DRAFT
STATE OF CALIFORNIADEPARTMENT OF CONSUMER AFFAIRS BOARD OF REGISTERED NURSING MINUTES
DATE: September 22-23, 2009
TIME: 9:00 am
LOCATION: Department of Consumer Affairs 1625 North Market Blvd.,
Hearing Room, #S102 Sacramento, CA 95834
PRESENT: Ann L. Boynton, President
Jeannine Graves, RN, Vice President Judy L. Corless, BSN, RN
Dian Harrison, MSW
Richard L. Rice
Catherine M. Todero, PhD, RN
Kathrine M. Ware, RN, MSN, ANP-C (Day 1 Only) Nancy Beecham, BS, RNC (Day 2 Only)
ALSO PRESENT: Louise Bailey, M.Ed., RN, Interim Executive Officer
Heidi Goodman, Assistant Executive Officer Carol Stanford, Diversion Program Manager
Stacie Berumen, Enforcement Division Chief Kathy Hodge, Enforcement Program Manager Beth Scott, Probation Program Manager Christina Sprigg, Administration Manager Louisa Gomez, Licensing Manager
Janette Wackerly, NEC Miyo Minato, NEC Kelly McHan, NEC Shelley Ward, NEC Badrieh Caraway, NEC Geri Nibbs, NEC
Alcidia Valim, Budget Analyst
Stephen Smith, Administrative Law Judge John Padrick, Deputy Attorney General
Leslie Burgermeyer, Deputy Attorney General
Julie Campbell-Warnock, Research Program Specialist Kimberly Ott, Enforcement Program Legal Analyst Dawn Kammerer, Recorder
Tuesday, September 22, 2009
1.0 CALL TO ORDER
A. Boynton, Board President, called the meeting to order at 9:20 am and had the Board Members introduce themselves. The Board welcomed students from American River College and De Anza Community College.
Genevieve Clavreul, RN came forward with a comment.
2.0 DISCIPLINARY MATTERS
The Board convened in closed session pursuant to Government Code Section 11126(c)(3) to deliberate on these matters and other disciplinary matters including stipulations and proposed decisions, and pursuant to Government Code Section 11126(e)(1, 2(A)) to confer with Legal Counsel regarding pending litigation.
Termination of Probation
Loretta Kay Bowens Ryan Castorino Reinstatements Jeffrey Graves Linda Hunt Darlene Fraschilla Mary Kelso Sondra Richards
Decisions are pending until final orders are received from the Administrative Law Judge with the Office of Administrative Law.
Closed Session Discussion Items
A. Boynton, Board President, called the closed session meeting to order at 12:42 pm. The closed session adjourned at 2:30 pm.
Wednesday 23, 2009
A. Boynton, Board President, called the meeting to order at 9:10 am and had the Board Members introduce themselves.
3.0 RE-ELECTION OF OFFICERS
D. Chang stated the reason for the re-election is due to the Board inadvertently not
providing the opportunity for public comment on the nominees for the offices of President and Vice President according to the Open Meetings Act at the Board Meeting held on August 12, 2009. D. Chang then outlined the re-election procedure for the nominations of President and Vice President.
MSC: Beecham/Rice to adopt the procedure for ratification of officers. 8/0/0
MSC: Rice/Corless to ratify the Board’s previous action of electing Ann Boynton for President. 8/0/0
MSC: Corless/Rice to ratify the Board’s previous action of electing Jeannine Graves for Vice President. 8/0/0
4.0 OPEN FORUM
Genevieve Clavreul, RN provided a comment.
5.0 APPROVE/NOT APPROVE MINUTES:
• August 12, 2009, Board Meeting
MSC: Harrison/Corless that the Board approve minutes from August 12, 2009. 8/0/0
6.0 REPORT ON BOARD MEMBERS’ ACTIVITIES
Jeannine Graves, Judy Corless, Dian Harrison and Kathrine Ware attended the Department of Consumer Affairs, Board Member Orientation on August 28, 2009. Jeannine Graves commented on the Board of Pharmacy’s Annual Report that was presented at the orientation and suggested the report be used as a model for the Board.
7.0 INTERIM EXECUTIVE OFFICER’S REPORT ON BOARD AND DEPARTMENT ACTIVITIES
L. Bailey presented this report
7.1 DCA Director Appointed
On August 11, 2009, Governor Schwarzenegger announced the appointment of Brian Stiger as the new Director of the Department of Consumer Affairs.
7.2 Board’s Budget Update
FY 2009/10 Budget Reduction Plan – Executive Order S-09-09 required state departments to submit FY 2009/10 budget reduction spending plan to Agency secretaries that provides for at least a 15% reduction for contracts and purchases. On July 20, 2009 the Board submitted the Budget Reduction Plan for FY 2009/10 that reduces our budget by $45,592. The plan was approved as submitted to Agency on August 3, 2009, with the following caveats:
¾ If the Governor's Office or DOF requests additional savings, we will need to adjust our plan to gain additional savings.
¾ If the State’s Chief Information Officer (CIO) asks for additional savings related to our IT acquisition plan, we will need to adjust the plan to gain additional savings. ¾ Continue to work with vendors to achieve a 15% reduction with all procurement
activities.
Budget Change Proposal (BCP) – The Department of Consumer Affairs (DCA) is working in conjunction with the healing arts boards to develop a comprehensive BCP for FY 20010/11 and on-going to support the department wide enforcement reform. Through the BCP, the Board is requesting additional spending authority of $13,508,000 for FY 2010/11, $10,844,000 for FY 2011/12, and ongoing, and includes the addition of sixty-three (63) positions. The Board’s Enforcement Program had previously submitted a BCP requesting
that 4.5 limited term positions be made permanent and this has been merged into the department wide enforcement reform BCP that is in process.
Fund Condition – The Board’s reserve as of June 30, 2009 is 9.4 months. However it is projected to drop to 4.5 months at FY year end 2009/10 due to no fee increase and the hiring of at least eight positions for the Board’s Enforcement Division. In order to
maintain a prudent reserve of at least 4 months for the next 3 years, fee increases need to be in effect by July 1, 2010.
7.3 Department of Consumer Affairs (DCA) Updates
Board Member Orientation – In accordance with Business and Professions Code Section 453, Board Members are required to attend DCA’s Board Member Orientation within one year of their appointment. The next Board Member Orientation is set for Wednesday, December 9, 2009, at DCA Headquarters in Sacramento from 8:30 am to 4:30 pm.
New Enforcement Model – On September 14, 2009, Director Stiger met with the Department regarding the new enforcement model for all of its allied health boards and bureaus. This meeting focused on current enforcement practices that included
presentations by senior management from the Division of Investigation (DOI), Attorney General Office (AGO), and the Office of Administrative Hearings (OAH). Additionally, information was provided on the status of Senate Bill 294; subpoena authority; the enforcement budget change proposal; the Enforcement Academy, the recruitment of the DCA Enforcement and Complaint Officer, non-sworn investigators; and the development of the new integrated IT system, the development of the Best Practices Committee, for which Beth Scott, Probation Manager is representing the BRN. This is a very robust undertaking and Board specific information will be presented by the Director during the Diversion/Discipline Committee Agenda.
