Amended  IN  Senate  April 20, 2017
Amended  IN  Senate  April 17, 2017

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Senate Bill No. 799

Introduced by Senator Hill

February 17, 2017

An act to amend Sections 801, 2701, 2708, 2770.7, and 2811.5 of, to add Section 2761.5 to, and to repeal Section 2718 of, the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


SB 799, as amended, Hill. Nursing.
Existing law, the Nursing Practice Act, establishes the Board of Registered Nursing within the Department of Consumer Affairs and sets forth its powers and duties regarding the licensure and regulation of registered nurses. Existing law requires the board to appoint an executive officer to perform duties delegated by the board.
The act on January 1, 2018, repeals the provisions establishing the board and the executive officer position.
This bill would extend the repeal date of those provisions to January 1, 2022.
The act requires the board, by February 1, 2016, to contract with the California State Auditor’s Office to conduct a performance audit of the board’s enforcement program, as specified.
This bill would repeal the performance audit provisions.
The act authorizes the board to take disciplinary action against certified or licensed nurses or to deny an application for a certificate or license for various acts and offenses.
This bill would require a registered nurse who has knowledge that another person has committed any act listed as grounds for discipline or a denial of application to make a written report to the board and cooperate with the board in furnishing information or assistance, as required. The bill would require an employer employer, as defined, of a registered nurse to report to the board the suspension or termination for cause, or resignation for cause, of any registered nurse in its employ. The bill would require an employment agency or nursing registry employer to report to the board the rejection from assignment of a registered nurse by a health facility or home health care provider due to certain acts that would be cause for suspension or termination. The bill would make the failure of a registered nurse, an employer, or an employment agency or nursing registry nurse or an employer to make a report as required by the bill punishable by an administrative fine up to $10,000 per violation. The bill would make the implementation of these reporting requirements contingent upon the necessary funding in the annual Budget Act.
The act provides for an intervention program to identify and rehabilitate registered nurses whose competency may be impaired due to abuse of alcohol and other drugs, or due to mental illness. The act authorizes a registered nurse under current investigation by the board to request entry into the intervention program by contacting the board. The act authorizes the board to close an investigation of a registered nurse who enters the program under specified circumstances and requires the board to reopen the investigation only if the registered nurse withdraws or is terminated from the program.
This bill would delete those provisions providing for the suspension of a current investigation while a registered nurse is in the program and, instead, would require the board to investigate all complaints against registered nurses participating in the intervention program.
The act requires a person renewing his or her license to submit proof satisfactory to the board that, during the preceding 2-year period, he or she has been informed of the developments in the registered nurse field or in any special area of practice engaged in by the licensee, occurring since the last renewal thereof, either by pursuing a course or courses of continuing education in the registered nurse field or relevant to the practice of the licensee, and approved by the board, or by other means deemed equivalent by the board. The act requires the board to adopt regulations establishing standards for continuing education for licensees, as specified, and prohibits the standards from exceeding 30 hours of continuing education.
This bill would revise those continuing education provisions to require that each person renewing his or her license to submit proof satisfactory to the board that he or she has completed at least 30 hours of continuing education by pursuing a course or courses in the registered nurse nursing field or relevant to the practice of the licensee. The bill would permit continuing education courses from providers approved by the board before January 1, 2018, or approved by accrediting agencies or associations deemed appropriate by the board. The bill would require the board to promulgate emergency regulations to establish a list of approved entities based on the entities’ history of sanctioning learning opportunities appropriate to the practice of registered nursing. The bill would require the board, by January 1, 2019, to deliver a report to the appropriate legislative policy committees detailing a comprehensive plan for approving and disapproving continuing education opportunities.
Existing law requires insurers that provide liability insurance to certain licensees, including persons licensed by the board, to report to the licensing agency certain settlement or arbitration awards over $3,000.
This bill would increase the report threshold to $10,000 for a person licensed under the act.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 801 of the Business and Professions Code is amended to read:

