Board Meeting Materials: 3.0 Board Meeting …States District Court for the Northern District of California, Case No. 19-cv-01184-EDL (Becerra v.Azar).Failure to call a special meeting

STATE OF CALIFORNIA

DEPARTMENT OF CONSUMER AFFAIRS

BOARD OF REGISTERED NURSING

BOARD MEETING MINUTES

DATE: March 14, 2019 DRAFT LOCATION: Sutter Health

2700 Gateway Oaks Drive

Big Sur/Manchester Room

Sacramento, CA 95833

PRESENT: Trande Phillips, President

Elizabeth A. Woods, MSN, FNP, RN

Pilar De La Cruz-Reyes, MSN, RN

Imelda Ceja-Butkiewicz

Michael D. Jackson, MSN, RN

NOT PRESENT: Donna Gerber, Vice President

Cynthia Klein, RN

ALSO PRESENT: Joseph Morris, Executive Officer

Ann Salisbury, DCA Legal Counsel

Stacie Berumen, Assistant Executive Officer

Christina Sprigg, Chief of Administration and Licensing

Shannon Johnson, Chief of Discipline, Probation, and Intervention

Joseph Pacheco, Chief of Complaint Intake and Investigations

Badrieh Caraway, Supervising NEC

Janette Wackerly, Supervising NEC

Wayne Boyer, NEC

Katie Daugherty, NEC

Susan Engle, NEC

Mary Ann McCarthy, NEC

Loretta Melby, NEC

Donna Schutte, NEC

Carol Velas, NEC

Kay Weinkam, NEC

Grace Arupo-Rodriguez, Asst Deputy Director for Legal Affairs, DCA

Neli Palma, Deputy Attorney General, OAG

Thursday, March 14, 2019– Immediately after the end of the Nursing Practice Committee

Meeting.

1.0 Call to Order/Roll Call /Establishment of a Quorum

Trande Phillips, President, called the meeting to order and

established a quorum 1:41 pm.

President Phillips announced the following:

The presiding officer of the Board has called this special meeting to consider pending

litigation relating to changes to the federal rules regarding Compliance with Statutory

Program Integrity Requirements, 83 Fed. Reg. 25502 (June 1, 2018), and State of

California, by and through Attorney General Xavier Becerra v. Alex Azar, et al., United

_______________________________ ______________________________

States District Court for the Northern District of California, Case No. 19-cv-01184-EDL

(Becerra v. Azar). Failure to call a special meeting would impose a substantial hardship on

the Board.

The specific facts giving rise to the special meeting are the rapid developments in the

Becerra v. Azar case and the Board’s need to respond to them quickly. I would entertain a

motion adopting these findings.

MOTION: by Michael Jackson to adopt the findings.

SECOND: Pilar De la Cruz Samoulian

Votes MJ EW DG IC-B TP CK PD-S

Y Y Absent Y Y Absent Y

2.0 Public Comment for Items Not on the Agenda

No Public Comment.

3.0 Closed Session

Closed session meeting was called order .

The Board will convene in closed session pursuant to Government Code section 11126,

subdivision (e)(2), to confer with and receive advice from legal counsel regarding

➢ Litigation relating to changes to the federal rules regarding compliance with statutory

program integrity requirements, 83 Fed. Reg. 25502 (June 1, 2018), and State of

California, by and through Attorney General Xavier Becerra v. Alex Azar, et al., United

States District Court for the Northern District of California, Case No. 19-cv-01184-

EDL.

4.0 Reconvene in Open Session for Purposes of Adjournment

Trande Phillips, President, reconvened the meeting in open session and called the meeting

to order

No public comment.

5.0 Adjournment

Meeting adjourned 2:15 pm.

Joseph Morris, PhD, MSN, RN Trande Phillips

Executive Officer Board President

STATE OF CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS

BOARD OF REGISTERED NURSING BOARD MEETING MINUTES

DATE: April 10-11, 2019 DRAFT LOCATION: UCD - Betty Irene Moore

School of Nursing Room 1000 2570 48th St Sacramento, CA 95817 916-734-6619

BOARD MEMBERS: Trande Phillips, RN, President

Donna Gerber, Vice President Elizabeth A. Woods, MSN, FNP, RN Pilar De La Cruz-Samoulian, MSN, RN Michael D. Jackson, RN, MSN Imelda Ceja-Butkiewicz Cynthia Klein, RN

STAFF PRESENT: Joseph Morris, Ph.D., RN, MSN, Executive Officer Ann Salisbury, DCA Legal Counsel Stacie Berumen, Assistant Executive Officer Thelma Harris, Chief of Legislation Christina Sprigg, Chief, Licensing and Administrative Services Joseph Pacheco, Chief, Complaint Intake and Investigations Shannon Johnson, Chief, Discipline, Probation and Intervention Jessica Hardwick, Decisions and Appeals Analyst

Wednesday, April 10, 2019

1.0 8:00 am Open Session: Staff Presentation to Public 1.1 Overview of the Board’s licensure process and enforcement process related to

applicants reporting convictions. 1.2 Questions and Answers.

Schools Present: American River College, Mission College, San Joaquin Delta college Chamberlain College of Nursing, Simpson University, Sacramento City college, Chabot College

2.0 Call to Order, Roll Call, and Establishment of a Quorum Trande Phillips, RN, President, called the meeting to order at 9:12 a.m. and established a quorum.

PRESENT: Trande Phillips, RN, President Elizabeth A. Woods, MSN, FNP, RN Pilar De La Cruz-Samoulian, MSN, RN Michael D. Jackson, RN, MSN Imelda Ceja-Butkiewicz

NOT PRESENT: Donna Gerber, Vice President Cynthia Klein, RN


No Public Comment

4.0 Disciplinary Matters. Hearings on Petitions for:

Termination/Modification of Probation • Roselynn Corona • Annie Gibson • Willie Harris • Julie Jarl • Darin Johnson • John Kelly • Laura O’Brien

Erin R. Koch-Goodman, Administrative Law Judge Kevin W. Bell, Deputy Attorney General Katelyn E. Docherty, Deputy Attorney General

Meeting adjourned for lunch. Time: 1:01 pm. Trande Phillips, RN, President, reconvened the meeting in open session, had the members introduce themselves and established a quorum at 1:19 pm. Trande Phillips, RN, President, adjourned open session. Time: 1:20 pm. Meeting adjourned to closed session. Time: 1:20 pm

5.0 Public Comment for Items on the Agenda (Gov. Code, § 11125.7, subd. (a).)

No Public Comment

6.0 Closed Session

6.1 Disciplinary Matters The Board will convene in closed session pursuant to Government Code Section 11126(c)(3) to deliberate on the above matters and other disciplinary matters including stipulations and proposed decisions.

6.2 Pending Litigation The Board will convene in closed session pursuant to Government Code section 11126(e)(1) to confer with and receive advice from legal counsel regarding Wenshi Ni v. California Board of Registered Nursing, Alameda Superior Court, Case No. RG18910618.

7.0 Reconvene in Open Session – Recess until April 11, 2019, at 9:00 a.m. Meeting adjourned at 4:21 pm.

Thursday, April 11, 2019 9:00 am

1.0 Call to Order/ Roll Call and Establishment of a Quorum Trande Phillips, RN, President called the meeting to order at 9:11 am, had the members introduce themselves, and established a quorum.

Votes MJ EW DG IC-B TP CK PD-S Y Y Absent Y Y Y Y

Members: Trande Phillips, RN, PresidentCynthia Klein, RN Elizabeth A. Woods, MSN, FNP, RN Pilar De La Cruz-Samoulian, MSN, RN Michael D. Jackson, MSN, RN Imelda Ceja-Butkiewicz

Not Present: Donna Gerber, Vice President

Staff Present: Joseph Morris, RN, MSN, Ph.D., Executive Officer Ann Salisbury, DCA Legal Counsel Stacie Berumen, Assistant Executive Officer Christina Sprigg, Chief, Licensing and Administrative Services Joseph Pacheco, Chief, Complaint Intake and Investigations Shannon Johnson, Chief, Discipline, Probation and Intervention Janette Wackerly, Supervising NEC Badrieh Caraway, Supervising NEC Carol Velas, NEC Susan Engle, NEC Katie Daugherty, NEC Mary Ann McCarthy, NEC Kay Weinkam, NEC, RA Shelley Ward, NEC Wayne Boyer, NEC

2.0 Public Comment for Items Not on the Agenda No Public Comment

3.0 Review and Vote on Whether to Approve Minutes:

3.1 February 13-14, 2019 Board Meeting Minutes 3.2 February 26, 2019 Board Meeting Minutes

No Public Comment

Motion: Trande Phillips moved to approve February 13-14, 2019 and February 26, 2019 Board Meeting Minutes.

Second: Michael Jackson

4.0 Report on Board Members’ Activities

Pilar De La Cruz-Samoulian– Speaker at a Regional meeting in the valley.

5.0 Board and Department Activities

5.1 Executive Officer Report

Organizational Update Budget Update Technology Update Staffing Update

Public Comment: Nicole Porter

5.1 Organizational Update Internal Business Process

The Board continues to review its internal business processes. The Board is scheduled to appear before the Assembly and Senate Budget Subcommittee 4 this month to discuss the additional staff requested in the 2019 Budget Change Proposal (BCP). The request for additional staff will be used to improve customer service and other essential operations of the Board.

Outreach Efforts The Board continues to increase its outreach efforts by collaborating with many of its community partners. In fact, the Board is scheduled within the next several months to release a newly designed BRN Newsletter/Report to highlight the Boards efforts and emerging topics. The report will be distributed to constituents throughout the state to better inform them about matters including enforcement, licensing, education, and other pertinent trends in nursing.

The enforcement division is currently planning a statewide webinar to better educate constituents about the Board’s Mission and enforcement process. The webinar will include a basic overview of the various units which include complaint intake, discipline, intervention, investigation, and probation. The proposed webinar is schedule to be conducted by June 2019. More information regarding the webinar will be discussed in the Enforcement report.

5.2 2017-2018 Annual School Survey The data report for the Annual School Survey is currently in the final stages of review. The BRN contracts with UCSF to collect data annually on nursing programs, students and f faculty. The Board anticipates releasing the data by late April 2019. For more information regarding the Annual School Survey please visit the Board’s website.

5.3 Public Record Requests The BRN continues to comply with public record requests (PRA) and respond within the

required timeframes that are set in Government Code Section 6250. For the period of February 7, 2019 to March 28, 2019, the Board has processed 17 PRAs.

