty, or
other equivalent rating, and whose service in the Armed Forces was
under honorable conditions to submit the record of that training to
the board for evaluation. The act requires the board to grant a
license to that person if he or she meets specified qualifications
and the board determines that his or her education would give
reasonable assurance of competence to practice as a registered nurse
in this state. The act requires the board to maintain records of
those applicants, including, but not limited to, applicants who are
rejected from examination.
This bill would revise and recast this provision to authorize a
person who has successfully completed the course of education,
training, or experience to qualify him or her for rating as a medical
service technician--independent duty, or other equivalent rating to
submit that record for evaluation, and would require the board to
provide that person with a list of coursework, if any, that the
applicant must complete to be eligible for licensure. This bill would
require the board to issue a license to that person if he or she
meets specified qualifications and the board determines that his or
her education, training, or experience would give reasonable
assurance of competence to practice as a registered nurse in the
state. The bill would delete the requirement on the board to maintain
records of certain applicants. The bill, on or before January 1,
2017, would also require the board to issue regulations in
conjunction with the Military Department that identify the Armed
Forces education, training, or experience that is equivalent or
transferable to the curriculum required for licensure by the board.
The act requires the board to maintain a list of approved schools
or programs of nursing in this state, as specified, and provides that
an approved school or program of nursing is one that has been
approved by the board and meets certain academic requirements. The
act requires the board to deny an application for approval of, and to
revoke the approval given to, any school of nursing that does not
give student applicants credit for previous education and the
opportunity to obtain credit for other acquired knowledge by the use
of challenge examinations or other methods of evaluation.
This bill would instead require the board to deny or revoke
approval of a school of nursing that does not give student applicants
credit for previous education and the opportunity to obtain credit
for other clinical and theoretical knowledge acquired through
experience by the use of challenge examinations or other methods of
evaluation. The bill would require the board, by January 1, 2017, to
promulgate regulations detailing acceptable evaluation
criteria for clinical and theoretical knowledge acquired through
prior experience. The bill would also authorize the board to
determine, upon review and recommendation, that an applicant for
licensure as a registered nurse who acquires his or her education or
a portion thereof at a school that is not approved or has been
previously disapproved by the board is eligible for a registered
nurse license if the applicant meets specified criteria, including,
but not limited to, that he or she was previously licensed as a
vocational nurse. requiring schools seeking approval
to have a process to evaluate and grant credit for education and
clinical and theoretical knowledge acquired through prior experience.
The bill would require the board to review a school's policies and
practices regarding granting credit for previously acquired education
and clinical and theoretical knowledge at least once every 4 years
to ensure consistency in evaluation and application across schools.
The bill would require the board to post on its In ternet
Web site information related to the acceptance of military coursework
and experience at each approved school. The bill would also require
the board, by January 1, 2018, to prepare a report to the Legislature
examining the barriers to California licensure for practitioners who
cannot meet California licensure requirements due to insufficient
academic or clinical preparation, but who are licensed and practicing
in other states.
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 2711 is added to the Business and Professions
Code, to read:
2711. (a) (1) The Director of Consumer Affairs shall appoint a
board enforcement program monitor no later than March 31, 2016. The
director may retain an independent contractor for this appointment by
a personal services contract. The Legislature hereby finds that the
services described in this section are a new state function, pursuant
to Section 19130 of the Government Code.
(2) The director shall supervise the enforcement program monitor
and may terminate or dismiss the enforcement program monitor from the
appointment.
(b) (1) The enforcement program monitor shall monitor and evaluate
the nursing disciplinary system and procedures and specifically
concentrate on improving the overall efficiency and consistency of
the enforcement program. The director shall specify further duties of
the program monitor.
(2) The monitoring duty shall be on a continuing basis for a
period of no more than two years from the date of the enforcement
program monitor's appointment and shall include, but not be limited
to, the following areas:
(A) Improving the quality and consistency of complaint processing
and investigation.
(B) Assuring consistency in the application of sanctions or
discipline imposed on licensees.
