BILL ANALYSIS
SENATE JUDICIARY COMMITTEE
Martha M. Escutia, Chair
2001-2002 Regular Session
AB 1253 A
Assembly Member Matthews B
As Amended July 9, 2001
Hearing Date: July 17, 2001 1
Evidence Code; Government Code; 2
Health and Safety Code; Insurance Code 5
GMO:cjt 3
SUBJECT
Nursing
DESCRIPTION
This bill would add clinical nurse specialists, to the list
of providers who may be reimbursed under the Victims of
Crime program. It would add clinical nurse specialists to
certain provisions, including the psychiatrist-patient
privilege provision in the Evidence Code), which now
applies to a registered nurse with a master's degree in
psychiatric mental health nursing.
BACKGROUND
Sponsored by the American Nurses Association of California,
this bill is intended to correct statutory references to
psychiatric-mental health nurses to reflect current nursing
practice. In 1998, a registered nurse with a master's
degree in nursing was allowed to have her credentials
reviewed by the Board of Registered Nursing in order to
attain the new title of "clinical nurse specialist." This
was instituted by the Board because of newly adopted
federal regulations that required payments for certain
health care services to be paid only to "clinical nurse
specialists."
Regulations adopted in 1983 pursuant to state law allowing
payments for mental health services for victims of crime
and their family provided by registered nurses practicing
(more)
AB 1253 (Matthews and Thomson)
Page 2
psychiatric-mental health care require the Board of
Registered Nursing to maintain a list of psychiatric-mental
health nurses who get paid for those services. Because not
all psychiatric-mental health nurses who are on the Board's
list for purposes of reimbursement from the Victims of
Crime Fund for services rendered have become "clinical
nurse specialists" and vice-versa, the latter group has not
been able to collect payment for services rendered as a
psychiatric-mental health nurse.
This bill is intended to correct both entitlement to
payment of specified nurses from the Victims of Crime fund
and the references to titles held by nurses as reflected in
current practice.
CHANGES TO EXISTING LAW
Existing law , the Nursing Practice Act, requires a nurse to
satisfy specified requirements in order to practice as a
clinical nurse specialist. Other provisions of law include
references to practice by a registered nurse with education
or experience in psychiatric-mental health nursing.
[Business and Professions Code Section 2700 et seq.]
This bill would revise those provisions to apply to an
"advanced practice registered nurse certified as a clinical
nurse specialist who participates in expert clinical
practice in the specialty of psychiatric-mental health
nursing."
Existing law includes, in the list of persons covered by
the psychiatrist-patient privilege, a registered nurse with
a master's degree in psychiatric-mental health nursing.
[Evidence Code Section 1010.]
This bill would require that those psychiatric-mental
health nurses be listed on the list maintained by the Board
of Registered Nursing in order for the privilege to apply.
This bill would also add to the list of persons covered by
Evidence Code 1010 "advanced practice registered nurse
certified as a clinical nurse specialist participating in
expert clinical practice in the specialty of
psychiatric-mental health nursing."
AB 1253 (Matthews and Thomson)
Page 3
This is an urgency measure.
COMMENT
1. Stated need for the bill
The sponsor states that this is an urgent measure because
currently, clinical nurse specialists who are not on the
Board of Registered Nursing list of practitioners payable
under the Victims of Crime Fund are not getting paid for
their services.
Additionally, they state, because current nursing
practice now requires most if not all psychiatric-mental
health nurses to obtain the title of "clinical nurse
specialist" in order to be paid for specified services,
the references to clinical nurse specialist should be
incorporated into the nursing statutes.
2. Evidence Code Section 1010 changes
The psychiatrist-patient privilege provided under
Evidence Code Section 1010 protects communication between
a patient and a list of health care providers dealing
with mental health services.
The list specifically includes registered nurses with
master's degrees in psychiatric-mental health nursing.
AB 253 would restrict this category to those listed in
the Board of Registered Nursing as psychiatric-mental
health nurses. This provision would grandfather into
Evidence Code Section 1010 those psychiatric-mental
health nurses who are not yet licensed as clinical nurse
specialists but who are registered with the Board of
Nursing for purposes of reimbursement from the Victims of
Crime Fund.
The bill also would create a new category of provider,
the "advanced practice registered nurse certified as a
clinical nurse specialist and who participates in expert
clinical practice in the specialty of psychiatric-mental
health nursing. " By creating this new category, the
sponsor states, those psychiatric-mental health nurses
AB 1253 (Matthews and Thomson)
Page 4
who are now clinical nurse specialists but who are not
registered on the Board of Registered Nursing as
psychiatric-mental health specialists for purposes of the
reimbursement from the Victims of Crime Fund would be
covered by Evidence Code Section 1010.
The bill contains double-joining amendments to SB 716
(Machado) which deals with an expansion of the
psychiatrist-patient privilege to those persons whom the
patient believes is a professional listed in the
provision.
Support: California Association of Psychiatric Mental
Health Nurses in Advanced Practice; California
Psychiatric Association; Kaiser Permanente Medical
Care Program
Opposition: None Known
HISTORY
Source: American Nurses Association of California
Related Pending Legislation: SB 716 (Machado) - would
amend Evidence Code Section 1010.
Double joining amendments are in the
bill.
Prior Legislation: None Known
Prior Vote:Asm. Health (Ayes 13, Noes 0)
Asm. Flr. (Ayes 77, Noes 0)
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