BILL ANALYSIS                                                                                                                                                                                                    



                                                                       


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          |SENATE RULES COMMITTEE            |                  AB 1253|
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                                 THIRD READING


          Bill No:  AB 1253
          Author:   Matthews (D) & Thomson (D)
          Amended:  8/27/01 in Senate
          Vote:     27 - Urgency

           
           SENATE HEALTH & HUMAN SERV. COMMITTEE  :  8-0, 6/13/01
          AYES:  Ortiz, Haynes, Battin, Chesbro, Kuehl, Romero,  
            Vasconcellos, Vincent

           SENATE JUDICIARY COMMITTEE  :  6-0, 7/17/01
          AYES:  Escutia, Ackerman, Haynes, O'Connell, Peace, Sher

           ASSEMBLY FLOOR  :  77-0, 5/10/01 -  See last page for vote


           SUBJECT  :    Nursing

           SOURCE  :     American Nurses Association of California


           DIGEST  :    This bill adds to the list of providers who may  
          be reimbursed under the Victims of Crime Program,  
          psychiatric-mental health nurses, as defined, and revises  
          the description of psychiatric-mental health nurses in  
          various codes to add certified clinical nurse specialists  
          who participate in expert clinical practice in the  
          specialty of psychiatric mental health nursing.

           Senate Floor Amendments of 8/27/01  :

          1.Provide that provisions of AB 1253, pertaining to the  
            definition of pecuniary losses that may be reimbursed,  
            will be inoperative if another bill, AB 1017 (Jackson),  
                                                           CONTINUED





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            is enacted and becomes effective during the 2001-2002  
            Regular Session.  According to the author's office, this  
            amendment is necessary to avoid a chaptering out problem.

          2.Make other technical revisions.

           ANALYSIS  :    Existing law:
          
          1.Licenses and regulates registered nurses through the  
            State Board of Registered Nursing (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 a 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 Victims of Crime Program, 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 or vision service provider of their  
            choice), upon referral by a physician and surgeon, those  
            licensed registered nurses who are on a list maintained  







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            by the 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.

          This bill:

          1.Adds to the list of providers who may be reimbursed for  
            mental health counseling services under the Victims of  
            Crime 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, and a registered nurse who possesses a master's  
            degree in psychiatric-mental health nursing and is listed  
            as a psychiatric-mental health nurse by the BRN.   
            Provides that these provisions will be inoperative if AB  
            1017 (Jackson) is enacted and becomes effective during  
            the 2001-02 Regular Session.

          2.Revises the description of psychiatric-mental health  
            nurses, for purposes of provisions of law regarding  
            privileged communications between patients and  
            psychotherapists, by including 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 service plans or disability insurers, from  
            prohibiting covered persons from selecting the type of  
            mental health provider of their choice, by adding 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.

          4.Is double-joined to SB 716 (Machado).  (See Related  
            Legislation below.)

           Intent of the bill








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           Since 1998, the 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 Victims of Crime Program, and to  
          update outdated definitions of psychiatric-mental health  
          nurses with the current clinical nurse specialist title.   
          However, according to the BRN, not all of the nurses who  
          meet the current definition of being on a list maintained  
          by BRN of  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.

          According to the author, this bill is sponsored by the  
          American Nurses Association of 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.

           Related legislation  

          SB 716 (Machado) redefines the term "psychotherapist" such  
          that communication between a psychotherapist and a patient  
          remain confidential and privileged.  This bill has been  
          returned to the Senate from the Assembly.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No    
          Local:  No

           SUPPORT  :   (Verified  8/28/01)

          American Nurses Association of California (source)
          California Association of Psychiatric Mental Health Nurses  
            in Advanced Practice
          California Psychiatric Association
          Kaiser Permanente Medical Care Program

           ARGUMENTS IN SUPPORT  :    This bill is supported by the  
          California Association of Psychiatric Mental Health Nurses  







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          in Advanced Practice, 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 also supports making  
          psychiatric advanced practice nurses eligible for  
          reimbursement for their professional services, as provided  
          in this bill.

           ASSEMBLY FLOOR  
          AYES:  Aanestad, Alquist, Ashburn, Bates, Bogh, Briggs,  
            Calderon, Bill Campbell, John Campbell, Canciamilla,  
            Cardenas, Cardoza, Cedillo, Chan, Chavez, Cogdill, Cohn,  
            Corbett, Correa, Cox, Daucher, Diaz, Dickerson, Dutra,  
            Firebaugh, Florez, Frommer, Goldberg, Harman, Havice,  
            Hollingsworth, Jackson, Keeley, Kehoe, Kelley, Koretz, La  
            Suer, Leach, Leonard, Leslie, Liu, Longville, Lowenthal,  
            Maddox, Maldonado, Matthews, Migden, Mountjoy, Nakano,  
            Nation, Negrete McLeod, Oropeza, Robert Pacheco, Rod  
            Pacheco, Papan, Pavley, Pescetti, Reyes, Richman, Runner,  
            Salinas, Shelley, Simitian, Steinberg, Strickland,  
            Strom-Martin, Thomson, Vargas, Washington, Wayne, Wesson,  
            Wiggins, Wright, Wyland, Wyman, Zettel, Hertzberg


          CP:kb  8/28/01   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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