BILL ANALYSIS �
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THIRD READING
Bill No: SB 122
Author: Price (D)
Amended: 1/10/12
Vote: 21
SENATE BUSINESS, PROF & ECON DEVELOP COMM : 7-0, 1/9/12
AYES: Price, Emmerson, Corbett, Correa, Hernandez, Negrete
McLeod, Vargas
NO VOTE RECORDED: Walters, Wyland
SENATE APPROPRIATIONS COMMITTEE : 7-0, 1/19/12
AYES: Kehoe, Alquist, Emmerson, Lieu, Pavley, Price,
Steinberg
NO VOTE RECORDED: Walters, Runner
SUBJECT : Nursing
SOURCE : Author
DIGEST : This bill grants the Board of Registered Nursing
(BRN) authority to be the only agency responsible for
approving schools of nursing and to receive an appropriate
fee from applicants and for renewal of the school of
nursing's authorization. In addition, this bill authorizes
the BRN to issue a cease and desist order to a school of
nursing not approved by the BRN and requires the BRN to
notify the Attorney General of such a school. Lastly, this
bill requires meetings of the BRN to be held in northern
and southern California.
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ANALYSIS : Existing law, the Business and Professions
Code:
1. Provides for the regulation of various health
professions by regulatory boards within the Department
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. Specifies that the BRN consists of nine members and
that as of January 1, 2012, the BRN sunsets and its
statutory authorization becomes inoperative and is
repealed.
4. Specifies that the provision which provides for the
appointment of the Executive Officer for the BRN is
also repealed as of January 1, 2012.
5. Specifies that an approved school of nursing is one
that has been approved by the BRN, gives the course of
instruction approved by the BRN, covering not less
than two academic years, is affiliated or conducted in
connection with one or more hospitals, and is an
institution of higher education or is affiliated with
an institution of higher education.
6. Defines "institution of higher education" as
community colleges offering an associate of arts or
associate of science degree and private postsecondary
institutions offering an associate of arts or
associate of science degree.
7. Requires that a school of nursing that is not an
"institution of higher education," as defined, shall
make an agreement with an institution of higher
education in the same general location to grant an
associate of arts or associate of science degree to
individuals who graduate from the school of nursing or
to grant a baccalaureate degree with successful
completion of an additional course of study as
approved by the BRN and the institution involved.
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8. Provides that the BRN shall determine by regulation
the required subjects of instruction in an approved
school of nursing and the amount of clinical
experience necessary.
9. Specifies that it shall be the duty of the BRN,
through its executive officer, to inspect all schools
of nursing in this state at such times as the BRN
shall deem necessary, and if it is found that a school
is not maintaining the standard(s) required by the
BRN, then the BRN may request the defects to be
corrected and if not corrected then the BRN may remove
them from the approved list.
10. Provides that it is unlawful for anyone to conduct
a school of nursing unless the school has been
approved as an accredited school by the BRN, or is
exempt as specified.
Existing law, the Education Code:
1. Establishes the Bureau of Private Postsecondary
Education within the DCA and provides for Bureau
oversight and regulation of California private
postsecondary institutions pursuant to the Private
Postsecondary Education Act of 2009 (PPE Act),
including a school of nursing that is not accredited
by accrediting agencies affiliated with the Western
Association of Schools and Colleges or regional
accrediting agencies recognized by the United States
Department of Education.
2. Establishes numerous unfair business practices for
institutions covered by the PPE Act, including
prohibiting an institution from promising employment
or otherwise overstating the availability of jobs or
making untrue or misleading statements regarding
student completion, placement or expected salary
rates.
3. Sets forth certain disclosure requirements
pertaining to completion, placement, licensure, and
earning potential.
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This bill:
1. Authorizes the BRN to issue a cease and desist
order to a school of nursing not approved by the BRN
and requires the BRN to notify the Attorney General of
such a school.
2. Requires meetings of the BRN to be held in northern
and southern California.
3. Deletes 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 instead requires that a school of nursing to
obtain BRN approval to grant nursing degrees.
4. Subjects a school of nursing or a new nursing
program seeking approval by the BRN to the following
fee schedule:
A. A fee of $5,000 for approval of a nursing
program.
B. A fee of $3,500 for continuing approval of a
new nursing program.
C. A fee of $500 for processing authorization of a
substantive change to an approval of a school of
nursing.
Background
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
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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:
California Pre-licensure Registered Nursing
Programs.
Nurse-Midwifery Programs.
Nurse Practitioner Programs.
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.
The BRN also recognizes registered nursing is an integral
component of the health care delivery system. The BRN
affects public policy by collaborating and interacting with
legislators, consumers, health care providers, health care
insurers, professional organizations, and other state
agencies. The BRN takes a proactive role in structuring
health care and evaluating nursing trends in order to make
sound policy decisions. 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
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BRN staff.
Due to the veto of SB 538, and the sunset of the BRN as of
January 1, 2012, the 9 members of the BRN have been
eliminated. The Governor does intend, however, to
immediately reconstitute the BRN in January of 2012. In
the meantime, the Governor, the former BRN and the DCA have
entered into an "Interagency Agreement" for the DCA and its
Director to assume the responsibilities, powers and duties
as permitted by law.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2012-13 2013-14
2014-15 Fund
Nursing school oversight
- investigations $50 $100
$100Special*
- cease and desist actions $100 to
$200 or more in any year
Special*
- revenue ($120 to $160)
annually Special*
* Board of Registered Nursing Fund
JJA:nl 1/23/12 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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