BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1119|
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UNFINISHED BUSINESS
Bill No: SB 1119
Author: Wright (D), et al
Amended: 6/23/10
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
SENATE FLOOR : 30-0, 5/10/10
AYES: Aanestad, Alquist, Ashburn, Calderon, Cedillo,
Cogdill, Cox, DeSaulnier, Ducheny, Florez, Hancock,
Hollingsworth, Huff, Kehoe, Leno, Lowenthal, Negrete
McLeod, Padilla, Pavley, Price, Romero, Runner, Simitian,
Steinberg, Strickland, Walters, Wolk, Wright, Wyland, Yee
NO VOTE RECORDED: Corbett, Correa, Denham, Dutton, Harman,
Liu, Oropeza, Wiggins, Vacancy, Vacancy
ASSEMBLY FLOOR : Not available
SUBJECT : Health care staffing
SOURCE : Author
CONTINUED
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DIGEST : This bill requires temporary licensed nursing
employment agencies to verify a nurse's fitness to work,
requires certain reporting of unfit nurses, and specifies
penalties for failure to do so.
Assembly Amendments authorize civil penalties of up to
$5,000 and $10,000, respectively, and require health
facilities that make reports regarding unfit nurses to send
a copy of that report to the employment agency that place
the relevant licensed vocational nurse or licensed physical
therapist with the facility.
ANALYSIS :
Existing law:
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.
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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.
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 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
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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
completed the criminal record process required by the
applicable licensing board, have had health exams and
tuberculosis 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 Department of
Public Health, a list of temporary employees who have
been referred to a specified health facility during
the 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/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.
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 (LVN) or licensed
psychiatric technician (LPT) referred to the facility by
the agency.
4. Requires a health facility that makes a report of an
unfit nurse to send a copy of the report to the
employment agency that placed the relevant LVN or LPT
with the health facility.
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5. Makes any employment agency 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.
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
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the nurses that are referred to several facilities as a
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
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Local: Yes
According to the Assembly Appropriations Committee, this
bill will create unknown fee-supported workload of less
than $50,000 to the Board of Registered Nursing and the
Board of Vocational Nursing and Psychiatric Technicians,
combined, to comply with oversight of increased reporting
of license suspensions and terminations.
SUPPORT : (Verified 8/25/10)
AMN Healthcare, Inc.
ARGUMENTS IN SUPPORT : The author's office cites that
there are 3,000 to 6,000 temporary nurse staffing agencies
nationwide. Additionally, 19,000 licensed registered
nurses in California service as temporary nurses.
According to the author's office, 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's
office 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.
CTW:mw 8/30/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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