5.4 Technology Update The Board continues to test the Tableau software for data management and reporting

purposes. As previously mentioned in the prior EO report, the software will be used to better manage, display, and scale data in a more user-friendly format for public use. Once approved, a notice regarding the launch of the new data reporting process will placed on the Board’s website.

Board is currently working with DCA’s OIS-BreEZe team to implement a process that would issue courtesy email notifications to RNs regarding their license renewal. The anticipated release of the electronic process is scheduled for May 2019. More information regarding this process will be detailed in the licensing report.

NEW HIRES

Name Classification Program Tenure

Michelle Mitchell Program Technician II Call Center LT

PROMOTIONS Name Classification Program

Timothy Buntjer Staff Services Manager I Probation Perm Sylvia Saenz Program Technician II Renewals Perm

SEPARATIONS Name Classification Program

Andrea Tillman Supervising Program Technician II

Call Center Perm

Christina Lane Supervising Program Technician II

Call Center Perm

Misty Marie Agheli Office Technician -Typing Discipline Perm

RETIREMENTS Name Classification Program

None.

VACANCIES

Classification Program FT/Perm vacancies

Associate Governmental Program Analyst Probation 2 Career Executive Assignment (CEA - B) Administration (AEO) 1 Career Executive Assignment (CEA - A) Licensing 1

5.5 Budget Update

SB 1480 Refund Update SB 1480 went into effect January 1, 2019 which amended the nonrefundable fee associated with the Public Health Nurse certification, along with a mandate to refund the fee difference for those applicants who paid the fee between April 5, 2018 to December 31, 2018. All refunds have been processed as of February 7, 2019.

Current Year Budget Board staff continue to monitor expenditures to ensure the budget remains healthy through the remainder of the fiscal year. Last year, staff took a granular approach to actual invoice tracking and forecasting of travel expenses for FY 18-19. This initiative has provided staff with improved visibility of expense trends and improved planning of meetings, conferences and training e vents. Staff are pleased with the results and will refine the process for FY 19-20.

Fund Condition See page 4 for current figures (as of 02-06-2019) of the Board’s analysis of Fund Condition, which includes the proposed 2019-20 Staffing Augmentation.

5.6 Staffing Update There are currently 16 positions which are actively being recruited for hire. For more information regarding the available job postings and how to apply please visit the BRN website.

Nursing Education Consultant (BCP) N. CA NECs 1 Nursing Education Consultant N. CA NECs 1 Nursing Education Consultant S. CA - NECs 2 Office Services Supervisor II Renewals 1 Office Technician – Typing Complaint Intake 1 Office Technician – Typing Discipline 1 Program Technician II Call Center 2 Supervising Program Technician II Call Center 2 Supervising Special Investigator Investigations Unit – Central CA 1 TOTAL: 16

Fund Condition

*Dollars in thousands, except in Salary Range. Numbers may not add or match to other statements due to rounding of budget details.

For more information regarding many of the Boards Activities and available resources please visit www.rn.ca.gov.

http://www.rn.ca.gov/

6.0 Report of the Administrative Committee Trande Phillips, RN, President, Chairperson

Dean Fairbanks and Thelma Harris presented report.

6.1 Review, Discussion, and Possible Action on Regulatory Proposal to Modify California Code of Regulations, Article 2, Section 1410 (Application), Article 4, Sections 1444 (Substantial Relationship Criteria), 1444.5 (Disciplinary Guidelines), and 1445 (Criteria for Rehabilitation)

Background: Existing law authorizes a board to deny, suspend, or revoke a license or take disciplinary action against a licensee on grounds that the applicant or licensee has, among other things, been convicted of certain crimes. AB 2138 (Chiu), was signed by Governor Edmund G. Brown on September 30, 2018, and will become operative July 1, 2020. This legislation amends various provisions of the Business and Professions Code relating to a board’s ability to deny a license or take disciplinary action based on criminal convictions and other license discipline , and revises requirements related to the rehabilitation criteria that boards must consider when evaluating the denial of an application, a petition for reinstatement, or a petition for early termination of probation.

Motion: by Trande Phillips for the Board to approve the language presented and authorize the Executive Officer to make any technical and non-substantive changes, if needed, and to move forward with the process of promulgating these proposed regulations. Second: Michael Jackson


No public comment

6.2 Review, Discussion, and Possible Action on Regulatory Proposal to Modify California Code of Regulations, Article 3, Sections 1423.1 (Grounds for Denial or Removal of Board Approval), 1427 (Clinical Facilities), and 1432 (Changes to an Approved Program)

Background: California Code of Regulations, title 16, division 14, article 3, sets forth the Board’s regulations for prelicensure nursing schools. The last major revision of these regulations took place in 2010. Over the last nine years the Board’s processes have continued to be refined and emerging issues have confronted the Board. This regulatory proposal is designed to address some of these changes.

Motion: by Trande Phillips for the Board to approve the concepts presented in these proposed regulations and authorizing the Executive Officer to further consult with staff and make additional changes to the proposed regulations, and that further revisions be presented to the Education Licensing Committee at the May 2019 meeting. Second: Michael Jackson.


Public comment- Saskia Kim, California Nurses Association

6.3 Discussion and Possible Action Regarding Revised Board Meeting Dates for 2020

Motion: Trande Phillips motion to discuss further and add to meeting agenda in June 2019. No action taken.

No public comment 7.0 Report of the Education/Licensing Committee

Michael Jackson, MSN, RN, Chairperson

7.1 Vote On Whether To Recommend Ratification Of Minor Curriculum Revision-Carol Velas Nec presented report.

BACKGROUND: According to Board policy, Nursing Education Consultants may approve minor curriculum changes that do not significantly alter philosophy, objectives, or content. Approvals must be reported to the Education/Licensing Committee and the Board. These minor curriculum revisions and progress reports were presented at the March 14, 2019 Education and Licensing Committee meeting.

Minor Curriculum revisions include the following categories: • Curriculum changes • Progress reports that are not related to • Work Study programs continuing approval • Preceptor programs • Approved Nurse Practitioner program • Public Health Nurse (PHN) certificate adding a category of specialization

programs

The following programs have submitted minor curriculum revisions that have been approved by the NECs:

Cabrillo College Associate Degree Nursing Program CNI Associate Degree Nursing Program College of the Canyons Associate Degree Nursing Program College of Marin Associate Degree Nursing Program College of the Siskiyous LVN to RN Associate Degree Nursing Program Holy Names University Family Nurse Practitioner MSN and Post Master’s Certificate FNP

Nursing Program University of San Diego Advanced Practice Nurse Practitioner Program University of San Francisco Advanced Practice Nurse Practitioner Program

Motion: Michael Jackson made a motion to accept Ratification of Minor Curriculum Revision

Second: Pilar De La Cruz-Samoulian


Y Y Absent Y Y Y Y

No public comment

7.2 Vote on Whether to Approve Education/Licensing Committee Recommendations

BACKGROUND: The Education/Licensing Committee met on March 14, 2019 and makes the following recommendations:

7.2.1 Continuation Of Approval Of Prelicensure Nursing Programs (BPC 2788, CCR 1421, 1423)

Santa Monica College Associate Degree Nursing Program Sacramento City College Associate Degree Nursing Program

Motion: Michael Jackson made a motion to accept the Recommendations for Continued Approval of Prelicensure Nursing Programs



Y Y Absent Y Y Y Y

No Public Comment.

7.2.2 Continuation of Approval of Advanced Practice Nurse Practitioner Program United States University Family Nurse Practitioner Program

Motion: Michael Jackson made a motion to Approval of Advanced Practice Nurse Practitioner Program

Second: Cynthia Klein


Y Y Absent Y Y Y Recuse

No Public Comment.

7.2.3 Approval of Prelicensure Curriculum Unit Adjustment or Change (CCR 1426) Los Angeles Southwest College Associate Degree Nursing Program

Motion: Michael Jackson made a motion to approve Prelicensure Curriculum Unit Adjustment or Change (CCR 1426)



Y Y Absent Y Y Y Y

No Public Comment.

7.2.4 Approval of Advanced Practice Nurse Practitioner Unit Adjustment or Change [CCR1484(H)] University of California, Irvine Nursing Practitioner Programs

Motion: Michael Jackson made a motion to approve Advanced Practice Nurse Practitioner Unit Adjustment or Change



Y Y Absent Y Y Y Y

No Public Comment.

7.2.5 Accept Progress Report from Prelicensure Nursing Program Glendale Career College-San Diego Associate Degree Nursing Program

Motion: Michael Jackson made a motion to Accept Progress Report from Prelicensure Nursing Program

Second: Pilar DeLaCruz-Samoulian


Y Y Absent Y Y Y Y

No Public Comment.

7.2.6 Approval of Separation of El Camino College from Compton College Associate Degree Nursing Program and maintain an enrollment pattern of 30 students twice a year for an annual enrollment of 60 students (CCR 1432)

Motion: Michael Jackson made a motion to Approve Teach-out plan for Brightwood College Associate Degree Nursing Program Closure



Y Y Absent Y Y Y Y

No Public Comment.

7.3.1 Vote on Whether to Recommend Acceptance of Self Study and Grant Initial Approval of Prelicensure Nursing Program for Brandman University Baccalaureate Degree Nursing Program -Loretta Melby, NEC presented report.

BACKGROUND: Brandman’s feasibility study for their proposed program was accepted by the Board at the April 2016 meeting. Rachel Choudhury was approved as the Director of Nursing for this proposed program on May 18, 2016 and she has worked diligently to bring Brandman in to compliance with all BRN rules and regulations. After receiving Brandman’s Self Study and reviewing the content, Loretta Melby NEC completed an initial program approval site visit at the San Diego Campus on May 17, 2017. Brandman University came before the ELC meeting October 2017, January 2018 and March 2018 seeking new program approval and received a one-year extension April 2018 from the BRN.

Brandman University is a private, non-profit university and a member of the Chapman University System. The university serves approximately 12,000 students annually in 52 programs on 27 campuses in California and Washington States. Brandman University is accredited through the Western Accreditation of Schools and Colleges (WASC) and Senior College and University Commission (SCUC). The proposed BSN program would be within the Marybelle and S. Paul Musco School of Nursing and Allied Health Professions (MSNaHP). MSNaHP is CCNE accredited and currently offers two other degree programs the RN-BSN since January 2011 and Doctor of Nursing Practice (DNP) since Spring 2012.

Brandman University has a faculty hiring and staffing plan based on an enrollment of (24) twenty-four students (3) three times a year (72 annually) and intends to initiate the program with generic student enrollment as soon as the self-study is approved. The University administration has stated that they will provide an adequate budget for program delivery with consideration for additional funds to enhance student support services, equipment and supplies as additional enrollment cycles take place.

