BILL ANALYSIS �
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|Hearing Date:May 2, 2011 |Bill No:SB |
| |539 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: SB 539Author:Price
As Amended: April 25, 2011 Fiscal:Yes
SUBJECT: Nursing.
SUMMARY: Extends the sunset date of the Board of Vocational Nursing
and Psychiatric Technicians (BVNPT) to January 1, 2016, and makes
other changes.
Existing law:
1) Provides for the licensure and regulation of about 119,003 licensed
vocation nurses (VNs) and 13,000 Psychiatric Technicians (PTs) by
the BVNPT. This provision will become inoperative on January 1,
2012.
2) Defines unprofessional conduct for VNs and PTs and authorizes the
BVNPT to suspend or revoke an individual's license for
unprofessional conduct. Additionally, determines the processes to
be used to suspend or revoke a license.
3) Requires any employer of a licensed vocational nurse or PT to
report the suspension or termination for cause, as defined, of any
VN or PT in its employ. Establishes penalties for failure to
report.
4) Establishes a process that the BVNPT must follow to approve VN and
PT vocational schools.
This bill:
1) Extends the sunset date of the BVNPT to continue to regulate the VN
and PT professions until January 1, 2016. Provides for the review
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of the BVNPT by the appropriate policy committees of the
Legislature.
2) Replaces the terms "accredit" or "accreditation" with "approve" or
"approval" for purposes of VN and PT programs.
3) Requires employers to also report resignations for cause, as
defined by the statute, in lieu of suspension or termination for
cause of VNs and PTs.
4) Specifies that the term employer for purposes of reporting also
includes employment agencies and nursing registries.
5) Makes other technical, non-substantive and conforming changes.
FISCAL EFFECT: Unknown. Legislative Counsel has keyed this bill as
"fiscal."
COMMENTS:
1. Purpose. The Author is the Sponsor of this measure. According to
the Author, in 2011, this Committee conducted oversight hearings to
review 7 boards: the Board of Registered Nursing, the BVNPT, the
Dental Board of California, the Board of Accountancy, the
Contractors State License Board, the Board for Professional
Engineers, Land Surveyors and Geologists, the California Architects
Board (and the Landscape Architects Committee). The Committee also
reviewed the Athletic Commission and the Professional Fiduciaries
Bureau and conducted oversight hearings of the Department of Real
Estate and the Office of Real Estate Appraisers. The Committee
began its review of these licensing agencies in March and conducted
three days of hearings. This bill, and the accompanying sunset
bills, is intended to implement legislative changes as recommended
in the Committee's Background/Issue Papers for all of the agencies
reviewed by the Committee this year.
This bill is one of the seven "sunset bills" authored by the Chair of
this Committee. According to the Author, this bill is necessary to
extend the sunset date of the BVNPT and continue the regulation of
VNs and PTs and continue with BVNPT's mission to protect the
public.
2. Background. The Board of Vocational Nursing and Psychiatric
Technicians (BVNPT) is responsible for regulating and enforcing the
laws related to the practice of licensed vocational nurses (LVNs)
and psychiatric technicians (PTs) in California. There are
currently 119,033 LVNs and 13,299 PTs in California, with over
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8,000 licenses issued annually, and more than 39,000 licenses
renewed annually. The BVNPT also accredits and approves 203 LVN
and 16 PT programs. It should be noted that the LVN and PT
licensure programs are completely distinct with their own statutes
and regulations, budget authority, curriculum requirements,
examinations, and staff. Additionally, the BVNPT serves as a
policy and decision maker in reinstatement hearings, proposed
disciplinary actions, accreditation of new schools, school survey
visits, follow up reports on programs, examination development,
contracts, budget issues, legislation, and regulatory proposals.
In order to further this public protection mission, the BVNPT
establishes minimum examination and licensure requirements, issues
and renews licenses, establishes educational standards for the
accreditation of vocational nurse (VN) and PT schools, adopts
regulations to clarify education and licensure, school
accreditation, practice requirements, and disciplinary standards
for its licensees, enforces the regulations governing the continued
accreditation of VN and PT schools in California, and takes
appropriate disciplinary action against incompetent or unsafe
licensees.
Existing law allows the Legislature to conduct policy review of
regulatory boards within DCA. This review includes an evaluation
of a board's regulatory programs, including staffing, enforcement,
budgetary, examination, and practice issues to ensure that consumer
protection remains the priority of these boards. This year, the
BVNPT was reviewed by this Committee and an oversight hearing was
held on March 14, 2011. As part of this hearing, Committee staff
prepared an extensive background paper detailing various issues and
recommendations for the BVNPT.
3. Former Sunset Review of the BVNPT. The BVNPT was last reviewed by
the Joint Legislative Sunset Review Committee (JLSRC) in 2002.
During the previous sunset review, the JLSRC and DCA raised
numerous issues. The BVNPT identified five issues and developed a
set of recommendations to address the issues. On October 1, 2010,
the BVNPT submitted its required sunset report to the Committee.
In this report, the BVNPT described actions it has taken since its
prior review to address the recommendations of the JLSRC. The
following are some of the more important programmatic and
operational changes and enhancements which the BVNPT has taken and
other important policy decisions or regulatory changes made by the
BVNPT:
Conducted retroactive fingerprinting of licensees who were
licensed prior to January 1, 1998.
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Annually updated its Strategic Plan to identify the strategic
issues and trends impacting the BVNPT and the professions it
regulates.
