BILL ANALYSIS
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|Hearing Date:August 30, 2010 |Bill No:AB |
| |378 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Gloria Negrete McLeod, Chair
Bill No: AB 378Author:Hagman
As Amended:August 23, 2010 Fiscal:Yes
SUBJECT: Nursing: continuing education.
SUMMARY: An urgency measure which requires that continuing education
courses contain only content relevant to the practice of nursing, as
specified. Provides that continuing education courses that advance or
promote labor organizing on behalf of a union, or that advance or
promote statutory or regulatory changes, political candidates,
political advocacy, or political strategy shall not be considered
content relevant to the practice of nursing and not acceptable for
meeting requirements for licensure renewal.
NOTE : This is an urgency measure and a new bill which was amended
on the Senator Floor and referred to this Committee pursuant to Rule
29.10 (c) for consideration. Because this measure is considered as a
new bill, the Committee may by a vote of the majority either refer
this measure to Appropriations Committee for consideration (a motion
to "do pass to Appropriations Committee"), amend the bill in
Committee as needed with a motion to "do pass to Appropriations
Committee" with amendments to be taken in that Committee," or hold
this measure in Committee.
Existing law:
1) Establishes the Nursing Practice Act, enforced by the Board of
Registered Nursing (BRN), to regulate the practice of nursing in
California.
2) Defines the practice of nursing, among other things, as those
functions, including basic health care, that help people cope with
the difficulties in daily living that is associated with their
actual or potential health or illness problems or the treatment
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thereof, and that require a substantial amount of scientific
knowledge or technical skill.
3) Requires a register nurse (RN) renewing his or her license to
submit proof satisfactory to the BRN that, during the preceding
two-year period, he or she has been informed of the developments in
the RN field or in any special area of practice engaged in by the
licensee, occurring since the last renewal thereof, either by
pursuing a course or courses of continuing education in the
registered nurse field or relevant to the practice of the licensee,
and approved by the BRN, or by other means deemed equivalent by the
BRN.
4) Requires the BRN by regulation to establish standards for
continuing education. States that the standards shall be
established in a manner to assure that a variety of alternative
forms of continuing education are available to licensees,
including, but not limited to, academic
studies, in-service education, institutes, seminars, lectures,
conferences, workshops, extension studies, and home study programs.
This bill:
1) Requires that continuing education courses contain only content
relevant to the practice of nursing, as specified. Provides that
continuing education courses that advance or promote labor
organizing on behalf of a union, or that advance or promote
statutory or regulatory changes, political candidates, political
advocacy, or political strategy shall not be considered content
relevant to the practice of nursing and shall not be acceptable for
meeting requirements for licensure renewal. Provides that courses
include institutes, seminars, lectures, conferences, workshops, and
any other public events.
2) Provides that if an approved provider offers a course specified in
#1) above, the provider shall not represent that the course is
acceptable for meeting the continuing education requirements for
licensure renewal. States that if a provider violates this
requirement, the BRN shall withdraw its approval of the provider,
as specified.
3) Indicates that if, after the BRN provides the provider notice and
an opportunity to be heard, the BRN finds that the provider
violated the requirements of #2) above, the BRN shall withdraw
approval of the provider for no less than five years.
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FISCAL EFFECT: Unknown. This bill has been keyed fiscal by
Legislative Counsel.
COMMENTS:
1.Purpose. The Author is the Sponsor of this measure. According to
the Author, it has come to his attention, through a complaint from a
member of the California Nurses Association (CNA), that CNA has
offered continuing education credits to some members of the
association as an inducement to attend CNA political events. The
Author points out that in doing independent research on this matter,
it is apparent CNA also offers continuing credits to nurses
attending classes focused upon lobbying and political organizing.
The Author has provided Committee staff with a description of a
class that CNA will be offering in September 2010 entitled "Social
Advocacy: Advancing Powerful Patient Advocacy and Nurses Values for
California." The description indicates that this course examines
the RNs unique ability to be the driving force in advancing a
powerful RNs' values agenda in the regulatory, legislative, and
their policy-making arenas on behalf of patients, families and
communities.