The BSN program curriculum includes the content required for licensure and college degree requirements and is intended to be completed in an accelerated format of eight 16-week Trimesters, each with 13-16 total units. A total of 108 units will be required for licensure, and 120 for graduation.

The University has secured clinical contracts with Sharp Healthcare and Desert Regional Medical Center and plans to continue to pursue obtaining additional pediatric clinical contracts including Rady’s Children’s Hospital, the San Diego Unified School District, Navy Medical Center (Balboa), and Together We Grow. These clinical agreements will allow the students to have access to clinical rotations in every clinical practice area required for licensure.

Brandman attended the Education Licensing Committee meeting in October 2017 where they requested the committee members to approve their proposed baccalaureate nursing program. After the agenda item summary and materials were submitted Loretta Melby NEC received information from the San Diego Nursing Education Consortium and Desert Regional Medical Center that she presented during the meeting. The information received from the Consortium showed clinical displacement occurring in San Diego and this included Sharp Healthcare facilities. This concerned the committee members and they shared their concern regarding clinical displacement. Additionally, after the committee members received the updated information regarding Desert Regional Medical Center they were concerned whether the students would have adequate pediatric clinical placements. Therefore, the committee voted to defer granting approval of Brandman University’s Baccalaureate Degree Nursing Program until there is adequate Pediatric clinical placement.

In January 2018, at the Education Licensing Committee meeting, Brandman University presented a plan to address their Pediatric Clinical Placements. Among the supporting documents submitted by Brandman for review were a proposed pediatric clinical learning experience schedule outlining 40 clinical hours in direct patient care and 5 clinical hours in simulation, a completed EPD-P-11 to show a staffing/hiring plan to cover all clinical placements and a facility verification form completed by Sharp Healthcare/Sharp Rees-Stealy (SRS) addressing staffing, daily census, and student placement. A Precepted clinical experience placement plan was also submitted explaining the proposed use of Desert Regional Medical Center’s pediatric unit, NICU, and outpatient pediatric clinics. The committee members voiced various concerns regarding conflicting information around clinical displacement, faculty supervision of the student during the proposed clinical rotations, students having comparable clinical experiences, and having an all outpatient pediatric clinical experience. Brandman shared their plans on how they would meet those specific regulations. At that time, the committee members decided that it would be best to have BRN’s legal counsel review current regulation prior to the Committee voting on the approving Brandman’s program therefore they asked Brandman to return to Education and Licensing Committee meeting in March 2018.

In March 2018 when Brandman attended the ELC meeting, they did not have any further materials to submit for review. They simply requested a decision on whether the committee will grant initial approval of their proposed prelicensure nursing program after receiving clarification from BRN legal counsel. The program did not receive approval, but they were granted a one-year extension that will expire April 2019.

Clinical displacement remains a concern with nursing programs in the San Diego area, where Brandman University plans to open their BSN program. Per e-mail communication with the manager of the San Diego Nursing Education Consortium (SDNEC), pediatric clinical placement requests through the SDNSEC between August 1, 2018 and July 31, 2019 are as follows:

• Total number of pediatric placement approvals: 1,494 students • Total number of pediatric placement rejections: 331

The number and reason(s) of pediatric placement rejections related to clinical group and/or precepted placements were not specified by the consortium. According to Brandman’s Response to BRN Deferral Action submitted 02.15.2019, the recent closure and subsequent teach out of Brightwood College provides an opportunity for Brandman University to seek pediatric clinical placements in the San Diego area with minimal or no impact on current placements of other programs. If approved by the BRN, Brandman University anticipates that the BSN program will be using pediatric clinical placements starting Fall of 2021. Brandman expects the Brightwood College teach out to be completed at this time. Brandman will also make adjustments in the clinical simulation hours for the pediatric practicum course. Simulation hours will be increased from 5 hours to 9 hours (20%) with 36 hours being in direct patient care.

The closing of Brightwood College’s ADN program could provide an opportunity for Brandman University to offer a BSN program in the same geographical location with minimal clinical impact. Brandman plans to enroll less than half of Brightwood’s previously approved annual enrollment of 150 and offer a higher-level degree. In addition, Pediatric rotations are planned to start after the scheduled completion of Brightwood’s teach out plan. Therefore, Brandman University is asking that the ELC consider granting approval of their program with the proposed changes or another extension for initial program approval. Board members can request historical documents on request. ELC Recommendation: Recommend acceptance of Self Study and grant initial approval of new prelicensure nursing program for Brandman University Baccalaureate Degree Nursing Program with an initial enrollment pattern of 24 students three times per year for an annual enrollment of 72.




Y Y Absent Y Y Y Y

No Public Comment.

7.3.2 Vote on Whether to Recommend Acceptance of Self Study and Grant Initial Approval of new Prelicensure Program for Pacific College Associate Degree Nursing Program

BACKGROUND: Pacific College (PC) is being presented today for approval of the Self Study and new Associate Degree in Nursing (A.D.N.) program. PC was founded in 1993 to provide accessible, innovative, and relevant education to adult learners (College Catalog, 2018). PC offers LVN diploma and associate degree, a RN to BSN program, and the master’s degree in Advanced Practice Nursing, Family Nurse Practitioner. PC is located in Costa Mesa, a community in Orange County. According to the recent Regional Summit meetings and the HealthImpact report, Orange County is not expected to have a demand for nurses in the near future. PC draws students from Orange, Riverside, San Bernardino, and Los Angeles counties. PC is accredited by the Western Association of Schools and Colleges and Senior College and University Commission (WASC, WSCUC) as a degree granting institution of higher education. The Baccalaureate Degree in Nursing Program is also accredited by the Commission on Collegiate Nursing Education (CCNE). The total cost of the ADN program is $81,550. The tuition for nursing courses alone (prerequisites completed) is $70,000.00. These costs include books and other program costs (CPR training, ATI supplement resources, uniforms and patch, skills supply tote, badge, and NCLEX licensing fee).

Bobbie-Ann Murphy, MHA, MSN/ED, RN has been appointed Program Director for the proposed program. Ms. Murphy comes from a vast background of experience in nursing education and was most recently the Program Director for Stanbridge University. Ms. Murphy was appointed after Dr. Winston resigned and has taken over where Dr. Winston left off, including the complete revision of the curriculum and Self Study. Ms. Murphy will have 100% release time to administer the new

https://70,000.00

program. She will be assisted by Jeannie Brown, MSN, RN who will be hired once the program is approved and will have 50% release time to assist Ms. Murphy. The other 50% of Ms. Brown’s time will be spent as the Student Success Coordinator providing support to students identified “at risk”, those students who score below passing on exams, and also clinical students who need extra support. A Student Success Action Plan (SSAP) would be activated by the faculty of record or clinical instructor that would generate the initiation of support for the student.

PC is proposing an A.D.N. Program with an initial enrollment of 45 students twice annually (Fall and Spring) for a total enrollment of 90 students. They will also offer two tracks for the LVN (Advanced Placement and Non-degree option). PC offers a diploma and Associate degree for the LVN and has been successful in their NCLEX-VN pass rates staying above the State reported rate for the past five years. The admission process includes multicriteria screening including TEAS score, GPA, ATI Critical Thinking Exam, Essay, and Interview.

The PC Campus is in Costa Mesa. The building is two-stories with ample parking. There is a reception area on the first floor. Administration and student services are also located on the first floor. The building has a state of the art science lab for the microbiology course. There are three classrooms that seat between 30-45 students with table/chairs/video/computer/projection. A computer lab has 45 computers and will be used for test taking. There are three large skills labs with a total of 17 beds. Two simulation theaters are newly furnished including video and a debriefing room is adjacent. Simulation will be integrated across the curriculum and use 25% of clinical time. Two high-fidelity and 10 mid-fidelity simulators were bought for this program and are on site. There is a birthing mannequin and several ages of newborns and pediatric mannequins. There are supplies and equipment to simulate nursing practice. Program Director, Assistant Director and Faculty will be on the second floor with private offices or cubicles for faculty with private conference room. There is a student lounge and conference room for faculty meetings. PC has a small library with table and chairs. Students will have access to the online Library that houses databases relevant to articles on the topics they will study. The resources for students are adequate.

Faculty for the proposed program will come in large part from existing RN-BSN and MSN faculty who have experience teaching in pre and post licensure programs. The proposed program will start with four full-time and 3 three part-time faculty until nursing courses begin and then will increase to six full-time and three part-time faculty. Content experts have already been identified. The program administrative support will include one fulltime administrative assistant, one technology staff, one Clinical Placement Coordinator, and one Student Success Coordinator (shared responsibility of Assistant Director). Two Assistant Directors, each with 50% release time will be in place as students enter the nursing curriculum. The Skills/Simulation lab will be staffed with one Director, two skills lab coordinators, and one simulation tech.

The Pre-Licensure Nursing Program curriculum structure emerges from the College, School of Nursing and Pre-licensure Nursing Program’s philosophies values and mission statements focusing on conscientious, considerate, and compassionate centered care as well as Quality and Safety in Nursing Education Prelicensure Competencies and the Nursing Process. The curriculum for the A.D.N. program consists of 76units for graduation with 43units in nursing (20u for theory and 23u for clinical), 6units in Communication, and 27units in Science and Math (statistics). LVN non-degree option offers 29units to qualify for the NCLEX exam. The nursing curriculum will be delivered over four 16-week semesters with prerequisites taken prior to the nursing courses as well as integrated throughout the curriculum. PC will use ATI resources for supplement instruction. Students will carry between 13-14 units per semester. Three courses in medical/surgical nursing are progressive from the fundamental concepts of patient-centered care to the multisystem, complex conditions of the adult and older adult. Simulation will account for 25% of clinical hours. Courses will be held at the Costa Mesa campus where I performed a site visit on February 26 & 27. When students reach the third

semester of the prelicensure program, they can choose to dually enroll in BSN Collaborative Pathway PC offers. Students will receive the first two courses at the rate of the $49.00 a unit and then $295.00/unit for the remaining courses. Students can begin to take upper division courses during the programs intersessions and continue taking courses concurrently during their prelicensure program.

