BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 122
                                                                  Page  1

          Date of Hearing:   June 19, 2012

                       ASSEMBLY COMMITTEE ON HIGHER EDUCATION
                                 Marty Block, Chair
                     SB 122 (Price) - As Amended:  June 12, 2012

           SENATE VOTE  :   30-6
           
          SUBJECT  :   Healing Arts.

           SUMMARY  :   Authorizes the Board of Registered Nursing (BRN) to 
          receive a fee from applicants and for renewal of a school of 
          nursing's authorization, requires BRN to enter into a Memorandum 
          of Understanding (MOU) with the Bureau for Private Postsecondary 
          Education (Bureau) to delineate the powers of the Bureau related 
          to consumer protection, as specified, and makes changes 
          affecting the Medical Board of California and the Massage 
          Therapy Council.  Specifically,  this bill  :   

          1)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 authorizes the BRN to grant 
            approval to these institutions to grant nursing degrees.

          2)Requires the BRN to have an MOU with the Bureau to:

             a)   Ensure that nursing schools approved by the BRN are not 
               required to pay an additional application fee to the Bureau 
               for the addition of a nursing school approved by the BRN.

             b)   Delineate the powers of the BRN to review and approve 
               schools of nursing approved by the BRN, and,

             c)   Delineate the powers of the Bureau to protect the 
               interest of students attending institutions governing by 
               the Private Postsecondary Education (PPE) Act of 2009.

          3)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 nursing 
               program established after January 1, 2013, and,








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             c)   A fee of $500 for processing authorization of a 
               substantive change to an approval of a school of nursing.

          4)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 Bureau and the Attorney General of such a 
            school.

          5)Requires meetings of the BRN to be held in northern and 
            southern California.

          The remaining provisions, which were recently amended into this 
          bill, fall within the purview of the Assembly Business, 
          Professions, and Consumer Protection Committee, to which this 
          bill is double referred, and include the following:

          1)Authorizes the Medical Board of California (Board) to issue a 
            physician and surgeon license to an applicant who successfully 
            completed a medical curriculum in a medical school that is not 
            approved or recognized by the Board or that has been 
            disapproved by the Board, if the applicant meets specified 
            requirements, except that the applicant shall have held an 
            unrestricted physician and surgeon license in another state or 
            country for a minimum of five, rather than four, years.

          2)Requires an applicant for a massage therapist certificate to 
            successfully complete either (a) the 500 hours or the credit 
            unit equivalent, as specified in existing law, or (b) the 
            competency assessment examination, as specified in existing 
            law, and curricula in massage and related subjects totaling a 
            minimum of 250 hours, at a single approved school.

          3)Requires the Massage Therapy Council (Council) to immediately 
            suspend the certificate of a certificate holder upon receipt 
            of clear and convincing evidence that the holder has committed 
            an act punishable as a sexually related crime or felony and to 
            consider any available credible mitigating evidence before 
            making a decision to so suspend a certificate.  Grants the 
            holder of a certificate so suspended the right to a hearing to 
            be held within 30 days, and requires the Council to send 
            notice of suspension to the certificate holder and to other 
            specified businesses.

          4)Authorizes a law enforcement agency or local government agency 








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            with responsibility for regulating massage or massage 
            business, upon request of the Council, to provide information 
            to the Council concerning an applicant or certificate holder, 
            including, but not limited to, information related to criminal 
            activity or unprofessional conduct allegedly engaged in by 
            that person.

          5)Authorizes the Council to deny an application or discipline a 
            certificate holder for a conviction of a felony, misdemeanor, 
            infraction, or municipal code violation, or liability in an 
            administrative or civil action, that is substantially related 
            to the qualifications, functions, or duties of a certificate 
            holder, and requires a certificate holder to provide 
            identifying information, upon request, as specified.

           EXISTING LAW  as it pertains to the education-related provisions 
          of this bill:

          1)Establishes the Bureau within the Department of Consumer 
            Affairs and provides for Bureau oversight and regulation of 
            California private postsecondary institutions pursuant to the 
            PPE Act of 2009, 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.  (Education Code � 94800 et seq.)

          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.  (EC � 94897)

          3)Sets forth certain disclosure requirements pertaining to 
            completion, placement, licensure, and earning potential.  (EC 
            � 94928)

          4)Authorizes the Bureau to accept the approval provided by 
            another state or federal government agency for the addition of 
            a program of study at a Bureau-approved institution with no 
            further review by the Bureau.  (EC � 94892)

           FISCAL EFFECT  :   The Senate Appropriations Committee determined 
          the following costs to the BRN Fund for nursing school 








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          oversight:

          1)Investigations:  $50,000 in 2012-13 and $100,000 annually 
            therafter.

