Amended in Assembly August 18, 2015

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 Bill No. 466

Introduced by Senator Hill

(Principal coauthor: Assembly Member Bonilla)

February 25, 2015

An act to amend begin delete Section end delete begin insert Sections 2701, 2708, and end insert 2786 of, to add begin delete Section 2786.1 to, to add and repeal Section 2711 of, end delete begin insert Sections 2718 and 2786.1 to, end insert and to repeal Section 2736.5 of, the Business and Professions Code, relating to nursing.

LEGISLATIVE COUNSEL’S DIGEST

SB 466, as amended, Hill. begin delete Nursing: end delete begin insert Registered nurses: end insert 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 begin delete Affairs, and end delete begin insert Affairs. Existing law end insert requires the board to appoint an executive officer to perform duties delegated by the board. begin delete The end delete begin insert Existing law repeals the board and the executive officer position on January 1, 2016. end insert

begin insert

This bill would extend the repeal date to January 1, 2018.

end insert

begin insert The end insert 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. begin insert Existing law establishes the California State Auditor’s Office, which is headed by the California State Auditor, to conduct financial and performance audits as directed by statute. end insert

This bill would begin delete 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 recommendations on improving the enforcement program, including, but not limited to, ensuring consistency in the application of board sanctions or discipline imposed on licensees. 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. The bill would make these provisions inoperative on March 31, 2018, and would repeal these provisions on January 1, 2019. end delete begin insert require the board, by February 1, 2016, to contract with the California State Auditor’s Office to conduct a performance audit of the board’s enforcement program, as specified. The bill would require the board to reimburse the office for the cost of the performance audit. The bill would require the office to report the results of the audit to the Governor, the department, and the appropriate policy committees of the Legislature by January 1, 2017. The bill would require the board’s staff and management to cooperate with the office and provide the office with access to data, case files, employees, and information. end insert

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 begin delete these end delete begin insert those end insert 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 begin delete promulgate end delete begin insert adopt end insert 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:

begin delete

SECTION 1.  

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

2711.  

(a) 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.

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

(c) (1) The enforcement program monitor shall monitor and
evaluate the nursing disciplinary system and procedures and
specifically concentrate recommendations on improving the
enforcement program. The enforcement program monitor shall
develop recommendations that acknowledge the board’s right to
exercise reasonable discretion in applying disciplinary standards
to particular circumstances and in deciding individual cases.

(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) Ensuring consistency in the application of board sanctions
or discipline imposed on licensees.

(C) Ensuring the accurate and consistent implementation of the
laws and rules affecting discipline, including adherence to the
Division of Investigation Case Acceptance Guidelines (Consumer
Protection Enforcement Initiative Model), as revised July 1, 2014.

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

(E) Addressing staff concerns regarding disciplinary matters or
procedures.

(F) Reviewing the appropriate use of licensed professionals to
investigate complaints.

(G) Reviewing the board’s cooperation with other governmental
entities charged with enforcing related laws and regulations
regarding nurses.

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

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

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

(4) 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.

(5) The enforcement program monitor shall have access to all
records and full and complete data in all official matters that are
in possession of the board and the board’s members, officers, and
employees.

(d) The enforcement program monitor shall submit an initial
written report of his or her findings and recommendations to the
board within six months after the enforcement program monitor
begins the review process, and shall submit a report every six
months after the initial report with a final report to be submitted
on or before December 31, 2018. The board shall be given 30 days
to review and prepare a response to each written report beginning
from the time the report is submitted to the board. After the 30
days expire, the program enforcement monitor shall submit each
written report to the department and the Legislature. The
enforcement program monitor shall make his or her reports and
the board’s response to the reports available to the public when
the reports are submitted to the department and the Legislature.
The enforcement program monitor shall make every effort to
provide the board with an opportunity throughout the entire review
process to reply to any facts, findings, issues, or recommendations
in his or her reports with which the board may disagree.

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

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

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

end delete

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 2701 of the end insert begin insert Business and Professions
Code end insert begin insert is amended to read: end insert

2701.  

(a) There is in the Department of Consumer Affairs the
Board of Registered Nursing consisting of nine members.