Clinical experience at PC will mostly occur in the evenings, on the night shift, and on weekends. PC’s Clinical Coordinator, Richard Jonokuchi, has performed due diligence to ensure that no clinical site used for this new program will displace any other nursing program’s students. Multiple emails were sent in March, July, and August of 2018 to 31 programs that shared clinical sites. Five supported the new program and seven opposed the new program with 19 schools not responding despite read receipts (Table 1). Twenty-two hospital sites supported the enrollment of students and report no clinical displacement of other programs. See att3 for clinical site schedule. Five of the nine hospitals are greater than 50 miles from the college campus. A shuttle service will be provided for any student whose clinical site in more than 50 miles from the main campus in Costa Mesa. One community college reported they were recently denied a clinical placement at Fountain Valley Hospital, one of the hospitals providing a letter of support. Seven clinical sites were visited on February 26 & 27, 2019 in Orange and San Bernardino Counties. Support for PC clinical rotations were verified at all sites visited with verbal guarantee that the addition of PC students would not displace other nursing programs currently using their sites. All sever hospitals also reported they were hiring nurses currently and that they would hire the A.D.N. new graduate. Other clinical sites (Parkview Community Hospital in Riverside, Totally Kids Rehab in Loma Linda, Riverside Univ. Health System in Moreno Valley, and Fountain Valley Hospital in Fountain Valley) were called and also responded that displacement would not occur. A total of 22 Program Clinical Facility Authorization Forms (EDP-P-18) were received and signed by authorized facility personnel.

Table 1 Program Oppose Support No response 31 7 5 19

Pacific College has met all the rules and regulations for a new prelicensure nursing program.



Public Comment: : Linda Zorn, Charlotte Gullette-Moore

7.4 Vote On Whether To Recommend Changing Defer Continuation of Prelicensure Nursing Program to Approval of Continuation of Prelicensure Nursing Program at West Hills-Lemoore Associate Degree Nursing Program-Report presented by NEC Shelley Ward.

BACKGROUND: A continuing approval visit was conducted on September 12-13, 2017, by Loretta Melby NEC and Shelley Ward NEC. The program had two areas of non-compliance, CCR Section 1424 (d) -Resources and CCR Section 1426 (b) - Curriculum.

At the time of the February 15, 2018 BRN Board Meeting, the program had resolved the area of non-compliance related to resources however, needed additional time to resolve the area of non-compliance remaining for CCR Section 1426 (b) - Curriculum. The September 2017 Continuing Approval Visit Report of Findings (ROF) document is attached, and stated the following specific to the curriculum:

“SECTION 5: CURRICULUM 1426 (b) The curriculum shall reflect a unifying theme, which includes the nursing process as defined by the faculty and shall be designed so that a student who completes the program will have the knowledge, skill, and abilities necessary to function in accordance with the registered nurse scope of practice as defined in code section 2725, and to meet minimum competency standards of a registered nurse.

This program is utilizing the 2006 California Curriculum Model that was adopted in 2008 with no major curriculum revisions since the inception of the program. Content does not sufficiently address the required elements.”

The Board Action Letter dated February 15, 2018 included the following: “Continue to Defer Continuing Approval Status for West Hills College, Lemoore Associate Degree Nursing Program until Major Curriculum Revision is complete and approved.” (Letter is attached)

The program submitted a Major Curriculum Revision to the Education and Licensing Committee on January 10, 2019, which was subsequently approved by the Board at its February 14, 2019 meeting. The revised curriculum complies with the requirements of CCR Section 1426 (b), and all curriculum related regulatory requirements.

It is also noteworthy to mention that the faculty received the assistance of college administration resources, in that a consultant was retained to support the change process. Additionally, NCLEX RN examination pass-rates with the existing curriculum following the continuing approval visit are: July 2017- June 2018 = 96.88%, and year to date July 2018- Dec. 2018= 93.55%.

Motion: Michael Jackson made a motion to approve Changing Defer Continuation of Prelicensure Nursing Program to Approval of Continuation of Prelicensure Nursing Program at West Hills-Lemoore Associate Degree Nursing Program. Second: Trande Phillips

Votes MJ EW DG IC-B TP CK PD-S Y Y Absent Y Y Y Recuse

No Public Comment

7.5 Vote on Whether to Accept Application for Prelicensure Nursing Program (Feasibility Study) For Xavier College Associate Degree Nursing Program (CCR 1421, 1423) Janette Wackerly, SNEC presented report.

Background: On December 18, 2018 Xavier College submitted a Feasibility Study (FS) for a new Associate Degree in Nursing Program at 1340 North El Dorado Street Stockton CA 95202.

Motion: Michael Jackson made a motion to defer action and report back during the May meeting Second: Imelda Ceja-Butkiewicz


Public Comment: Lisa Lucchesi, Jennifer Guest, Bernadette Betancourt


7.6 Vote on Whether to Recommend Acceptance of Self Study and Grant Initial Approval Of Advanced Practice Nursing Program for University of Southern California Advanced Practice Nurse Practitioner Program (CCR 1483.1) - Janette Wackerly, SNEC presented report.

BACKGROUND: Sharon O’Neill, JD, DNP, FNP Vice Chair, Director of MSN-FNP Program, Clinical Associate Professor and Janet Schneiderman PhD, RN Interim Chair requested the Board of

Registered Nursing conduct Nurse Practitioner school approval visit for their online nurse practitioner program.

An initial approval visit was conducted on November 26, 2018 by Janette Wackerly, Katie Daugherty and Donna Schutte, Nursing Education Consultants as requested by USC MSN-FNP program.

Nursing@USC is an online Master of Science in nursing at the USC Suzanne Dwork-Peck School of Social Work Department of Nursing, offering a Family Nurse Practitioner (FNP) program that prepares advanced practice nurses to deliver primary care to infants, children, adolescents and adults throughout their life. The online FNP program has a full-time track that can be completed in 21 months and part-time track that can be completed in 33 months. Total units for the MSN-FNP are 49 units; theory units 37 which includes 555 hours and supervised clinical units are 12 units with 784 supervised clinical hours. At the time of the program visit there were 264 traditional students enrolled and 14 graduates.

The MSM-FNP Self Study was reviewed by the NECs which is inclusive of California Code of Regulation 1484 Standards of Education. The NECs determined the Nurse Practitioner program was in non-compliance with CCR 1484 (c) Faculty and Business and Professions Code 2732.05, requiring employers of registered nurses to verify current CA R.N licensure and verify “board-issue certification” such as CA nurse practitioner-nurse practitioner furnishing and any other advanced practice certification for a faculty. An area of recommendation (B) course of instruction: three hours of clinical practice each week throughout a semester or quarter equals one (1) unit. The area of non-compliance and recommendation are explained in detail in the Report of Finding (att1).

All faculty are academically qualified to teach in the assigned content areas having graduate degrees in nursing and or having a doctoral degree in nursing (PhD/DNP) and certified as a nurse practitioner in primary care with national certification and current clinical practice.

The University of Southern California, Master in Nursing- Family Nurse Practitioner (MSN-FNP) program was launched August 2016. In April 2016 the school contacted the Board of Registered Nursing and was informed that the current requirement does not mandate nurse practitioner program approval, and the approval process is on a voluntary basis. USC’s MSN program initiated the process to obtain the Commission on Collegiate Nursing Education (CCNE) approval for accreditation in November 2017 and is now CCNE approved. The University of Southern California is WASC approved.

Motion: Michael Jackson made a motion to defer action and report back during the May meeting Second: Pilar DelaCruz-Samoulian

No Public Comment

7.7 Discussion of Inspection Report for American Career College With Verification of Information Presented By American Career College At The Education Licensing

Committee Meeting And Vote To Determine Whether American Career College Is Maintaining The Standard Required By The Board – NEC Wayne Boyer presented report.

BACKGROUND: On February 12, 2013, American Career College (ACC) submitted a feasibility study to the Board for a new pre-licensure Associate Degree Nursing (ADN) program. The feasibility study was based on an estimated annual enrollment pattern of 40 students, three times per year. On February 11, 2014, the Board notified ACC that it accepted ACC’s feasibility study “with the revision of proposed enrollments reduced to a maximum of 30 students admitted twice each year,” and noting that the self-study should further develop “appropriate clinical placements which do not displace existing students in other programs.”

After the Board conducted the initial approval visit, the Education and Licensing Committee (ELC) voted on October 14, 2014, to recommend that the Board “Grant Initial Approval for the American Career College Associate Degree Nursing Program, Los Angeles Campus, with enrollment of thirty students twice per year.” The Board voted to adopt this recommendation on November 20, 2014.

On April 10, 2018, ACC applied to the Board for an enrollment increase, proposing to change its enrollment to 30 students, four times per year. On August 16, 2018, the ELC voted to recommend that the Board “Defer recommendation for enrollment pattern change-increase in enrollment until after the Regional Summit Meetings and more is understood about clinical capacity. Return to Education and Licensing Committee at that time.” On November 15, 2018, the Board adopted this recommendation.

On December 13, 2018, ACC wrote the Board challenging the Board’s authority to grant or deny enrollment increases and providing “notice that its Los Angeles campus intends to immediately implement increases in enrollment in its ADN program . . . .” In response to questions posed by Board counsel, ACC informed the Board on January 11, 2019, that it would begin enrolling 50 students, five times per year, beginning on February 20, 2019.

On January 10, 2019, the ELC considered ACC’s enrollment increase application again. Since the prior ELC meeting, ACC’s NCLEX-RN pass rate dropped to 74.6%, which is below the Board’s regulatory minimum standard of 75%. (Cal. Code Regs., tit. 16, § 1431.) Finding that ACC’s NCLEX-RN pass rate was below the regulatory standard and that there was some evidence of clinical displacement, the ELC voted to recommend that the Board deny ACC’s enrollment increase application.

On February 7, 2019, ACC notified the Board that it was withdrawing its then-pending enrollment increase application and proceeding “with five starts per year of fifty students.”

Nursing Education Consultant (NEC), Dr. Mary Ann McCarthy visited ACC on February 20, 2019, which was the day that ACC said the new larger cohort would begin classes. Dr. McCarthy met with Program Director Ellen Lewis. Director Lewis stated that new students would not be enrolled until Friday, February 22, 2019, and that the program would be admitting 83 students every 10 weeks.

On March 6, 2019, in response to an e-mail from NEC Dr. Boyer, Program Director Lewis stated that “ACC enrolled 50 students in the ADN Program February 20th, 2019.” This statement differs from her representation to Dr. McCarthy that ACC would enroll 83 students on February 22, 2019.

On March 12, 2019, ACC sent a letter to the Board requesting the legal basis on which the Board relies to regulate enrollment patterns or size. The Board responded by letter on March 13, 2019, reiterating the Board’s legal authority for regulating enrollment patterns and size.

