Amended in Senate April 30, 2015

Amended in Senate April 23, 2015

Amended in Senate April 20, 2015

Senate Bill No. 466

Introduced by Senator Hill

February 25, 2015

An act to amend begin delete Sections end delete begin insert Section end insert 2786 begin delete and 2786.6 end delete of, begin delete and end delete begin insert to add Section 2786.1 to, end insert to add and repeal begin delete Sections end delete begin insert Section end insert 2711 begin delete and 2736.7 end delete of, begin insert and to repeal Section 2736.5 of, end insert 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.

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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.

end insert begin insert

This bill would repeal these provisions.

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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 begin delete instead end delete require the board to deny or revoke approval of a school of nursing that does not give student applicants credit begin insert in the field of nursing end insert for begin delete previous end delete begin insert military end insert education and begin delete the opportunity to obtain credit for other clinical and theoretical knowledge acquired through end delete 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 requiring schools seeking approval to have a process to evaluate and grant begin delete credit end delete begin insert credit, as defined, end insert for begin insert military end insert education and begin delete clinical and theoretical knowledge acquired through prior end delete experience. The bill would require the board to review a school’s policies and practices regarding granting credit for begin delete previously acquired end delete begin insert military end insert education and begin delete clinical and theoretical knowledge at least once every 4 end delete begin insert experience at least every 5 end insert years to ensure consistency in evaluation and application across schools. The bill would require the board to post on its Internet Web site information related to the acceptance of military coursework and experience at each approved school. begin delete 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. end delete

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.

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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.

end delete

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 2736.5 of the end insert begin insert Business and Professions Code end insert
begin insert is repealed. end insert

begin delete

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 instruction required
to qualify him or her for rating as a medical service
technician--independent duty, or other equivalent rating in his
particular branch of the Armed Forces, and whose service in the
Armed Forces has been under honorable conditions, may submit
the record of such training to the board for evaluation.

(b) If such person meets the qualifications of paragraphs (1)
and (3) of subdivision (a) of Section 2736, and if the board
determines that his or her education 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 such licensure.

(c) The board shall, by regulation, establish criteria for
evaluating the education of applicants under this section.

(d) The board shall maintain records of the following categories
of applicants under this section:

(1) Applicants who are rejected for examination, and the areas
of such applicants’ preparation which are the causes of rejection.

(2) Applicants who are qualified by their military education
alone to take the examination, and the results of their examinations.

(3) Applicants who are qualified to take the examination by
their military education plus supplementary education, and the
results of their examinations.

(e) The board shall attempt to contact by mail or other means
individuals meeting the requirements of subdivision (a) who have
been or will be discharged or separated from the Armed Forces of
the United States, in order to inform them of the application
procedure provided by this section. The board may enter into an
agreement with the federal government in order to secure the names
and addresses of such individuals.

end delete

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 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.

begin delete

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 promulgate regulations by January 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.

(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.

end delete

begin insert

begin insert SEC. 4. end insert   

end insert

begin insert Section 2786.1 is added to the end insert begin insert Business and Professions
Code end insert begin insert , to read: end insert

begin insert

begin insert 2786.1. end insert   

(a) The board shall deny the application for approval
made by, and shall revoke the approval given to, any school of
nursing that does not give student applicants credit in the field of
nursing for military education and experience by the use of
challenge examinations or other methods of evaluation.

(b) The board shall promulgate regulations by January 1, 2017,
requiring schools to have a process to evaluate and grant credit
for military education and experience. 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.

(c) The board shall review a school’s policies and practices
regarding granting credit for military education and experience
at least once every five 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.

end insert