(b) For purposes of this chapter, “board,” or “the board,” refers
to the Board of Registered Nursing. Any reference in state law to
the Board of Nurse Examiners of the State of California or the
California Board of Nursing Education and Nurse Registration
shall be construed to refer to the Board of Registered Nursing.

(c) The board shall have all authority vested in the previous
board under this chapter. The board may enforce all disciplinary
actions undertaken by the previous board.

(d) This section shall remain in effect only until January 1, begin delete 2016, end delete
begin insert 2018, end insert and as of that date, is repealed, unless a later enacted statute
that is enacted before January 1, begin delete 2016, end delete begin insert 2018, end insert deletes or extends
that date. Notwithstanding any other begin delete provision of end delete law, the repeal
of this section renders the board subject to review by the
appropriate policy committees of the Legislature.

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 2708 of the end insert begin insert Business and Professions Code end insert begin insert is
amended to read: end insert

2708.  

(a) The board shall appoint an executive officer who
shall perform the duties delegated by the board and who shall be
responsible to it for the accomplishment of those duties.

(b) The executive officer shall be a nurse currently licensed
under this chapter and shall possess other qualifications as
determined by the board.

(c) The executive officer shall not be a member of the board.

begin delete

(d) Notwithstanding any other provision of law, the person
serving on December 31, 2011, as executive officer of the board
shall serve as an interim executive officer until the board appoints
a permanent executive officer. The board may appoint this interim
executive officer as the permanent executive officer.

(e)

end delete

begin insert (d) end insert  This section shall remain in effect only until January 1, begin delete 2016, end delete
begin insert 2018, end insert and as of that date is repealed, unless a later enacted statute,
that is enacted before January 1, begin delete 2016, end delete begin insert 2018, end insert deletes or extends
that date.

begin insert

begin insert SEC. 3. end insert   

end insert

begin insert Section 2718 is added to the end insert begin insert Business and Professions
Code end insert begin insert , to read: end insert

begin insert

begin insert 2718. end insert   

(a) (1) By February 1, 2016, the board shall contract
with the office to conduct a performance audit of the board’s
enforcement program. The board shall reimburse the office for
the cost of the performance audit. The office shall report the results
of the audit, with any recommendations, to the Governor, the
department, and the appropriate policy committees of the
Legislature by January 1, 2017.

(2) The performance audit shall include, but not be limited to,
an evaluation of all the following:

(A) The quality and consistency of, and compliance with,
complaint processing and investigation.

(B) The consistency and adequacy of the application of board
sanctions or discipline imposed on licensees.

(C) The accuracy and consistency in implementing the laws and
rules affecting discipline, including adherence to the Division of
Investigation Case Acceptance Guidelines (Consumer Protection
Enforcement Initiative Model), as revised July 1, 2014.

(D) The timeframes for completing complaint processing,
investigation, and resolution.

(E) Staff concerns regarding licensee disciplinary matters or
procedures.

(F) The appropriate utilization of licensed professionals to
investigate complaints.

(G) The adequacy of the board’s cooperation with other state
agencies charged with enforcing related laws and regulations
regarding nurses.

(H) Any existing backlog, the reason for the backlog, and the
timeframe for eliminating the backlog.

(I) The adequacy of board staffing, training, and fiscal resources
to perform its enforcement functions.

(b) Board staff and management shall cooperate with the office
and shall provide the office with access to data, case files,
employees, and information as the office may, in its discretion,
require for the purposes of this section.

(c) For the purposes of this section, “office” means the
California State Auditor’s Office.

end insert

begin delete SEC. 2. end delete
begin insert SEC. 4. end insert   

Section 2736.5 of the Business and Professions Code
is repealed.

begin delete SEC. 3. end delete
begin insert SEC. 5. end insert   

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 begin delete may end delete begin insert shall end insert 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. end delete
begin insert SEC. 6. end insert   

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

2786.1.  

(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 begin delete promulgate end delete begin insert adopt end insert regulations by January 1,
2017, requiring schools to have a process to evaluate and grant
credit for military education and experience. begin insert The regulations shall
be adopted pursuant to the Administrative Procedure Act (Chapter
3.5 (commencing with Section 11340) of Part 1 of Division 3 of
Title 2 of the Government Code). end insert The word “credit,” as used in begin delete the preceding sentence, end delete begin insert this subdivision, end insert 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.