BILL ANALYSIS �
------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 98|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 445-6614 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
UNFINISHED BUSINESS
Bill No: SB 98
Author: Senate Budget and Fiscal Review Committee
Amended: 1/26/12
Vote: 21
SENATE VOTE NOT RELEVANT
ASSEMBLY FLOOR : Not available
SUBJECT : Budget Trailer Bill: Board of Registered
Nursing
SOURCE : Author
DIGEST : This bill establishes, until January 1, 2016, a
new Board of Registered Nursing and vests the new board
with the same powers as the previous board of the same name
which was repealed on January 1, 2012.
Assembly amendments delete the Senate version of the bill,
which expressed Legislative intent to enact statutory
changes related to the Budget Act of 2011, and instead add
the current language.
ANALYSIS :
Existing law:
1. Provides for the regulation of various health
professions by regulatory boards within the Department
CONTINUED
SB 98
Page
2
of Consumer Affairs (DCA).
2. Establishes the Nursing Practice Act, which provides for
the certification and regulation of registered nurses,
nurse practitioners, and advanced practice nurses by the
BRN within the DCA.
3. Establishes within the DCA, the Division of
Investigation (DOI), to investigate alleged misconduct
by licensees of boards. Allows the Director of the DCA
to employ such investigators, inspectors, and deputies
as are necessary to investigate and prosecute all
violations of any law. States Legislative intent that
inspectors used by boards are not required to be
employees of the DOI, but may be either employees or
under contract to the boards.
4. Provides that investigators of the DOI and the Medical
Board of California and Dental Board of California have
the authority of peace officers and that those entities
are also authorized to employ individuals who are not
peace officers to provide investigative services.
5. (Repealed) Specifies that the BRN consisted of nine
members and that as of January 1, 2012, the BRN sunsets
(and be repealed), unless a later enacted statute were
to be enacted prior to January 1, 2012. This did not
occur. The BRN is subject to review by the Legislature
prior to its sunset date.
6. Specifies that the provision, which provided for the
appointment of the Executive Officer for the BRN will be
repealed as of January 1, 2012, unless a later enacted
statute was enacted before January 1, 2012.
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 DCA.
3. Re-establishes the terms of office for the nine members
of the BRN at four years, but with staggered initial
SB 98
Page
3
appointments in order to have staggered terms going
forward, as follows:
Senate appointment - public member: four years
Assembly appointment - public member: four years
Governor's appointments:
#1 - public member: one year
#2 - public member: five years
#3 - RN #1: two years
#4 - RN #2: three years
#5 - nurse educator: four years
#6 and #7 - nurse administrator and advanced practice
nurse: Governor's choice on which one serves two years
and which one serves three years for their initial
terms.
4. Ratifies the interagency agreement between the BRN and
the Director of Consumer Affairs.
5. Provides for an interim executive officer until the BRN
appoints a permanent executive officer, and deems that
interim executive officer to be the same person who was
serving as executive officer before the BRN expired.
6. 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
Fund for the purpose of administering the Nursing
Practice Act.
Comments
The BRN is responsible for regulating the practice of
registered nurses (RNs) in California. 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
SB 98
Page
4
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
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.
The former composition of the BRN included seven members
who were appointed by the Governor, one by the Senate Rules
Committee and one by the Assembly Speaker. The Board
included four public members, two registered nurses in
direct patient care practice, an advanced practice
SB 98
Page
5
registered nurse, a registered nurse educator, and a
registered nurse administrator.
The former statute included a sunset on the BRN of January
1, 2012 and no subsequent legislation was passed and signed
to extend the sunset. This is due in part to the fact that
there was legislation last year (SB 538 �Price]) to extend
it to 2016, as this bill does, however SB 538 contained
additional provisions that made changes to the operation of
the BRN, related to pension benefits, which the Governor
objected to 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 : Appropriation: Yes Fiscal Com.: Yes
Local: No
JJA:do 2/1/12 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
**** END ****