Amended  IN  Senate  August 15, 2024
Amended  IN  Senate  June 10, 2024
Amended  IN  Assembly  May 16, 2024
Amended  IN  Assembly  March 18, 2024

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Assembly Bill
No. 2131

Introduced by Assembly Member Valencia
(Coauthors: Assembly Members Alvarez, Bonta, Ortega, Quirk-Silva, and Blanca Rubio)

February 06, 2024

An act to amend Section 1337.3 of the Health and Safety Code, relating to health facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 2131, as amended, Valencia. Certified nurse assistant training programs.
Existing law establishes the State Department of Public Health and sets forth its powers and duties to license and administer health facilities, as defined, including skilled nursing facilities and intermediate care facilities.
Existing law requires skilled nursing facilities and intermediate care facilities to adopt certified nurse assistant training programs approved by the department. A violation of the provisions relating to those training requirements is a misdemeanor. Existing law requires the department to prepare and maintain a list of approved training programs for nurse assistant certification, training programs conducted by skilled nursing facilities or intermediate care facilities, as well as local agencies and education programs.
This bill additionally would require the department to prepare and maintain on its internet website a list of approved training programs and to publish an update at least twice annually, to include the competency test pass rates, aggregated by the language in which the test was taken. The bill would require the department, no later than December 31, 2025, to make available the option to take solicit applications from vendors to provide the written and oral competency examination of a nurse assistant certification examination in Spanish. The bill would authorize the department to use a vendor contracted to provide testing services under a specified federal regulation to fulfill the requirement to provide the Spanish testing option. also would require the department, by July 1, 2029, to publish on its internet website, and to update at least twice annually, a list of information including, but not limited to, approved training programs, as specified, competency test pass rates for the previous 2 years, aggregated by the language in which the test was taken, and the number of nurse assistants trained in the previous 2 years.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1337.3 of the Health and Safety Code is amended to read:

1337.3.
 (a) (1) The department shall prepare and maintain on its internet website a list of approved training programs for nurse assistant certification. The list shall include training programs conducted by skilled nursing facilities or intermediate care facilities, as well as local agencies and education programs. In addition, the list shall be updated at least twice annually and shall include information on whether a training center is currently training nurse assistants, their competency test pass rates, aggregated by the language in which the test was taken, and the number of nurse assistants they have trained. Clinical portions of the training programs may be obtained as on-the-job training, supervised by a qualified director of staff development or licensed nurse.
(2) No later than December 31, 2025, the department shall make available the option to take solicit applications from vendors to provide the written and oral competency examination of a nurse assistant certification examination in Spanish. The department may use the vendor that is contracted to provide testing services under 42 C.F.R. 483.154(c) to fulfill this requirement.
(3) No later than July 1, 2029, the department shall publish on its internet website, and update at least twice annually, a list including all of the following:
(A) All approved training programs, including skilled nursing facilities, intermediate care facilities, and local agencies and education programs.
(B) Whether each training center is currently training nurse assistants.
(C) The competency test pass rates for the previous two years, aggregated by the language in which the test was taken.
(D) The number of nurse assistants trained in the previous two years.
(b) It shall be the duty of the department to inspect a representative sample of training programs. The department shall protect consumers and students in any training program against fraud, misrepresentation, or other practices that may result in improper or excessive payment of funds paid for training programs. In evaluating a training center’s training program, the department shall examine each training center’s trainees’ competency test passage rate, and require each program to maintain an average 60 percent test score passage rate to maintain its participation in the program. The average test score passage rate shall be calculated over a two-year period. If the department determines that a training program is not complying with regulations or is not meeting the competency passage rate requirements, notice thereof in writing shall be immediately given to the program. If the program has not been brought into compliance within a reasonable time, the program may be removed from the approved list and notice thereof in writing given to it. Programs removed under this article shall be afforded an opportunity to request reinstatement of program approval at any time. The department’s district offices shall inspect facility-based centers as part of their annual survey.
(c) Notwithstanding Section 1337.1, the approved training program shall consist of at least the following:
(1) A 16-hour orientation program to be given to newly employed nurse assistants prior to providing direct patient care, and consistent with federal training requirements for facilities participating in the Medicare or Medicaid programs.
(2) (A) A precertification training program consisting of at least 60 classroom hours of training on basic nursing skills, patient safety and rights, the social and psychological problems of patients, and elder abuse recognition and reporting pursuant to subdivision (e) of Section 1337.1. The 60 classroom hours of training may be conducted within a skilled nursing facility, an intermediate care facility, or an educational institution or agency. A health facility, educational institution, or local agency may conduct the 60 classroom hours of training in an online or distance learning course format, as approved by the department.
(B) In addition to the 60 classroom hours of training required under subparagraph (A), the precertification program shall also consist of 100 hours of supervised and on-the-job training clinical practice. The 100 hours may consist of normal employment as a nurse assistant under the supervision of either the director of staff development or a licensed nurse qualified to provide nurse assistant training who has no other assigned duties while providing the training.
(3) At least two hours of the 60 hours of classroom training and at least four hours of the 100 hours of the supervised clinical training shall address the special needs of persons with developmental and mental disorders, including intellectual disability, Alzheimer’s disease, cerebral palsy, epilepsy, dementia, Parkinson’s disease, and mental illness.
(d) The department, in consultation with the State Department of Education and other appropriate organizations, shall develop criteria for approving training programs, that includes program content for orientation, training, inservice and the examination for testing knowledge and skills related to basic patient care services and shall develop a plan that identifies and encourages career ladder opportunities for certified nurse assistants. This group shall also recommend, and the department shall adopt, regulation changes necessary to provide for patient care when facilities utilize noncertified nurse assistants who are performing direct patient care. The requirements of this subdivision shall be established by January 1, 1989.
(e) On or before January 1, 2004, the department, in consultation with the State Department of Education, the American Red Cross, and other appropriate organizations, shall do the following:
(1) Review the current examination for approved training programs for certified nurse assistants to ensure the accurate assessment of whether a nurse assistant has obtained the required knowledge and skills related to basic patient care services.
(2) Develop a plan that identifies and encourages career ladder opportunities for certified nurse assistants, including the application of on-the-job postcertification hours to educational credits.
(f) A skilled nursing facility or intermediate care facility shall determine the number of specific clinical hours within each module identified by the department required to meet the requirements of subdivision (d), subject to subdivisions (b) and (c). The facility shall consider the specific hours recommended by the state department when adopting the precertification training program required by this chapter.
(g) This article shall not apply to a program conducted by any church or denomination for the purpose of training the adherents of the church or denomination in the care of the sick in accordance with its religious tenets.
(h) The Chancellor of the California Community Colleges shall provide to the department a standard process for approval of college credit. The department shall make this information available to all training programs in the state.
(i) An online or distance learning nurse assistant training program shall meet the same standards as a traditional, classroom-based program.
(j) An online nurse assistant training program shall contract with a licensed skilled nursing facility or intermediate care facility for the purpose of coordinating and completing the clinical portion of the nurse assistant training program.