At the Education Licensing Committee (ELC) meeting on March 14, 2019, Program Director Lewis reiterated that ACC enrolled only 50 students in February 2019. ACC also presented a chart titled “BRN Enrollment Increase Data” (found directly behind this AIS). Various NECs disputed the interpretation of the data presented by ACC, and the ELC directed Board staff to provide the information the staff felt relevant related to the chart. That information is located directly behind the chart. Consistent with the Board’s interpretation of its regulations, ACC’s increase in enrollment from 66 students annually to 250 or 415 students annually (depending on which ACC representation is accurate) constitutes a substantive change without prior Board approval in violation of California Code of Regulations, title 16, section 1432(b). To the extent the program has made any material misrepresentations of fact to the Board, such action would be grounds for revocation of the program’s approval pursuant to California Code of Regulations, title 16, section 1423(b).

Motion: by Michael Jackson for the Board to find that American Career College’s nursing program is not maintaining the standard required by the Board because it made a substantive change without prior approval of the Board in violation of 16 CCR § 1432(b) by enrolling significantly more students than permitted by the Board’s approval. Second: Trande Phillips

Votes MJ EW DG IC-B TP CK PD-S Y Y Absent N Y Y N

No Public Comment

7.8 Licensing Program Update-Christina Sprigg presented report.

LICENSING UPDATE: The Licensing Program evaluators are currently processing the initial review of CA/US exam and endorsement applications received in March. The board is preparing for spring graduation and anticipates a higher volume in comparison to fall graduation.

We continue to utilize the CloudDrive to receive electronic transcripts from all California programs. Additionally, out of state applicants can submit electronic transcripts, to the board, via third-party vendors. The board consistently receives US electronic transcripts daily and this significantly cuts down on application processing time. With the implementation of several BreEZe system improvements, application streamlining and online features such as online application status checks, we expect to see a further decrease in application processing times.

The Licensing and Enforcement Chiefs continue to present an overview regarding the application, eligibility process and reporting of arrest and conviction information to California students at every board petitioner hearing day.

BreEZe Enhancement: The Board will be the first to implement a new BreEZe enhancement. The DCA initiated a work authorization to send out courtesy email notifications to applicants and licensees and the Board will be the pilot board to implement. The four case scenarios will be:

1. Email notification to all licensees when their license is open for renewal (104 days prior to renewal).

a. The Board will continue to send out the 1-page renewal notice in addition to the courtesy email as we currently do not have validated email addresses for the entire licensee population.

2. Email notification to all licensees at specified intervals prior to renewal if their license or certifications have not been renewed.

a. For example: a reminder email notification will be sent at 45 days and at 15 days prior to expiration date informing the licensee that their license or certification still has not

been renewed. 3. Email notification once a licensee’s license or certification has been renewed.

a. This email will include the new expiration date and the license status active or inactive.

4. Email notification when an initial license is approved and issued. a. The Board will continue to send via regular mail the congratulations letter and wall

certificate to new licensee’s. This notification will be an immediate congratulations notification that they have been issued a new license or certification.

b. This notification will provide the licensee with their new license or certification number and the expiration date. It will also inform them that they will receive a wall certificate via regular mail.

This is scheduled to be implemented in May 2019. Future enhancements to this email feature will include automatic email notifications once a deficiency is added to an application record.

Consumer Assistance Call Center:

The Board’s call center supports a population of over 448,000 licensees and over 35,000 applicants. The call center currently has 12 permanent and 4 limited term positions. We are recruiting to fill 2 vacant permanent positions and additional limited term positions in this area. We are also recruiting to fill 2 call center supervisor positions. The call center supervisors vacated their positions on March 22nd for promotional opportunities at another department. These positions are in the recruitment process and we hope to have them filled by the end of April. Until these positions have been filled myself, the Administration and Licensing managers will rotate working in the call center area to ensure that there is a manager available daily to assist staff.

The Licensing, Administration and Licensee Services management team continues to work implementing suggested changes regarding communication and staff training & development. I along with my management team continue to host quarterly all staff meetings for the Licensing, Administration and Licensee Services units. Our next quarterly meeting is scheduled for late April 2019.

Staffing Updates: Currently the Licensing, Administration, Call Center, Renewals and NEC units have eleven (11) permanent vacancies due to newly established positions, staff movement and promotions. Below is a chart outlining the status of new hires, promotion, separations and vacancies:

NEW HIRES Name Classification Program

Michelle Mitchell Program Technician II Call Center

PROMOTIONS

Name Classification Program

Sylvia Saenz Program Technician II Renewals

SEPARATIONS

Name Classification Program

Andrea Tillman Supervising Program Technician II

Call Center

Christina Lane Supervising Program Technician II

Call Center

VACANCIES

Classification Program FT/PERM Vacancies

Career Executive Assignment (CEA - B) Assistant Executive Officer

Administration 1

Career Executive Assignment (CEA - A) Licensing Chief Licensing 1

Nursing Education Consultant N. CA NECs 2

Office Services Supervisor II Renewals 1

Supervising Program Technician II Call Center 2

Program Technician II Call Center 2

STATISTICS: The board continues to use Quality Business Interactive Report Tool (QBIRT) and can create and run various reports upon request. The board utilizes custom reports to find areas of improvement in our processes, as well as better predict workflow fluctuations. Below is the total number of applications

Licensing Applications Received

Application Type Fiscal Year 2014-2015

Fiscal Year 2015-2016




( J u l y 2 0 1 8 -c u r r e n t ) Exams 15,777 16,059 16,879 15,571 8,518

Endorsement 13,534 15,713 20,040 15,326 10,827 Repeat/Reapply 7,734 6,879 7,043 5,792 3,248 Advanced Practice 8,084 6,701 9,774 8,408 4,054

Total 45,129 45,352 53,736 45,097 26,647

the board has received by fiscal year:

No Public Comment

8.0 Report of the Legislative Committee Trande Phillips in absence of Donna Gerber, Chairperson Kay Weinkam and Thelma Harris presented report.

8.1 Discussion of Bills of Interest to the Board of Registered Nursing (Board) and Possible Action Regarding Adoption or Modification of Positions on Bills Introduced during the 2019-2020 Legislative Session.

BACKGROUND: Bills of interest for the 2019-2020 legislative session are listed on the April 10-11, 2019 agenda.

Bold denotes a new bill for Committee or Board consideration, is one that has been amended since the last Committee or Board meeting or is one about which the Board has taken a position and may wish to discuss further and restate or modify its position.

8.1.1 AB 62, 193, 362, 389, 476, 496, 538, 714, 732, 743, 862, 931, 993, 1145, 1271, 1529 and SB 207, 305, 464, 601 and 697

Motion: Trande Phillips made a motion to put a watch position on Bills: AB 62, 193, 362, 389, 476, 496, 538, 714, 732, 743, 862, 931, 993, 1145, 1271, 1529 and SB 207, 305, 464, 601 and 697. Second: Michael Jackson


Public Comment: Saskia Kim

8.1.2 AB 239 (Salas) Community colleges: registered nursing programs

Motion: Trande Phillips made a motion to support AB 239. Second: Pilar DeLaCruz-Samoulian


Public Comment: Dr. Carol Mountain, Sharon Goldfarb, Linda Zorn, Dr. Wanda Morris.

8.1.3 AB 241 (Kamlager-Dove) Implicit bias: continuing education: requirements.

Motion: Michael Jackson made a motion to watch AB 241. Second: Trande Phillips


Public Comment: Sharon Goldfarb, Saskia Kim,

8.1.4 AB 251 (Patterson) Personal income taxes: credit: family caregiver



No Public Comment

8.1.5 AB 329 (Rodriguez) Hospitals: assaults and batteries

Motion: Trande Phillips made a motion to watch AB 329. Second: Pilar DelaCruz-Samoulian


No Public Comment

http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200AB239


http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200AB251&firstNav=tracking



8.1.6 AB 535 (Brough) Personal income taxes: credit: professional license fees



No Public Comment

8.1.7 AB 544 (Kiley) Professions and vocations: inactive license fees and accrued and unpaid renewal fees

Motion: Trande Philips made a motion to watch AB 544. Second: Michael Jackson


No Public Comment

8.1.8 AB 613 (Low) Professions and vocations: regulatory fees



No Public Comment

8.1.9 AB 768 (Brough) Professions and vocations



No Public Comment

8.1.10 AB 822 (Irwin) Phlebotomy

Motion: Michael Jackson made a motion to oppose AB 822. Second: Trande Phillips



8.1.11 AB 890 (Wood) Nurse practitioners: scope of practice: unsupervised practice

Motion: Michael Jackson made a motion to oppose AB 890 unless amended. Second: Cynthia Klein







Y Y Absent Y Y Y Y Public Comment: Dr. Carol Mountain, Saskia Kim,

8.1.12 AB 1051 (Smith) Community colleges: temporary faculty members: clinical nursing faculty



Public Comment: Carol Goldfarb, Linda Zorn,

8.1.13 AB 1364 (Blanca Rubio) Nursing: schools and programs: exemptions

Motion: Michael Jackson made a motion to oppose AB 1364. Second: Imelda Ceja-Butkiewicz


Public Comment: Carol Mountain, Linda Zorn, Saskia Kim, Carol Goldfarb, Carrie Wybrough, Sasha Rarang, Susan Polay,

8.1.14 AB 1490 (Carrillo) Medical assistants



No Public Comment

8.1.15 AB 1514 (Patterson) Deaf and Disabled Telecommunications Program



Public Comment: Charlotte Gullette-Moore

8.1.16 AB 1544 (Gipson) Community Paramedicine or Triage to Alternate Destination Act




8.1.17 AB 1622 (Carrillo) Family physicians

Motion: Michael Jackson made a motion to oppose AB 1622. Second: Elizabeth Woods








No Public Comment

8.1.18 AB 1676 (Maienschein) Health care: mental health



No Public Comment

8.1.19 SB 53 (Wilk) Open meetings

Motion: Michael Jackson made a motion to oppose SB 53. Second: Trande Phillips

Votes MJ EW DG IC-B TP CK PD-S Y Y Absent Y Y Y Absent

No Public Comment

8.1.20 SB 223 (Hill) Pupil health: administration of medicinal cannabis: schoolsites

Motion: Trande Phillips made a motion to watch SB 223. Second: Cynthia Klein


No Public Comment

8.1.21 SB 227 (Leyva) Health and care facilities: inspections and penalties

Motion: Cynthia Klein made a motion to support SB 227. Second: Michael Jackson


Public Comment: Joyce Powell

8.1.22 SB 322 (Bradford) Health facilities: inspections: employee reporting

Motion: Trande Phillips made a motion to support SB 322. Second: Michael Jackson



8.1.23 SB 425 (Hill) Health care practitioners: licensee’s file: probationary physician’s and surgeon’s certificate: unprofessional conduct

Motion: Michael Jackson made a motion to watch SB 425. Second: Trande Phillips


http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200SB53






No Public Comment

8.1.24 SB 567 (Caballero) Workers compensation: hospital employees

Motion: Imelda Ceja-Butkiewicz made a motion to support SB 567. Second: Michael Jackson



8.1.25 SB 700 (Roth) Business and professions: noncompliance with support orders and tax delinquencies

Motion: Michael Jackson made a motion to watch SB 700. Second: Trande Phillips


No Public Comment

9.0 Report of the Intervention/Discipline Committee Imelda Ceja-Butkiewicz, Chairperson

9.1 Information Only: Complaint Intake and Investigations Update Joseph Pacheco Presented report.

COMPLAINT INTAKE UPDATE:

GENERAL UPDATE

The Complaint Intake Unit is piloting a new process for transmitting Expert case reviews electronically through the secure DCA Cloud. Transmitting electronically is more secure, eliminates shipping time, and is less costly than the current method of mailing investigation report copies. The goal is to transmit all Expert reviews electronically by July 2019. Recruitment for Expert Practice Consultants continues successfully. In addition to updated information on the BRN Website, the RN Renewal Application in Breeze now asks licensees if they are interested in becoming an Expert. Staff reaches out to interested RN’s monthly to recruit for high need specialties. BRN now has 189 RN’s under contract for Expert Practice Consultant services. Cases are being assigned and reviewed much faster; currently 33 days on average compared to 56 days in July 2018.

