BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     SB 466


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          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                   |                     |








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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)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.









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          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  








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            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,  








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          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  








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          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