BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 1409|
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THIRD READING
Bill No: AB 1409
Author: Chan (D)
Amended: 7/18/01 in Senate
Vote: 27
SENATE BUSINESS & PROFESSIONS COMMITTEE : 5-0, 7/9/01
AYES: Figueroa, Johannessen, Machado, Morrow, Murray
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 72-0, 6/6/01 - See last page for vote
SUBJECT : Nursing Home Administrators Program
SOURCE : Department of Health Services
Department of Consumer Affairs
DIGEST : This bill establishes within the Department of
Health Services the authority to regulate and license
nursing home administrators and makes additional changes to
the Nursing Home Administrator's Act regarding the
examination and licensing of nursing home administrators,
and makes other various technical and conforming changes to
the Act.
ANALYSIS : This bill:
1. Establishes the Nursing Home Administrator Program
(Program) within the Department of Health Services (DHS)
and repeals the statute relating to licensure by the
former State Board of Nursing Home Administrators.
CONTINUED
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2. Makes additions, changes and modifications to the
existing Nursing Home Administrator's (NHA's) Act and
codifies certain regulations pertaining to the Act.
3. Defines the "Administrator-in-Training Program" (AIT
Program) as a program approved by the Program in which
qualified persons participate under the coordination,
supervision, and teaching preceptor as defined.
4. Requires the Program to adopt rules and regulations, and
requires regulations adopted pursuant to the NHA Act
prior to January 1, 2002, to remain in effect if they
are not in conflict with the new Program and until new
regulations are adopted.
5. Requires a person who is acting in the capacity of an
NHA, without a license as specified, to act in that
capacity for no more than 10 days unless arrangements
have been made for part-time supervision that includes 8
hours per week of direct onsite supervision, but under
no circumstances shall a person act in this capacity
longer than two months unless approved by the Program,
and no longer than six months once approved. Also,
specifies that a person acting in this capacity for more
than 10 days must have management experience in a
health facility.
6. Allows a preceptor who supervises an AIT who acts in the
capacity of an NHA without a license, to have the total
number of supervised training count towards their
overall training requirements of an AIT.
7. Specifies examination requirements as stated in current
regulations that requires applicants for an initial
license as a NHA to pass both a state and national
examination. Requires the state examination to be
provided four times a year, rather the once a year, and
the national examination to be computer-based and
scheduled for the applicant after they have been
notified of their eligibility to take the examination.
8. Specifies education or experience requirements as stated
in current regulations and additionally allows a person
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to qualify for the licensing examination if they:
A. Have a doctorate degree in medicine and a current
valid license as a physician and surgeon with 10 years
of recent work experience, and complete an approved
AIT Program of at least 1,000 hours.
B. Have ten years of full-time hospital administration
experience in an acute care hospital with at least 60
semester units (or 90 quarter units) of college or
university courses, and completion of an approved AIT
Program of at least 1,000 hours.
1. Allows the 1,000 hours of training required in an AIT
Program to be waived if an applicant and preceptor can
provide compelling evidence that previous work
experience directly relates to NHA duties.
2. Requires an applicant who applies for the licensing
examination to submit a declaration signed under penalty
of perjury to verify his or her work experience.
3. Exempts minor traffic violations from the statement of
whether the applicant has been convicted of a crime.
4. Requires applicants for a NHA license to submit evidence
of electronic transmission of fingerprints or
fingerprints cards to the Program.
5. Allows the DHS to institute or continue with a
proceeding against the applicant for the denial of the
license even though the application has been withdrawn
by the applicant.
6. Allows the DHS to institute or continue with a
disciplinary proceeding against a licensee even if the
license may have been suspended, expired, cancelled or
was forfeited by operation of law or by order of the DHS
or a court of law.
7. Allows a one-year period for an applicant to pass the
national and state examinations and to meet all
requirements for licensure, otherwise the applicant will
have to submit another application and examination fees
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before attempting further examinations. Allows for an
extension upon a showing of good cause.
8. Requires an applicant to read and sign an Examination
Security Agreement and comply with its terms at the time
of the examination.