STAFFING The Complaint Intake Unit has finalized the recruitment to fill one office technician position. The new staff person begins on April 15. The Complaint Intake Unit has no other vacancies.

FISCAL YEAR 2019 TOTAL WORKLOAD STATISTICS, AS OF 03/19/2019

Public Complaints Received 3,045 Licensee Arrest & Conviction Reports 972 Applicant Conviction & Discipline Reports 2,261

http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201920200SB567&firstNav=tracking


Total Complaints Received (FY 18/19) 6,278*

* Complaint volume is equal to FY 2018

OPEN COMPLAINT INTAKE WORKLOAD, AS OF 03/19/2019 Complaint Intake Desk Investigations Pending (All open complaints, except Applicant and Field Investigations)

668

Desk Investigations Pending > 1 year 79

Applicant Open Cases 351 Applicant Cases Pending > 1 year 7

Cases Pending Expert Review 46

INVESTIGATION PROGRAM UPDATE:

GENERAL UPDATE

In late February, the BRN Investigation Unit held its annual investigator training conference. The two-day training event included presentations from the US Drug Enforcement Agency, the Department of Justice Bureau of Medi-Cal and Fraud, the San Diego District Attorney, the BRN Liaison Deputy Attorneys General, an RN Expert on Wound and Ostomy Care, and Lexis Nexis Accurint.

The BRN Investigation Unit is enjoying a period of high productivity and low average processing times. I wish to congratulate the entire Investigation Unit Staff and Management team for their efforts to improve work processes and investigative timeframes. Currently, BRN Investigation Unit average processing times for the year are the lowest on record at 199 days. The unit has only 4 cases over one year old; the lowest in the team’s 7-year history.

In response to DOI’s presentation to the Intervention Discipline Committee in March, Dr. Morris, Stacie Berumen and I are planning to meet with DOI management to discuss ongoing backlogs in the DOI workload. Per the Committee’s recommendation, we will also discuss possible changes to the DOI/DCA CPEI Guidelines to better address the workload. I will report to the Committee the results of these meetings.

STAFFING – BRN INVESTIGATION UNIT

The BRN Investigation Unit has a vacant Supervising Special Investigator position in our Central Unit. Recruitment to fill this position is ongoing.

SUMMARY INVESTIGATION STATISTICS

Cumulative Investigation Referrals – Fiscal Year 2019

No. of Cases Percent of all Referrals Referred to DOI 350 36% Referred to BRN Investigation Unit 621 64%

Cumulative Investigation Closures – Fiscal Year 2019

No. of Completed Investigation Reports

Average Days to Complete Investigation

Average Hours Per Case

Average Cost Per Case

Division of Investigation Closures 307 330 39.2 $7,684 BRN Investigation Unit Closures 566 199 28.9 $2,567

As of April 1, 2019, BRN has 4 and DOI has 93 open investigation cases over one year old.

OUTREACH ACTIVITIES:

Sonya Wilson, Complaint Intake Manager, has volunteered to present the DCA SOLID Enforcement Academy Class on Complaint Intake.

As a result of a renewed relationship between BRN and BVNPT, our two agencies have finalized a Memorandum of Understanding which allows the sharing of investigation materials between boards. This agreement will eliminate duplication of investigation efforts and streamline investigations for complaints with joint BRN and BVNPT licensure. BRN shares approximately 14,800 mutual licensees with BVNPT, more than BRN shares with any other Board or Bureau within DCA.

No Public Comment.

9.2 Information Only: Discipline and Probation Program Update Shannon Johnson presented report.

PROBATION UNIT The unit has two vacant positions, which are Associate Governmental Program Analyst (AGPA) positions. These positions are vacant due to the promotion of John Knowles and Tim Buntjer into the Probation and Discipline Manager positions (SSMI). These positions should be filled mid-April 2019.

Current caseloads are 91 cases per monitor. This includes all cases active and tolled.

New employment and employment modifications continue to get approved on average in 3-4 weeks.

The Probation team continues to partner with SOLID to instruct the Probation Monitoring Module of DCA’s SOLID Enforcement Academy. The course was instructed by Lisa Hall and John Knowles and was held on Thursday, March 28, 2019.

Probation Information FY

2014/2015 FY

2015/2016 FY

2016/2017 FY

2017/2018 Current

FY Active In-State Probationers 1,095 1,189 1,196 1,003 875 # of Chemical Dependency Probationers 707 785 787 580 489

Tolled Out of State Probationers 290 345 380 394 397

Total Probationers 1,385 1,534 1,576 1,397 1,272

CITE AND FINE

The unit is currently fully staffed.

As of March 18, 2019, staff have issued 435 citations. Of those, full payment has been received on 288 and 158 appeal conferences held and 2 Administrative Hearing Appeals.

Citation Information FY 2015/16 FY 2016/17 FY 2017/2018 Current FY Citations Issued 542 366 770 435 Amount Ordered $299,638 $266,428 $519,133 $321,076 Amount Received $253,974 $202,614 $391,233 $211,725

DISCIPLINE UNIT

Tammy Logan, Discipline Manager, retired February 28, 2019. Tim Buntjer was promoted from the Probation Unit as the new Discipline Manager (SSMI) effective March 1, 2019.

Cases Pending As of 03/18/2019 Total cases at AG 1,103 Pending Board Vote 30 Final Decision Processing 86 Pending hearing 145 Over 2 yrs. at AG 57 1-2 yrs. at AG 200 Subsequent AG Cases (Probationers) 96

Board Final Decisions FY 2015/16

FY 2016/17

FY 2017/2018

CURRENT FY

AG Referrals 1,395 1,198 1,282 917 Petitions to Revoke Probation 87 120 100 65 Pleading Served 1,067 938 848 657 EO Signed Surrenders 255 254 218 229 Withdrawals of SOI 15 9 9 2 Decisions Adopted 1,641 1,282 1,141 967

No Public Comment. 9.3 Intervention Program

INTERVENTION PROGRAM UPDATE Staffing

The Intervention unit is fully staffed.

INTERVENTION PROGRAM UPDATE

Staffing

The Intervention unit is fully staffed.

Program Update

On March 22, 2019, the Intervention program hosted the last Mental Health Ad-Hoc Committee meeting. The committee members worked effectively to review and finalize the draft report. The report is currently being prepared and will be submitted to DCA legal for review and approval. The final report will be submitted to the Intervention Discipline Committee (IDC) for review at the May 2019 IDC meeting.

The Intervention team is currently involved in ongoing meetings with DCA contract and legal staff along with the participating boards alternative to discipline programs to work on the upcoming Recovery Programs Request for Proposal (RFP) bid process. The current contract ends December 31, 2019.

Intervention Evaluation Committees (IEC)

There are currently four physician member vacancies.

San Jose (IEC 7) Fresno (IEC 5)

Los Angeles (IEC 3) Irvine (IEC 4)

There are two public member vacancies.

San Jose (IEC 7) Fresno (IEC 5)

Statistics – Intervention

The Statistical Summary Report is attached. As of March 27, 2019, there have been 2,369 successful completions.

No Public Comment.

9.3.1 Intervention Evaluation Committee Member/ New Appointment

BACKGROUND: In accordance with B & P Code Section 2770.2, the Board of Registered Nursing is responsible for appointing persons to serve on the Intervention Evaluation Committees. Each Committee for the Intervention Program is composed of three registered nurses, a physician and a public member with expertise in substance use disorders and/or mental health.

APPOINTMENT Below is the name of the candidate who is being recommended for appointment to the Intervention Evaluation Committee (IEC). Mr. Rashid’s application and résumé are attached. If approved, his term will expire June 30, 2022.

NAME TITLE IEC NO

Saqib Rashid, MD Physician Member Fresno 5

Motion: Imelda Ceja-Butkiewicz made a motion to appoint Saqib Rashid, MD Second: Elizabeth Woods


No Public Comment.

10.0 Report of the Nursing Practice Committee Elizabeth Woods, RN, Chairperson Reports presented by Janette Wackerly- Supervising Nursing Education Consultant

10.1 Discussion and Possible Action: SB 1109 (2018), Controlled substances: Schedule II drugs: opioids. The law would require Nurse-Midwives to include Board certification of a pharmacology course to include the risks of addiction and neonatal abstinence syndrome associated with the use of Schedule II (opioids).

BACKGROUND:

Existing law, Business and Professions Code (BCP) authorizes a certified nurse-midwife to furnish drugs and devices under specified circumstances including board certification that the certified nurse-midwife has completed a course in a pharmacology, as specified, that includes furnishing Schedule II controlled substances (opioid). The new law (SB 1109 of 2018) to include Board certification of the pharmacology course for Schedule II Controlled Substance and the risk of addiction including and neonatal abstinence syndrome with use of Schedule II opioid.

In collaboration the Supervising Nursing Education Consultant with the two midwifery educational programs, California State University Fullerton and University of California San Francisco, and the California Nurse-Midwifery Association updated the pharmacology course content related to furnishing Schedule II Controlled Substance with the risk of addiction including neonatal abstinence syndrome with the use of Schedule II opioid.

