BILL ANALYSIS �
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|SENATE RULES COMMITTEE | SB 538|
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THIRD READING
Bill No: SB 538
Author: Price (D)
Amended: 5/31/11
Vote: 21
SENATE BUS., PROF. & ECON. DEVEL. COMMITTEE : 8-1, 5/2/11
AYES: Price, Emmerson, Corbett, Correa, Hernandez, Negrete
McLeod, Vargas, Wyland
NOES: Walters
SENATE APPROPRIATIONS COMMITTEE : 6-2, 5/26/11
AYES: Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
NOES: Walters, Runner
NO VOTE RECORDED: Emmerson
SUBJECT : Nursing
SOURCE : Author
DIGEST : This bill makes a number of changes to the
Nursing Practice Act including: (1) granting the Board of
Registered Nursing (BRN) the authority to hire
investigators and to have such investigators designated as
peace officers, (2) granting the 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, (3)
authorizing the BRN to issue a cease and desist order to a
school of nursing that has not been approved by the BRN and
to inform the Attorney General of a school which continues
CONTINUED
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to operate illegally, and (4) extending the BRN's sunset
date for four years to January 1, 2016.
ANALYSIS :
Existing law:
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. 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 officer and that those entities
are also authorized to employ individuals who are not
peace officers to provide investigative services.
5. Specifies that the BRN consists of nine members and that
as of January 1, 2012, the BRN will sunset (is
repealed), unless a later enacted statute is enacted
prior to January 1, 2012. The BRN is subject to review
by the Legislature prior to its sunset date.
6. Specifies that the provision which provides for the
appointment of the Executive Officer for the BRN shall
be repealed as of January 1, 2012, unless a later
enacted statute is enacted before January 1, 2012.
7. States that it is the intent of the Legislature that the
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BRN shall implement a diversion program for registered
nurses whose competency may be impaired due to abuse of
alcohol and other drugs, or due to mental illness, as a
voluntary alternative to traditional disciplinary
actions and so that registered nurses so afflicted may
be rehabilitated and returned to the practice of nursing
in a manner which will not endanger the public health
and safety.
8. Requires the BRN to establish criteria for the
acceptance, denial, or termination of registered nurses
in the diversion program and that only those nurses who
have voluntarily requested to participate in the
diversion program shall participate in the program.
9. Provides that the BRN shall produce reports which
include, but are not limited to, the information
concerning the number of cases accepted, denied, or
terminated with compliance or noncompliance and to
conduct a periodic cost analysis of the program.
10.Requires the BRN to approve and regulate registered
nursing schools that are institutions of higher
education, as defined, or affiliated with an institution
of higher education, as specified. Requires 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.
11.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.
12.Establishes the Bureau of Private Postsecondary
Education (Bureau) within the DCA and provides for
Bureau oversight and regulation of California private
postsecondary institutions pursuant to the Private
Postsecondary Education Act of 2009 (Act).
13.Establishes numerous unfair business practices for
institutions covered by the Act, including prohibiting
an institution from promising employment or otherwise
overstating the availability of jobs or making untrue or
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misleading statements regarding student completion,
placement or expected salary rates.
14.Sets forth certain disclosure requirements pertaining to
completion, placement, licensure, and earning potential.
This bill:
1. Authorizes the BRN to hire or designate investigators of
the BRN as peace officers and to also employ individuals
who are not peace officers to provide investigative
services.
2. Extends the sunset and repeal of the BRN to January 1,
2016, and provides that notwithstanding any other
provision of law, the BRN shall be subject to review by
the appropriate policy committees of the Legislature
prior to January 1, 2016.
3. Extends the repeal of the provision for the appointment
of the Executive Officer by the BRN to January 1, 2016.
4. Subjects a school of nursing that is not an institution
of higher education, or that is affiliated with an
institution of higher education, as required by the BRN
to the requirements set forth in the Act, and subjects
all approved institutions of higher education and those
schools regulated under the Act to specified fees for
approval by the BRN.
5. Requires the BRN, rather than encourage, when designing
standards of instruction for an approved nursing school,
require all schools provide clinical instruction in all
phases of the educational process.
6. Authorizes the BRN to issue cease and desist orders to a
school of nursing that is not approved by the BRN and
would require the BRN to notify the Attorney General of
such a school and would provide that it is
unprofessional conduct for any registered nurse to
violate this provision.
7. Provides that persons employed by the BRN may be peace
officers if designated as such by the Director of DCA,
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and that the primary duty of these peace officers shall
be the enforcement of the law as that duty is set forth
in Section 160 of the BPC.
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
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
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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
BRN staff.
The current composition of the BRN is seven members who are
appointed by the Governor, one by the Senate Rules
Committee and one by the Assembly Speaker. The current
make-up of the BRN includes four public members, two
registered nurses in direct patient care practice, an
advanced practice registered nurse, a registered nurse
educator and a registered nurse administrator.
FISCAL EFFECT : Appropriation: Yes Fiscal Com.: Yes
Local: No
According to the Senate Appropriations Committee:
Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13
2013-14 Fund
Nursing school oversight
-investigations $50 $100 $100
Special*
-cease and desist actions $100 to $200 or more in any
year
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-revenue ($50) ($100)$100)
Special*
*Board of Registered Nursing Fund and Private Postsecondary
and Vocational Education Administration Fund.
SUPPORT : (Verified 5/26/11)
California Association of Nurse Anesthetists, Inc.
California Nurse Midwives Association
JJA:do 5/31/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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