(C) The accurate and consistent implementation of the laws and
rules affecting discipline, including adhering to the Consumer
Protection Enforcement Initiative complaint priority guidelines as
described in the memorandum dated August 31, 2009, by Brian J. Stiger
titled "Complaint Prioritization Guidelines for Health Care
Agencies."
(D) Staff concerns regarding disciplinary matters or procedures.
(E) Appropriate use of licensed professionals to investigate
complaints.
(F) The board's cooperation with other governmental entities
charged with enforcing related laws and regulations regarding nurses.
(3) The enforcement program monitor shall exercise no authority
over the board's discipline operations or staff. However, the board
and its staff shall cooperate with the enforcement program monitor,
and the board shall provide data, information, and case files
requested by the enforcement program monitor to perform all of his or
her duties.
(4) The director shall assist the enforcement program monitor in
the performance of his or her duties, and the enforcement program
monitor shall have the same investigative authority as the director.
(c) The enforcement program monitor shall submit an initial
written report of his or her findings and conclusions to the board,
the department, and the Legislature no later than September 1, 2016,
and every six months thereafter, and be available to make oral
reports to each, if requested to do so. The enforcement program
monitor may also provide additional information to either the
department or the Legislature at his or her discretion or at the
request of either the department or the Legislature. The enforcement
program monitor shall make his or her reports available to the public
or the media. The enforcement program monitor shall make every
effort to provide the board with an opportunity to reply to any
facts, findings, issues, or conclusions in his or her reports with
which the board may disagree.
(d) The board shall pay for all of the costs associated with the
employment of an enforcement program monitor.
(e) This section shall become inoperative on March 31, 2018, and
as of January 1, 2019, is repealed.
SEC. 2. Section 2736.5 of the Business and
Professions Code is amended to read:
2736.5. (a) Any person who has served on active duty in the
medical corps of any of the Armed Forces of the United States and who
has successfully completed the course of education, training, or
experience required to qualify him or her for rating as a medical
service technician--independent duty, or other equivalent rating in
his or her particular branch of the Armed Forces, and whose service
in the Armed Forces has been under honorable conditions, may submit
the record of that education, training, or experience to the board
for evaluation toward licensure.
(b) After making an evaluation pursuant to subdivision (a), the
board shall provide an applicant with a list of coursework, if any,
that the applicant must complete to be eligible for licensure.
(c) If an applicant meets the qualifications of subdivision (a)
and paragraphs (1) and (3) of subdivision (a) of Section 2736, and if
the board determines that his or her education, training, or
experience would give reasonable assurance of competence to practice
as a registered nurse in this state, he or she shall be granted a
license upon passing the standard examination for licensure.
(d) The board shall, by regulation, establish criteria for
evaluating the education, training, or experience of applicants under
this section.
(e) On or before January 1, 2017, the board shall, by regulation
and in conjunction with the Military Department, identify the Armed
Forces education, training, or experience that is equivalent or
transferable to the curriculum required for licensure by the board.
SEC. 3. Section 2736.7 is added to the Business
and Professions Code, to read:
2736.7. Upon review and recommendation, the board may determine
that an applicant for licensure as a registered nurse who acquired
his or her education or a portion thereof at a school that is not
approved or has been previously disapproved by the board is eligible
for a registered nurse license if the applicant meets all of the
following criteria:
(a) Was previously licensed as a licensed vocational nurse.
(b) Has successfully completed a nursing education program
accredited by the Accreditation Commission for Education in Nursing,
Commission on Collegiate Nursing Education, or other accreditation
entity approved by the board.
(c) Has not held a healing arts license that has been the subject
of disciplinary action by a healing arts board of this state or by
another state, federal territory, or Canadian province.
(d) Holds an unencumbered registered nursing license issued by
another state licensing board or agency.
(e) Has continuously practiced as a licensed registered nurse for
the equivalent of five full-time years in an acute care hospital
setting before the date of application.
(f) Demonstrates clinical experience as a registered nurse in
medical-surgical, including geriatrics, psychiatric-mental health,
obstetrics, and pediatrics.