9. Requires applicants to undergo a criminal record
clearance by submitting to the DHS two sets of
completed fingerprint cards for clearance by the
Department of Justice and the Federal Bureau of
Investigation.
10.Requires the Program to require applicants to provide
his or her federal employer identification number (FEIN)
or social security number (SSN) at the time of
application, issuance, or renewal of a NHA license.
Limits the use of this information to the purpose of
establishing the identification of persons affected by
state tax laws and compliance with court orders for
child support.
11.Provides that any applicant or licensee failing to
provide his or her FEIN or SSN shall be reported to the
Franchise Tax Board (FTB) and subject to penalties as
specified under the Revenue and Taxation Code, and in
addition the Program may not process any application or
license unless the licensee provides the FEIN or SSN.
12.Requires the Program to provide the FTB with specified
information relating to licensees upon request by the
FTB.
13.Requires the Program to require compliance with any
judgment or order for support prior to issuance or
renewal of a license to NHAs.
14.Permits the Program to deny, suspend, revoke, or
otherwise restrict the license of an applicant or
licensee for specified act(s) of misconduct relating to
the examination required for NHAs. Specifies that is a
misdemeanor for any person to engage in conduct to
subvert or attempt to subvert the administration of the
examination as described, and that a person found guilty
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of this provision shall be liable for actual damages to
the agency administering the examination not to exceed
$10,000.
15.Allows the examination to be administered and evaluated
by the DHS or a contractor or vendor pursuant to a
written agreement with the Program or the DHS.
16.Requires an applicant who fails to pass either the
national or state examination to retake the entire
national or state examination and allows three attempts,
after which the applicant shall be required to receive
additional training as specified. Requires the results
of either examination to be provided within 90 days and
for a license to be issued to an applicant who passes
the examination and meets all other requirements of
licensure.
17.Requires the license to be displayed in a locality that
is in public view in order to inform patients or the
public as to the regulatory agency they may contact if
they have questions or complaints regarding the
licensee.
18.Increases the fees for actual costs of the state and
national examinations and adds a new fee for provisional
licensure.
19.Allows applicants from another state to receive a
provisional license for one-year if the other state has
standards that are substantially equivalent to those of
this state, and the applicant complies with all
informational requirements as specified. Requires
applicants for a provisional license to pass the state
examination within one year, and if not, then seek
licensure in this state through standard procedures.
20.Allows a licensee whose license has expired to be
reinstated under specified circumstances.
21.Permits a licensee who does not intend to engage in
activity requiring NHA licensure, to file a request to
place his or her license in inactive status.
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22.Specifies subject areas for purposes of continuing
education (CE) of NHAs, and that 10 hours of CE shall be
in the area of aging and patient care.
23.Requires an AIT Program to be developed by the NHA
Program in consultation with representatives from the
long-term care industry and advocacy groups and
specifies what areas of instruction shall be included
within the AIT Program, and what education and/or
experience requirements an applicant must meet to be
eligible for an AIT Program.
24.Provides that the Program shall approve preceptors to
provide a training program to coordinate, supervise and
teach persons seeking to qualify for the licensing
examination. Requires a preceptor to provide a directly
supervised training program, as defined, that includes
a minimum of 20 hours per week and a maximum of 60
hours per week, be available by telephone at all other
times, and meet other requirements as specified.
25.Requires each licensee to notify the Program of their
appointment or termination of appointment as an
administrator of a nursing home and provide information
as specified that shall be considered as public
information.
26.Requires that within 24 hours after the NHA acquires
actual knowledge or credible information about the
occurrence of specified acts affecting the
administration of the nursing home facility, that the
NHA shall notify, in writing, the DHS's office for
licensing and certification.
27.Requires the Program to establish a system for the
issuance of citations to licensees, examinees, or
participants of any program activity offered or approved
by the program, and includes current regulations for
issuing citations and fines to licensees.
28.Allows the Program to deny, suspend, or revoke a NHA's
license upon specified grounds, including: gross
negligence, incompetence, conviction of a crime, using
fraud or deception in obtaining a license, treating or
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attempting to treat any physical or mental condition
without being currently licensed to do so, or violating
any other rules of regulation adopted pursuant to the
Program.