CSU Fullerton is the continuing education provider that will produce the continuing education course for nurse-midwives in the content area of Schedule II Controlled Substance and the risk of addiction including neonatal abstinence syndrome with the use of Schedule II opioids.

Nurse-Midwives requesting to furnish Schedule II controlled substances are required to complete either a minimum 2-hour Board of Registered Nursing approved continuing education course in Schedule II pharmacology, which also includes content regarding the risk of addition associated with the use of Schedule II controlled substances and neonatal abstinence syndrome, OR successfully complete the required pharmacology content for Schedule II controlled substance, including risk of addiction associated with their use and neonatal abstinence syndrome, in a board approved advanced pharmacology course. The Board of Registered Nursing is required to verify each nurse-midwife’s completion of the required Scheduled II controlled substance continuing education or advanced pharmacology course content.

The BRN advance practice licensing unit will process the nurse-midwives’ request for Schedule II furnishing privileges upon receipt of documentation regarding the continuing education course or pharmacology course content. The DEA will process nurse-midwife applications after accessing the

Board’s website to ensure that Schedule II with Risk of Addiction and Neonatal Abstinence Syndrome designation, have been added to the Nurse-Midwife’s furnishing number.

Please see attached document when Board approval is completed on BRN Website “Nurse-Midwifery Schedule II Controlled Substances to include the Risk of Addition and Neonatal Abstinence Syndrome with the use of Opioids.

Motion: Michael Jackson made a motion to approve Second: Trande Phillips


No Public Comment.

10.2 Information Only: Report from Advance Practice Registered Nursing Committee: February 7, 2019 Meeting:

BACKGROUND:

The follow agenda items were discussed at the Advance Practice Registered Nursing Advisory Committee Meeting on February 7, 2019.

10.1 Discussion only: Request Board of Registered Nursing (BRN) Board Members to provide specific examples of the barriers or lack of transparency in application deficiencies encountered in the BreEZe system regarding the Advance Practice constituents in California and out-of-state endorsement, new applications and renewals.

As a constituent and user of the BreEZe system for initial license, renewal of license, and endorsement from compact states there is an absence of transparency regarding deficiencies in an initial nursing and renewal application. It creates frustration and delays with applicant processing and renewing of registered nursing licenses.

Since all applications are reviewed for payment and other requirements, there needs to be a place within the online portal for the applicant to review and determine if they have failed to complete the license process correctly. It saves the Board of Registered Nursing and the BreEZe system from direct communication with thousands of licensees and creates a truly online experience where the applicant can clearly see any deficiencies in the review process. This goes beyond the way BreEZe identifies their processing times from date of submission.

Healthcare facilities have had to suspend providers for failure of having an active license. After further investigation with the constituent, it was discovered that the licensee had failed to fully pay for all parts of their license or was somehow incomplete in their application submission.

10.2 Discussion only: Discuss and evaluate the classification of First Assistant standardization of practice certification requirements.

Currently the BRN statement around RNFA has no requirements or guidelines or policy regarding the specifics of education requirement or certification to have the privilege or first assist in the OR. Since APRNs typically do not include this in their curricula it is important to establish some guidelines to ease the process within health systems tasked with credentialing and privileging APRNs under standardized procedures.

The National Institute of First Assisting, Inc. (NIFA) is a Colorado institution that specializing in health care education specific to operating room nurses and APRNs since 1995. The NIFA RN First Assistant Program for APRNs is presented through accredited colleges nationwide, overseen by their accredited nursing programs and meets all AORN Standards for RNFA Education.

This college RNFA online program addresses all the modules of the AORN Core Curriculum for RN First Assistants. In total, home studies would represent approximately 48 hours followed by a 140-hour internship which the student arranges at their facility.

10.3 Discussion only: Discuss nursing practice curricula for nurse practitioners and the length of residency requirements of all students and applicants.

Various health systems across the state of California that feel nurse-practitioner graduates are not prepared and students feeling the need, especially outside of primary care but even in the primary care setting. Additional information will be presented during the Advance Practice Registered Nursing Advisory Committee meeting for discussion only.

While PAs need to accumulate over 1,000 hours of clinical, most FNP nursing programs only need about 600 +/- hours of clinical hours to graduate. Furthermore, the quality and number of hours in their area of specialty are often fragmented, limited and differs from individual experiences. Whereas in the past most graduate FNP students are experienced RNs (about 5 years of active nursing practice), the current generation of new graduates are going straight into graduate FNP curriculum without or very limited RN experience. Therefore, one can no longer argue that what RNs lack in clinical hours is compensated by the numbers of years they have practiced as a RN.

10.4 Discussion only: Discuss and analyze standard clinical hour requirement for Doctor of Nursing Practice (DNP) program in California.

The fairly new doctoral degree in nursing, the DNP is a clinical focused doctoral degree as compared to the research focus PhD degree. However, it is noted that DNP programs throughout the Bay Area and/or even nationally focus on research rather than clinical. Furthermore, there seems to be no uniform requirement for DNP clinical hours. In addition, in most programs, most faculties are with PhD degrees rather than DNP.

Mitchel Erickson, Advance Practice Registered Nursing Advisory Committee Member Chair, will present additional information during the Advance Practice Advisory Committee meeting for discussion of standard clinical hour requirements for Doctor of Nursing Practice (DNP) programs in California.

No Public Comment.

10.3 Information Only: Report from Nurse-Midwifery Advisory Committee: February 26, 2019 Meeting.

BACKGROUND: The follow agenda items were discussed at the Nurse-Midwifery Advisory Committee Meeting on February 26, 2019.

2.0 Information Only: Report from Board Meeting: November 15, 2018 the Board voted to maintain the current appointment terms and provided that members could serve an additional two-year term, if reappointment was approved by the Board.

The Nurse Midwifery Advisory Committee was approved by the Board for one (1) two-year term with the ability for a member(s) to be reappointed to an additional two 2-year term. The current 4 members with the exception a newly appointed CNM are serving their second two 2-year term.

At the June 27, 2018, Nurse Midwifery Advisory Committee meeting, BJ Snell PhD CNM proposed that the CNM Advisory Committee terms of appointment be changed to longer term of appointment, suggesting appointments from two-2 years to four-2-year terms.

The Nurse-Midwifery Advisory Committee members request consideration to increase the term of office from (1) from two- year term with the ability for a member (s) to reappointed to an additional four 2-year term and to forward to the request to the Practice Committee and Board.

The term of member appointments to the Nurse-Midwifery Advisory Committee will include staggered terms of appointment. The initial two-year term for members to the Nurse-Midwifery Advisory Committee and any subsequent approved two-year membership on the Nurse-Midwifery Committee means a total appointment of four years.

August 16, 2018; The Nursing Practice Committee presented agenda item 10.3.1 Discussion and Possible Action: Increasing Nurse-Midwifery Advisory Committee Member Terms of Appointment from 2-two years terms to four, 2-year terms.

On November 15, 2018, The Board declined the request of the current Nurse-Midwifery Committee to serve four two-year terms or a total of eight years, but members could serve an additional two-year term, if reappointment was approved by the Board.

3.0 Discussion of Proposal to Amend the Nursing Practice Act and Possible Vote to Recommend Such Amendments to the Board: The proposal is to recommend to the Board an amendment to the Nursing Practice Act, specifically Business & Professions Code sections 2746.51 and 2746.52, that would allow certified Nurse-Midwives to (1) procure certain supplies and medications, and (2) perform and repair episiotomies in a home setting.

Specifically, delete Business & Professions Code section 2746.51, subdivision (b)(3), and add subdivision (f) to state as follows: “A certified nurse-midwife is authorized to directly procure supplies and devices, or order, obtain and administer drugs and diagnostic tests, to order laboratory and diagnostic testing, and to receive reports that are necessary to his or her practice as a certified nurse-midwife and consistent with nurse-midwifery education program.”

Further, amend Business & Professions Code section 2746.52 to read as follows:

(a) Notwithstanding Section 2746.5, the certificate to practice nurse-midwifery authorizes the holder to perform and repair episiotomies, and to repair first-degree and second-degree lacerations of the perineum, in a licensed acute care hospital, as defined in subdivision (a) of Section 1250 of the Health and Safety Code, a nationally accredited birth center, or in a home. (b) The certified nurse-midwife performing episiotomies and repairing first-degree and second-degree lacerations of the perineum shall do both of the following:

(1) Ensure that all complications are referred to a physician and surgeon immediately; and (2) Ensure immediate care of patients who are in need of care beyond the scope of practice of the certified nurse-midwife or provide emergency care for times when a physician and surgeon is not available.

4.0 Information Only: The midwife assistant role was created by SB 408, now Business and Professions Code section 2516.5, which is found within the Licensed Midwifery Practice Act of

1993 (Business and Professions Code section 2505, et. seq.) It states that a midwife assistant is one who, among other things, possesses “at least the minimum amount of hours of appropriate training pursuant to standards established by the Board for a medical assistant pursuant to Section 2069.” (Bus. & Prof. Code, § 2516.5, subd. (a).) For purpose of the Licensed Midwifery Practice Act of 1993, “board” is defined as the Medical Board of California. (Bus. & Prof. Code, § 2506, subd. (a).)

Business and Professions Code section 2746.5, subdivision (e) requires that the BRN be consulted when a state department promulgates regulations “that affect the scope of practice of a certified nurse-midwife…” the midwife assistant regulations, however, only impact the training and scope of practice of the midwife assistant, and not the scope of practice of a certified nurse-midwife.

To the extent people not involved with the Medical Board wished to participate, they could have, as proposed regulations must be published and open to public comment. Please see the Guide to Public Participation in the Regulatory Process published by the Office of Administrative Law, located at: https://www.oal.ca.gov/wp-content/uploads/sites/166/2017/05/How-2-Participate-102016.pdf

The Medical Board published on its website the Notice, text of proposed regulations, ISOR, modified text, and notice of approval here: http://www.mbc.ca.gov/About_Us/Laws/Proposed_ Regulations/ (look under the category for “Midwife Assistants”)

To the extent that interested persons wish to see the existing regulations modified, they may make such suggestions to the Medical Board. Also, to the extent that one wished to know what actions the Medical Board is pursing, one may subscribe to the Medical Board’s e-mail alerts here: http://www.mbc.ca.gov/Suscribers/

5.0 Information Only: Introduction of information from the Nurse-Midwifery Advisory Committee to recognize the credentialed certified nurse-midwife legislation. Section 2746.5 section (e) Any regulation promulgated by a state department that affect the scope of practice of a certified nurse-midwife shall be developed in consultation with the Board.

