BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          SB 122 (Price)
          
          Hearing Date: 1/19/2012         Amended: 1/10/2012
          Consultant: Bob Franzoia        Policy Vote: B,P&ED 7-0
          _________________________________________________________________
          ____
          BILL SUMMARY: SB 122 would do the following:
          - Authorize the Board of Registered Nursing (board) to issue a 
          cease and desist order to a school of nursing not approved by 
          the board and require the board to notify the Attorney General 
          of such a school.
          - Require meetings of the board to be held in northern and 
          southern California.
          - Delete provisions requiring a school of nursing that is not 
          affiliated with an institution of higher education to make an 
          agreement with such an institution for purposes of awarding 
          nursing degrees and to instead require that a school of nursing 
          to obtain board approval to grant nursing degrees.
          - Subject all approved schools of nursing to specified fees for 
          deposit into the Board of Registered Nursing Fund, a 
          continuously appropriated fund.  Because this bill adds a new 
          source of revenue to a continuously appropriated fund, this bill 
          would make an appropriation.
          _________________________________________________________________
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2012-13      2013-14       2014-15     Fund
           Nursing school oversight
            - investigations     $50        $100        $100      Special*

            - cease and desist actions      $100 to $200 or more in any 
          year                   Special*

            - revenue            ($120 to $160) annually          Special*

          * Board of Registered Nursing Fund 
          _________________________________________________________________
          ____

          STAFF COMMENTS: SUSPENSE FILE.
          
          The board is responsible for regulating the practice of 








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          registered nurses in California.  There are nearly 380,000 
          licensed registered nurses with over 23,000 new licenses issued 
          annually, and more than 170,000 licenses renewed annually.  

          As noted by the policy committee, approval of pre-licensure 
          nursing programs is an integral component of the board's 
          operation.  The purpose of approval is to ensure the program's 
          compliance with statutory and regulatory requirements.  Approval 
          of advanced practice nursing (i.e., nurse practitioner and 
          nurse-midwifery) programs is voluntary and at the request of the 
          program.  Board approval of advanced practice programs is 
          advantageous to program graduates because it facilitates their 
          obtaining board certification as a nurse practitioner or 
          nurse-midwife.  Currently, there are 148 approved pre-licensure 
          nursing programs and 26 approved advanced practice nursing 
          programs.
          This bill provides the board the authority to charge a fee for 
          reviewing documents, consulting with the program, and conducting 
          site visits. Preliminary information indicates the board 
          annually receives 5 to 10 applications to approve a new school 
          of nursing ($5,000 per approval), provides continuing approval 
          for 25 to 30 new schools of nursing ($3,500 per continuing 
          approval) on an approximately six year cycle, and annually 
          processes substantive changes for 10 to 15 schools of nursing.

          If the board determines that the annual If the board determines 
          that the annual cost of providing oversight and review of a 
          school of nursing is less than the amount of any fees required 
          to be paid by that institution, the board may decrease the fees 
          applicable to that institution to an amount that is proportional 
          to the board's costs associated with that institution.

          This bill is similar to SB 538 (Price) 2011 which was vetoed by 
          Governor Brown with the following message:

          The Board of Registered Nursing protects consumers and regulates 
          professional nursing in California and this measure would extend 
          the existence of this longstanding regulatory body until 2016. 
          Unfortunately, extraneous harmful provisions lurk within this 
          otherwise benign sunset extension bill. 

          These provisions would dramatically expand pension benefits for 
          a select group of the Board's investigators. This makes no sense 
          fiscally and flies in the face of much needed pension reform. 








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          It is unacceptable to jeopardize the extension of this Board's 
          critical consumer protection role by allowing these provisions 
          to be included in this otherwise simple sunset extension 
          measure. The Board has existed for 106 years without these 
          enhanced benefits and should continue to do so. 

          I would ask that as soon as it reconvenes, the Legislature send 
          me legislation that both restores the Board of Registered 
          Nursing and restores the provisions of law relating to "bureau 
          status" for expired boards. In the interim, I direct my 
          administration to take all actions necessary under the law to 
          protect consumers and nurses alike until the Board is 
          reconstituted in January.

          This bill does not contain the provisions which prompted the 
          Governor's veto.

          Due to the veto of SB 538 (Price), and the sunset of the board 
          as of January 1, 2012, the nine members of the board have been 
          eliminated.  The Governor intends to reconstitute the board 
          though such legislation remains pending.  In the meantime, the 
          Governor, the board and the Department of Consumer Affairs have 
          entered into an interagency agreement for the department to 
          assume the responsibilities, powers and duties as permitted by 
          law.