BreEZe Project – The BreEZe project will provide a new on-line licensing system that will allow applicants and licensees to file their respective application on-line and use a credit or debit card. The new Request for Proposal (RFP) has generated a significant increase in vendor interest over the previous release of the RFP. The Project Team responded to the first round of bidder questions and is scheduled to receive final proposals in early October 2009, with an anticipated award of contract in April 2010.
DCA Scanning and Records Retrieval System (ScanRRs) – This project is to obtain an imaging system at the Department to replace all paper files with electronic images. Heidi Goodman is a member of the Steering Committee and participated in the first meeting that was held on August 26th. The Project Team is researching alternative solutions to
recommend for the Feasibility Study Report (FSR). The FSR development contract has been amended and is in the final approval stages at DCA. As directed by Executive Order S-09-09, the vendor has adjusted the cost of this contract to meet the 15 percent budget reduction.
DCA Staff Appreciation Day – On October 6th, lunch, refreshments, games and a car show is being provided due to various fund-raising events that have been held recently. This is an opportunity to bring the northern California staff together to thank them and provide a fun-filled time that is being held in the Headquarters Parking Lot.
7.4 Retired Annuitants and Vacancies
In late August all state agencies were required to review their vacant positions and the various jobs being performed by retired annuitants (RAs) and identify those positions that could be eliminated. The BRN requested an exemption for three retired annuitant Nursing Education Consultants (NEC) who work with the Board’s Enforcement and Probation units. Two other RA’s have been separated until further notice.
7.5 BRN Web site Updates
Below are two anticipated additions to the Board’s Web site that should be available in October:
2008 RN Survey - An interactive data base that displays data from the 2008 RN survey by various categories including region, education, age and ethnicity. For example, a user can go to this database on the website and select region and then view data about nurses in different regions related to their age, gender, education, employment, income, etc. They can also view data based on age, ethnicity or education level. We hope this will be very helpful for researchers from various state agencies and organizations as well as the public at large. This data will be included under the Forms Section of the Web site.
2009 Forecasts of the Registered Nurse Workforce - The 2009 Forecasts of the Registered Nurse Workforce in California report presents the supply and demand of the RN workforce forecasts/projections for 2009-2030 and is based on a variety of data sources including the 2008 Survey of California RNs, BRN licensing data, data from other California state agencies (i.e., OSHPD, EDD, DOF) and national survey data. It will be included under the Forms Section of the Web site.
7.6 2008-2009 Annual School Survey
The Annual School Survey, which is completed on-line by all pre-licensure nursing programs and includes questions on enrollments, graduations, program and faculty data, will be available beginning October 1st. The survey is currently being beta tested by a few programs before an e-mail is sent to all schools announcing its availability. The deadline date for schools to provide their data is November 17th. This survey is conducted by our contractor, The Center for Health Professions at UCSF and they compile the data and provide the Board with an annual report which will be provided at a future Board Meeting in 2010.
7.7 National Council State Boards of Nursing (NCSBN) Updates
Uniform Core Licensure Requirements (UCLR) – On August 31-September 3, 2009, Heidi Goodman attended this meeting. The goal of this committee is to review and recommend revisions to the 1999 Delegate Assembly UCLRs that include all requirements to become a registered nurse, including what is required to take the national exam, NCLEX-RN. Some of the areas under review include: nursing education, criminal convictions, and chemical dependency.
Chemical Dependency Committee Meeting – On September 1-2, 2009, Carol Stanford attended this committee meeting that is charged to review discipline and alternative programs and provided recommendations on a national level for chemically dependent licensees.
7.8 Public Record Request
The Board continues to comply with public record request and responds within the required timeframes that are set in Government Code Section 6250. For the period of June 10, 2009 through September 14, 2009, the Board has received and processed 46 public record
requests.
7.9 Personnel
The following personnel changes have transpired since the last Board Meeting:
New Hires Classification Board Program
Alicia Newcomb Shelley Ward Kelly McHan Office Technician Nursing Ed Consultant Nursing Ed Consultant Probation NEC – So. CA NEC – No. CA
Promotions Classification Board Program
Christina Rice Laura Dobbs Shannon Silberling Julie C-Warnock Anita Rodriguez Jennifer Roseberry Mgmt Services Technician Key Data Operator
Staff Services Analyst Research Program Spec II
Assoc Governmental Program Analyst Assoc Information Systems Analyst
Cashiering Licensee Services Probation Administration Probation Administrative Services
Retirements Classification Board Program
Jody Curto Mary Fowler
Assoc Information Systems Analyst Assoc Governmental Program Analyst
Administrative Services Licensing
Jody Curto began her state career in 1989 at Department of Housing and Community Development as an Office Assistant. In October 1993, she joined the Board of Registered Nursing’s Renewal Unit providing excellent customer service. Jody was involved in a variety of project s that supported the Renewal Unit and received numerous letters of appreciation from RNs, the public, and management due to her innate ability and tenacity to troubleshoot any issue. In 1997, Jody began her IT career and she worked on a variety of special projects most notably the Department’s E-Government project that brought the Board into the 21th century with the ability to renew an RN license on-line using a credit card for payment. Additionally she was instrumental in the design and development of the Board’s Web site and the On-Line License Verification System. In 2008, Jody was
promoted to Associate Information Systems Analyst. Jody retired on September 16, 2009.
Mary Fowler began her state career in 1985 with Franchise Tax Board as an Assistant Clerk. In November 1990, she joined the Board of Registered Nursing as a Cashier in the Board’s Cashiering Unit. Dedicated to customer service, Mary transferred to the Licensing Program where she prepared correspondence in response to public inquiries and provided in-depth technical assistance to the program manager. In 2001, Mary was promoted to Licensing Analyst where she assisted the Board by troubleshooting inquiries regarding the immediate need to issue an RN license, issue temporary licenses, and evaluating files with fingerprint issues or conviction issues in a timely manner. Mary will retire on September 30, 2009.
Our congratulations to both Jody and Mary on the outstanding work they did during their careers with the Board of Registered Nursing. They will be missed. Enjoy your
retirement.
8.0 REPORT OF THE ADMINISTRATIVE COMMITTEE
Ann L. Boynton, Chairperson
8.1 Information Only: Update on Pending Education Regulations
G. Nibbs presented this report
The Board has statutory authority to approve and regulate prelicensure nursing programs in California. Accordingly, the Board adopted the regulations in Article 3, California Code of Regulations (CCR), Title 16, Division 14, to interpret, implement, and make specific Business and Professions Code, Article 4, “Nursing Schools.” The regulations were last amended in 1985. At its February 20, 2009, meeting, the Board approved a regulatory proposal amending numerous sections of Article 3. The primary purpose of the amendments is to ensure that Board-approved prelicensure programs meet minimum educational standards, and prepare students who have the requisite knowledge, skills and abilities to practice safely and competently as a registered nurse, at the entry level, upon completion of the program. The proposed amendments:
1. Reflect changes in nursing education and practice, technology, and health care delivery systems that have occurred since the regulations were last amended. As stated by the Legislature in amending the Nursing Practice Act in the 1973-74 session,
“…nursing is a dynamic field, the practice of which is continually evolving to include more sophisticated patient care activities.” Nursing practice has changed dramatically in the last twenty five (25) years, as a result of biotechnology and information
technology advances. Moreover, information technologies have caused changes in education, and a variety of new educational teaching strategies have emerged. Online teaching, computer-mediated courses, simulation labs, and interactive virtual
technologies are being integrated in curricula. There has been a concurrent shift in the locus of health care from the hospital, with shortened hospital stays, to community healthcare agencies and the patient’s home. Prelicensure nursing programs must prepare students to practice in a variety of technology-driven healthcare settings and must utilize current educational strategies and modalities in the educational process. 2. Codify existing Board policies and procedures. The Board has adopted various guidelines and policy statements to address the aforementioned changes and to provide direction and guidance to nursing programs. These include criteria and guidelines for completing the self-study, which the nursing program is required to submit prior to a BRN approval visit; explanation of faculty-related regulations in CCR 1425;
preceptorship course guidelines; policy statement setting a licensing examination pass rate standard for nursing programs; and faculty remediation guidelines. Additionally, the Board uses several forms, such as the faculty approval form, for programs to submit required information. The regulatory proposal incorporates by reference four (4) Board documents and three (3) forms, and includes content from two (2) Board documents.