(g) Has not been the subject of a disciplinary action by a nursing
licensing authority or of adverse judgments or settlements resulting
from the practice of nursing that the board determines constitutes a
pattern of negligence or incompetence.
(h) Is not subject to denial of licensure under Division 1.5
(commencing with Section 475).
SEC. 2. Section 2736.7 is added to the
Business and Professions Code , to read:
2736.7. (a) The board shall, by January 1, 2018, prepare a report
to be submitted to the Legislature examining barriers to California
licensure for practitioners who cannot meet California licensure
requirements due to insufficient academic or clinical preparation,
but who are licensed and practicing in other states.
(b) The report required by this section shall be submitted in
compliance with Section 9795 of the Government Code.
(c) Pursuant to Section 10231.5 of the Government Code, this
section is repealed on January 1, 2022.
SEC. 4. SEC. 3. Section 2786 of the
Business and Professions Code is amended to read:
2786. (a) An approved school of nursing, or an approved nursing
program, is one that has been approved by the board, gives the course
of instruction approved by the board, 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. For
purposes of this section, "institution of higher education" includes,
but is not limited to, community colleges offering an associate of
arts or associate of science degree and private postsecondary
institutions offering an associate of arts, associate of science, or
baccalaureate degree or an entry-level master's degree, and is an
institution that is not subject to the California Private
Postsecondary Education Act of 2009 (Chapter 8 (commencing with
Section 94800) of Part 59 of Division 10 of Title 3 of the Education
Code).
(b) A school of nursing that is affiliated with an institution
that is subject to the California Private Postsecondary Education Act
of 2009 (Chapter 8 (commencing with Section 94800) of Part 59 of
Division 10 of Title 3 of the Education Code), may be approved by the
board 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 in nursing with successful completion of an
additional course of study as approved by the board and the
institution involved.
(c) The board shall determine by regulation the required subjects
of instruction to be completed in an approved school of nursing for
licensure as a registered nurse and shall include the minimum units
of theory and clinical experience necessary to achieve essential
clinical competency at the entry level of the registered nurse. The
board's standards shall regulations may
be designed to require all schools to provide clinical instruction
in the educational process.
(d) The board shall perform or cause to be performed an analysis
of the practice of the registered nurse no less than every five
years. Results of the analysis shall be utilized to assist in the
determination of the required subjects of instruction, validation of
the licensing examination, and assessment of the current practice of
nursing.
SEC. 5. SEC. 4. Section 2786.6 of
the Business and Professions Code is amended to read:
2786.6. (a) The board shall deny the application for approval
made by, and shall revoke the approval given to, any school of
nursing that either:
(1) Does not give to student applicants credit, in the field of
nursing, for previous education and the opportunity to obtain credit
for other clinical and theoretical knowledge acquired through prior
experience by the use of challenge examinations or other methods of
evaluation.
(2) Is operated by a community college and discriminates against
an applicant for admission to a school solely on the grounds that the
applicant is seeking to fulfill the units of nursing required by
Section 2736.6.
(b) The board shall prescribe, by regulation, the
education for which credit is to be given and the amount of credit
that is to be given for each type of education, including clinical
and theoretical knowledge acquired through prior experience.
promulgate regulations by Jan uary 1, 2017,
requiring schools to have a process to evaluate and grant credit for
previous education and clinical and theoretical knowledge acquired
through prior experience, including that gained from military
service. The word "credit," as used in the preceding sentence,
is limited to credit for licensure only. The board is not authorized
to prescribe the credit that an approved school of nursing shall give
toward an academic certificate or degree. The board shall
promulgate regulations detailing acceptable evaluation criteria for
clinical and theoretical knowledge acquired through prior experience
by January 1, 2017.
(c) The board shall review a school's policies and practices
regarding granting credit for previous education and clinical and
theoretical knowledge acquired through prior experience at least once
every four years to ensure consistency in evaluation and application
across schools. The board shall post on its Internet Web site
information related to the acceptance of military coursework and
experience at each approved school.