Amended  IN  Assembly  April 29, 2021

CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 1536

Introduced by Committee on Business and Professions

February 19, 2021

An act to amend Sections 2841, 2841.3, 2847.1, 2847.3, 2859, 2860.5, 2860.7, 2866, 2867, 2867.6, 2876, 2878.1, 4501, and 4503 of 4502.1, 4502.2, 4502.3, 4503, 4510, and 4521.2 of, and to add Section 2881.2 to, the Business and Professions Code, relating to healing arts.


LEGISLATIVE COUNSEL'S DIGEST


AB 1536, as amended, Committee on Business and Professions. Board of Vocational Nursing and Psychiatric Technicians of the State of California. California: vocational nursing and psychiatric technicians.
Existing law, until January 1, 2022, establishes the Board of Vocational Nursing and Psychiatric Technicians of the State of California to license and regulate vocational nurses and psychiatric technicians. Existing law requires the board to discipline the holder of any license whose default has been entered or who has been heard by the board and found guilty.
Existing law, prior to January 1, 2018, required the board to appoint an executive officer to perform duties delegated by the board. Existing law, beginning January 1, 2018, and until January 1, 2022, instead requires the Governor to appoint an executive officer, and, commencing January 1, 2022, requires the executive officer to again be appointed by the board. Existing law repeals the authority to appoint an executive officer on January 1, 2023.
This bill would require the board to delegate to the executive officer the authority to adopt a decision entered by default and to adopt a stipulation for surrender of a license. The bill would make various other additional nonsubstantive changes to related provisions establishing the board and appointing the executive officer. changes.
Existing law, the Vocational Nursing Practice Act, provides for the licensure and regulation of vocational nurses by the board. That act, among other things, authorizes a licensed vocational nurse to withdraw blood, administer medications, and start and superimpose intravenous fluids, as described, when directed by a physician and surgeon. That act also authorizes a licensed vocational nurse to perform certain tests and immunization techniques, as described, when acting under the direction of a physician and requires the physician to fulfill certain requirements when authorizing the nurse to perform those tests or techniques.
This bill would instead impose those requirements on licensed physicians and surgeons, and would provide authorization to licensed vocational nurses to take the above-described actions upon or under the direction of a licensed physician and surgeon.
The Vocational Nursing Practice Act requires an applicant for a vocational nursing license to pay the required fees upon filing of the application. Under the act, the board is also required to prepare and maintain a list of approved schools of vocational nursing in this state whose graduates, if they have the other necessary qualifications, shall be eligible to apply for a vocational nursing license.
This bill would require the vocational nursing license application to be on a form prescribed by the board. The bill would also require the board to maintain a list of inactive vocational nursing schools and programs seeking board approval and would impose additional requirements on those schools and programs. The bill would provide that a vocational nursing school or program seeking board approval that remains on the inactive list for 90 days shall be taken out of consideration for a new program and may only reapply after 6 months.
Existing law, the Psychiatric Technicians Law, provides for the licensure and regulation of psychiatric technicians (PTs) by the board. That law, among other things, authorizes a psychiatric technician to perform certain activities, withdraw blood, and administer medications when prescribed by a physician and surgeon.
This bill would specify that a psychiatric technician is authorized to take these actions when prescribed by a licensed physician and surgeon.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

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


SECTION 1.

 Section 2841 of the Business and Professions Code is amended to read:

2841.
 (a) There is in the Department of Consumer Affairs a Board of Vocational Nursing and Psychiatric Technicians of the State of California, which consists of 11 members.
(b) As used in this chapter, “board” means the Board of Vocational Nursing and Psychiatric Technicians of the State of California.
(c) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.

SEC. 2.

 Section 2841.3 of the Business and Professions Code is amended to read:

2841.3.
 If the board is made inoperative or is repealed, the director may, until December 31, 2024, assume the duties, powers, purposes, responsibilities, and jurisdiction of the board and its executive officer that are not otherwise repealed or made inoperative.

SEC. 3.

 Section 2847.1 of the Business and Professions Code is amended to read:

2847.1.
 (a) The board shall select an executive officer who shall perform duties as are delegated by the board and who shall be responsible to it for the accomplishment of those duties.
(b) The executive officer shall not be a member of the board.
(c) With the approval of the Director of Finance, the board shall fix the salary of the executive officer.
(d) The executive officer shall be entitled to traveling and other necessary expenses in the performance of their duties. The executive officer shall make a statement, certified before a duly authorized person, that the expenses have been actually incurred.
(e) Commencing January 1, 2018, the executive officer appointed by the board pursuant to subdivision (a) is abolished. Thereafter, until January 1, 2022, the executive officer shall be appointed as set forth in Section 2847.3. Commencing January 1, 2022, the executive officer shall, again, be appointed by the board as set forth in subdivision (a).
(f) This section shall remain in effect only until January 1, 2023, and as of that date is repealed.