3. Provide direction and guidance for proposed programs. There has been a dramatic increase in the number of institutions seeking approval to start a prelicensure registered nursing program, from one (1) in 1998 to twenty-one (21) in 2008. The regulatory proposal incorporates by reference “Instructions for Institutions Seeking Approval of
New Prelicensure Registered Nursing Program”. The document provides detailed information and instructions on the requirements and process for approving a new nursing program.
The proposed regulatory action was submitted to the Office of Administrative Law September 15, 2009, for publication in the September 25, 2009, Regulatory Notice Register. The public hearing is scheduled for 10:00 a.m., on November 9, 2009, in the Department of Consumer Affairs, 1st floor hearing room. The regulatory proposal
information will be mailed to individuals on the Board’s regulation mailing list and posted on the Board’s website by September 28th.
8.2 Approve/Not Approve: Proposed Fee Increase Regulation for Licensure and Certification Applications, Renewal Fees, Interim Permit Fees, Delinquency and Returned Check Fees, Endorsement Fees, and Temporary License Fees
G. Nibbs presented this report
In accordance with directions given by the Board at its August 12, 2009, meeting, staff submitted a fees increase regulatory proposal package to the Office of Administrative Law (OAL) on September 15th. The notice will be published in the September 25, 2009, Regulatory Notice Register. The public hearing is scheduled for November 9, 2009, at 9:00 a .m. in the Department of Consumer Affairs first floor hearing room. The regulatory proposal
information will be mailed to individuals on the Board’s regulation mailing list and posted on the Board’s website by September 28th.
As authorized by the Board and in consultation with Legal Counsel, the Executive Officer revised the proposed language, making non-substantive and technical changes. The changes included eliminating fee increases for continuing education provider approval and for initial Board-certification for clinical nurse specialists, nurse midwives, nurse anesthetists, and public health nurses. These fees generate approximately $250,000/annually and are “earned fees”; they cannot be used for enforcement purposes or the reserve fund. Any proposed increase must be based on the actual cost of completing the evaluation, and cost justification must be included in the rulemaking file. The following chart details the fee increases submitted to OAL:
FEES EXISTING PROPOSED
Application fee for licensure by examination $75 $150
Application fee for licensure by endorsement $50 $100
Biennial license renewal fee* $75 $150
Penalty fee for failure to timely renew a license $37 $75
Penalty fee for check returned unpaid $15 $30
Interim permit fee $30 $50
Temporary license fee $30 $50
Biennial nurse-midwife certificate renewal fee $50 $75
Penalty fee for failure to timely renew a nurse-midwife certificate $25 $37
Biennial nurse-anesthetist certificate renewal fee $50 $75
Penalty fee for failure to timely renew a nurse-anesthetist certificate $25 $37
Application fee for clinical nurse specialist certificate** $75 $75
Biennial clinical nurse specialist certificate renewal fee** $50 $75
Penalty fee for failure to timely renew a clinical nurse specialist certificate** $25 $37
**Clinical nurse specialist fees are based on statute, and are not included in existing regulations.
The proposed fee increases ensure adequate revenues to fund the proposed increase in Enforcement Program staff, and to maintain a minimum four (4) month reserve fund for the next three (3) years. The Board estimates revenues will increase approximately $16,800,000 annually. The Department of Consumer Affairs is submitting a department-wide enforcement reform budget change proposal (BCP) for all healing arts boards. Through the BCP, the Board is requesting additional spending authority of $13,508,000 for FY 2010/11, $10,844,000 for FY 2011/12, and ongoing, and includes the sixty-three (63) positions for the Enforcement Program. The remaining $3,292,000 generated from the increase in fees will be used to maintain a minimum four (4) month fund reserve for the next three (3) years. Four (4) months is a prudent reserve, and is well below the 24-month maximum statutory limit prescribed in B&P Code, Section 128.5.
Board operating expenses have been increasing an average of $1.4 million per year for the past three (3) years, and are projected to be the same in FY 2009/10. The Board’s revenue
increased only an average of $320,000 per year during the same time frame. Analysis of the Board’s fund condition shows that without a fees increase, the Board will be operating at a deficit by FY 2012/13 even without an increase in staff. The following table shows the prior, current and three (3) year projected fund reserve under three (3) conditions.
RESERVE FUND Fiscal Year No Fee Increase No BCP No Fee Increase Current BCP Fee Increase Current BCP 2008/09 9.4 9.4 9.4 2009/10 7.0 4.5 4.5 2010/11 4.9 -1.2 4.5 2011/12 1.7 -7.1 4.3 2012/13 -1.7 3.8
Kelly Green, California Nurses Association, provided a comment.
MSC: Rice/Corless that the Board approve the proposed fee increase regulation for licensure and certification applications, renewal fees, interim permit fees, delinquency and returned check fees, endorsement fees, and temporary license fees. 8/0/0
8.3 Approve/Not Approve: Authorization for the Executive Officer to Sign Petitions to Compel a Mental Health Examination
S. Berumen presented this report
The Board of Registered Nursing has the authority to order a licensee to undergo a mental and/or physical evaluation if there is cause to believe that the licensee may not be able to practice safely pursuant to Business and Professions Code Section 820 which reads:
§ 820. Whenever it appears that any person holding a license,
certificate or permit under this division or under any initiative act referred to in this division may be unable to practice his or her
profession safely because the licentiate's ability to practice is impaired due to mental illness, or physical illness affecting competency, the licensing agency may order the licentiate to be examined by one or
more physicians and surgeons or psychologists designated by the agency. The report of the examiners shall be made available to the licentiate and may be received as direct evidence in proceedings conducted pursuant to Section 822.
In approximately 1999, the Board changed the process for ordering an evaluation of a licensee who may not be able to practice safely due to mental illness or physical condition. The current process requires the Executive Officer to sign a Petition to Compel an
Examination which is sent to the Board President to determine whether an Order should be issued to require the licensee to complete a mental and/or physical examination. The Petition to Compel and the Order are sent to the Board President for his/her original
signature which then must be mailed back to the Board for processing. Additionally, if any type of action comes before the Board regarding the subject of the mental or physical examination it would require the Board President to recuse him/herself from the vote.
In an effort to reduce the number of steps and time it takes to complete the process the Administrative Committee recommends that the Board consider approving the following action:
Authorize the Executive Officer or his/her designee to sign the Order to compel a mental and/or physical examination of a licensee when it is suspected the licensee may not be able to practice safely.
