Bill Text: CA SB1042 | 2023-2024 | Regular Session | Introduced

California Senate Bill 1042

NOTE: There are more recent revisions of this legislation. Read Latest Draft

Bill Title: Health facilities and clinics: clinical placements: nursing.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2024-04-26 - Set for hearing May 6. [SB1042 Detail]

Download: California-2023-SB1042-Introduced.html

CALIFORNIA LEGISLATURE— 2023–2024 REGULAR SESSION

Senate Bill

No. 1042

Introduced by Senator Roth
(Coauthor: Senator Caballero)

February 07, 2024

An act to amend Section 128735 of, and to add Article 1 (commencing with Section 127750) to Chapter 1 of Part 3 of Division 107 of, the Health and Safety Code, relating to health facilities.

LEGISLATIVE COUNSEL'S DIGEST

SB 1042, as introduced, Roth. General acute care hospitals: clinical placements: nursing.

Existing law establishes the Department of Health Care Access and Information in the Health and Welfare Agency to oversee health planning and health policy research, such as the health care workforce research and data center. Existing law, the Nursing Practice Act, establishes the Board of Registered Nurses within the Department of Consumer Affairs for the licensure and regulation of the practice of nursing.

This bill would require a health facility, as defined, that offers prelicensure clinical placement slots upon the request of an approved school of nursing or an approved nursing program, as defined, and regardless of whether the school or program is public or private, to meet with representatives of the school or program to discuss the clinical placement needs of the school or program. The bill would require an approved school of nursing or an approved nursing program, regardless of whether the school or program is public or private, to notify the department and the board of the beginning and end dates of the academic term for each clinical slot needed by a clinical group with content area and education level and the number of clinical slots that the school or program has been unable to fill by March 1 of each year.

Existing law requires an organization that operates, conducts, owns, or maintains a health facility, and the officers thereof, to make and file with the department specified reports, including, among others, balance sheets detailing the assets, liabilities, and net worth of the health facility at the end of its fiscal year.

This bill would further require a report on clinical placement date that includes specified information, including, among other things, the estimated number of days and shifts available for student use for each type of licensed bed or unit. The bill would require the department to post the data in this report with the information required in the March 1 report described above on the department’s internet website in a manner that allows for specified information in both reports to be cross-referenced against each other.

The bill would also require the department and board to utilize the data in both reports described above to work to meet the clinical placement needs of approved schools of nursing or approved nursing programs, regardless of whether the school or program is public or private, by conferring with health facilities within the appropriate geographic region of each school or program in an attempt to match available clinical placement slots with needed slots and to create additional clinical placement slots to meet school or program demands. In meeting these requirements, the bill would require the department and board to prioritize the clinical placement needs of the approved schools of nursing or approved nursing programs of community colleges and California State University campuses.

The bill would require a health facility to provide the department with written justification if it cannot provide additional slots and would require the department, in collaboration with the board, to notify the health facility of the department’s acceptance or rejection of the health facility’s justification. The bill would require the department to post all written justifications and outcomes on the department’s internet website. The bill would also prohibit any attempt to create or secure additional clinical placement slots by the department, board, or a health facility from supplanting or disrupting the clinical placement of any nursing student for whom a clinical placement is already in progress or has already been scheduled.

The bill would also make certain findings and declarations of the Legislature.

Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: NO

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

SECTION 1.

The Legislature finds and declares all of the following:

(a) To graduate from a nursing program, students must complete units in both theoretical coursework and hands on clinical experience. The Board of Registered Nursing (BRN) regulations require that 75% of a nursing student’s clinical hours be in a direct patient care model.

(b) Direct patient care means providing services to a live patient, which can include both inperson and telehealth. As a result, most clinical placements occur within a health care facility and require agreements between nursing programs and the health facility partners for placement of students.

(c) The availability of student placements for clinical experiences is based on clinical facilities, such as hospitals or clinics that are willing to accept and teach students. The facilities must have staff that are qualified to teach and supervise students, and often develop contracts with partner educational programs to outline responsibilities, liability, and expectations. As a result, clinical placements are often difficult to find.

(d) The California State Auditor Report 2019-120 on the Board of Registered Nursing found that due to a lack of reliable data, the BRN lacked critical information about the location and availability of clinical placement slots. Therefore, the California State Auditor recommends that the BRN require nursing programs to annually update information about the clinical facilities they use for student placements.

(e) Collecting data on nursing programs’ clinical placement needs and comparing it with the availability of clinical placement slots at health facilities would provide the information necessary for the BRN and the Department of Health Care Access and Information to properly match scarce clinical placements with the nursing students that need them.

SEC. 2.

Article 1 (commencing with Section 127750) is added to Chapter 1 of Part 3 of Division 107 of the Health and Safety Code, to read:

Article 1. Nursing Clinical Placements

127750.

(a) A health facility, as defined in Section 1250, that offers prelicensure clinical placement slots shall, upon the request of an approved school of nursing or an approved nursing program and regardless of whether the school or program is public or private, meet with representatives from the school or program to discuss the clinical placement needs of the school or program. The health facility and the school or program shall work together in good faith to meet the demands of the school or program to educate and train nursing students.

(b) By March 1 of each year, an approved school of nursing or an approved nursing program, regardless of whether the school or program is public or private, shall report to the Department of Health Care Access and Information and the Board of Registered Nursing the following information:

(1) The beginning and end dates of the academic term for each clinical slot needed by a clinical group with content area and education level.

(2) The number of clinical slots that the school or program has been unable to fill.