SEC. 4.

 Section 2847.3 of the Business and Professions Code is amended to read:

2847.3.
 (a) Commencing January 1, 2018, the executive officer position established pursuant to subdivision (a) of Section 2847.1 is temporarily abolished. Commencing January 1, 2018, the Governor shall appoint an executive officer who shall perform duties as are delegated by the board and who shall be responsible for the accomplishment of those duties. The executive officer shall exercise all powers, discharge all responsibilities, and administer and enforce all laws pursuant to this chapter and Chapter 10 (commencing with Section 4500) of Division 2 that are necessary to perform the duties delegated by the board.
(b) The executive officer shall serve at the pleasure of the Governor and the Governor shall fix the salary of the executive officer.
(c) The executive officer shall not be a member of the board.
(d) The executive officer shall be entitled to traveling and other necessary expenses in the performance of their duties.
(e) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.

SEC. 5.

 Section 2859 of the Business and Professions Code is amended to read:

2859.
 (a) The practice of vocational nursing within the meaning of this chapter is the performance of services requiring those technical, manual skills acquired by means of a course in an approved school of vocational nursing, or its equivalent, practiced under the direction of a licensed physician, physician and surgeon, or registered professional nurse, as defined in Section 2725.

A

(b) A vocational nurse, within the meaning of this chapter, is a person who has met all the legal requirements for a license as a vocational nurse in this state and who for compensation or personal profit engages in vocational nursing as the same is hereinabove defined. nursing, as defined under subdivision (a).

SEC. 6.

 Section 2860.5 of the Business and Professions Code is amended to read:

2860.5.
 A licensed vocational nurse when directed by a licensed physician and surgeon may do all of the following:
(a) Administer medications by hypodermic injection.
(b) Withdraw blood from a patient, if prior thereto such the licensed vocational nurse has been instructed by a licensed physician and surgeon and has demonstrated competence to such the licensed physician and surgeon in the proper procedure to be employed when withdrawing blood, or has satisfactorily completed a prescribed course of instruction approved by the board, or has demonstrated competence to the satisfaction of the board.
(c) Start and superimpose intravenous fluids if all of the following additional conditions exist:
(1) The licensed vocational nurse has satisfactorily completed a prescribed course of instruction approved by the board or has demonstrated competence to the satisfaction of the board.
(2) The procedure is performed in an organized health care system in accordance with the written standardized procedures adopted by the organized health care system as formulated by a committee which includes representatives of the medical, nursing, and administrative staffs. “Organized health care system,” as used in this section, includes facilities licensed pursuant to Section 1250 of the Health and Safety Code, clinics, home health agencies, physician’s offices, and public or community health services. Standardized procedures so adopted will be reproduced in writing and made available to total medical and nursing staffs.

SEC. 7.

 Section 2860.7 of the Business and Professions Code is amended to read:

2860.7.
 (a) A licensed vocational nurse, acting under the direction of a licensed physician and surgeon may perform: (1) tuberculin skin tests, coccidioidin skin tests, and histoplasmin skin tests, providing such administration is within the course of a tuberculosis control program, and (2) immunization techniques, providing such administration is upon standing orders of a supervising physician, licensed physician and surgeon, or pursuant to written guidelines adopted by a hospital or medical group with whom the supervising licensed physician and surgeon is associated.
(b) The supervising licensed physician and surgeon under whose direction the licensed vocational nurse is acting pursuant to subdivision (a) shall require such the licensed vocational nurse to: to do all of the following:
(1) Satisfactorily demonstrate competence in the administration of immunizing agents, including knowledge of all indications and contraindications for the administration of such agents, and in the recognition and treatment of any emergency reactions to such agents which constitute a danger to the health or life of the person receiving the immunization; and immunizations.
(2) Possess such medications and equipment as required, in the medical judgment of the supervising licensed physician and surgeon, to treat any emergency conditions and reactions caused by the immunizing agents and which constitute a danger to the health or life of the person receiving the immunization, and to demonstrate the ability to administer such medications and to utilize such equipment as necessary.
(c) Nothing in this section shall be construed to require physical presence of a directing or supervising physician, licensed physician and surgeon, or the examination by a licensed physician and surgeon of persons to be tested or immunized.

SEC. 8.