MSC: Harrison/Beecham that the Board approve the authorization for the executive officer to sign petitions to compel a mental health examination. 8/0/0
8.4 Approve/Not Approve: To Seek Legislation to Authorize the Executive Officer to Sign Default and Stipulated Decisions that Result in the Surrender and/or Revocation of a License
S. Berumen presented this report
Pursuant to Business and Professions Code Section 2708, the Board shall appoint an Executive Officer who shall perform the duties delegated by the Board. The Board’s delegation of certain functions to the Executive Officer is described in California Code of Regulations Title 16, Division 14, Article 1, Section 1403 which reads:
§ 1403. Delegation of Certain Functions.
The power and discretion conferred by law upon the board to receive and file accusations; issue notices of hearing, statements to respondent and statements of issues; receive and file notices of defense; determine the time and place of hearings under Section 11508 of the
Government Code; issue subpoenas and subpoenas duces tecum; set and calendar cases for hearing and perform other functions necessary to the efficient dispatch of the business of the board in connection with proceedings under the provisions of Sections 11500 through 11528 of the Government Code, prior to the hearing of such
proceedings; and the certification and delivery or mailing of copies of decisions under Section 11518 of said code are hereby delegated to and conferred upon the executive officer, or, in his/her absence from the office of the board, his/her designee.
This delegation of functions is related to the Board’s disciplinary process and more specifically refers to actions taken pursuant to the Administrative Procedures Act (APA) which sets out the statutory requirements for adjudication of administrative evidentiary hearings. As part of the Board’s discipline process, all decisions are forwarded to the Board members for review and action. The current process for voting on decisions is by mail vote. Decisions are received at the Board on a daily basis and are scanned and saved on a compact disc which is mailed to each board member for review and vote. It is a lengthy process from start to finish and can take 90-120 days from the date the decision is received at the Board’s office until it is mailed out to a licensee as a final action.
There are three types of decisions that the Board votes on by mail: proposed decisions after a hearing in front of an administrative law judge; stipulated settlements, which are
negotiated between board staff, the Attorney General’s office, and the licensee (who may have legal counsel); and default decisions, which are as a result of not appearing at a hearing or more commonly not filing a notice of defense. Stipulated settlements can involve a public reprimand, probation, a period of license suspension or
surrender/revocation of a license. Default decisions result in license revocation. Like most decisions, default decisions are generally effective 30 days after mailing.
The Board members were sent over 200 decisions in 2008, which resulted in a stipulated license surrender/revocation or a default decision.
The resulting time savings at the Board for processing cases could be as much as 120 days if a decision is signed by the Executive Officer on the date it is received at the Board office. This will reduce the number of cases that Board members must review and decide, and will achieve the Board’s overall mission of consumer protection by, in a much faster manner, removing licensees from practice who could potentially harm patients.
In an effort to reduce the amount of time to process disciplinary decisions which result in license revocation or surrender the Administrative Committee requests the Board to approve the following action:
Authorize Board members and/or staff to Seek Legislation to Authorize the Board to Delegate to the Executive Officer the Authority to Sign Default and Stipulated Decisions that Result in the Surrender or Revocation of a License
The following people provided a comment: Genevieve Clavreul, RN
Kelly Green, California Nurses Association
MSC: Todero/Rice that the Board seek legislation to authorize the executive officer to sign default and stipulated decisions that result in the surrender and/or revocation of a license. 8/0/0
9.0 REPORT OF THE LEGISLATIVE COMMITTEE
9.1 Adopt/Modify Positions on Bills of Interest to the Board and any other Bills of Interest to the Board.
L. Bailey presented this report
AB1071 Emmerson: Professions and Vocations MSC: Niemela/Graves that the Board support AB 1071. 8/0/0
AB 1116 Carter: Cosmetic Surgery
Tricia Hunter, American Nurses Association provided a comment. MSC: Rice/Beecham that the Board watch AB 1116. 8/0/0
AB 1215 De La Torre: Community Colleges: temporary and part-time faculty No longer applicable to the Board.
AB 1310 Hernandez: Healing Arts: database Bill dropped.
SB 303 Alquist: Nursing Facility Residents: informed consent Board did not change stance to watch.
SR 25 Negrete McLeod: Relative to State Employee Furloughs The following people provided a comment:
Tricia Hunter, American Nurses Association Kelly Green, California Nurses Association Katherine Huges, SEIU Nurse Alliance
Barbara Blake, United Nurses Association of California
Rosie Lynn Pulmono-Thompson, Senate Business and Professions Economic Development Committee
MSC: Niemela/Todero that the Board support SR 25. 5/3/0
10.0 REPORT OF THE DIVERSION/DISCIPLINE COMMITTEE
Richard Rice, Chairperson
Brian Stiger, Director, Department of Consumer Affairs (DCA) addressed the Board and commended the Board and staff on all it’s hard work in improving enforcement matters. B. Stiger also indicated DCA is continuing to work on the Enforcement Model for the
Department and launched an Enforcement Progress Report on the DCA’s website for public review and comment.
10.1 Information Only: Enforcement Program Update and Statistics
S. Berumen presented this report
PROGRAM UPDATE Staff
There are two remaining positions from the Fingerprint BCP which are authorized to be filled in June and September 2009.
The Probation Program was not successful recruiting at the AGPA level which was authorized to be filled on June 1, 2009. The position was reclassified to a Staff Services Analyst for a broader pool of candidates and promotional opportunities.
Due to the changes at the Board the Nurse Evaluator position is still undergoing review. It is anticipated that the duty statement will be approved and the position advertised beginning in September.
A BCP concept paper was submitted to the Department of Consumer Affairs to convert the limited term positions which were recently approved in the Governor’s budget. The BCP is for Fiscal Year 2010/2011 when the positions will expire and cease to exist leaving an ongoing workload without staff to complete it.
Staff are in the process of preparing another Fiscal Year 2010/2011 BCP once direction has been given by the Board members.
Program
Several newspaper articles about the Board’s enforcement program were published by the Los Angeles Times/ProPublica beginning on July 11, 2009. Staff have been responding, dealing with, and continuing to make improvements in our internal enforcement processes which were provided in a detailed report to the Department of Consumer Affairs at an informational hearing on July 27, 2009, at the Board meeting held on August 12, 2009, and at a hearing before the Senate Business and Professions Committee on August 17, 2009.
To date, the Board has received over 83,000 fingerprint results which include: clearances, rejections for various reasons, and rap sheets. The sheer volume of fingerprint results has been extremely overwhelming for both Renewals and Enforcement staff. Electronic
transmission of fingerprint results from the Department of Justice to the two Department data systems began at the end of July 2009. The process to transition the data is very time
consuming for the staff in licensing.
Louise Bailey, Interim Executive Officer, Heidi Goodman, Assistant Executive Officer, Kathy Hodge, Enforcement Program Manager, and I met with Daryl Walker, Acting Chief of DOI, Mike Kania, retired Supervising Investigator, and Patricia Harris, Acting Deputy Director of DCA to review and discuss DOI’s Intake Task Force Action Plan for cases that are not assigned to any investigator on August 5, 2009. We are scheduled to meet on August 19, 2009, to complete the review of the process and forms so that cases can be reviewed the week of August 24, 2009 by most of the Board’s Nursing Education Consultants in the DOI HQ office in Sacramento.