(c) (1) Following receipt of the information required by subdivision (b) and utilizing the data reported pursuant to subdivision (h) of Section 128735, the department and board shall work to meet the clinical placement needs of all approved schools of nursing or approved nursing programs, regardless of whether the school or program is public or private, by conferring with health facilities within the appropriate geographic region of each school or program in an attempt to match available clinical placement slots with needed slots and to create additional clinical placement slots to meet school or program demands.

(2) In meeting the requirements of paragraph (1), the department and board shall prioritize the clinical placement needs of the approved schools of nursing or approved nursing programs of community colleges and California State University campuses.

(d) If a health facility cannot provide additional slots, the health facility shall provide the department with written justification of its lack of capability or capacity within 30 days. The department shall, in collaboration with the board, notify the health facility within 30 days of its acceptance or rejection of the health facility’s justification. The department shall post all written justifications and outcomes on the department’s internet website.

(e) Any attempt to create or secure additional clinical placement slots by the department, board, or a health facility pursuant to this section shall not supplant or disrupt the clinical placement of any nursing student for whom a clinical placement is already in progress or has already been scheduled.

(f) For purposes of this section, “approved school of nursing” and “approved nursing program,” or variations thereof, have the same meaning as set forth in Section 2786 of the Business and Professions Code.

(g) Nothing in this section shall be construed to limit, prevent, or justify the approval or denial of new schools of nursing or the expansion of approved nursing programs.

SEC. 3.

Section 128735 of the Health and Safety Code is amended to read:

128735.

An organization that operates, conducts, owns, or maintains a health facility, and the officers thereof, shall make and file with the department, at the times as the department shall require, all of the following reports on forms specified by the department that are in accord, if applicable, with the systems of accounting and uniform reporting required by this part, except that the reports required pursuant to subdivision (g) shall be limited to hospitals:

(a) A balance sheet detailing the assets, liabilities, and net worth of the health facility at the end of its fiscal year.

(b) A statement of income, expenses, and operating surplus or deficit for the annual fiscal period, and a statement of ancillary utilization and patient census.

(c) A statement detailing patient revenue by payer, including, but not limited to, Medicare, Medi-Cal, and other payers, and revenue center.

(d) A statement of cashflows, including, but not limited to, ongoing and new capital expenditures and depreciation.

(e) (1) A statement reporting the information required in subdivisions (a), (b), (c), and (d) for each separately licensed health facility operated, conducted, or maintained by the reporting organization.

(2) Notwithstanding paragraph (1), a health facility that receives a preponderance of its revenue from associated comprehensive group practice prepayment health care service plans and that is operated as a unit of a coordinated group of health facilities under common management may report the information required pursuant to subdivisions (a) and (d) for the group and not for each separately licensed health facility.

(f) Data reporting requirements established by the department shall be consistent with national standards, as applicable.

(g) A Hospital Discharge Abstract Data Record that includes all of the following:

(1) Date of birth.

(2) Sex.

(3) Race.

(4) ZIP Code.

(5) Preferred language spoken.

(6) Patient social security number, if it is contained in the patient’s medical record.

(7) Prehospital care and resuscitation, if any, including all of the following:

(A) “Do not resuscitate” (DNR) order on admission.

(B) “Do not resuscitate” (DNR) order after admission.

(8) Admission date.

(9) Source of admission.

(10) Type of admission.

(11) Discharge date.

(12) Principal diagnosis and whether the condition was present on admission.

(13) Other diagnoses and whether the conditions were present on admission.

(14) External causes of morbidity and whether present on admission.

(15) Principal procedure and date.

(16) Other procedures and dates.

(17) Total charges.

(18) Disposition of patient.

(19) Expected source of payment.

(20) Elements added pursuant to Section 128738.

(h) (1) A report on clinical placement data that includes, but is not limited to, all of the following information:
(A) Estimated number of days and shifts available for student use for each type of licensed bed or unit.
(B) Number of days and shifts being utilized for student use for each type of licensed bed or unit.
(C) Name of the academic institution with an approved school of nursing or nursing program utilizing each type of licensed bed or unit.
(D) Average daily patient census per type of licensed bed or unit.
(E) Average daily number of registered nurses staffing each type of licensed bed or unit.
(2) If a prelicensure clinical placement slot is available or filled for a period of time that begins in one reporting period, but ends in another reporting period, the slot shall be reported for the period in which the student began the clinical placement and not for the reporting period in which the student ended the clinical placement.
(3) The department shall post the information specified in paragraph (1) with the information specified in subdivision (b) of Section 127750 on its internet website in a manner that allows for the information in subparagraphs (A) to (C), inclusive, of paragraph (1) to be cross-referenced against the information specified in subdivision (b) of Section 127750.
~~(h)~~

(i) It is the intent of the Legislature that the patient’s rights of confidentiality shall not be violated in any manner. Patient social security numbers and other data elements that the department believes could be used to determine the identity of an individual patient shall be exempt from the disclosure requirements of the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code).

~~(i)~~

(j) A person reporting data pursuant to this section shall not be liable for damages in an action based on the use or misuse of patient-identifiable data that has been mailed or otherwise transmitted to the department pursuant to the requirements of subdivision (g).

~~(j)~~

(k) A hospital shall use coding from the International Classification of Diseases in reporting diagnoses and procedures.

~~(k)~~

(l) On or before July 1, 2021, the department shall promulgate regulations as necessary to implement subdivision (e). A health facility that receives a preponderance of its revenue from associated comprehensive group practice prepayment health care service plans and that is operated as a unit of a coordinated group of health facilities under common management shall comply with the reporting requirements of subdivisions (b), (c), and (e) once the department finalizes related regulations.