Amended in Assembly June 18, 2015

Amended in Senate April 30, 2015

Amended in Senate April 23, 2015

Amended in Senate April 20, 2015

Senate BillNo. 466


Introduced by Senator Hill

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(Principal coauthor: Assembly Member Bonilla)

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February 25, 2015


An act to amend Section 2786 of, to add Section 2786.1 to, to add and repeal Section 2711 of, and to repeal Section 2736.5 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 concentratebegin insert recommendationsend insert on improving thebegin delete overall efficiency and consistency of theend delete enforcement program, including, but not limited to,begin delete assuringend deletebegin insert ensuringend insert consistency in the application ofbegin insert boardend insert sanctions or discipline imposed on licensees.begin insert The bill would require the program enforcement monitor to submit an initial written report 6 months after he or she begins the review process and every 6 months after the initial report to the board, the Director of Consumer Affairs, and the Legislature, as specified, and would require a final written report to be submitted by December 31, 2018, as specified.end insert 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 repeal these provisions.

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 require the board to deny or revoke approval of a 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. 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 credit, as defined, for military education and experience. The bill would require the board to review a school’s policies and practices regarding granting credit for military education and experience at least every 5 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.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

Section 2711 is added to the Business and
2Professions Code
, to read:

3

2711.  

(a) begin delete(1)end deletebegin deleteend deleteThe Director of Consumer Affairs shall appoint
4a board enforcement program monitor no later than March 31,
52016. The director may retain an independent contractor for this
6appointment by a personal services contract. The Legislature hereby
7finds that the services described in this section are a new state
8function, pursuant to Section 19130 of the Government Code.

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9(2) The director shall supervise the enforcement program
10monitor and may terminate or dismiss the enforcement program
11monitor from the appointment.

end delete
begin insert

12(b) The director shall advertise the availability of the
13enforcement program monitor position. The requirements of the
14position shall include, but not be limited to, performance audit
15experience and familiarity with state laws, regulations, and
16administrative procedures pertaining to the board. The enforcement
17program monitor shall not have a pecuniary interest, outside of
18the direct compensation referenced in this section, in reviewing
19the board or any recommendations made pursuant to this section.

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20(b)

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21begin insert(c)end insert (1) The enforcement program monitor shall monitor and
22evaluate the nursing disciplinary system and procedures and
23 specifically concentratebegin insert recommendationsend insert on improvingbegin delete the overall
24efficiency and consistency ofend delete
the enforcement program.begin delete The
25director shall specify further duties of the program monitor.end delete
begin insert The
26enforcement program monitor shall develop recommendations
27that acknowledge the board’s right to exercise reasonable
28discretion in applying disciplinary standards to particular
29circumstances and in deciding individual cases.end insert

30(2) The monitoring duty shall be on a continuing basis for a
31period of no more than two years from the date of the enforcement
P4    1program monitor’s appointment and shall include, but not be
2limited to, the following areas:

3(A) Improving the quality and consistency of complaint
4processing and investigation.

5(B) begin deleteAssuring end deletebegin insertEnsuring end insertconsistency in the application ofbegin insert boardend insert
6 sanctions or discipline imposed on licensees.

7(C) begin deleteThe end deletebegin insertEnsuring the end insertaccurate and consistent implementation
8of the laws and rules affecting discipline, includingbegin delete adheringend delete
9begin insert adherenceend insert to thebegin delete Consumer Protection Enforcement Initiative
10complaint priority guidelines as described in the memorandum
11dated August 31, 2009, by Brian J. Stiger titled “Complaint
12Prioritization Guidelines for Health Care Agencies.”end delete
begin insert Division of
13Investigation Case Acceptance Guidelines (Consumer Protection
14Enforcement Initiative Model), as revised July 1, 2014.end insert

begin insert

15(D) Reducing the timeframes for completing complaint
16processing and investigation.

end insert
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17(D)  Staff

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18begin insert(E)end insertbegin insertend insertbegin insertAddressing staffend insert concerns regarding disciplinary matters or
19procedures.

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20(E) Appropriate

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21begin insert(F)end insertbegin insertend insertbegin insertReviewing the appropriateend insert use of licensed professionals to
22investigate complaints.

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23(F) The

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24begin insert(G)end insertbegin insertend insertbegin insertReviewing theend insert board’s cooperation with other governmental
25entities charged with enforcing related laws and regulations
26regarding nurses.

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27(H) Generally assessing the adequacy of staffing, operations,
28and fiscal resources of other governmental entities as they affect
29the board’s enforcement functions and identifying any delays
30caused by these other entities.

end insert
begin insert

31(I) Assessing the adequacy of board staffing and fiscal resources
32to perform its enforcement functions.

end insert
begin insert

33(3) In fulfilling the monitoring duties described in
34subparagraphs (A) through (H), inclusive, of paragraph (2), the
35enforcement program monitor shall perform those duties consistent
36with paragraph (1).

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37(3)

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38begin insert(4)end insert The enforcement program monitor shall exercise no authority
39over the board’s discipline operations or staff. However, the board
40and its staff shall cooperate with the enforcement program monitor,
P5    1and the board shall provide data, information, and case files
2requested by the enforcement program monitor to perform all of
3his or her duties.

