Current Status:

Passed

(2026-09-20: Chaptered by Secretary of State. Chapter 429, Statutes of 2026.)

Introduced

In Committee

Awaiting First Chamber Vote

Passed First Chamber

In Committee

Awaiting Second Chamber Vote

Passed Second Chamber

Enacted

What does this bill do?

This bill changes state nursing law for nurses, nursing schools, and advanced practice nurses. It extends the Board of Registered Nursing to 2031, requires the board to post approved schools and use national simulation and inspection standards, allows limited use of simulation and temporary cuts to some clinical hours with oversight, expands nurses' ability to give medicines ordered by nurse practitioners and nurse midwives, lets furnishing numbers be issued or renewed without penalty, removes certain written‑exam and minimum‑fee rules, and requires documented continuing education at renewal starting in 2029.

Version:

(1)Existing law, the Nursing Practice Act, establishes the Board of Registered Nursing within the Department of Consumer Affairs, until January 1, 2027, and sets forth its powers and duties regarding the licensure and regulation of registered nurses. Existing law creates the Board of Registered Nursing Fund and makes all moneys in the fund available upon appropriation by the Legislature. A violation of the act is a crime.

Existing law requires the board, until January 1, 2027, to appoint an executive officer to perform the duties delegated by the board and to be responsible to the board for the accomplishment of those duties, as specified. Existing law requires the board, for the purpose of transacting its business, to meet at least once every 3 months, at times and places it designates by resolution, and requires those meetings to be held in northern and southern California.

This bill would extend those dates until January 1, 2031. The bill would remove the above-described location requirements for meetings held by the board, and, instead, require the board to meet at least once every 3 months in locations that are, to the extent practicable, geographically diverse.

(2)Existing law specifies that an approved school of nursing, or an approved nursing program, is one that, among other things, gives a course of instruction approved by the board, as specified. Existing law requires the board to prepare and maintain a list of approved schools of nursing whose graduates are eligible to apply for a license to practice nursing, as provided. Existing law requires the board, through its executive officer, to inspect all schools of nursing in the state at the times the board deems necessary, as specified.

This bill would require the board to make the list of approved schools of nursing available on its internet website. The bill would require the inspection criteria to be consistent with the 2020 Nursing Education Approval Guidelines established by the National Council of State Boards of Nursing, or its successor, as specified.

Existing law requires an approved school of nursing or a nursing program to meet a minimum of 500 direct patient care clinical hours in a board-approved clinical setting, as specified, and requires additional clinical hours required by the program for nursing education preparation in each nursing area as specified by the board to be identified and documented in the curriculum plan for each area.

The bill would require any clinical practice hours that are not required to be in direct patient care and are provided using simulation experiences to be based on the best practices published by, among other specified entities, the International Nursing Association for Clinical Simulation and Learning, or based on any equivalent standards approved by the board.

Existing law authorizes the director of an approved nursing program, until the end of the 202324 academic year, or whenever the Governor declares a state of emergency for a county in which an agency or facility used by an approved nursing program for direct patient care clinical practice is no longer available, to submit to a board nursing education consultant requests to, among other things, allow the program to reduce the required number of direct patient care hours to, among other requirements, 50% in geriatrics and medical-surgical, if certain conditions are met. Existing law prohibits the approval of that request after the 202324 academic year and makes an approved request expire at the end of that year.

This bill would, instead, authorize a director to submit requests for the approved nursing program to reduce the required number of direct patient care hours to 200 hours in medical-surgical, as specified, if certain conditions are met. The bill would remove the prohibition of the approval of that request after the 202324 year and the provision making any an approved request expire at the end of that year.

If the board requires the approval of the faculty or directors, as specified, existing law authorizes the board to approve an individual to serve as a member of the faculty, director, or assistant director of an approved school of nursing or nursing program. Existing law makes an individual approval valid for 5 years and authorizes an individual approval to be renewed if the individual demonstrates to the board that they continue to meet the requirements established by the board for faculty, directors, and assistant directors of an approved school of nursing or nursing program.

This bill would, instead, make only an individual faculty approval valid for 5 years and authorize only an individual faculty approval to be renewed if the individual demonstrates to the board that they continue to meet the requirements established by the board for faculty of an approved school of nursing or nursing program.

