BILL ANALYSIS
AB 1253
Page 1
Date of Hearing: April 17, 2001
ASSEMBLY COMMITTEE ON HEALTH
Helen Thomson, Chair
AB 1253 (Matthews and Thomson) - As Amended: March 27, 2001
POLICY QUESTION :
Should clinical nurse specialists in the specialty of
psychiatric-mental health nursing be included in the list of
providers who may be reimbursed under the Victims of Crime
Program?
SUBJECT : Victims of Crime: clinical nurse specialists.
SUMMARY : Adds to the list of providers who may be reimbursed
under the Victims of Crime Program (Program), an advanced
practice registered nurse who is certified as a clinical nurse
specialist and who participates in expert clinical practice in
the specialty of psychiatric-mental health nursing, and revises
the description of psychiatric-mental health nurses in various
provisions of law to reflect the certification of clinical nurse
specialists. Specifically, this bill :
1)Adds to the list of providers who may be reimbursed for mental
health counseling services under the Program, an advanced
practice registered nurse who is certified as a clinical nurse
specialist, as specified, and who participates in expert
clinical practice in the specialty of psychiatric-mental
health nursing.
2)Revises the description of psychiatric-mental health nurses,
for purposes of provisions of law regarding privileged
communications between patients and psychotherapists, by
eliminating references to registered nurses who possess a
master's degree in psychiatric-mental health nursing and two
years of supervised experience in psychiatric-mental health
nursing, and instead providing a definition of an advanced
practice registered nurse who is certified as a clinical nurse
specialist, as specified, and participates in expert clinical
practice in the specialty of psychiatric-mental health
nursing.
3)Revises the description of psychiatric-mental health nurses,
for purposes of provisions of law prohibiting health care
AB 1253
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service plans or disability insurers from prohibiting covered
persons from selecting the type of mental health provider of
their choice, by eliminating references to registered nurses
who are on a list maintained by the Board of Registered
Nursing (BRN) of psychiatric-mental health nurses who possess
a master's degree in psychiatric mental health nursing and two
years of supervised experience in psychiatric mental health
nursing, and instead providing a definition of an advanced
practice registered nurse who is certified as a clinical nurse
specialist, as specified, and participates in expert clinical
practice in the specialty of psychiatric-mental health
nursing.
EXISTING LAW :
1)Licenses and regulates registered nurses through BRN, and
provides for the certification of clinical nurse specialists
for registered nurses who meet certain requirements, including
possessing a master's degree in a clinical field of nursing.
2)Establishes the Program, administered by the State Board of
Control, to reimburse victims of crime for the pecuniary
losses they suffer as a direct result of criminal acts. The
Program is funded by restitution fines, which are required to
be imposed by the court on all persons convicted of a
misdemeanor or a felony.
3)Includes in the definition of "pecuniary loss," for purposes
of the Program, is the amount of psychiatric, psychological,
or other mental health counseling related expenses which
became necessary as a direct result of the crime, and
specifies that these counseling services may only be
reimbursed if provided by specified individuals, including
physicians, psychologists, clinical social workers, and
marriage and family therapists.
4)Includes in the definition of "psychotherapist," for purposes
of provisions of law regarding privileged communications
between patients and psychotherapists, a licensed registered
nurse who possesses a master's degree in psychiatric-mental
health nursing.
5)Includes, for purposes of provisions of law prohibiting health
care service plans or disability insurers from prohibiting
covered persons from selecting the type of mental health
AB 1253
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provider of their choice, those licensed registered nurses who
are on a list maintained by BRN of psychiatric-mental health
nurses who possess a master's degree in psychiatric mental
health nursing and two years of supervised experience in
psychiatric-mental health nursing.
FISCAL EFFECT : Unknown
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, this bill is
sponsored by the American Nurses Association/California to
enable clinical nurse specialists in the field of
psychiatric-mental health nursing to be reimbursed for
counseling services to victims of crime, and to make title
changes in various provisions of law to reflect the current
title for nurses with a master's degree in a clinical nursing
field.
2)SUPPORT . This bill is supported by the California Association
of Psychiatric Mental Health Nurses in Advanced Practice
(Association), which states that current law discriminates
against victims who attempt to seek therapy from more than 400
licensed clinical nurse specialists in California. According
to the Association, although psychiatric-mental health
clinical nurse specialists are legally recognized providers of
mental health services, they are not specifically listed in
the Program.
The California Psychiatric Association (CPA) also supports this
bill, stating that psychiatric advanced practice nurses are
valuable members of the psychiatric care team, and CPA
supports their being eligible for reimbursement for their
professional services.
3)DRAFTING CONCERN/SUGGESTED AMENDMENT . Since 1998, BRN has
been able to issue clinical nurse specialist certifications to
registered nurses who meet certain requirements. The stated
intent of this bill is to enable these clinical nurse
specialists, who practice in the field of psychiatric-mental
health nursing, to be reimbursed under the Program, and to
update outdated definitions of psychiatric-mental health
nurses with the current clinical nurse specialist title.
However, according to BRN, not all of the nurses that meet the
current definition of being on a list maintained by BRN of
AB 1253
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psychiatric-mental health nurses with a master's degree and
two years of supervised experience in psychiatric-mental
health nursing, meet the new definition of certified clinical
nurse specialists.
The effect of this title change may be to exclude some nurses
who have been providing mental health services for a number of
years. Since this does not appear to be the intent of the
sponsor, the author may wish to consider an amendment that
would retain the current definition and simply add the new
category of clinical nurse specialist to the affected
provisions of law. Additionally, the author may wish to add
the current definition of those nurses on the list maintained
by BRN to the list of providers eligible for reimbursement by
the Program.
REGISTERED SUPPORT / OPPOSITION :
Support
American Nurses Association/California (sponsor)
California Association of Psychiatric Mental Health Nurses in
Advanced Practice
California Psychiatric Association
Opposition
None on file
Analysis Prepared by : Vincent D. Marchand / HEALTH / (916)
319-2097