BILL ANALYSIS Ó SB 466 Page 1 SENATE THIRD READING SB 466 (Hill) As Amended September 1, 2015 Majority vote SENATE VOTE: 40-0 -------------------------------------------------------------------- |Committee |Votes|Ayes |Noes | | | | | | | | | | | | | | | | |----------------+-----+-----------------------+---------------------| |Business & |14-0 |Bonilla, Jones, Baker, | | |Professions | |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 | | SB 466 Page 2 | | | | | | | | | | -------------------------------------------------------------------- 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; SB 466 Page 3 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)Inserts the phrase "all phases of" back into the existing requirement that the BRN develop regulations requiring schools to provide clinical instruction in all phases of the educational process. 6)Provides an exception to the above clinical instruction requirement to accommodate military experience and education as specified in Business and Professions Code Section 2786.1. SB 466 Page 4 7)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 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. 8)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. 9)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. 10)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 SB 466 Page 5 approved school. 11)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 annually for two years to continue the operation of the BRN. This 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, SB 466 Page 6 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. 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 SB 466 Page 7 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 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: 0001841