After communication with the AG’s office in July 2009 to request a number of changes in the way the AG’s office processes our cases, Alfredo Terrazas, Senior Assistant Attorney General for the Licensing Section, provided an update to the previously established, “Case Movement Guidelines for BRN Cases.” The guidelines provide some specific timeframes for the process at the AG’s office. The Enforcement Division Chief and Program Manager communicated our approval of implementing the Case Movement Guidelines for BRN Cases immediately on August 19, 2009. An initial training session was scheduled in early September for board staff to begin serving accusations on respondents. We will continue discussions and implement additional improvements in the next few months. Our next change involves board staff preparing default decisions.
Kathy Hodge has scheduled the next meeting date with Enforcement staff and our liaison DAGs - Hannah Rose and Linda Sun for September 10, 2009, to continue preparing a training program for BRN’s Expert Witnesses. It is hoped that the program will be ready to present by the end of 2009 or early 2010.
STATISTICS
Attached are the standard Enforcement Program statistics for fiscal year (July 2008 through June 2009). Staff has also worked with DCA’s Office of Information Systems to create ad-hoc
reports to monitor the time it takes our cases through a number of the steps in the enforcement process. We will provide preliminary reports for your review as they are still being built.
The number of complaints received is the highest the board has ever received at 5,794 which is 49% higher than last year’s record number of 3,900. The board has received over 1,000 fingerprint conviction notices for those licensees who were previously not fingerprinted by the board.
The board issued 115 citations and fines this year. This exceeded last year’s number by 229%. Enforcement staff continues to explore expanding its use for cases which do not rise to the level of pursuing disciplinary action against a license.
Pleadings for the last fiscal year were down by 12% over fiscal year 2007/08 while we referred more cases to the Attorney General’s Office this year than last year. We are
improving our case tracking and will begin to follow up on cases that have been at the AG’s office for an extended period of time.
We will continue to closely monitor all Enforcement statistics as a result of implementing the Board’s new fingerprint and conviction/discipline question requirements as well as all other changes that are and will continue to occur.
10.1.1 Information Only: 2009-2010 Goals and Objectives
S. Berumen presented this report
GOAL 1 The Enforcement Program will promote consumer protection by effectively intervening to restrict the practice or revoke the licenses of registered nurses who have violated the Nursing Practice Act and related laws.
Objective 1.1 The Enforcement Program will develop cost effective, efficient, and innovative methods for managing discipline cases to achieve desired outcomes.
♦ Evaluate and monitor activities at the Attorney General’s (AG’s) Office and Division of Investigation (DOI), using case statistics, and future projections, which include the additional workload generated by new fingerprinting requirements.
♦ Explore and implement procedural changes with external agencies, such as the AG’s Office, DOI, state and local law enforcement, and other state boards of nursing, to ensure timely completion of BRN enforcement cases.
♦ Evaluate and modify internal procedures to effectively and
efficiently process enforcement complaints and investigations, and to monitor the progression of disciplinary proceedings to ensure timely adjudication.
♦ Evaluate case outcomes to identify training issues or best practices that may lead to additional modifications of processes to ensure accuracy, consistency, and timeliness of all enforcement activity.
♦ Recruit, educate and retain qualified expert witnesses.
Objective 1.2 The Enforcement Program will evaluate the impact of state and federal statutes and regulations affecting the program, identify the need for modifications, and proceed with implementation of new statutes and state regulations, and policy.
♦ Initiate, facilitate, and promote legislation, regulation, and policy changes.
♦ Use the regulatory process to update the Disciplinary Guidelines that went into effect in 2003.
Objective 1.3 The Enforcement Program will continue its contact with the National Council of State Boards of Nursing (NCSBN), and improve outreach to the public, health care providers, and other health related government agencies.
♦ Work with NCSBN in any enforcement-related areas, committees, and projects as they arise.
♦ Disseminate enforcement-related information through the Board’s newsletter, website, and any other methods available.
♦ Conduct outreach to health care providers, the public, and other government agencies through innovative ways, as permitted under the current budget situation.
10.1.2 Information Only: Update on the Enforcement Program Report from August 12, 2009 Board Meeting.
S. Berumen presented this report
The Board has been provided with a number of plans from board staff, the Department of Consumer Affairs (DCA), the Attorney General’s Office (AGO), and the Senate Business, Professions, and Economic Development Committee (Senate B & P).
Board staff, DCA, and Senate B & P plans have many similar components. The areas that enforcement staff have identified as most important which we believe can overhaul the Board’s enforcement program are the following:
¾ Work with the legislature so the Board can gain statutory authority to obtain all records associated with an investigation (including but not limited to- medical records, personnel records, incident reports, and criminal records).
¾ While the Board is ultimately accountable for our enforcement process it is not possible with the current fragmented agencies involved. Begin to create actual accountability for all aspects of the enforcement process by creating an
investigation unit within the Board consisting of RN and non-sworn investigators. Board staff also supports recommendations to obtain authority to hire and house prosecuting attorneys within DCA or the Board office.
¾ Expand the complaint intake unit with additional staff to adequately handle the current and forecasted workload. This would also involve enhancing and
streamlining the triage process at the outset of the complaint review process with criteria driven review of complaints by nurse evaluators.
¾ Review workload information to add case management and probation staff and establish manageable caseloads along with benchmarks and a timeline to meet goals.
¾ Change processes with the Attorney General’s Office and Division of Investigation ¾ Work with the legislature to gain statutory authority to suspend practice for any
person who is unsuccessful in the diversion program as well as concurrent investigation of all diversion participant complaints in enforcement. Additional review to acquire suspension authority to improve consumer protection.
¾ Explore mandatory reporting and work with the legislature to obtain authority with appropriate sanctions for non-compliance.
DCA Director, Brian Stiger, and Acting Deputy Director, Patricia Harris, have been working closely with board staff to identify department resources that can be called upon to assist us in making internal improvements until significant system wide changes can be made.
IMMEDIATE RECOMMENDATIONS
Board staff are aware that several of the changes requested must rely on outside entities and established time frames in order to happen (statute changes, BCP to add new staff, acquire additional/new office space to accommodate staff).
However, board staff recommends pursuing administratively establishing positions to enhance the complaint intake unit and creating a small “pilot” investigative unit within the board office.
10.2 Information Only: Probation Program Update and Statistics
S. Berumen presented this report
Program Update
On July 20, 2009, Alicia Newcomb started at the Board as the new full-time, Limited Term Office Technician for the Probation Program. Alicia has experience with the California Department of Corrections and Rehabilitation working in the records Unit of California State Prison - Solano.
Beginning July 3, 2009, the probation unit implemented a pre-probation file audit prior to completion of probation. This audit will be conducted six months prior to the end date of probation to assure all conditions of probation have been met prior to probationer being released from probation.
Beginning July 10, 2009, all new probationers are being sent a pre-orientation information packet with specific directions regarding each condition of their probation. This procedure will result in probationers beginning random drug screening within two weeks of the effective date of their decisions and allow the probation monitors to monitor those
conditions that could result in a suspension of the RNs practice if not completed within 45 days of the decision (mental health exam, physical exam, etc).