801.
 (a) Except as provided in Section 801.01 and subdivisions (b), (c), (d), and (e) of this section, every insurer providing professional liability insurance to a person who holds a license, certificate, or similar authority from or under any agency specified in subdivision (a) of Section 800 shall send a complete report to that agency as to any settlement or arbitration award over three thousand dollars ($3,000) of a claim or action for damages for death or personal injury caused by that person’s negligence, error, or omission in practice, or by his or her rendering of unauthorized professional services. The report shall be sent within 30 days after the written settlement agreement has been reduced to writing and signed by all parties thereto or within 30 days after service of the arbitration award on the parties.
(b) Every insurer providing professional liability insurance to a person licensed pursuant to Chapter 13 (commencing with Section 4980), Chapter 14 (commencing with Section 4990), or Chapter 16 (commencing with Section 4999.10) shall send a complete report to the Board of Behavioral Sciences as to any settlement or arbitration award over ten thousand dollars ($10,000) of a claim or action for damages for death or personal injury caused by that person’s negligence, error, or omission in practice, or by his or her rendering of unauthorized professional services. The report shall be sent within 30 days after the written settlement agreement has been reduced to writing and signed by all parties thereto or within 30 days after service of the arbitration award on the parties.
(c) Every insurer providing professional liability insurance to a dentist licensed pursuant to Chapter 4 (commencing with Section 1600) shall send a complete report to the Dental Board of California as to any settlement or arbitration award over ten thousand dollars ($10,000) of a claim or action for damages for death or personal injury caused by that person’s negligence, error, or omission in practice, or rendering of unauthorized professional services. The report shall be sent within 30 days after the written settlement agreement has been reduced to writing and signed by all parties thereto or within 30 days after service of the arbitration award on the parties.
(d) Every insurer providing liability insurance to a veterinarian licensed pursuant to Chapter 11 (commencing with Section 4800) shall send a complete report to the Veterinary Medical Board of any settlement or arbitration award over ten thousand dollars ($10,000) of a claim or action for damages for death or injury caused by that person’s negligence, error, or omission in practice, or rendering of unauthorized professional service. The report shall be sent within 30 days after the written settlement agreement has been reduced to writing and signed by all parties thereto or within 30 days after service of the arbitration award on the parties.
(e) Every insurer providing professional liability insurance to a person licensed pursuant to Chapter 6 (commencing with Section 2700) shall send a complete report to the Board of Registered Nursing as to any settlement or arbitration award over ten thousand dollars ($10,000) of a claim or action for damages for death or personal injury caused by that person’s negligence, error, or omission in practice, or by his or her rendering of unauthorized professional services. The report shall be sent within 30 days after the written settlement agreement has been reduced to writing and signed by all parties thereto or within 30 days after service of the arbitration award on the parties.
(f) The insurer shall notify the claimant, or if the claimant is represented by counsel, the insurer shall notify the claimant’s attorney, that the report required by subdivision (a), (b), or (c) has been sent to the agency. If the attorney has not received this notice within 45 days after the settlement was reduced to writing and signed by all of the parties, the arbitration award was served on the parties, or the date of entry of the civil judgment, the attorney shall make the report to the agency.
(g) Notwithstanding any other provision of law, no insurer shall enter into a settlement without the written consent of the insured, except that this prohibition shall not void any settlement entered into without that written consent. The requirement of written consent shall only be waived by both the insured and the insurer.

SEC. 2.

 Section 2701 of the Business and Professions Code is amended to read:

2701.
 (a) There is in the Department of Consumer Affairs the Board of Registered Nursing consisting of nine members.
(b) For purposes of this chapter, “board,” or “the board,” refers to the Board of Registered Nursing. Any reference in state law to the Board of Nurse Examiners of the State of California or the California Board of Nursing Education and Nurse Registration shall be construed to refer to the Board of Registered Nursing.
(c) The board shall have all authority vested in the previous board under this chapter. The board may enforce all disciplinary actions undertaken by the previous board.
(d) This section shall remain in effect only until January 1, 2022, and as of that date, is repealed, unless a later enacted statute that is enacted before January 1, 2022, deletes or extends that date. Notwithstanding any other law, the repeal of this section renders the board subject to review by the appropriate policy committees of the Legislature.

SEC. 3.

 Section 2708 of the Business and Professions Code is amended to read:

2708.
 (a) The board shall appoint an executive officer who shall perform the duties delegated by the board and who shall be responsible to it for the accomplishment of those duties.
(b) The executive officer shall be a nurse currently licensed under this chapter and shall possess other qualifications as determined by the board.
(c) The executive officer shall not be a member of the board.
(d) This section shall remain in effect only until January 1, 2022, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2022, deletes or extends that date.

SEC. 4.

 Section 2718 of the Business and Professions Code is repealed.

SEC. 5.

 Section 2761.5 is added to the Business and Professions Code, to read:

2761.5.
 (a) If a registered nurse has knowledge that another person has committed any act listed as grounds for discipline or a denial of application pursuant to Section 2761, the registered nurse shall report this information to the board in writing and shall cooperate with the board in furnishing information or assistance as may be required.
(b) An employer of a registered nurse shall report to the board the suspension or termination for cause, or resignation for cause, of any registered nurse in its employ. In the case of a registered nurse employed by the state, the report shall not be made until after the conclusion of the review process specified in Section 52.3 of Title 2 of the California Code of Regulations and Skelly v. State Personnel Bd. (1975) 15 Cal.3d 194. This required reporting shall not constitute a waiver of confidentiality of medical records. The information reported or disclosed shall be kept confidential except as provided in subdivision (d) and shall not be subject to discovery in civil cases.
(c) An employment agency or nursing registry employer shall report to the board the rejection from assignment of a registered nurse by a health facility or home health care provider due to acts that would be cause for suspension or termination as described in subdivision (d).
(d) For purposes of this section, “suspension, termination, or resignation for cause” or “rejection from assignment” are defined as suspension, termination, or resignation from employment, or rejection from assignment, for any of the following reasons:
(1) Use of controlled substances or alcohol to the extent that it impairs the licensee’s ability to safely practice vocational registered nursing.
(2) Unlawful sale of a controlled substance or other prescription items.
(3) Patient or client abuse, neglect, physical harm, or sexual contact with a patient or client.
(4) Falsification of medical records.
(5) Gross negligence or incompetence.
(6) Theft from patients or clients, other employees, or the employer.
(e) Failure of a registered nurse, an employer, nurse or an employment agency or nursing registry employer to make a report required by this section is punishable by an administrative fine not to exceed ten thousand dollars ($10,000) per violation and shall not be punished pursuant to Section 2799.
(f) Pursuant to Section 43.8 of the Civil Code, a person shall not incur any civil penalty as a result of making any report required by this chapter.