If an applicant for approval has a faculty position and does not meet a requirement established by the board for a different position, existing law authorizes the board to accept a remediation plan submitted by an approved school of nursing or nursing program to help the applicant meet the requirement, and if the board accepts the plan, to approve the applicant to instruct in theory under the mentorship and supervision of the content expert identified in the plan for up to one year.

If an applicant for approval as an assistant director or director does not have a faculty position and does not meet a requirement established by the board for a different position, the bill would authorize the board to accept a remediation plan submitted by an approved school of nursing or nursing program to help the applicant meet the requirement, and if the board accepts the plan, to approve the applicant to serve in the role of the assistant director under the mentorship of a board-approved director or assistant director while completing the remediation plan for up to one year, as specified.

(3)Existing law defines the practice of nursing to include specified activities, including the administration of medications ordered by a physician and surgeon, dentist, podiatrist, or clinical psychologist, as specified.

This bill would expand the definition of the practice of nursing to include the administration of medications ordered by a nurse practitioner or certified nurse midwife and the administration of medications as directed by an advanced practice registered nurse to the extent allowable by the advanced practice registered nurses scope of practice.

(4)Existing law requires the board to issue a license as a registered nurse to each applicant who passes the examination and meets all other licensing requirements. Existing law requires all examinations to be written, but authorizes exams in the discretion of the board to be supplemented by an oral or practical examination in subjects the board determines.

This bill would remove the requirement that all examinations be written, and the authorization for exams to be supplemented by an oral or practical examination in subjects the board determines.

Existing law authorizes a registered nurse under current investigation by the board to request entry into an intervention program by contacting the board. Existing law requires each registered nurse who requests participation in an intervention program to agree to cooperate with the rehabilitation program designed by the intervention evaluation committee and approved by the program manager, as defined.

This bill would require the committee, in developing the rehabilitation program, to determine whether a participant is required to practice nursing prior to completion of the program.

Existing law requires each person renewing their license as a registered nurse to submit proof satisfactory to the board that, during the preceding 2-year period, they have been informed of the developments in the registered nurse field or in any special area of practice engaged in by the licensee, occurring since the last renewal thereof, either by pursuing a course or courses of continuing education in the registered nurse field or relevant to the practice of the licensee, as specified, or by other means deemed equivalent by the board.

This bill would, beginning January 1, 2029, require the board to require each licensee to submit the above-described proof at the time of renewal and require the proof to include, but not be limited to, documentation verifying the completion of the continuing education requirements during the preceding renewal period or the preceding 2 years.

Existing law authorizes a registered nurse whose license has been revoked or suspended or who has been placed on probation to petition the board for reinstatement or modification of penalty, as specified, subject to specified time periods.

This bill would specify that no minimum time period applies if the registered nurse has had their license revoked by default for failure to submit a notice of defense.

(5)Existing law requires the board to issue a certificate to practice nurse-midwifery to a person licensed as a registered nurse who meets specified qualifications. Existing law authorizes a certified nurse-midwife to attend cases of low-risk pregnancy and childbirth and to provide certain types of care, including prenatal care.

Existing law generally authorizes a certified nurse-midwife to furnish drugs or devices incidentally to the provision of, among other things, the care and services described above. Existing law makes the furnishing or ordering of drugs or devices by a certified nurse-midwife conditional on the issuance by the board of a number to the applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs to implement these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500.

This bill would authorize the board to also issue a furnishing number described above upon renewal application, and would remove the authorization for the board to charge a penalty fee for failure to renew a furnishing number within the prescribed time. The bill would specify that the initial application and renewal application are those for a certificate to practice nurse-midwifery.

(6)Existing law, the Nurse Anesthetists Act, which is part of the Nursing Practice Act, requires the board to issue a certificate to practice nurse anesthesia to a person licensed as a registered nurse who meets specified qualifications. Existing law fixes the amounts of fees in connection with the issuance of certificates of nurse anesthetists, including that the fee to be paid upon the filing of an application for a certificate is fixed by the board at not less than $500 and no more than $1,500.

This bill would remove the minimum fee amount for the above-described fees.

(7)Existing law requires, on and after January 1, 2008, an applicant for initial qualification or certification as a nurse practitioner who has not been qualified or certified as a nurse practitioner in California or any other state to meet certain requirements, including holding a valid and active registered nursing license.