Beginning July 17, 2009, the probation unit began a project to correct Consumer Affairs System (CAS) data entry errors and set the standard for all data entry within the unit. This project will result in accurate record keeping within the probation unit and allow for probation specific statistical reports to be created.
Statistics
Below are the current statistics for the Probation Program through July 31, 2009.
MALE 118
FEMALE 342
CHEMICAL DEPENDENCY CASES 247
PRACTICE CASES 163 CONVICTION CASES 45 MENTAL HEALTH 5 SOUTHERN CALIFORNIA 240 NORTHERN CALIFORNIA 220 PENDING AT THE AG 97 ADVANCED CERTIFICATES 34
REVOKED OR SURRENDERS (May - July 2009) 25
TOTAL IN-STATE PROBATIONERS 460
10.2.1 Information Only: 2009-2010 Goals and Objectives
S. Berumen presented this report
GOAL 1 The Probation Program will promote consumer protection by effectively monitoring registered nurses’ rehabilitation and ability to safely practice who have violated the Nursing Practice Act and related laws.
Objective 1.1 The Probation Program will develop cost effective, efficient, and innovative methods for managing probation cases to achieve desired outcomes.
¾ Document, evaluate, and modify internal procedures to effectively and efficiently manage probation cases and
investigations, and to monitor the progression of disciplinary proceedings to ensure timely adjudication.
¾ Evaluate case outcomes to identify training issues or best practices that may lead to additional modifications of processes to ensure accuracy, consistency, and timeliness of all probation activity.
¾ Evaluate and monitor activities at the Attorney General’s (AG’s) Office and Division of Investigation (DOI), utilizing case
statistics and future projections, also including the additional workload generated by new fingerprinting requirements.
Objective 1.2 The Probation Program will evaluate the impact of state and federal statutes and regulations affecting the program, identify the need for modifications, and proceed with implementation of new statutes and state regulations, and policy.
¾ Initiate, facilitate, and promote legislation, regulation, and policy changes.
¾ Coordinate with the Enforcement Program to review, modify, and update the Disciplinary Guidelines that went into effect in 2003.
Objective 1.3 The Probation Program will collaborate with internal and external stakeholders to improve outreach to the public, health care providers, and other health related government agencies.
¾ Create, modify, and disseminate probation-related information through the Board’s newsletter, website, and any other methods available.
¾ Conduct outreach to health care providers, the public, and other government agencies through innovative ways, as permitted under the current budget situation.
10.3 Information Only: Diversion Program Update and Statistics
C. Stanford presented this report
Program Update
As one of several representatives from different boards and committees delegated to the SB 1441 Uniform Standard Staff Working Group to obtain best practice information to be used by the Substance Abuse Committee, the Diversion Program Manager will continue to provide updated information regarding the uniform standards that are being drafted for alternative programs and probation programs that monitor professionals who misuse or abuse alcohol or drugs.
Diversion Program staff are in the process of drafting a Diversion Evaluation Committee (DEC) member handbook. This will incorporate the new 16 uniform standards outlined in SB1441, as appropriate, along with other pertinent information pertaining to the program.
Contractor Update
The Diversion Program Committee which consists of seven Boards and Committees, legal and contract staff from the Department worked diligently to score the Request for
Proposals that were submitted for the Diversion Program Contract. On July 21, 2009, the Intent to Award was posted on the Department’s website. Pursuant to contract
requirements, the contract has been tentatively awarded to Maximus.
Diversion Evaluation Committees (DEC)
There are currently eleven vacancies as follows: five Physicians, four Registered Nurses, and two public members. Interviews were conducted and several recommendations are included on today’s agenda for approval. Recruitment efforts continue.
Statistics
Attached is the Monthly Statistical Summary Report for April, May and June 2009. As of June 30, 2009, there were 1,393 successful completions.
10.3.1 Information Only: Committee Member Resignation/Term Expiration
C. Stanford presented this report
In accordance with B & P Code Section 2770.2, the Board of Registered Nursing is
responsible for appointing persons to serve on the Diversion Evaluation Committees. Each Committee for the Diversion Program is composed of three registered nurses, a physician and a public member with expertise in chemical dependency and/or mental health.
INFORMATION ONLY:
Diversion Evaluation Committee Member Resignation
Name Title DEC Number
Maureen Keating Nurse Burbank 8
10.3.2 Approve/Not Approve: Diversion Evaluation Committee Members
C. Stanford presented this report
In accordance with B & P Code Section 2770.2, the Board of Registered Nursing is
responsible for appointing persons to serve on the Diversion Evaluation Committees. Each Committee for the Diversion Program is composed of three registered nurses, a physician and a public member with expertise in chemical dependency and/or mental health.
APPOINTMENTS
Below are the names of candidates who were interviewed and are being recommended for appointment to the Diversion Evaluation Committees (DEC). If appointed, their terms will expire June 30, 2013.
NAME TITLE DEC NO
William Hamilton Nurse Sacramento 1
John Barnes Nurse Bay Area 2
Jennifer Dibley Nurse Orange County 4
Anna Seiders Nurse Ontario 9
Marilyn Dray Nurse North Coast 11
10.3.3 Information Only: 2009-2010 Goals and Objectives
C. Stanford presented this report
GOAL 1 The Diversion Program will operate in a manner that protects the consumer and promotes the rehabilitation of registered nurses whose practice may be impaired due to chemical dependency and/or mental illness.
Objective 1.1 The Diversion Program will continue to be strengthened, particularly in the areas of consumer protection, cooperation with other states’ rehabilitation programs, and response to effects of the changing health care environment.
¾ Protect consumers by reviewing, statutes, regulations, and policies in conjunction with standards of best practices to determine if changes are needed.
¾ Continue to increase interactions with other states’ recovery programs.
¾ Actively recruit for Diversion Evaluation Committee (DEC) members and Nurse Support Group Facilitators.
¾ Continue to observe DEC meetings to ensure all DECs
consistently enforce the mandates of the Diversion Program with all participants. Obtain feedback from DECs, participants and Contractor regarding any Program needs.
Objective 1.2 The Diversion Program will strengthen its outreach to educate registered nurses (RNs), employers of RNs, the health care
community and consumers so they will be able to identify impaired practice, intervene, report, and refer individuals to local treatment resources and the Program.
¾ Solicit opportunities to present the Diversion Program to the health care community and give Diversion Program presentations when requested.
¾ Provide Diversion Program information to consumers directly or through any other method.
¾ Require Contractor to conduct outreach programs to organizations and associations by providing information
regarding the Diversion Program’s purpose, legislation, reporting requirements, and its benefits to the public and to the health care profession.
¾ Expand use of innovative outreach methods such as the Internet and other focused outreach efforts.
Objective 1.3 The Diversion Program will regularly interact with the Enforcement Program, Probation Program, and others to improve consumer protection and identify innovative methods to improve the Diversion Program.
¾ Work with Enforcement and Probation staff on cases involving substance abuse and mental health issues to evaluate processes between both programs to determine if changes are needed.
¾ Work closely with DCA’s Contract Unit, Legal Unit and other Boards in developing the new Diversion contract until it is awarded and implemented.
Objective 1.4 The Diversion Program and Program Contractor will coordinate efforts to improve the monitoring of participants in the program by those who provide services and information to the program.
¾ Work closely with the Program Contractor to implement the new requirements in the new contract once it is awarded.
