Nursing.

Source-provided summary

(1) Existing law, the Nursing Practice Act, establishes the Board of Registered Nursing within the Department of Consumer Affairs, until January 1, 2027, and sets forth its powers and duties regarding the licensure and regulation of registered nurses. Existing law creates the Board of Registered Nursing Fund and makes all moneys in the fund available upon appropriation by the Legislature. A violation of the act is a crime. Existing law requires the board, until January 1, 2027, to appoint an executive officer to perform the duties delegated by the board and to be responsible to the board for the accomplishment of those duties, as specified. Existing law requires the board, for the purpose of transacting its business, to meet at least once every 3 months, at times and places it designates by resolution, and requires those meetings to be held in northern and southern California. This bill would extend those dates until January 1, 2031. The bill would remove the above-described location requirements for meetings held by the board, and, instead, require the board to meet at least once every 3 months in locations that are, to the extent practicable, geographically diverse. (2) Existing law specifies that an approved school of nursing, or an approved nursing program, is one that, among other things, gives a course of instruction approved by the board, as specified. Existing law requires the board to prepare and maintain a list of approved schools of nursing whose graduates are eligible to apply for a license to practice nursing, as provided. Existing law requires the board, through its executive officer, to inspect all schools of nursing in the state at the times the board deems necessary, as specified. This bill would require the board to make the list of approved schools of nursing available on its internet website. The bill would require the inspection criteria to be consistent with the 2020 Nursing Education Approval Guidelines established by the National Council of State Boards of Nursing, or its successor, as specified. Existing law requires an approved school of nursing or a nursing program to meet a minimum of 500 direct patient care clinical hours in a board-approved clinical setting, as specified, and requires additional clinical hours required by the program for nursing education preparation in each nursing area as specified by the board to be identified and documented in the curriculum plan for each area. The bill would require any clinical practice hours that are not required to be in direct patient care and are provided using simulation experiences to be based on the best practices published by, among other specified entities, the International Nursing Association for Clinical Simulation and Learning, or based on any equivalent standards approved by the board. Existing law authorizes the director of an approved nursing program, until the end of the 2023–24 academic year, or whenever the Governor declares a state of emergency for a county in which an agency or facility used by an approved nursing program for direct patient care clinical practice is no longer available, to submit to a board nursing education consultant requests to, among other things, allow the program to reduce the required number of direct patient care hours to, among other requirements, 50% in geriatrics and medical-surgical, if certain conditions are met. Existing law prohibits the approval of that request after the 2023–24 academic year and makes an approved request expire at the end of that year. This bill would, instead, authorize a director to submit requests for the approved nursing program to reduce the required number of direct patient care hours to 200 hours in medical-surgical, as specified, if certain conditions are met. The bill would remove the prohibition of the approval of that request after the 2023–24 year and the provision making any an approved request expire at the end of that year. If the board requires the approval of the faculty or directors, as specified, existing law authorizes the board to approve an individual to serve as a member of the faculty, director, or assistant director of an approved school of nursing or nursing program. Existing law makes an individual approval valid for 5 years and authorizes an individual approval to be renewed if the individual demonstrates to the board that they continue to meet the requirements established by the board for faculty, directors, and assistant directors of an approved school of nursing or nursing program. This bill would, instead, make only an individual faculty approval valid for 5 years and authorize only an individual faculty approval to be renewed if the individual demonstrates to the board that they continue to meet the requirements established by the board for faculty of an approved school of nursing or nursing program. If an applicant for approval has a faculty position and does not meet a requirement established by the board for a different position, existing law authorizes the board to accept a remediation plan submitted by an approved school of nursing or nursing program to help the applicant meet the requirement, and if the board accepts the plan, to approve the applicant to instruct in theory under the mentorship and supervision of the content expert identified in the plan for up to one year. If an applicant for approval as an assistant director or director does not have a faculty position and does not meet a requirement established by the board for a different position, the bill would authorize the board to accept a remediation plan submitted by an approved school of nursing or nursing program to help the applicant meet the requirement, and if the board accepts the plan, to approve the applicant to serve in the role of the assistant director under the mentorship of a board-approved director or assistant director while completing the remediation plan for up to one year, as specified. (3) Existing law defines the practice of nursing to include specified activities, including the administration of medications ordered by a physician and surgeon, dentist, podiatrist, or clinical psychologist, as specified. This bill would expand the definition of the practice of nursing to include the administration of medications ordered by a nurse practitioner or certified nurse midwife and the administration of medications as directed by an advanced practice registered nurse to the extent allowable by the advanced practice registered nurse's scope of practice. (4) Existing law requires the board to issue a license as a registered nurse to each applicant who passes the examination and meets all other licensing requirements. Existing law requires all examinations to be written, but authorizes exams in the discretion