Existing law generally authorizes a nurse practitioner to furnish drugs or devices when certain conditions are met, including that the nurse practitioner is functioning pursuant to standardized procedure, as defined, or protocol, as specified. Existing law makes the furnishing or ordering of drugs or devices by a nurse practitioner conditional on the issuance by the board of a number to an applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs to implement these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500.

Existing law authorizes a nurse practitioner to perform certain functions, including conducting an advanced assessment, without standardized procedures in accordance with their education and training, as specified, if the nurse practitioner meets certain requirements, including that they have completed a transition to practice in California of a minimum of 3 full-time equivalent years of practice or 4600 hours, as specified.

This bill would also authorize the completion of a transition to practice in another state, as described above, for purposes of that requirement. For purposes of a transition to practice completed in another state, the bill would require the board to, among other things, on or before January 1, 2028, identify states where practice experience would meet or exceed the requirements under specified provisions if obtained in this state.

(8)Existing law requires a registered nurse applying to be a clinical nurse specialist for the evaluation of their qualifications to use that title to pay a nonrefundable fee of not less than $500 but not exceeding $1,500, and requires a fee to be paid for a temporary certificate to practice as a clinical nurse special to be not less than $30 but no more than $50. Existing law requires a biennial renewal fee to be paid upon submission of an application to renew the clinical nurse specialist certificate, and to be established by the board at no less than $150 and not more than $1,000. Existing law requires the penalty fee for failure to renew a certificate within the prescribed time to be 50% of the renewal fee in effect on the date of the renewal of the license to be not less than $75 and no more than $500.

This bill would delete the minimum fee amounts prescribed above.

(9)The bill would also make various nonsubstantive changes to various nursing related provisions.

This bill would remove the requirement that all examinations be written, and the authorization for exams to be supplemented by an oral or practical examination in subjects the board determines.

This bill would require the committee, in developing the rehabilitation program, to determine whether a participant is required to practice nursing prior to completion of the program.

This bill would specify that no minimum time period applies if the registered nurse has had their license revoked by default for failure to submit a notice of defense.

This bill would remove the minimum fee amount for the above-described fees.

This bill would delete the minimum fee amounts prescribed above.

(9)The bill would also make various nonsubstantive changes to various nursing related provisions.

(3)

This bill would remove the requirement that all examinations be written, and the authorization for exams to be supplemented by an oral or practical examination in subjects the board determines.

This bill would require the committee, in developing the rehabilitation program, to determine whether a participant is required to practice nursing prior to completion of the program.

This bill would specify that the above-described authorization no minimum time period applies if the registered nurse has had their license revoked or suspended, or has been placed on probation, for cause. by default for failure to submit a notice of defense.

(4)

(5)

This bill would remove the minimum fee amount for the fee paid upon the filing of an application for a nurse anesthetist certificate that is fixed by the board.

(6)

Existing law generally authorizes a nurse practitioner to furnish drugs or devices when certain conditions are met, including that the nurse practitioner is functioning pursuant to standardized procedure, as defined, or protocol, as specified. Existing law makes the furnishing or ordering of drugs or devices by a nurse practitioner conditional on the issuance by the board of a number to an applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500.

This bill would also include the completion of a transition to practice in another state, as described above, for purposes of that requirement. For purposes of a transition to practice completed in another state, the bill would require the board to, among other things, on or before July 1, 2027, January 1, 2028, identify states where practice experience would meet or exceed the requirements under specified provisions if obtained in this state.

(7)

This bill would delete the minimum fee amounts prescribed above.

(8)

(9)The bill would also make various nonsubstantive changes to various nursing related provisions.

This bill would extend those dates until January 1, 2031. The bill would remove the above-described location requirements for meetings held by the board, and, instead, require the board to meet at least once every 3 months in appropriate locations that are necessary to transact its business. are, to the extent practicable, geographically diverse.

(3)Existing law requires the board to issue a license as a registered nurse to each applicant who passes the examination and meets all other licensing requirements. Existing law requires all examinations to be written, but authorizes exams in the discretion of the board to be supplemented by an oral or practical examination in subjects the board determines.

This bill would remove the requirement that all examinations be written, and the authorization for exams to be supplemented by an oral or practical examination in subjects the board determines.

This bill would require the committee, in developing the rehabilitation program, to determine whether a participant is required to practice nursing prior to completion of the program.