¾ Meet regularly with the Program Contractor to improve the quality of the Program.
¾ Add and monitor any new DECs established by the new contract to meet the continued growth of the Program.
¾ Continue to closely evaluate and audit the contractor’s processes to determine if they meet the needs of the program.
¾ Ensure that the Diversion Program’s internal and external stakeholders have adequate training to effectively support the requirements of the program; including DEC members, board and contractor personnel, and Nurse Support Group Facilitators.
Objective 1.5 The Diversion Program will monitor and respond to changes in health care.
¾ Monitor statistical and public data to determine changes and trends in order to maintain an effective monitoring system for participants.
¾ Collaborate with the SB1441 Uniform Standards Committee, Diversion Discipline Committee, Enforcement Program, Probation Program, and the Diversion Program’s external network regarding any changes that may require new or revised methods of protecting public safety.
10.3.4 Information Only: Maximus Overview
C. Stanford presented this report
The BRN staff works closely with Maximus, to provide statewide services for participants in the Diversion Program. After the previous Board meeting, some of the members requested an overview of the services provided by Maximus, the contractor who was selected to work cooperatively with the Department of Consumer Affairs (DCA), and its regulatory entities to implement and administer the statewide program for Diversion Services.
These services are provided through the Diversion Program which is a statewide voluntary, confidential, comprehensive, chemical dependency and mental illness program, involving treatment, rehabilitation, monitoring, compliance referrals and recovery for health care professionals who are chemically dependent, mentally impaired or both. Its purpose is to protect the public by early identification of impaired health care professionals. It provides these individuals immediate access to appropriate intervention and treatment services so they can recover and return to practice in a manner that will not endanger the public’s health and safety.
The primary goal of the Diversion Program is public protection. Consequently, it is essential that impaired practitioners are monitored closely and removed from practicing and/or restricted from practice should they pose a threat to the public or themselves. The secondary goal is to provide impaired practitioners a means of recovery without the loss of their license to practice.
To enhance the Diversion Program’s effectiveness and efficiency, the Boards contract with a private entity that has the expertise and knowledge in chemical dependency, mental illness, and the treatment of impaired health care professionals. Maximus successfully bid for the contract in 2003 through the Request for Proposal (RFP) bidding process and is participating in the 2009 bidding process. Virginia Matthews, who is the Project Manager provided a program overview as requested by the Board.
11.0 REPORT OF THE EDUCATION/LICENSING COMMITTEE
Catherine Todero, PhD, RN, Chairperson
11.1 Ratify Minor Curriculum Revisions
M. Minato presented this report
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.
Minor Curriculum revisions include the following categories: ¾ Curriculum changes
¾ Work Study programs ¾ Preceptor programs
¾ Public Health Nurse (PHN) certificate programs
¾ Progress reports that are not related to continuing approval
The following programs have submitted minor curriculum revisions that have been approved by the NECs:
¾ California State University, Fresno, Baccalaureate Degree Nursing Program, Entry Level Master’s Degree Option
¾ University of San Diego, Entry Level Master’s Degree Nursing Program ¾ Antelope Valley College Associate Degree Nursing Program
¾ College of Marin Associate Degree Nursing Program ¾ College of San Mateo Associate Degree Nursing Program ¾ College of the Canyons Associate Degree Nursing Program ¾ Copper Mountain College Associate Degree Nursing Program ¾ El Camino College Associate Degree Nursing Program ¾ Kaplan College Associate Degree Nursing Program
¾ Los Angeles Southwest College Associate Degree Nursing Program ¾ Mira Costa College LVN to RN Associate Degree Nursing Program ¾ Mission College LVN to RN Associate Degree Nursing Program ¾ Modesto Junior College Associate Degree Nursing Program ¾ Napa College Associate Degree Nursing Program
¾ San Joaquin Valley College Associate Degree Nursing Program Progress Report:
¾ InterAmerican College, Entry Level Master’s Degree Nursing Program ¾ University of California, Irvine, Baccalaureate Degree Nursing Program ¾ University of California, Los Angeles, Entry Level Master’s Degree Nursing
Program
¾ Contra Costa College Associate Degree Nursing Program
¾ West Hills College, Lemoore, Associate Degree Nursing Program MSC: Corless/Graves that the Board ratify minor curriculum revisions. 8/0/0
11.2 Approve/Not Approve: Education/Licensing Committee Recommendations
M. Minato presented this report
The Education/Licensing Committee met on August 20, 2009 and made the following recommendations.
Continue Approval of Nursing Program
(Group 1 with the exception of San Diego State University, Baccalaureate Degree Nursing Program)
¾ California State University, Chico, Baccalaureate Degree Nursing Program ¾ San Diego State University, Baccalaureate Degree Nursing Program
¾ University of San Francisco, Baccalaureate and Entry Level Master’s Degree Nursing Programs
¾ College of the Redwoods Associate Degree Nursing Program ¾ Evergreen Valley College Associate Degree Nursing Program ¾ Grossmont College Associate Degree Nursing Program Continue Approval of Advanced Degree Nursing Program
(Group 2 with the addition of San Diego State University, Baccalaureate Degree Nursing Program)
¾ San Diego State University Nurse-Midwifery Program ¾ San Diego State University Nurse Practitioner Program
Approve Major Curriculum Revision (Group 3)
¾ University of San Francisco Baccalaureate Degree Nursing Program ¾ Fresno City College Associate Degree Nursing Program
¾ Los Angeles Harbor College Associate Degree Nursing Program ¾ Mira Costa College Associate Degree Nursing Program
MSC: Boynton/Niemela that the Board approve Education/Licensing Committee Recommendations for Group 1 and Group 3. 8/0/0
MSC: Corless/Graves that the Board approve Education/Licensing Committee Recommendations for Group 2. 7/0/1 (C. Todero)
11.3 Accept/Not Accept Feasibility Study for Holy Names University LVN to Baccalaureate Degree Nursing Program
M. Minato presented this report
Holy Names University (HNU) is a not-for-profit organization established in 1868 as a college by the Sisters of the Holy Names. In 2007 the college became a university and was awarded ten years of accreditation by WASC without any recommendations. They are also approved by CCNE, last approval was 2002.
HNU is a small university with very low attrition rate and have been providing education for 140 years. Currently, the university offers post-licensure programs for RNs pursuing a BSN and or a graduate degree as Family Nurse Practitioners, clinical faculty and/or administrator.
HNU is located in Alameda County; and the areas served by this proposed program will be the counties of Alameda, Contra Costa, and the Northern Santa Clara. The feasibility describes well the area to be served.
The program proposed is a LVN to BSN program patterned after the current RN/BSN program offered at HSN, except there will be an addition of basic sciences, social sciences and nursing courses offered, as well as upper division leadership, community health, research, health assessment and pathophysiology courses.
This program will recruit LVN students through a partnership agreement with a local LVN school called American College of Nursing. However, admission is open to any LVN that meets the requirements. There are currently 19 LVN programs in the area and only three provide advancement for LVN. Based on the potential number of applicants from so many programs HNU is certain that they will sustain a reasonable enrollment of students.
The program requires 120 units for graduation, forty-four of those units are nursing. The rest of the units are devoted to GE courses and requirements for graduation. Twenty-one of these nursing courses are currently offered in the RN to BSN program and the other
twenty-three units will be new courses.