(g)The board shall implement this section contingent upon the necessary funding in the annual Budget Act.

(h)

(g) For purposes of this section, “employer” includes employment agencies and nursing registries.

SEC. 6.

 Section 2770.7 of the Business and Professions Code is amended to read:

2770.7.
 (a) The board shall establish criteria for the acceptance, denial, or termination of registered nurses in the intervention program. Only those registered nurses who have voluntarily requested to participate in the intervention program shall participate in the program.
(b) A registered nurse under current investigation by the board may request entry into the intervention program by contacting the board.
(c) The board shall investigate all complaints against registered nurses participating in the intervention program.
(d) Neither acceptance nor participation in the intervention program shall preclude the board from investigating or continuing to investigate, or taking disciplinary action or continuing to take disciplinary action against, any registered nurse for any unprofessional conduct committed before, during, or after participation in the intervention program.
(e) All registered nurses shall sign an agreement of understanding that the withdrawal or termination from the intervention program at a time when the program manager or intervention evaluation committee determines the licentiate presents a threat to the public’s health and safety shall result in the utilization by the board of intervention program treatment records in disciplinary or criminal proceedings.
(f) Any registered nurse terminated from the intervention program for failure to comply with program requirements is subject to disciplinary action by the board for acts committed before, during, and after participation in the intervention program. A registered nurse who has been under investigation by the board and has been terminated from the intervention program by an intervention evaluation committee shall be reported by the intervention evaluation committee to the board.

SEC. 7.

 Section 2811.5 of the Business and Professions Code is amended to read:

2811.5.
 (a) Each person renewing his or her license under Section 2811 shall submit proof satisfactory to the board that he or she has completed at least 30 hours of continuing education by pursuing a course or courses in the registered nurse field or relevant to the practice of the licensee.
(b) Continuing education courses may be from a continuing education provider either approved by the board before January 1, 2018, or approved by accrediting agencies or associations as the board deems appropriate, which shall include, but not be limited to, the following: American Association of Nurse Practitioners, American Association of Critical-Care Nurses, American Association of Nurse Anesthetists, American Nurses Credentialing Center, and the National Association for Practical Nurse Education. The board shall promulgate emergency regulations to establish a list of approved entities based on the entities’ history of sanctioning learning opportunities appropriate to the practice of registered nursing.
(c) Notwithstanding Section 10231.5 of the Government Code, the board, by January 1, 2019, in compliance with Section 9795 of the Government Code, shall deliver a report to the appropriate legislative policy committees detailing a comprehensive plan for approving and disapproving continuing education opportunities.
(d) The board shall not renew existing continuing education providers or approve individual continuing education providers or courses.
(e) For purposes of this section, the board shall, by regulation, establish standards for continuing education. The standards shall be established in a manner to ensure that a variety of alternative forms of continuing education are available to licensees, including, but not limited to, academic studies, in-service education, institutes, seminars, lectures, conferences, workshops, extension studies, and home study programs. The standards shall take cognizance of specialized areas of practice, and content shall be relevant to the practice of nursing and shall be related to the evidence-based scientific knowledge or technical skills required for the practice of nursing or be related to direct or indirect patient or client care.
(f) The board shall audit continuing education providers at least once every five years to ensure adherence to regulatory requirements, and shall withhold or rescind approval from any provider that is in violation of the regulatory requirements.
(g) The board shall encourage continuing education in spousal or partner abuse detection and treatment. In the event the board establishes a requirement for continuing education coursework in spousal or partner abuse detection or treatment, that requirement shall be met by each licensee within no more than four years from the date the requirement is imposed.
(h) In establishing standards for continuing education, the board shall consider including a course in the special care needs of individuals and their families facing end-of-life issues, including, but not limited to, all of the following:
(1) Pain and symptom management.
(2) The psycho-social dynamics of death.
(3) Dying and bereavement.
(4) Hospice care.
(i) In establishing standards for continuing education, the board may include a course on pain management.
(j) This section shall not apply to licensees during the first two years immediately following their initial licensure in California or any other governmental jurisdiction.
(k) The board may, in accordance with the intent of this section, make exceptions from continuing education requirements for licensees residing in another state or country, or for reasons of health, military service, or other good cause.