 Section 2866 of the Business and Professions Code is amended to read:

2866.
 An applicant for a licensed vocational nurse license shall comply with each of the following:
(a) Be at least 17 years of age.
(b) Have successfully completed at least an approved course of study through the 12th grade or the equivalent thereof as specified by the board.
(c) Have successfully completed the prescribed course of study in an approved school of vocational nursing or have graduated from a school which, in the opinion of the board, maintains and gives a course which is equivalent to the minimum requirements for an approved school of vocational nursing in this state.
(d) Not be subject to denial of licensure under Section 480.

SEC. 9.

 Section 2867 of the Business and Professions Code is amended to read:

2867.
 An applicant for a license authorizing him to the practice of vocational nursing in this State under this chapter, upon the filing of his an application for a vocational nurse license on a form prescribed by the board, shall pay the fee required by this chapter.

SEC. 10.

 Section 2867.6 of the Business and Professions Code is amended to read:

2867.6.
 After receiving the results of having passed the examination and upon receipt of the initial license fee required by subdivision (e) (h) of Section 2895, the board shall issue a receipt or temporary certificate which will serve as a valid permit for the licensee to practice under this chapter.

SEC. 5.SEC. 11.

 Section 2876 of the Business and Professions Code is amended to read:

2876.
 (a) The board shall discipline the holder of any license, whose default has been entered or who has been heard by the board and found guilty, by any of the following methods:
(1) Suspending judgment.
(2) Placing the licensee on probation.
(3) Suspending the licensee’s right to practice vocational nursing for a period not exceeding one year.
(4) Revoking the licensee’s license.
(5) Taking such other action in relation to disciplining the licensee as the board in its discretion may deem proper.
(b) The board shall delegate to its executive office the authority to adopt a decision entered by default and a stipulation for surrender of a license.

SEC. 12.

 Section 2878.1 of the Business and Professions Code is amended to read:

2878.1.
 (a) If a licensed vocational nurse has knowledge that another person has committed any act prohibited by Section 2878, the licensed vocational nurse shall report this information to the board in writing and shall cooperate with the board in furnishing information or assistance as may be required.
(b) Any employer of a licensed vocational nurse shall report to the board the suspension or termination for cause, or resignation for cause, of any licensed vocational nurse in its employ. In the case of licensed vocational nurses employed by the state, the report shall not be made until after the conclusion of the review process specified in Section 52.3 52.6 of the California Code of Regulations and Skelly v. State Personnel Bd. (1975) 15 Cal.3d 194. This required reporting shall not constitute a waiver of confidentiality of medical records. The information reported or disclosed shall be kept confidential except as provided in subdivision (d) and shall not be subject to discovery in civil cases.
(c) An employment agency or nursing registry shall report to the board the rejection from assignment of a licensed vocational nurse by a health facility or home health care provider due to acts that would be cause for suspension or termination as described in subdivision (d).
(d) For purposes of the section, “suspension, termination, or resignation for cause” or “rejection from assignment” are defined as suspension, termination, or resignation from employment, or rejection from assignment, for any of the following reasons:
(1) Use of controlled substances or alcohol to the extent that it impairs the licensee’s ability to safely practice vocational nursing.
(2) Unlawful sale of a controlled substance or other prescription items.
(3) Patient or client abuse, neglect, physical harm, or sexual contact with a patient or client.
(4) Falsification of medical records.
(5) Gross negligence or incompetence.
(6) Theft from patients or clients, other employees, or the employer.
(e) Failure of an employer to make a report required by this section is punishable by an administrative fine not to exceed ten thousand dollars ($10,000) per violation.
(f) Pursuant to Section 43.8 of the Civil Code, no person shall incur any civil penalty as a result of making any report required by this chapter.
(g) The board shall implement this section contingent upon the necessary funding in the annual Budget Act.
(h) For purposes of this section, “employer” includes employment agencies and nursing registries.

SEC. 13.

 Section 2881.2 is added to the Business and Professions Code, to read:

2881.2.
 (a) The board shall maintain a list of inactive vocational nursing schools and programs seeking board approval.
(b) A vocational nursing school or program seeking board approval shall respond to the board within two weeks of each inquiry or request during all phases. A school or program that does not respond within two weeks shall be designated as inactive.
(c) A vocational nursing school or program seeking board approval that remains on the inactive list for 90 days shall be taken out of consideration for a new program and may only reapply after six months.

SEC. 6.SEC. 14.

 Section 4501 of the Business and Professions Code is amended to read:

4501.
 (a) As used in this chapter, “board” means the Board of Vocational Nursing and Psychiatric Technicians of the State of California.
(b) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.

SEC. 15.

