BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1119|
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THIRD READING
Bill No: SB 1119
Author: Wright (D), et al
Amended: 4/21/10
Vote: 21
SENATE HEALTH COMMITTEE : 9-0, 4/14/10
AYES: Alquist, Strickland, Aanestad, Cedillo, Cox, Leno,
Negrete McLeod, Pavley, Romero
SENATE BUSINESS, PROF. & ECON. DEV. COMM. : 7-0, 4/19/10
AYES: Negrete McLeod, Wyland, Aanestad, Calderon, Correa,
Oropeza, Yee
NO VOTE RECORDED: Florez, Walters
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
SUBJECT : Health care staffing
SOURCE : Author
DIGEST : This bill requires agencies that refer licensed
nursing staff for temporary employment in health
facilities, including general acute care, acute
psychiatric, and special hospitals, to meet requirements
similar to those that apply to the referral of licensed
nursing staff to long-term care facilities.
ANALYSIS :
Existing law:
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1. Establishes, within the Business and Professions Code,
the Board of Registered Nursing (BRN) to license and
regulate the practice of nursing.
2. Establishes the Board of Vocational Nursing and
Psychiatric Technicians (BVNPT) to license and regulate
the practice of vocational nursing and psychiatric
technicians.
3. Provides for the certification and regulation of
certified nurse assistants under the Department of
Public Health.
4. Requires, under the Nurse Practice Act, that every
employer of a registered nurse, including a nurse
registry to verify that the nurse is currently
authorized to practice.
5. Establishes, in the Civil Code, the Employment Agency,
Employment Counseling, and Job Listing Services Act
(Act) to regulate the business of employment agencies,
including nursing registries.
6. Requires every nurses' registry to maintain a $3,000
bond issued by a surety company admitted to do business
in this state and filed with the Secretary of State.
7. Requires a nurses' registry to provide a copy of the
registry's fee schedule and payment terms to any nurse
from whom a fee or deposit is to be received, prior to
the nurse being interviewed by the registry.
8. States that it is the duty of the nurses' registry to
verify in writing the claims as to the experience or
training listed on the application and to keep a file of
those records in the nurse's folder within the nurses'
registry. Specifies that it is also the duty of the
person interviewing the jobseeker to require the
jobseeker to exhibit his or her license as issued by the
BRN or the BVNPT with a notation to be made on the
application by the interviewer that the license has been
inspected and the date of expiration of the license.
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9. Requires every employment agency that refers licensed
nursing staff, certified nurse assistant, or temporary
licensed nursing staff to an employer who is a licensed
long-term health care facility to provide the employer
with specified information.
10.Allows any facility or individual to refer complaints
concerning employment agencies which place licensed
nursing staff in long-term health care facilities to the
appropriate licensing, certification, ombudsman, adult
protective services, or law enforcement agency for
action.
11.Defines health care facility to include general acute
care hospital, acute psychiatric hospital, skilled
nursing facility, or intermediate care facilities, as
specified.
This bill:
1. Requires employment agencies that refer licensed nursing
staff for temporary employment in health facilities,
including general acute care, acute psychiatric, and
special hospitals, to meet similar requirements that
apply to the referral of licensed nursing staff to
long-term care facilities.
2. Applies the following requirements to employment
agencies that refer licensed nursing staff for temporary
employment in health facilities:
A. Provide written verification that the individual
is in good standing with the BRN and BVNPT as
applicable, has successfully secured a criminal
record clearance, provide to the employer the
individual's professional license and registration
number and date of expiration.
B. Provide a statement that the licensed nursing
staff person has had a health examination within 90
days prior to employment with the employment agency
or seven days after employment with the employment
agency and at least annually thereafter by a person
lawfully authorized to perform that procedure.
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Requires the examination to include a medical history
and physical evaluation. The employment agency shall
also provide verification that the individual has had
tuberculosis screening within 90 days prior to
employment and annually thereafter.
C. Adopt policies and procedures regarding prevention
of resident or patient abuse by temporary staff.
D. Provide written verification that any certified
nurse assistants or licensed nursing staff referred
by the agency do not have any unresolved allegations
against them involving the mistreatment, neglect, or
abuse of a patient, including injuries of unknown
source and misappropriation of resident property.