Section 2746.5 (a) The certificate to practice nurse-midwifery authorizes the holder, under the supervision of a licensed physician and surgeon, to attend cases of normal childbirth and to provide prenatal, intrapartum, and postpartum care, including family-planning care, for the mother, and immediate care for the newborn. (b) As used in this chapter, the practice of nurse-midwifery constitutes the furthering or undertaking by any certified person, under the supervision of a licensed physician and surgeon who has current practice or training in obstetrics, to assist a woman in childbirth so long as progress meets criteria accepted as normal. All complications shall be referred to a physician immediately. The practice of nurse-midwifery does not include the assisting of childbirth by any artificial, forcible, or mechanical means, nor the performance of any version. (c) As used in this article, “supervision” shall not be construed to require the physical presence of the supervising physician. (d) A certified nurse-midwife is not authorized to practice medicine and surgery by the provisions of this chapter. (e) Any regulations promulgated by a state department that affect the scope of practice of a certified nurse-midwife shall be developed in consultation with the board. (Amended by Stats. 2002, Ch. 764, Sec. 1. Effective January 1, 2003.)

Regulations that were developed by the Board of Medicine also impacts certified nurse-midwives. The Nurse-Midwifery Advisory Committee will discuss and give feedback regarding the Board of Registered Nursing’s affiliation with Section 2746.5 (e).

https://www.oal.ca.gov/wp-content/uploads/sites/166/2017/05/How-2-Participate-102016.pdf

http://www.mbc.ca.gov/About_Us/Laws/Proposed_%20Regulations/

http://www.mbc.ca.gov/Suscribers/

6.0 Information Only: On November 29, 2018, hospitals who are members of the California Maternal Quality Care Collaborative (CMQCC) Maternal Data Center were notified of a new statistic called “Percent Deliveries by Certified Nurse-Midwives” to be publicly reported on to CalHospitalCompare.org. CalHospitalCompare.org will help women more easily identify their hospital choices that have a certified nurse-midwife presence as it will help ensure that what the consumer sees on CalHospitalCompare.org is an accurate reflection of the proportion of certified nurse-midwives at their facilities.

Cal Hospital Compare is a performance reporting initiative managed by a multi-stakeholder Board of Directors, with representatives from hospitals, purchasers, health plans, and consumer groups. Prior to 2016, Cal Hospital Compare was known as the California Hospital Assessment Task Force (CHART). CHART was first established in 2004 for the purposes of developing a statewide hospital performance reporting system using a multi-stakeholder collaborative process. CHART aggregated data from participating hospitals until 2011, when its Board of Directors moved to using only publicly available data sources for all hospitals, not just those participating voluntarily.

If a hospital is a member of the California Maternal Quality Care Collaborative (CMQCC) Maternal Data Center (MDC), Certified Nurse-Midwives who currently use the MDC at their facility will begin to be publicly reported to CalHospitalCompare.org. This data will come directly from the birth certificate. The system features information on California hospitals that helps consumers make smarter and more informed choices when making medical decisions.

The Nurse-Midwifery Advisory Committee will discuss information presented the after attending the online California Maternal Quality Care Collaborative (CMQCC) Maternal Data Center webinar. The webinar will be held Wednesday, January 16, 2019 from 12:00 noon-1:30pm, pacific standard time.

Please visit: https://stanford.zoom.us/webinar/register/WN_Q_Z67_HOQP6q7nAUSoUnpA (note that the first 20 minutes will include non-CNM related topics as this is an MDC update webinar; please remain on the call to hear about the CNM statistic).

7.0 Discussion and Possible Vote Regarding Meeting Schedule: Review 2019 Board and Committee meeting schedule to establish future meeting schedules for Nurse-Midwifery meetings and determine agenda submission deadlines.

The Nurse-Midwifery Advisory Committee will review the 2019 Board of Registered Nursing (BRN) Board and Committee meeting schedule to determine, vote and establish future meeting dates.

The Nurse-Midwifery Advisory Committee will review, discuss, and commit the Committee meeting guidelines and deadlines for Agenda and Meeting Material procedures.

No Public Comment.

11.0 Adjournment The meeting adjourned at 3:00 pm.

Joseph Morris, PhD, MSN, RN Trande Phillips Executive Officer Board President

https://stanford.zoom.us/webinar/register/WN_Q_Z67_HOQP6q7nAUSoUnpA

https://CalHospitalCompare.org






DATE: May 09, 2019 DRAFT LOCATION: MemorialCare Health System

17360 Brookhurst Street, 3rd Floor Aliso Assembly Room Fountain Valley, CA 92708

PRESENT: Trande Phillips, President Elizabeth A. Woods, MSN, FNP, RN Imelda Ceja-Butkiewicz Michael D. Jackson, MSN, RN Ken Malbrough

NOT PRESENT: Donna Gerber, Vice President Pilar De La Cruz-Reyes, MSN, RN Cynthia Klein, RN

ALSO PRESENT: Joseph Morris, Executive Officer Ann Salisbury, DCA Legal Counsel Christina Sprigg, Chief of Administration and Licensing Shannon Johnson, Chief of Discipline, Probation, and Intervention Joseph Pacheco, Chief of Complaint Intake and Investigations Thelma Harris, Chief of Legislation Badrieh Caraway, Supervising NEC Janette Wackerly, Supervising NEC Wayne Boyer, NEC Katie Daugherty, NEC Susan Engle, NEC Mary Ann McCarthy, NEC Loretta Melby, NEC Donna Schutte, NEC Carol Velas, NEC Kay Weinkam, NEC Mary Ann McCarthy, NEC Shelley Ward, NEC Wayne Boyer, NEC Donna Schutte, NEC Loretta Melby, NEC Alexandra Finch (Duke) , NEC Debra Lewis, NEC Heather Sands, NEC Kim Kasreliovich, Deputy Attorney General, OAG

Thursday, May 09, 2019

1.0 Call to Order/Roll Call /Establishment of a Quorum Trande Phillips, President, called the meeting to order at 1:02 p.m. and established a quorum.


_______________________________ ______________________________

Note: The Board may not discuss or take action on any matter raised during the Public Comment section that is not included on this agenda, except whether to decide to place the matter on the agenda of a future meeting. (Government Code Section 11125 and 11125.7(a)).

Public Comment: Catherine Hughes-SEIU

3.0 Closed Session

3.1 Disciplinary Matters The Board will convene in closed session pursuant to Government Code Section 11126(c)(3) to deliberate on the disciplinary matter for RN Wenshi Ni.

3.2 Pending Litigation The Board will convene in closed session pursuant to Government Code section 11126(e)(1) to confer with and receive advice from legal counsel regarding American Career College v. The California Board of Registered Nursing, Los Angeles Superior Court Case No. 19STCP01383.

4.0 Reconvene in Open Session Trande Phillips, President, reconvened the meeting in open session and called the meeting to order 1:07 pm.

No public comment.

5.0 Report of the Education Licensing Committee Michael Jackson, MSN, RN, Chair

5.1 Review, Discussion, and Possible Action on Regulatory Proposal to Modify California Code of Regulations, Article 3, Sections 1423 (Approval Requirements), and 1432 (Changes to an Approved Program)

Motion: Michael Jackson made a motion to adopt recommendations from the Education Licensing Committee. [Recommendation was to approve the proposed language and direct staff to pursue the regulations process.]

Second: Imelda Ceja-Butkiewicz

Votes MJ EW DG IC-B TP CK PD-S KM Y Y Absent Y Y Absent Absent Y

No public comment

6.0 Adjournment Meeting adjourned1:08 pm.




DATE: May 28, 2019 DRAFT

LOCATION: Board of Registered Nursing 1747 N. Market Blvd HQ-2 Hearing Room, Ste. 186 Sacramento, CA 95834

PRESENT: Trande Phillips, President Elizabeth A. Woods, MSN, FNP, RN Pilar De La Cruz-Reyes, MSN, RN Imelda Ceja-Butkiewicz Michael D. Jackson, MSN, RN Ken Malbrough

NOT PRESENT: Donna Gerber, Vice President Cynthia Klein, RN

Teleconference sites: Board of Registered Nursing 1747 N. Market Blvd., Suite 186 HQ-2 Hearing Room Sacramento, CA 95834

Central California Center for Excellence in Nursing 1625 E Shaw Ave, Suite 146 Fresno, CA 93710

1888 Holland Circle Walnut Creek, CA 94597

173 Vineyard Circle Sonoma Ca. 95476

Central Labor Council 200 West Jeffrey Street Bakersfield, CA 93305

Chula Vista Public Library Otay Ranch Town Center Library 2015 Birch Rd, Chula Vista, CA 91915

Malcolm X Library 5148 Market Street San Diego, CA 92114

ALSO PRESENT: Joseph Morris, Executive Officer Ann Salisbury, DCA Legal Counsel Patrick Le, Assistant Deputy Director Board and Bureau Services Kathleen Boergers, Supervising Deputy Attorney General, OAG Melanie Fontes Rainer, Special Assistant to the Attorney General, OAG Stacie Berumen, Assistant Executive Officer Christina Sprigg, Chief Administration and Licensing

Tuesday, May 28, 2019 – 1:00 p.m.

1.0 Call to Order/Roll Call /Establishment of a Quorum 1:01 pm


Note: The Board may not discuss or take action on any matter raised during the Public Comment section that is not included on this agenda, except whether to decide to place the matter on the agenda of a future meeting. (Gov. Code, §§ 11125 and 11125.7, subdivision (a).)

No Public Comment.

_______________________________ ______________________________

3.0 Discussion and possible action regarding changes to the federal rules regarding Protecting Statutory Conscience Rights in Health Care; Delegations of Authority, 83 Fed. Reg. 3880 (Jan. 26, 2018) – Stacie Berumen presented report.

Motion: Trande Phillips moved to oppose the proposed changes to the federal rules regarding Protecting Statutory Conscience Rights in Health Care; Delegations of Authority, 83 Fed. Reg. 3880 (Jan. 26, 2018) and delegate authority to the Executive Officer to assist the Office of the Attorney General in opposing it, including executing any truthful and accurate declaration. Second: Michael Jackson

Votes MJ EW DG IC-B TP CK PD-S KM Y Y Absent Y Y Absent Y Y

Public Comment: Saskia Kim, Sasha Cutler, Rita Lewis, Katherine Hughes

4.0 Adjournment

Meeting adjourned at 1:38 pm.


Documents

Board Meeting Materials: 3.0 Board Meeting …States District Court for the Northern District of California, Case No. 19-cv-01184-EDL (Becerra v.Azar).Failure to call a special meeting