 Section 4502.1 of the Business and Professions Code is amended to read:

4502.1.
 A psychiatric technician, working in a mental health facility or developmental disability facility, when prescribed by a licensed physician and surgeon, may administer medications by hypodermic injection.

SEC. 16.

 Section 4502.2 of the Business and Professions Code is amended to read:

4502.2.
 A psychiatric technician, when prescribed by a licensed physician and surgeon, may withdraw blood from a patient with a mental illness or developmental disability if the psychiatric technician has received certification from the board that the psychiatric technician has completed a prescribed course of instruction approved by the board or has demonstrated competence to the satisfaction of the board.

SEC. 17.

 Section 4502.3 of the Business and Professions Code is amended to read:

4502.3.
 (a) A psychiatric technician, when prescribed by a licensed physician and surgeon, may perform the following activities on a patient with a mental illness or developmental disability:
(1) Tuberculin, coccidioidin, and histoplasmin skin tests, providing the administration is within the course of a tuberculosis control program.
(2) Immunization techniques, providing the administration is upon the standing orders of a supervising licensed physician and surgeon or pursuant to written guidelines adopted by a hospital or medical group with whom the supervising licensed physician and surgeon is associated.
(b) In performing activities pursuant to subdivision (a), the psychiatric technician shall satisfactorily demonstrate competence in all of the following:
(1) Administering the testing or immunization agents, including knowledge of all indications and contraindications for the administration of the agents.
(2) Recognizing any emergency reactions to the agent that constitute a danger to the health or life of the patient.
(3) Treating those emergency reactions by using procedures, medication, and equipment within the scope of practice of the psychiatric technician.

SEC. 7.SEC. 18.

 Section 4503 of the Business and Professions Code is amended to read:

4503.
 (a) The board shall administer and enforce the provisions of this chapter.
(b) This section shall remain in effect only until January 1, 2022, and as of that date is repealed.

SEC. 19.

 Section 4510 of the Business and Professions Code is amended to read:

4510.
 (a) The board shall issue a psychiatric technician’s license to each applicant who qualifies therefor, and, if required to take it, successfully passes the examination given pursuant to this chapter. The board shall also issue a psychiatric technician’s license to each holder of a psychiatric technician license who qualifies for renewal pursuant to this chapter and who applies for renewal.

After

(b) After the applicant passes the examination and upon receipt by the board of the initial license fee required by subdivision (e) (h) of Section 4548, the board may issue a receipt or temporary certificate that shall serve as a valid permit for the licensee to practice under this chapter.

SEC. 20.

 Section 4521.2 of the Business and Professions Code is amended to read:

4521.2.
 (a) If a psychiatric technician has knowledge that another person has committed any act prohibited by Section 4521, the psychiatric technician shall report this information to the board in writing and shall cooperate with the board in furnishing information or assistance as may be required.
(b) Any employer of a psychiatric technician shall report to the board the suspension or termination for cause, or resignation for cause, of any psychiatric technician in their employ. In the case of psychiatric technicians employed by the state, the report shall not be made until after the conclusion of the review process specified in Section 52.3 52.6 of Title 2 of the California Code of Regulations and Skelly v. State Personnel Bd. (1975) 15 Cal.3d 194. The reporting required herein shall not constitute a waiver of confidentiality of medical records. The information reported or disclosed shall be kept confidential except as provided in subdivision (d), and shall not be subject to discovery in civil cases.
(c) An employment agency or nursing registry shall report to the board the rejection from assignment of a licensed psychiatric technician by a health facility or home health care provider due to acts that would be cause for suspension or termination as described in subdivision (d).
(d) For purposes of this section, “suspension, termination, or resignation for cause” or “rejection from assignment” are defined as suspension, termination, or resignation from employment, or rejection from assignment, for any of the following reasons:
(1) Use of controlled substances or alcohol to such an extent that it impairs the licensee’s ability to safely practice as a psychiatric technician.
(2) Unlawful sale of controlled substances or other prescription items.
(3) Patient or client abuse, neglect, physical harm, or sexual contact with a patient or client.
(4) Falsification of medical records.
(5) Gross negligence or incompetence.
(6) Theft from patients or clients, other employees, or the employer.
(e) Failure of an employer to make a report required by this section is punishable by an administrative fine not to exceed ten thousand dollars ($10,000) per violation.
(f) Pursuant to Section 43.8 of the Civil Code, no person shall incur any civil penalty as a result of making any report required by this chapter.
(g) The board shall implement this section contingent upon necessary funding being provided in the annual Budget Act.
(h) For purposes of this section, “employer” includes employment agencies and nursing registries.