Increased the number of VN & PT Programs by 44% (from 154 in
2004/2005 to 221 in FY 2009/10). Additionally, the BVNPT
continues to assist schools in becoming an accredited program by
assigning a Nursing Education Consultant (NEC) to the school and
by inviting the Program Directors to a "New Director
Orientation." Information presented at these orientations
provides clarification regarding the statutes and regulations
with which the programs must comply to become accredited.
Additionally, the NEC reviews the material from each school in
attendance and provides feedback to the Program Director. This
information helps schools understand the requirements before
directing an inordinate amount of time to development of program
elements that are not compliant with regulations.
Established the Vocational Nurse Education Fund, which helps
fund scholarships and loan repayment programs. Each LVN is
assessed an additional $5 fee when they renew their license every
two years to fund this program.
Proposed and obtained budget authority to implement mandatory
reporting requirements for employers of LVNs or PTs who have been
suspended or terminated for cause. On October 11, 2007, the
BVNPT's regulatory proposal to implement the mandatory reporting
statutes became effective.
Adopted regulations regarding Consumer Complaint Disclosure
Policy.
Participated in the Nurse Workforce Initiative.
Increased the number of students attending LVN and PT
programs.
1. This Measure Includes the Following Statutory Changes as Identified
by This Committee During Its Oversight Hearings of March, 2011:
a) Requires employers of VNs and PTs to also report
resignations in lieu of suspension or termination for cause.
Current law requires that employers of VNs and PTs report to
the BVNPT the suspension or termination for cause of any LVN or
PT in its employ. Suspension or termination for cause is
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defined as: (1) use of controlled substances or alcohol to the
extent that it impairs the licensee's ability to safely
practice; (2) unlawful sale of a controlled substance or other
prescription items; Patient or client abuse, neglect, physical
harm, or sexual contact with a patient or client; (3)
falsification of medical records; (4) gross negligence or
incompetence; and, (5) theft from patients or clients other
employees, or the employer. The BVNPT points out that this
reporting mechanism has been an important public protection
tool, and the BVNPT continues to receive many reports from
employers. (For FY 2009/2010, there were 213 VN and 56 PT
employer reports.) However, in order to further promote
patient safety, the BVNPT is recommending that employers also
report resignations in lieu of suspension or termination for
cause submitted by VNs and PTs. According to the BVNPT, many
licensees are permitted to submit resignations in lieu of
suspension or termination from employment for gross negligence,
incompetence, and unsafe or deceitful acts. As such, the
employer is not required to report these types of resignations.
When this occurs, the licensee is able to work for an
unsuspecting hospital, nursing or convalescent home, or other
healthcare facility because no negative employment history
exists. Frequently, the licensees continue to commit similar
acts of misconduct and this jeopardizes consumer protection.
b) Defines Employer for Purposes of Reporting to Include
Employment Agencies and Nursing Registries. BVNPT indicates
that existing law is unclear if employment agencies and
registries are required to report to the BVNPT a licensee who
was rejected from assignment at a health facility or home
health care due to acts which would normally be cause for
suspension or termination. BVNPT points out that it is
necessary to require employment agencies and registries to
report licensees who are "rejected" for cause as well as
suspended, terminated or resigned in lieu of suspension or
termination for cause.
c) Replaces the terms "accredit" or "accreditation" with
"approve" or "approval" for purposes of VN and PT programs.
Current law states that an accredited school of vocational
nursing is one which has been approved by the BVNPT. The use
of the term "accredited" to refer to BVNPT program approval can
cause confusion, given the general application of that term to
educational institutions. In California there may be schools
not accredited by a national accrediting body that receive
BVNPT accreditation (approval) for programs offered.
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Similarly, there may be schools approved by Board of Private
Postsecondary Education, but whose VN or PT program may not
receive BVNPT accreditation. Students may not understand the
difference between accreditation in the traditional,
educational sense of the word and application of the term to
BVNPT approved schools. Unaccredited schools offering
programs accredited by BVNPT may advertise or promote their
"accreditation," misleading students and potentially leaving
them at a serious disadvantage if they are not able to
successfully transfer academic credits. Potential
participants in VN or PT training programs are required to
answer whether they graduated from an accredited school on
their licensing exam; students may not know if a school is
accredited, despite operating a BVNPT accredited VN or PT
training program.
d) Extends the Sunset Date of the BVNPT. The health and
safety of consumers are protected by a well-regulated VN and PT
professions. The BVNPT protects the consumer from
unprofessional and unsafe licensed vocational nurses and
psychiatric technicians. The BVNPT has been an effective
regulatory body for these professions. The BVNPT should be
continued with a four-year extension of its sunset date.
2. Related Legislation This Session. Other sunset review bills to be
presented before the Senate Business and Professions Committee
include:
a) SB 538 which deals with the Board of Registered Nursing
b) SB 540 which deals with the Dental Board of California
c) SB 541 which deals with the DCA and the contracting for
expert consultants by the boards.
d) SB 542 which deals with the California Board of
Accountancy and the Professional Fiduciaries Bureau.
e) SB 543 which deals with the California Architects Board ,
Contractors State License Board, Landscape Architects Technical
Committee, Board for Professional Engineers, Land Surveyors,
and Geologists, State Board of Guide Dogs for the Blind, State
Athletic Commission.
f) SB 706 which deals with the Department of Real Estate and
the Office of Real Estate Appraisers.
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SUPPORT AND OPPOSITION:
Support: None on file as of April 26, 2011
Opposition: None on file as of April 26, 2011
Consultant:Candace Choe