E. Upon the request of the Department of Health
Services, provide a list of temporary employees who
have been referred to a specified facility during the
period in which the facility is involved in a labor
action.
F. Require that any employee referred to a long-term
care facility be identified as a temporary staff
person in the facility's daily staffing levels
required to be posted, as specified.
G. Allow a temporary staff person to be responsible
for a unit only if that person has received a full
orientation to the facility.
H. Comply with specified advertising requirements.
3. Requires an employment agency that refers licensed
nursing staff for temporary employment in a health
facility to be certified or accredited by the Joint
Commission or an accrediting body recognized by the
federal Centers for Medicare and Medicaid Services.
4. Requires an employment agency to report to the board the
suspension or termination for cause by a health facility
of a licensed vocational nurse or psychiatric technician
referred to the facility by the agency.
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5. Requires a health facility that refuses to accept a
placement of a licensed nursing staff or certified nurse
assistant from an employment agency to inform the agency
of its reasons and of any action that may constitute
grounds for reporting of the person's termination or
suspension for cause.
Background
Nurse registries . Current law defines a nursing registry
as a person who engages in the business of obtaining and
filling commitments for nursing services. Nurse registries
contract out the services of registered nurses, vocational
nurses, psychiatric technicians or certified nurse
assistants to various employers and entities. Nurse
registries, to operate in California, must maintain a
$3,000 surety bond, a copy of which is filed with the
Secretary of State. Nurse registries may contract with any
private duty nurse, who serves as an agent of the registry
for purposes of assignment. There is no regulatory
oversight of nurse registries in California, except when
nursing staff are referred to long-term health care
facilities, specified requirements must be met.
Requirements for nursing registries at long-term health
care facilities . This bill requires employment agencies
that refer licensed nursing staff for temporary employment
in health facilities to meet similar requirements that
apply to the referral of licensed nursing staff to
long-term health care facilities. AB 1643 (Negrete
McLeod), Chapter 326, Statutes of 2001, established
existing requirements that nursing registries must meet in
order to refer temporary nursing staff to long-term health
care facilities. The requirements of AB 1643 were adopted
at that time because of the recognition that no statutory
or regulatory rules exist for employment agencies that
refer temporary staff to long-term care facilities in
California. At that time, there was evidence that
employment agencies have referred temporary staff without
verifying that these employees possess the necessary
qualifications, or are in good standing with the
appropriate licensing boards. Similarly, the author of
this bill cites several lapses by nursing registries and
the nurses that are referred to several facilities as a
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justification for this bill.
Failures of nursing registries . On December 5, 2009, the
Los Angeles Times , in conjunction with Pro-Publica
published an article entitled "Temp Firms a Magnet for
Unfit Nurses." The article pointed out that the nursing
registry industry is a $4-million industry lacking any
regulatory oversight. The article provided several stories
on the lapses of nurses that are referred by nursing
registries to various facilities in California.
Specifically, the article pointed out that nurse registries
are failing in their obligation to conduct criminal
background checks, which have allowed the employment of
nurses whose licenses are revoked, placed on probation, and
have criminal histories. Furthermore, nursing registries
are also failing to conduct competency assessment of
nursing staff, resulting in the referral of nurses with
inadequate nursing skills. Additionally, the lack of a
reporting requirement for employers of nurses, including
hospitals and nurse registries, have allowed the shuffling
of nurses from one facility to another facility, often
undetected and to the detriment of patients. The article
asserted that these failures are especially critical to
states like California where nurses are in short supply.
Lack of employer reporting requirement for nurses; a
barrier to patient care . As the Los Angeles Times article
pointed out, the lack of reporting requirements for
employers of problem nurses has resulted in the shuffling
of errant nurses from one facility to another. Unlike
nurses, employers of vocational nurses and psychiatric
technicians are required to report to the BVNPT any
suspension or termination for cause resulting from any of
the following: (1) use of controlled substances or alcohol
to such an extent that it impairs the licensee's ability to
safely practice, (2) unlawful sale of controlled substances
or other prescription items, (3) patient or client abuse,
neglect, physical harm, or sexual contact with a patient or
client, (4) falsification of medical records, (5) gross
negligence or incompetence, and (6) theft from patients or
clients, other employees, or the employer.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
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SUPPORT : (Verified 5/4/10)
AMN Healthcare, Inc.
JJA:mw 5/4/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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