BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 466|
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UNFINISHED BUSINESS
Bill No: SB 466
Author: Hill (D), et al.
Amended: 9/1/15
Vote: 21
SENATE BUS, PROF. & ECON. DEV. COMMITTEE: 9-0, 4/27/15
AYES: Hill, Bates, Berryhill, Block, Galgiani, Hernandez,
Jackson, Mendoza, Wieckowski
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/28/15
AYES: Lara, Bates, Beall, Hill, Leyva, Mendoza, Nielsen
SENATE FLOOR: 40-0, 6/1/15
AYES: Allen, Anderson, Bates, Beall, Berryhill, Block,
Cannella, De León, Fuller, Gaines, Galgiani, Glazer, Hall,
Hancock, Hernandez, Hertzberg, Hill, Hueso, Huff, Jackson,
Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning,
Moorlach, Morrell, Nguyen, Nielsen, Pan, Pavley, Roth, Runner,
Stone, Vidak, Wieckowski, Wolk
ASSEMBLY FLOOR: 80-0, 9/3/15 - See last page for vote
SUBJECT: Registered nurses: Board of Registered Nursing
SOURCE: Author
DIGEST: This bill extends the sunset date on the Board of
Registered Nursing (BRN) until January 1, 2018, requires the
California State Auditors Office (Auditor) to conduct an audit
of the BRN's enforcement program, requires BRN to promulgate
regulations to ensure that schools grant credit for military
education and experience, and makes technical changes.
Assembly Amendments replace the enforcement monitor with an
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Page 2
audit by the State Auditor, extends the sunset of the BRN until
2018, and makes other technical changes.
ANALYSIS:
Existing law:
1)Establishes the BRN until January 1, 2016, to license and
regulate the practice of nursing. (Business and Professions
Code (BPC) § 2701)
2)Requires the BRN's rules and regulations to provide for
methods of evaluating education, training, and experience
obtained in military service if such training is applicable to
the requirements of the particular profession or vocation
regulated by the board. (BPC § 710)
3)Requires the BRN to evaluate for registered nurse (RN)
licensure the training record submitted by any person who has
served on active duty in the medical corps of any of the Armed
Forces and completed the course of instruction required to
qualify him or her for rating as a medical service
technician--independent duty, or other equivalent rating in
his particular branch, and whose service in the Armed Forces
has been under honorable conditions.
(BPC § 2736.5)
4)Requires the BRN to deny or revoke the application for
approval for any nursing school which does not 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. Requires the BRN to prescribe,
by regulation, the education for which credit is to be given
and the amount of credit which is to be given for each type of
education. The word "credit" is limited to credit for
licensure only, and the BRN is not authorized to prescribe the
credit which an approved school of nursing shall give toward
an academic certificate or degree. (BPC § 2786.6)
This bill:
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1)Extends the sunset date on the BRN and its executive officer
until January 1, 2018.
2)Deletes existing provisions of law that requires the BRN to
evaluate for RN licensure the training record submitted by any
person who has served on active duty in the medical corps of
any of the Armed Forces, and completed the course of
instruction required to qualify him or her for rating as a
medical service technician--independent duty, or other
equivalent rating in his particular branch, and whose service
in the armed forces has been under honorable conditions.
3)Requires the BRN to contract with the Auditor by February 1,
2016, to conduct a performance audit of the BRN's enforcement
program.
4)Requires the Auditor to report the results of the audit, with
any recommendations, to the Governor, the Department of
Consumer Affairs, and the appropriate policy committees of the
Legislature by January 1, 2017.
5)Requires the BRN's educational regulations to be designed to
require all schools to provide clinical instruction in all
phases of the educational process, except as necessary to
accommodate military education and experience, as specified.
6)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.
7)Requires the BRN to adopt regulations by January 1, 2017,
requiring schools to have a process to evaluate and grant
credit for military education and experience.
8)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
board shall post on its Internet Web site information related
to the acceptance of military coursework and experience at
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each approved school.
Background
In 2015, the Senate Business, Professions and Economic
Development Committee and the Assembly Business and Professions
Committee conducted joint oversight hearings to review 12
regulatory entities, including the BRN.
Issue: Consideration of Military Experience. The BRN is
required by law to evaluate and credit military experience and
training towards RN licensure. Until 2000, there were parallel
training requirements in the military and civilian worlds to
qualify for the RN license examination. The BRN adopted
regulations in 1976 and 1985 that specifically identified
military titles and supplemental experience that would be
exhaustive of the BRN requirements. In 2000, the BRN determined
that the military coursework had changed and was no longer
directly transferrable. The BRN then updated the regulations
for evaluating military training to be broadly descriptive,
which made identifying any specific relevant military coursework
difficult. The BRN has not evaluated military coursework since,
although the board reports they were told by military
representatives in 2010 that the military does not have a
directly comparable RN training program.
The BRN has effectively delegated the duty of identifying
eligible military coursework to approved RN programs, for which
the BRN is required to approve the curriculum. However,
according to the Executive Officer (EO) of the BRN, the Board
does not know to what extent, if any, schools are providing
credit for military experience and education. The EO stated
that the BRN has never spoken to schools about accepting
military coursework and experience for credit, nor has the BRN
suggested which military coursework may be transferrable.
This bill requires the board to promulgate regulations to ensure
that schools have a process to evaluate and grant credit for
previous education and experience acquired through military
service, and requires the BRN to review schools' policies and
practices at least once every five years to ensure consistency
in evaluation and application across schools. This bill also
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requires the BRN to post on its Web site information related to
the acceptance of military coursework and experience at each
approved school.
Issue: Enforcement Concerns. Administrative Law Judges rely on
the Disciplinary Guidelines adopted by the BRN when issuing
disciplinary orders for violations of the Nursing Practice Act,
but these guidelines have not been substantially updated in 13
years. As a result of this, and enforcement staff's lack of
coordination and communication, stakeholders note a wide range
of disciplinary case outcomes.
BRN noted in its response to the background paper that it plans
to present revised guidelines at its June 2015 board meeting.
This is a positive step, but systemic problems still remain. It
has been reported that BRN advises enforcement case managers to
treat every discipline matter on a case-by-case basis, which,
while certain nuances are inevitable, the wide variation in
disciplinary decisions reported for seemingly similar offenses
is concerning. BRN's continuing overages in its Attorney
General allowance also indicate an enforcement program in need
of restructure.
This bill will require the BRN to contract with the Auditor to
conduct a performance audit of the BRN's enforcement program by
January 1, 2017.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Assembly Appropriations Committee:
1)Costs of $37.3 million annually for two years to continue the
operation of the BRN (BRN Fund).
2)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
(BRN Fund). Ongoing costs to maintain compliance and update
policies appear as if they should be absorbable.
3)Staff costs to the Auditor, likely in the range of low
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hundreds of thousands (Reimbursements from BRN Fund).
SUPPORT: (Verified9/3/15)
None received
OPPOSITION: (Verified9/3/15)
None received
ASSEMBLY FLOOR: 80-0, 9/3/15
AYES: Achadjian, Alejo, Travis Allen, Baker, Bigelow, Bloom,
Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang,
Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle,
Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina
Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,
Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden,
Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder,
Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina,
Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen,
Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez,
Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting,
Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins
Prepared by:Sarah Huchel / B., P. & E.D. / (916) 651-4104
9/3/15 18:47:44
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