BILL ANALYSIS
SB 1119
Page 1
Date of Hearing: June 22, 2010
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
SB 1119 (Wright) - As Amended: June 10, 2010
SENATE VOTE : 30-0
SUBJECT : Health care staffing.
SUMMARY : Requires agencies that refer licensed nurses for
temporary employment in specified health facilities to meet
requirements similar to those that apply to the referral of
licensed nurses to long-term care facilities. Requires an
employment agency to report to the Board of Vocational Nursing
and Psychiatric Technicians (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, and imposes specified fines for
violating the provisions of this bill. Specifically, this
bill :
1)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.
2)Requires an employment agency that refers temporary staff for
employment in a health facility, as defined, to do the
following:
a) Adopt policies and procedures regarding prevention of
resident or patient abuse by temporary staff;
b) Verify that individuals referred to facilities are
licensed and in good standing, have successfully secured a
criminal record clearance, have had health exams and TB
screening, as specified, and do not have any unresolved
allegations against them involving the mistreatment,
neglect, or abuse of a patient;
c) Provide, upon the request of the State Department of
Public Health (DPH), a list of temporary employees who have
been referred to a specified health facility during the
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period in which the facility is involved in a labor action;
d) Provide that no licensed nursing staff referred by an
employment agency to a health facility may be solely
responsible for a unit unless that person has received a
full orientation to the facility and the applicable unit
for which he or she is assigned;
e) 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; and,
f) Comply with specified advertising requirements.
3)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.
4)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.
5)Makes any person that violates any part of this bill subject
to a $5,000 penalty for each violation, and up to $10,000 for
each willful or knowing violation and states that civil
penalties may be assessed and recovered through a civil action
brought by the Attorney General, by any district attorney, or
any city attorney.
EXISTING LAW :
1)Provides for the certification and regulation of certified
nurse assistants under DPH, and licenses registered nurses
under the Board of Registered Nursing (RN Board).
2)Requires an employment agency that refers temporary certified
nurse assistants to an employer that is a long-term health
care facility to provide written verification that the
employment agency has verified that the certified nurse
assistant is registered on the state registry of certified
nurse assistants and is in good standing, and a statement that
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the certified nurse assistant has at least six months of
experience working in a long-term health care facility.
3)Requires an employment agency that refers licensed nursing
staff, defined to include a licensed registered nurse (RN),
licensed vocational nurse, or psychiatric technician, to a
long-term care facility to verify that the individual is in
good standing with either the Board or the RN Board, as
applicable, and has successfully secured a criminal record
clearance.
4)Requires an employment agency that refers temporary certified
nurse assistants or licensed nursing staff to an employer who
is a licensed long-term care facility to additionally do all
of the following:
a) Provide a statement that the individual 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, and
verification that the individual has had TB screening
within 90 days prior to employment and annually thereafter;
b) Provide written verification that the individual does
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;
c) Maintain a record of all advertisements, showing the
date of publication and the publication in which the
advertisement appeared, for a period of one year from the
date of the advertisement;
d) Refrain from advertising or making any other
representation that it is a home health agency; and,
e) Adopt policies and procedures regarding prevention of
resident or patient abuse by temporary staff.
5)Requires 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
pursuant to federal law.
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6)Provides that no temporary staff person referred by an
employment agency may be solely responsible for a unit unless
that person has received a full orientation to the facility
and the applicable unit for which he or she is assigned.
7)Allows any facility or individual to refer complaints
concerning employment agencies which place licensed nursing
staff or certified nurse assistants in long-term health care
facilities to the appropriate licensing, certification,
ombudsman, adult protective services, or proper law
enforcement agency for action.
8)Provides for licensure of private duty nurse registry agencies
and requires nurse registries to verify nurses' experience and
training and to verify that applicants hold current licenses.
FISCAL EFFECT : According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, negligible state costs.
COMMENTS :
1)PURPOSE OF THIS BILL . The author cites that there are 3,000
to 6,000 temporary nurse staffing agencies nationwide.
Additionally, 19,000 licensed RNs in California service as
temporary nurses. According to the author, the health care
staffing industry is poorly regulated and acts as a haven for
problem nurses. There is no regulatory oversight of nurse
registries in California except when nursing staff are
referred to long-term health care facilities. The author
states that this bill seeks to address this problem by
requiring agencies that refer licensed nursing staff for
temporary employment in health facilities, including general
acute care, acute psychiatric, and special hospitals to meet
background check requirements similar to those that apply to
the referral of licensed nursing staff to long-term care
facilities. This bill also 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,
which will ensure that problem nurses are not continually
referred to health facilities.
2)BACKGROUND . AB 1643 (Negrete McLeod), Chapter 326, Statutes
of 2001, requires employment agencies that refer temporary
certified nurse assistants or licensed nursing staff to
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long-term care facilities to verify that the individuals are
licensed and in good standing, have had health exams and TB
screening, and do not have any unresolved allegations against
them. AB 1643 was passed in response to concerns that
increasing dependence by long-term care facilities on nurse
registries and employment agencies for nurses and other staff
was diminishing the quality of care provided to long-term care
residents. However, these responsibilities are limited to
referrals by employment agencies to long-term care facilities.
This bill seeks to expand these provisions to all health
facilities.
3)SUPPORT . The National Association of Travel Health
Organizations (NATHO) supports this bill as it will impose
background check requirements and qualification standards.
NATHO also believes that there is room for improvement in this
bill and continues to support requiring healthcare staffing
agencies to be certified by an agency approved by the Centers
for Medicare and Medicaid Services, such as the Joint
Commission.
4)RELATED LEGISLATION . SB 360 (Yee) would have required each
new direct care registered nursing hire to receive and
complete an orientation to the hospital and patient care unit
in which he or she will be working. Would have precluded a
nurse who has not completed this orientation from being
assigned to direct patient care, and would require observation
of the nurse during the orientation by a direct care
registered nurse. SB 360 was held in Senate Appropriations
Committee.
5)PREVIOUS LEGISLATION . SB 1721 (Yee) of 2008 contained
provisions that are similar to the provisions of this bill.
SB 1721 was held in Assembly Appropriations Committee.
6)DOUBLE REFERRAL . This bill has been double-referred. Should
this bill pass out of this committee, it will be referred to
the Assembly Committee on Business, Professions, and Consumer
Protection.
7)AUTHOR'S AMENDMENTS .
On page 3, line 34, strike out "secured a criminal record
clearance" and insert: completed the criminal record process
required by the applicable licensing board.
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On page 5, strike out lines 37 to 40, inclusive on page 6,
strikeout lines 1 to 4, inclusive, and insert:
(b) A health facility that makes a report pursuant to
subdivision (a) shall send a copy of the report to the
employment agency that places the relevant licensed vocational
nurse or psychiatric technician with the health facility.
On page 6, line 7, strike out "person" and insert: employment
agency
REGISTERED SUPPORT / OPPOSITION :
Support
AMN Healthcare, Inc.
National Association of Travel Health Organizations
Opposition
None on file.
Analysis Prepared by : Martin Radosevich / HEALTH / (916)
319-2097