2.Background: Existing Regulations of the BRN on Continuing
Education. Current law requires a nurse renewing his or her license
to fulfill 30 hours of continuing education approved by the BRN
every two years. Courses must be taken through a continuing
education provider recognized by the BRN. Nursing regulations
provide that:
a) Continuing education undertaken by registered nurse for
re-licensure are learning experiences that are meant to enhance
the knowledge of the registered nurse in the practice of nursing
in direct and indirect patient care.
b) A course in continuing education means a systematic learning
experience, at least one hour in length, which deals with and is
designed for the acquisition of knowledge, skills, and
information in direct and indirect patient care.
c) The learning experiences are expected to enhance the knowledge
of the RN at a level above that required for licensure. Courses
related to the scientific knowledge for the practice of nursing
include basic and advanced courses in the physical, social, and
behavioral sciences, as well as advanced nursing in general or
specialty areas.
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d) The content relevant to the practice of nursing means content
related to the development and maintenance of current competency
in the delivery of nursing care and includes courses related to
the scientific knowledge and/or technical skills required for the
practice of nursing, or related to direct and/or indirect
patient/client care.
e) Courses in nursing administration, management, education,
research legal aspects of nursing, current trends in nursing and
health care, or other functional areas of nursing related to
indirect patient/client care would be acceptable. However,
courses which deal with self-improvement, changes in attitudes,
financial gain, and those courses designed for lay people are not
acceptable for meeting requirements for license renewal.
f) The BRN may withdraw its approval of a provider of continuing
education or deny a provider application for specified reasons
and after giving the provider written notice setting forth its
reason for withdrawal and after affording a reasonable
opportunity to be heard by the BRN.
3.Arguments in Opposition. The California Nurses Association points
out that this bill unfairly singles out RNs, and undermines an RN's
legal duty to advocate in the sole interest of patients. CNA points
out that the duty to advocate on behalf of patients takes place in a
number of different ways, including collective patient advocacy,
which is often a topic during continuing education courses. Second,
CNA indicates that this bill would keep RNs in the dark about
important legislative and regulatory developments in the health care
field in which they practice. There are numerous legislative and
regulatory changes that occur each year affecting RNs and the
practice of nursing and RNs should not be singled out and denied
valuable education about health care policy that affects them and
their patients.
The United Nurses Associations of California/Union of Health Care
Professionals (UNAC) indicates that this bill would place unwieldy
constraints on the ability of nurses to be educated in important
legal developments relevant to their field. Additionally, UNAC
asserts that this bill would form as a censorship over the content
of education that could be made available to members of the nursing
profession. Education on regulatory and statutory changes provides
an important tool in the professional development of nurses, and
should not be prohibited.
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4.Staff Comments. This bill would prohibit offering courses that
advance or promote labor organizing on behalf of a union, or that
advance or promote statutory or regulatory changes, political
candidates, political advocacy, or political strategy. Continuing
education courses on the legislative or executive processes, how a
bill becomes a law, and advocating on important health care issues,
including health care reform, nurse staffing and seismic safety,
would be disallowed by this bill since these are courses that
advance or promote statutory or regulatory changes, involve
political advocacy, or discussions on political strategy. However,
it is not unusual for any profession to be educated and get involved
in the legislative or regulatory processes, and to learn the
advocacy process, including those in the health care profession,
because of the importance and timeliness of health care in the
legislative and political debates. Furthermore, according to the
BRN, courses dealing with the legislative process and political
climate are relevant to the practice of nursing and are currently
approved as continuing education courses. However, the BRN also
indicates that any continuing education course that involves
political activity, such as a demonstration or rally in support or
in opposition to a particular candidate or policy would be
disapproved by the BRN.
5.Staff Recommends: Since it appears as if the provisions of this
bill are overbroad and could potentially prohibit courses that are
relevant to the practice of nursing and would be approved by the
BRN, the Committee should consider requesting the BRN to investigate
this matter and if it is found that the CE course(s) provided, or
intended to be provided, may involve direct political activity, then
to issue a letter to registered nurses and CE providers indicating
that continuing education courses that include political activities
which may involve rallies or demonstrations would not be approved or
provided continuing education credit by the BRN.
SUPPORT AND OPPOSITION:
Support:
None on file as of August 23, 2010
Opposition:
California Nurses Association
United Nurses Associations of California/Union of Health Care
Professionals
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Consultant:Rosielyn Pulmano