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4(4)

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5begin insert(5)end insert Thebegin delete director shall assist theend delete enforcement program monitor
6begin delete in the performance of his or her duties, and the enforcement
7program monitorend delete
shall havebegin delete the same investigative authority as
8the director.end delete
begin insert access to all records and full and complete data in
9all official matters that are in possession of the board and the
10board’s members, officers, and employees.end insert

begin delete

11(c)

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12begin insert(d)end insert The enforcement program monitor shall submit an initial
13written report of his or her findings andbegin delete conclusions to the board,
14the department, and the Legislature no later than September 1,
152016, and every six months thereafter, and be available to make
16oral reports to each, if requested to do so. The enforcement program
17monitor may also provide additional information to either the
18department or the Legislature at his or her discretion or at the
19request of either the department or theend delete
begin insert recommendations to the
20board within six months after the enforcement program monitor
21begins the review process, and shall submit a report every six
22months after the initial report with a final report to be submitted
23on or before December 31, 2018. The board shall be given 30 days
24to review and prepare a response to each written report beginning
25from the time the report is submitted to the board. After the 30
26days expire, the program enforcement monitor shall submit each
27written report to the department and theend insert
Legislature. The
28enforcement program monitor shall make his or her reportsbegin insert and
29the board’s response to the reports end insert
available to the publicbegin delete or the
30media.end delete
begin insert when the reports are submitted to the department and the
31Legislature.end insert
The enforcement program monitor shall make every
32effort to provide the board with an opportunitybegin insert throughout the
33entire review processend insert
to reply to any facts, findings, issues, or
34begin delete conclusionsend deletebegin insert recommendationsend insert in his or her reports with which the
35board may disagree.

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36(e) The final report shall include final findings and
37recommendations on the topics addressed in the prior reports
38submitted by the program enforcement monitor pursuant to
39subdivision (c) and in compliance with the process described in
40subdivision (d).

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P6    1(d)

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2begin insert(f)end insert The board shall pay for all of the costs associated with the
3employment of an enforcement program monitor.

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4(e)

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5begin insert(g)end insert This section shall become inoperative on March 31, 2018,
6and as of January 1, 2019, is repealed.

7

SEC. 2.  

Section 2736.5 of the Business and Professions Code
8 is repealed.

9

SEC. 3.  

Section 2786 of the Business and Professions Code is
10amended to read:

11

2786.  

(a) An approved school of nursing, or an approved
12nursing program, is one that has been approved by the board, gives
13the course of instruction approved by the board, covering not less
14than two academic years, is affiliated or conducted in connection
15with one or more hospitals, and is an institution of higher
16education. For purposes of this section, “institution of higher
17education” includes, but is not limited to, community colleges
18offering an associate of arts or associate of science degree and
19private postsecondary institutions offering an associate of arts,
20associate of science, or baccalaureate degree or an entry-level
21master’s degree, and is an institution that is not subject to the
22California Private Postsecondary Education Act of 2009 (Chapter
238 (commencing with Section 94800) of Part 59 of Division 10 of
24Title 3 of the Education Code).

25(b) A school of nursing that is affiliated with an institution that
26is subject to the California Private Postsecondary Education Act
27of 2009 (Chapter 8 (commencing with Section 94800) of Part 59
28of Division 10 of Title 3 of the Education Code), may be approved
29by the board to grant an associate of arts or associate of science
30degree to individuals who graduate from the school of nursing or
31to grant a baccalaureate degree in nursing with successful
32completion of an additional course of study as approved by the
33board and the institution involved.

34(c) The board shall determine by regulation the required subjects
35of instruction to be completed in an approved school of nursing
36for licensure as a registered nurse and shall include the minimum
37units of theory and clinical experience necessary to achieve
38essential clinical competency at the entry level of the registered
39nurse. The board’s regulations may be designed to require all
40schools to provide clinical instruction in the educational process.

P7    1(d) The board shall perform or cause to be performed an analysis
2of the practice of the registered nurse no less than every five years.
3Results of the analysis shall be utilized to assist in the
4determination of the required subjects of instruction, validation of
5the licensing examination, and assessment of the current practice
6of nursing.

7

SEC. 4.  

Section 2786.1 is added to the Business and Professions
8Code
, to read:

9

2786.1.  

(a) The board shall deny the application for approval
10made by, and shall revoke the approval given to, any school of
11nursing that does not give student applicants credit in the field of
12nursing for military education and experience by the use of
13challenge examinations or other methods of evaluation.

14(b) The board shall promulgate regulations by January 1, 2017,
15requiring schools to have a process to evaluate and grant credit for
16military education and experience. The word “credit,” as used in
17the preceding sentence, is limited to credit for licensure only. The
18board is not authorized to prescribe the credit that an approved
19school of nursing shall give toward an academic certificate or
20degree.

21(c) The board shall review a school’s policies and practices
22regarding granting credit for military education and experience at
23least once every five years to ensure consistency in evaluation and
24application across schools. The board shall post on its Internet
25Web site information related to the acceptance of military
26coursework and experience at each approved school.



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