BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      SB 466


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         SENATE THIRD READING


         SB  
         466 (Hill)


         As Amended  August 18, 2015


         Majority vote


         SENATE VOTE:  40-0


          ------------------------------------------------------------------ 
         |Committee       |Votes|Ayes                  |Noes                |
         |                |     |                      |                    |
         |                |     |                      |                    |
         |                |     |                      |                    |
         |----------------+-----+----------------------+--------------------|
         |Business &      |14-0 |Bonilla, Jones,       |                    |
         |Professions     |     |Baker, Bloom, Burke,  |                    |
         |                |     |Campos, Chang, Dodd,  |                    |
         |                |     |Eggman, Gatto,        |                    |
         |                |     |Mullin, Ting, Wilk,   |                    |
         |                |     |Wood                  |                    |
         |                |     |                      |                    |
         |----------------+-----+----------------------+--------------------|
         |Appropriations  |17-0 |Gomez, Bigelow,       |                    |
         |                |     |Bloom, Bonta,         |                    |
         |                |     |Calderon, Chang,      |                    |
         |                |     |Nazarian, Eggman,     |                    |
         |                |     |Gallagher, Eduardo    |                    |
         |                |     |Garcia, Holden,       |                    |
         |                |     |Jones, Quirk, Rendon, |                    |
         |                |     |Wagner, Weber, Wood   |                    |
         |                |     |                      |                    |








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         SUMMARY:  Implements the recommendations from the Board of  
         Registered Nursing's (BRN) Sunset Review Oversight Hearings,  
         including requiring the California State Auditor's Office to  
         conduct a performance audit of the board's enforcement program and  
         extending the BRN's sunset date by two years.  Specifically, this  
         bill:


         1)Defines "office" as the California State Auditor's Office.
         2)Requires the BRN, by February 1, 2016, to contract with the  
           office to conduct a performance audit of the BRN's enforcement  
           program.  The BRN must reimburse the office for the cost of the  
           audit.  The office must report the results of the audit, with  
           any recommendations, to the Governor, the Department of Consumer  
           Affairs (DCA), and the appropriate policy committees of the  
           Legislature by January 1, 2017.


         3)Provides that the performance audit shall include an evaluation  
           of 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;










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            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; and,


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


         4)Requires the BRN staff and management to cooperate with the  
           office and to provide the office with access to data, case  
           files, employees, and information as the office may require.
         5)Deletes the phrase "all phases" from the requirement that the  
           BRN develop regulations requiring schools to provide clinical  
           instruction in all phases of the educational process.


         6)Repeals the provisions relating to the BRN's evaluation and  
           licensure of an applicant who has served on active duty in the  
           medical corps of the armed forces, including: 


            a)   The requirement that the BRN grant a license if the person  








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              meets specified qualifications and the BRN determines that  
              the education would give reasonable assurance of competence  
              to practice as a registered nurse in this state; 
            b)   The requirement that the BRN promulgate regulations  
              establishing criteria for evaluating the education of the  
              applicants; and,


            c)   The requirement that the BRN maintain records of specified  
              applicants.


         7)Requires the BRN to deny the application for approval made by,  
           and 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.
         8)Requires the BRN to promulgate regulations by January 1, 2017,  
           requiring schools to have a process to evaluate and grant credit  
           for military education and experience.  The term "credit" is  
           limited to credit for licensure only - the BRN may not prescribe  
           the credit that an approved school of nursing must give toward  
           an academic certificate or degree.


         9)Requires the BRN to 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 BRN must post on  
           its Web site information related to the acceptance of military  
           coursework and experience at each approved school.


         10)Extends the BRN's sunset dates from January 1, 2016, to January  
           1, 2018.


         FISCAL EFFECT:  According to the Assembly Appropriations  
         Committee, this bill will result in costs of $37.3 million  








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         annually for two years to continue the operation of the BRN.  The  
         bill will also result in minor one-time costs to issue  
         regulations, and one-time costs to review school polices for  
         compliance with military training requirements of approximately  
         $400,000 per year for two years.  There will also be ongoing costs  
         to maintain compliance and update policies appear as if they  
         should be absorbable.  Lastly, there will be staff costs to the  
         state auditor's office, likely in the range of low hundreds of  
         thousands.


         COMMENTS:


         Purpose.  This bill is author sponsored.  According to the author,  
         "The Sunset Report identified many issues, and the [BRN] is  
         actively working to resolve many of them.  I look forward to  
         seeing the [audit] reports and maintaining engagement with the  
         [BRN] to protect California consumers."


         Background.  In March of this year, the Assembly Business and  
         Professions Committee and the Senate Business, Professions and  
         Economic Development Committee (Committees) conducted joint  
         oversight hearings to review 12 regulatory entities: California  
         Accountancy Board, California Architects Board and Landscape  
         Architects Committee, California State Athletic Commission, Board  
         of Barbering and Cosmetology, Cemetery and Funeral Bureau,  
         Contractors State License Board, Dental Board of California, Board  
         for Professional Engineers, Land Surveyors and Geologists, BRN,  
         Bureau of Security and Investigative Services, and BVNPT.


         This bill is one of several sunset bills that are intended to  
         implement the legislative changes recommended by Committee staff.   
         The recommendations are reflected in the background papers  
         prepared by Committee staff for each agency and program reviewed.










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         Experiential Learning.  Current law requires the BRN to require  
         approved schools to "give student applicants credit, in the field  
         of nursing, for previous education and the opportunity to obtain  
         credit for other acquired knowledge by the use of challenge  
         examinations or other methods of evaluation."  It also requires  
         the BRN to develop regulations to determine the types of education  
         and "the amount of credit which is to be given for each type of  
         education," which appears to include education beyond the  
         classroom.


         However, instead of making its own determination, the BRN  
         promulgated regulations delegating the responsibility to determine  
         credit to the approved schools.  Despite the delegation, the BRN  
         has stated that it does not believe any schools grant credit or  
         allow testing to prove skills or knowledge based on prior  
         professional experience. 


         Therefore, this bill requires the BRN to promulgate regulations  
         requiring schools to have a process to evaluate and grant credit  
         for previous education and clinical and theoretical knowledge  
         acquired through prior experience.  This bill also requires the  
         BRN to review school policies and practices at least once every  
         four years to ensure consistency in evaluation and application  
         across schools.


         Military Experience.  Existing law requires the BRN to evaluate  
         and credit military experience and training towards a RN license.   
         However, the BRN does not currently do so, and it does not require  
         schools to do so either.  Therefore, this bill requires the BRN to  
         require schools to evaluate and credit military experience and  
         makes conforming changes.


         JLAC Audit.  The recent sunset oversight hearings revealed issues  
         within the BRN.  Therefore, a short-term audit may help to provide  
         a review of the BRN's operations in order to ensure that any  








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         remaining issues are resolved.  Therefore, this bill will require  
         the State Auditor to conduct an audit of the BRN.  




         Analysis Prepared by:                                             
                         Vincent Chee / B. & P. / (916) 319-3301  FN:  
         0001658