BILL ANALYSIS �
SENATE COMMITTEE ON BUDGET AND FISCAL REVIEW
Mark Leno, Chair
Bill No: SB 98
Author: Budget and Fiscal Review
As Amended: January 26, 2012
Consultant: Brady Van Engelen
Fiscal: Yes
Hearing Date: February 2, 2012
Subject: Board of Registered Nursing
Summary: This bill would restore the Board of Registered
Nursing until 2016. Specifically, this bill:
1.Restores the Board of Registered Nursing (BRN) and
establishes a new sunset date of January 1, 2016;
2.Establishes the BRN within the Department of Consumer
Affairs (DCA);
3.Re-establishes the terms of office for the nine members
of the BRN at four years, but with staggered initial
appointments in order to have staggered terms going
forward, as follows:
a) Senate appointment - public member: 4 years
b) Assembly appointment - public member: 4 years
Governor's appointments:
c) #1 - public member: 1 year
d) #2 - public member: 5 years
e) #3 - RN #1: 2 years
f) #4 - RN #2: 3 years
g) #5 - nurse educator: 4 years
h) #6 and #7 - nurse administrator and advanced
practice nurse: Governor's choice on which one serves
2 years and which one serves 3 years for their initial
terms
1.Ratifies the interagency agreement between the BRN and
the Director of Consumer Affairs;
2.Provides for an interim executive officer until the board
appoints a permanent executive officer, and deems that
interim executive officer to be the same person who was
serving as executive officer before the board expired;
3.Appropriates to the BRN unencumbered funds in the Board
of Registered Nursing Fund (Fund) that were appropriated
to the BRN in the 2011 Budget Act and $1,000 from the
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Fund for the purpose of administering the Nursing
Practice Act.
Background: The BRN sunset on January 1, 2012 after the
Governor vetoed SB 538 (Price), which extended the sunset
of the BRN to 2016 and contained additional provisions that
made changes to the operation of the BRN related to pension
benefits. The Governor objected to the benefit pension
changes and therefore vetoed the bill. In his veto
message, the Governor asked the Legislature to send him
legislation to restore the BRN as soon as possible.
The dissolution of the BRN means that substantial work in
the area of licensing, disciplinary action, and general
nursing practice oversight cannot continue. The BRN
adopts, amends, or rejects proposed decisions by
administrative law judges who hear cases on nurse
discipline. Now, judges' decisions will automatically take
effect if no board action is taken in 100 days. The BRN
also approves or rejects settlements reached between
attorneys representing nurses accused of misconduct and
deputy attorneys general representing the board. Those
cases also will be subject to approval by administrative
judges whose decisions are final if the board takes no
action in 100 days. The DCA continues to do the staff
work, such as processing licensing applications and
investigating complaints.
Fiscal Effect: Approximately $30 million (BRN Fund)
annually in regulatory costs will continue to be incurred
as a result of extending the sunset on the BRN. The BRN is
fully-funded with fee revenue.
Support:
California Hospital Association
American Federation of State, County and Municipal
Employees (AFSCME)
SEIU California
Opposed: None on file
Comments: The BRN is responsible for regulating the
practice of registered nurses (RNs) in California.
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Currently, there are almost 380,000 licensed RNs in
California, with over 23,000 new licenses issued annually,
and more than 170,000 licenses renewed annually. The BRN
also regulates interim permittees, i.e., applicants who are
pending licensure by examination, and temporary licensees,
i.e., out-of-state applicants who are pending licensure by
endorsement. The interim permit allows the applicant to
practice while under the supervision of an RN while
awaiting examination results. Similarly, the temporary
license enables the applicant to practice registered
nursing pending a final decision on the licensure
application. The BRN also issues certificates to Clinical
Nurse Specialists, Nurse Anesthetists, Nurse Practitioners,
Nurse-Midwives and Public Health Nurses. These titles are
those most commonly used by the California RNs and use of
the titles is protected under the Business and Professions
Code. The BRN also issues furnishing numbers to nurse
practitioners and nurse midwives to administer
prescriptions and lists psychiatric/mental health nurses.
In addition to its licensing and certification functions,
the BRN also regulates and approves the following entities:
1) California Pre-licensure Registered Nursing Programs;
2) Nurse-Midwifery Programs; 3)
Nurse Practitioner Programs; and 4) Registered Nursing
Continuing Education Providers.
The BRN is responsible for implementation and enforcement
of the Nursing Practice Act -- the laws and regulations
related to nursing education, licensure, practice and
discipline. The BRN implements regulatory programs and
performs a variety of activities to protect the public.
These programs and activities include: setting registered
nurse educational standards for pre-licensure and advanced
practice nursing programs; issuing and renewing registered
nurse licenses; issuing certificates for advanced practice
nurses and public health nurses; taking disciplinary action
for violation of the Nursing Practice Act; and managing a
Diversion Program for registered nurses whose practice may
be impaired due to chemical dependency or mental illness.
Recognizing that registered nursing is an integral
component of the health care delivery system, the BRN seeks
to affect public policy by collaborating and interacting
with legislators, consumers, health care providers, health
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care insurers, professional organizations, and other state
agencies. According to the BRN, this enhances the Board's
ability to interpret the Nursing Practice Act and establish
policies for its regulatory programs and activities, which
are then implemented by the BRN staff.
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