29.Allows the Program to deny an applicant or licensee a
license based upon specified grounds, and to deny,
suspend or revoke a license or participation in a
specific training program upon specified grounds.
30.Requires the Program to develop criteria to use to
determine whether a crime or act is substantially
related to the qualifications, functions or duties of
the NHA and use such criteria when considering whether
to deny, suspend of revoke a license.
31.Requires the Program to develop criteria to be used to
evaluate the rehabilitation of a person when considering
the denial, suspension, or revocation of a license.
32.Permits the Program to place a NHA licensee on probation
in lieu of formal disciplinary action and establishes
criteria for the probationary license.
33.Permits the Program to temporarily suspend any license
prior to any administrative hearing if the action is
necessary to protect the public welfare and allows the
Program to suspend or revoke a license prior to any
hearing when immediate action is necessary in the
judgment of the Director of the DHS to protect public
welfare.
34.Permits the Program to make application to the Attorney
General or a district attorney to request a superior
court of any county to issue an injunction or other
appropriate order to restrain conduct that constitutes
or will constitute a violation the Program law.
35.Makes other various technical and conforming changes
relating to the licensure of NHAs.
36.Contains double-jointing amendments to prevent
chaptering out a provision in SB 26 (Figueroa)
pertaining to names of boards and bureaus.
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SEE SENATE BUSINESS AND PROFESSIONS COMMITTEE ANALYSIS FOR
COMMENTS AND PURPOSE.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 8/20/01)
Department of Consumer Affairs (co-source)
Department of Health Services (co-source)
American Association of Retired Persons
California Association of Health Facilities
California Association of Homes and Services for the Aging
Department of Finance
The Office of the Governor
ARGUMENTS IN SUPPORT : According to the co-sponsor of
this bill, the Department of Consumer Affairs, this bill
will follow through on recommendations made by the JLSRC.
Permanently transferring the program to the DHS will allow
the Department to pursue alternative sources of funding,
including federal monies available through the Health Care
Financing Administration. In addition, the DHS will be
able to incorporate regulation of administrators with its
enforcement of nursing home facilities to streamline and
strengthen enforcement efforts. The DCA also indicates,
that by increasing the frequency and implementing a
provisional license, the number of qualified nursing home
administrators in the state should increase. The
California Association of Health Facilities supports the
changes in this measure and also appreciates the language
which addresses: frequency of testing, examination fees,
reciprocity for out-of-state administrators, provisional
licensing, and changes to the preceptor qualifications and
AIT training program. In addition, they would like to
acknowledge the willingness of the DHS to work with all of
the provider groups to address the concerns they had with
the original language within this measure.
The California Association of Homes and Services for the
Aging supports this bill and indicates the current NHA
Program has made significant progress and improvement since
moving to the DHS, and that because of the clinical nature
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of the nursing home administrator licensing category, the
program has been better served by the DHS regulatory staff
having specific knowledge of the industry. The American
Association of Retired Persons is also in support of this
measure and states that the more oversight and training
that the DHS can exercise over NHAs the better off
Californians living in nursing homes will be.
ASSEMBLY FLOOR :
AYES: Aanestad, Alquist, Aroner, Ashburn, Bates, Briggs,
Calderon, Bill Campbell, John Campbell, Canciamilla,
Cardenas, Cardoza, Cedillo, Chan, Chavez, Chu, Cogdill,
Cohn, Corbett, Correa, Cox, Daucher, Diaz, Dickerson,
Dutra, Firebaugh, Florez, Frommer, Harman, Havice,
Horton, Jackson, Keeley, Kehoe, Kelley, Koretz, Leach,
Leonard, Leslie, Liu, Longville, Lowenthal, Maddox,
Maldonado, Matthews, Migden, Mountjoy, Nakano, Nation,
Negrete McLeod, Oropeza, Robert Pacheco, Papan, Pavley,
Pescetti, Richman, Runner, Salinas, Shelley, Simitian,
Steinberg, Strickland, Strom-Martin, Thomson, Vargas,
Wayne, Wesson, Wiggins, Wright, Wyland, Wyman, Hertzberg
CP:jk 8/21/01 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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