The program is planning to use an off-site skill lab located at the American College of Nursing LVN program. HNU will rent the space and pay for the use of the equipment. HNU also has a skill lab on campus that is currently used for the FNP program.
The program is seeking clinical placement, as it is a challenge in that area, and are in current dialog with CCPS. HNU intends to hire a clinical placement coordinator to facilitate placement; however, the first clinical site will be needed by summer of 2010. HNU, and is hoping to find clinical placements for 30 students in an acute care facility before then.
Tuition is the primary source of income; however, HNU has funding from many other sources such as the Moore Foundation, the CAL Endowment Foundation, the San Francisco Foundation, HEDCO and alumni and Board members. HNU states that they have the financial support and stability to open and sustain this new program. Clinical placement and off-site skill lab remains a concern.
MSC: Beecham/Rice that the Board accept the feasibility study for Holy Names University LVN to Baccalaureate Degree Nursing Program. 8/0/0
11.4 Accept/Not Accept Feasibility Study for Shepherd University, Associate Degree Nursing Program
M. Minato presented this report
Shepherd University is a Judeo-Christian college providing higher education founded in biblical principles established to educate students to integrate faith into practice. The mission of Shepherd University is to educate men and women to be leaders to serve the church to improve the world through the excellent programs of Christian higher education.
Shepherd University is located in the heart of Los Angeles, in an area referred as Korea town. Reverend Dr Richard Cornel Seong Yon Lee established Shepherd University in 1999. Dr Lee saw a compelling need to serve the growing Korean-immigrant population through education and service.
There are more than 25 registered nursing programs located in the surrounding Los
Angeles area where Shepherd University is located. Currently, Shepherd University has an LVN program and for the last six years they have offered an NCLEX preparation course. Additionally, they offer an Associate of Art for the LVN graduate, BA in Biblical studies, BA in Information Technology, Masters of Divinity, Master in Music, Masters in IT, Doctor of Music Art, Doctor of Ministry and Doctor in Theology.
The proposed Associate degree nursing program curriculum requires that the students have completed all required basic sciences and core courses for the associate degree prior to the admission to Shepherd University. The nursing courses could be completed in two years. The degree will require 99 units: 45 units for General Education, 10 units of Christian Studies and 44 units of Nursing (24.5 theory and 19.5 clinical)
One of the greatest challenges for Shepherd University is to locate and secure clinical placement for the proposed program. Numerous efforts have been done resulting in
procuring some clinical sites in a variety of agencies such as Monterey Park Hospital, Saint Vincent Medical Center, Hollywood Community Hospital, Norwalk Community Hospital, Hollywood Presbyterian and others sub-acute agencies. Shepherd University is proposing that the clinical experiences be during” off peak” hours in the acute clinical facilities. Shepherd projected enrollment is 20 students every semester with the first group of students targeted for March 2010.
Shepherd University is committed to supporting the proposed Associate Degree Program and has allocated space, lecture rooms, skill lab, resources, support and administrative staff. It is expected that the students will have a faculty ratio of 10:1.
Shepherd University is also aware of the need in recruitment and retention of qualified faculty in theory and clinical and is committed to recruiting qualified faculty. Shepherd University has allocated the use of $1,561,050 of the school for the promotion of a quality nursing program.
Shepherd University members of the Board of Trustees has committed support and intentions to provide sufficient resources over $2.8 million to open and maintain the new program. This board is aware that a nursing program will be more expensive than the other programs.
Shepherd University’s accreditation was with the Bureau of Private Post-Secondary and Vocational Education (BPPVE) and had approval to offer a degree in Associate Degree in Vocational Nursing, Bachelor of Arts in Biblical Studies, and Bachelor in Music, Master in Divinity and Masters of Music. The BPPVE ceased operations on July 2007, and their last letter from the BPPVE giving the authority to grant degrees expired July 1, 2008.
Shepherd University is looking to receive accreditation through other accrediting agencies such as Western Association of Schools and Colleges (WASC). The university has met all 23 criteria and has submitted a candidacy application and is expected to be visited by WASC spring 2010. Therefore, Shepherd University is now eligible to proceed in its pursuit of accreditation. Eligibility was granted for a period of four years, which means the institution should achieve Candidacy prior to the fall semester 2013.
Dr. Richard Winn, Associate Director of WASC, Accrediting Commission for Senior Colleges &Universities was contacted to verify Shepherd’s application process. Dr. Winn stated that since Shepherd University is a nonprofit institution the process for accreditation is shorter. Furthermore, Shepherd University has met eligibility and a team will visit in the near future.
Shepherd University has also applied for candidacy with National League for Nursing Accrediting Commission (NLNAC) and has been assigned a mentor to guide them through this accreditation process.
Shepherd University understands this limitation and will not be able to proceed to the next step without the ability to grant degrees.
MSC: Beecham/Corless that the Board accept the feasibility study for Shepherd University, Associate Degree Nursing Program. 8/0/0
11.5 Information Only: Presentation Health Professions Education Foundation for the Scholarship and Loan Repayment Awards Program for Registered Nurses
J. Campbell-Warnock presented this report
The purpose of the Scholarship and Loan Repayment Awards Program for Registered Nurses is to ensure that funds are available to support the education of Registered Nurses in Associate and Baccalaureate degree nursing programs in counties with the highest need.
The Bachelor of Science Scholarship and Loan Repayment Program (RNEP), established through Senate Bill 1267 (Maddy, Chapter 252, Statutes of 1988), allow eligible applicants to receive up to $13,000 for scholarship and up to $19,000 for the loan repayment program. In return, award recipients agree to complete a two to four year service obligation
practicing full-time direct patient care in a medically underserved area or county health facility in California.
The Associate Degree Nursing Scholarship Pilot (ADNSP) Program, established pursuant to Assembly Bill 1241 (Parra, Chapter 396, Statutes of 2003), allow eligible applicants to receive up to $10,000 for scholarship and must commit to two years of service.
The Programs are funded by the Registered Nurses Education Fund, supported through a $10 surcharge on Registered Nurse licensure renewals. The Health Professions Education Foundation (Foundation) was established in 1987 and administers the Scholarship and Loan Repayment Awards program.
Ms. Lupe Alonzo-Diaz, Executive Director of Programs Administration from the Foundation presented information about the Registered Nurse Education Fund.
11.6 Information Only: Report on Survey of Clinical Placement Issues for Prelicensure Nursing Programs
M. Minato presented this report
On June 9, 2009, the Board of Registered Nursing conducted a survey on clinical placement of prelicensure nursing students. A survey was distributed to 124 nursing schools by e-mail and by mail asking question on clinical placement. The purpose of the survey was to obtain information on issues and concerns related to clinical placement of prelicensure nursing students.
Nancy Spradley, Executive Director, California School Nurse Organization, provided a comment.
11.7 Information Only: NCLEX Pass Rate Update
K. Daugherty presented this report
The Board of Registered Nursing receives quarterly reports from the National Council of State Boards of Nursing (NCSBN) about the NCLEX-RN test results by quarter and with an annual perspective. The following tables show this information for the last 12 months and by each quarter.
NCLEX RESULTS – FIRST TIME CANDIDATES July 1, 2008 – June 30, 2009
JURISDICTION TOTAL TAKING TEST PERCENT PASSED %
California 10, 499 87.90