          2)Cease and desist actions:  $100,000-$200,000 or more in any 
            year.                                             

          3)Revenue:  $120,000-$160,000 annually.

           COMMENTS  :   This bill is double referred to the Assembly 
          Business, Professions, and Consumer Protection Committee, where 
          the issues pertaining the California Medical Board and Massage 
          Therapy Council are appropriately considered.  The provisions of 
          this bill that fall within the Higher Education Committee's 
          jurisdiction affect the approval of nursing schools and the 
          oversight roles of the Bureau, which are the focus of this 
          analysis.

           Background  .  The BRN is responsible for regulating the practice 
          of registered nurses in California, including implementation and 
          enforcement of the laws and regulations related to nursing 
          education, licensure, practice and discipline.  In March 2011, 
          the Senate Business, Professions, and Economic Development 
          Committee held a sunset review hearing of the BRN, which 
          resulted in recommendations for improving numerous BRN 
          functions, including its nursing school approval process, in 
          order to decrease the time for approval and increase the number 
          of for-profit nursing schools.  

           Need for this bill  .  According to information provided by the 
          author, the average length of time for initial BRN approval of a 
          nursing school application is 18 months, but there have been 
          instances when the process has taken four to five years, 
          especially if the applicant is a for-profit institution.  With 
          over 41,500 qualified applicants in 2009-10 and the ability of 
          both public and private programs to admit only about 14,200 
          applicants in 2009-10, the BRN must find ways to improve its 
          approval process so that private for-profit schools have an 
          equal chance of meeting the requirements to provide nursing 
          programs.  

           BRN sunset review recommendations  .  The BRN is responsible for 
          ensuring that applicants to operate a nursing school program are 
          in compliance with statutory and regulatory requirements.  The 








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          sunset review report recommended the BRN explore any opportunity 
          to streamline their current nursing program approval process, 
          including providing staff training to more consistently apply 
          rules and regulations to new programs, authorizing BRN to charge 
          a fee to cover its costs for approving new schools, having the 
          BRN assume student protection provisions currently required 
          under the PPE Act, and removing the involvement of the Bureau in 
          approving nursing schools.

           The role of the Bureau and its fee  .  The Bureau is generally 
          responsible for protecting consumers and students against fraud, 
          misrepresentation, or other business practices at private 
          postsecondary institutions that may lead to loss of students' 
          tuition and related educational funds; establishing and 
          enforcing minimum standards for ethical business practices and 
          the health and safety and fiscal integrity of postsecondary 
          education institutions; and establishing and enforcing minimum 
          standards for instructional quality and institutional stability 
          for all students in all types of private postsecondary 
          educational and vocational institutions.  

          Under existing law, if a Bureau-approved institution is granted 
          approval to offer a program by the relevant licensing board 
          (such as the BRN), the Bureau may simply incorporate that 
          approval into the institution's approval to operate from the 
          Bureau after it has received documentation signifying the 
          approval by the relevant agency.  The Bureau does not charge an 
          application fee in these cases.  However, the institution would 
          include any income from the students enrolled in these programs 
          when calculating their annual fees owed to the Bureau.  Thus, 
          the provision of this bill that requires the Bureau to waive its 
          fee for nursing school applicants under an MOU with the BRN is 
          unnecessary, since the Bureau already has this authority and 
          follows this practice.  
           
          Author's amendment  .  The author has agreed to accept the 
          following amendment to remove language pertaining to the 
          Bureau's authority to charge an application fee: 

          Page 7, line 30:  ? the Bureau for Private Postsecondary 
          Education  to ensure that institutions approved by the bureau are 
          not required to pay an additional application fee to the bureau 
          for the addition of a school of nursing approved by the board, 
          and  to delineate the powers of ?









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           Prior legislation  .  SB 538 (Price) of 2011, granted the BRN 
          authority to be the only agency responsible for approving 
          schools of nursing and to receive an appropriate fee from 
          applicants; however, provisions related to the Bureau's ability 
          to charge a fee were removed.  The bill was vetoed for reasons 
          unrelated to these provisions.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          California School Nurses Organization
           
            Opposition 
           
          None on file.


           Analysis Prepared by  :    Sandra Fried / HIGHER ED. / (916) 
          319-3960