of the board to be supplemented by an oral or practical examination in subjects the board determines. This bill would remove the requirement that all examinations be written, and the authorization for exams to be supplemented by an oral or practical examination in subjects the board determines. Existing law authorizes a registered nurse under current investigation by the board to request entry into an intervention program by contacting the board. Existing law requires each registered nurse who requests participation in an intervention program to agree to cooperate with the rehabilitation program designed by the intervention evaluation committee and approved by the program manager, as defined. This bill would require the committee, in developing the rehabilitation program, to determine whether a participant is required to practice nursing prior to completion of the program. Existing law requires each person renewing their license as a registered nurse to submit proof satisfactory to the board that, during the preceding 2-year period, they have 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, as specified, or by other means deemed equivalent by the board. This bill would, beginning January 1, 2029, require the board to require each licensee to submit the above-described proof at the time of renewal and require the proof to include, but not be limited to, documentation verifying the completion of the continuing education requirements during the preceding renewal period or the preceding 2 years. Existing law authorizes a registered nurse whose license has been revoked or suspended or who has been placed on probation to petition the board for reinstatement or modification of penalty, as specified, subject to specified time periods. This bill would specify that no minimum time period applies if the registered nurse has had their license revoked by default for failure to submit a notice of defense. (5) Existing law requires the board to issue a certificate to practice nurse-midwifery to a person licensed as a registered nurse who meets specified qualifications. Existing law authorizes a certified nurse-midwife to attend cases of low-risk pregnancy and childbirth and to provide certain types of care, including prenatal care. Existing law generally authorizes a certified nurse-midwife to furnish drugs or devices incidentally to the provision of, among other things, the care and services described above. Existing law makes the furnishing or ordering of drugs or devices by a certified nurse-midwife conditional on the issuance by the board of a number to the applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs to implement these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500. This bill would authorize the board to also issue a furnishing number described above upon renewal application, and would remove the authorization for the board to charge a penalty fee for failure to renew a furnishing number within the prescribed time. The bill would specify that the initial application and renewal application are those for a certificate to practice nurse-midwifery. (6) Existing law, the Nurse Anesthetists Act, which is part of the Nursing Practice Act, requires the board to issue a certificate to practice nurse anesthesia to a person licensed as a registered nurse who meets specified qualifications. Existing law fixes the amounts of fees in connection with the issuance of certificates of nurse anesthetists, including that the fee to be paid upon the filing of an application for a certificate is fixed by the board at not less than $500 and no more than $1,500. This bill would remove the minimum fee amount for the above-described fees. (7) Existing law requires, on and after January 1, 2008, an applicant for initial qualification or certification as a nurse practitioner who has not been qualified or certified as a nurse practitioner in California or any other state to meet certain requirements, including holding a valid and active registered nursing license. Existing law generally authorizes a nurse practitioner to furnish drugs or devices when certain conditions are met, including that the nurse practitioner is functioning pursuant to standardized procedure, as defined, or protocol, as specified. Existing law makes the furnishing or ordering of drugs or devices by a nurse practitioner conditional on the issuance by the board of a number to an applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs to implement these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500. This bill would authorize the board to also issue a furnishing number described above upon renewal application, and would remove the authorization for the board to charge a penalty fee for failure to renew a furnishing number within the prescribed time. The bill would specify that the initial application and renewal application are those for the qualification or certification as a nurse practitioner. Existing law authorizes a nurse practitioner to perform certain functions, including conducting an advanced assessment, without standardized procedures in accordance with their education and training, as specified, if the nurse practitioner meets certain requirements, including that they have completed a transition to practice in California of a minimum of 3 full-time equivalent years of practice or 4600 hours, as specified. This bill would also authorize the completion of a transition to practice in another state, as described above, for purposes of that requirement. For purposes of a transition to practice completed in another state, the bill would require the board to, among other things, on or before January 1, 2028, identify states where practice experience would meet or exceed the requirements under specified provisions if obtained in this state. (8) Existing law requires a registered nurse applying to be a clinical nurse specialist for the evaluation of their qualifications to use that title to pay a nonrefundable fee of not less than $500 but not exceeding $1,500, and requires a fee to be paid for a temporary certificate to practice as a clinical nurse special to be not less than $30 but no more than $50. Existing law requires a biennial renewal fee to be paid upon submission of an application to renew the clinical nurse specialist certificate, and to be established by the board at no less than $150 and not more than $1,000. Existing law requires the penalty fee for failure to renew a certificate within the prescribed time to be 50% of the renewal fee in effect on the date of the renewal of the license to be not less than $75 and no more than $500. This bill would delete the minimum fee amounts prescribed above. (9) The bill would also make various nonsubstantive changes to various nursing related provisions.