This bill would specify that the above-described authorization applies if the registered nurse has had their license revoked or suspended, or has been placed on probation, for cause.

(4)Existing law requires the board to issue a certificate to practice nurse-midwifery to a person licensed as a registered nurse who meets specified qualifications. Existing law authorizes a certified nurse-midwife to attend cases of low-risk pregnancy and childbirth and to provide certain types of care, including prenatal care.

(5)Existing law, the Nurse Anesthetists Act, which is part of the Nursing Practice Act, requires the board to issue a certificate to practice nurse anesthesia to a person licensed as a registered nurse who meets specified qualifications. Existing law fixes the amounts of fees in connection with the issuance of certificates of nurse anesthetists, including that the fee to be paid upon the filing of an application for a certificate is fixed by the board at not less than $500 and no more than $1,500.

This bill would remove the minimum fee amount for the fee paid upon the filing of an application for a nurse anesthetist certificate that is fixed by the board.

(6)Existing law requires, on and after January 1, 2008, an applicant for initial qualification or certification as a nurse practitioner who has not been qualified or certified as a nurse practitioner in California or any other state to meet certain requirements, including holding a valid and active registered nursing license.

Existing law generally authorizes a nurse practitioner to furnish drugs or devices when certain conditions are met, including that the nurse practitioner is functioning pursuant to standardized procedure, as defined, or protocol, as specified. Existing law makes the furnishing or ordering of drugs or devices by a nurse practitioner conditional on the issuance by the board of a number to an applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500.

This bill would also include the completion of a transition to practice in another state, as described above, for purposes of that requirement. For purposes of a transition to practice completed in another state, the bill would require the board to, among other things, on or before July 1, 2027, identify states where practice experience would meet or exceed the requirements under specified provisions if obtained in this state.

(7)Existing law requires a registered nurse applying to be a clinical nurse specialist for the evaluation of their qualifications to use that title to pay a nonrefundable fee of not less than $500 but not exceeding $1,500, and requires a fee to be paid for a temporary certificate to practice as a clinical nurse special to be not less than $30 but no more than $50. Existing law requires a biennial renewal fee to be paid upon submission of an application to renew the clinical nurse specialist certificate, and to be established by the board at no less than $150 and not more than $1,000. Existing law requires the penalty fee for failure to renew a certificate within the prescribed time to be 50% of the renewal fee in effect on the date of the renewal of the license, but not less than $75 and no more than $500.

This bill would delete the minimum fee amounts prescribed above.

(8)The bill would also make various nonsubstantive changes to various nursing related provisions.

This bill would extend those dates until January 1, 2031. The bill would remove the above-described location requirements for meetings held by the board, and, instead, require the board to meet at least once every 3 months in appropriate locations that are necessary to transact its business.

This bill would remove the requirement that all examinations be written, and the authorization for exams to be supplemented by an oral or practical examination in subjects the board determines.

This bill would remove the minimum fee amount for the fee paid upon the filing of an application for a nurse anesthetist certificate that is fixed by the board.

Existing law generally authorizes a nurse practitioner to furnish drugs or devices when certain conditions are met, including that the nurse practitioner is functioning pursuant to standardized procedure, as defined, or protocol, as specified. Existing law makes the furnishing or ordering of drugs or devices by a nurse practitioner conditional on the issuance by the board of a number to an applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500.

This bill would also include the completion of a transition to practice in another state, as described above, for purposes of that requirement.

This bill would delete the minimum fee amounts prescribed above.

(8)The bill would also make various nonsubstantive changes to various nursing related provisions.

Existing

(1)Existing law, the Nursing Practice Act, establishes the Board of Registered Nursing. Existing law requires the board to prepare and maintain a list of approved school of nursing whose graduates are eligible to apply for a license to practice nursing, as provided. Nursing within the Department of Consumer Affairs, until January 1, 2027, and sets forth its powers and duties regarding the licensure and regulation of registered nurses. Existing law creates the Board of Registered Nursing Fund and makes all moneys in the fund available upon appropriation by the Legislature. A violation of the act is a crime.

This bill would require the board to make this list available on its internet website. The bill would also make nonsubstantive changes. would extend those dates until January 1, 2031. The bill would remove the above-described location requirements for meetings held by the board, and, instead, require the board to meet at least once every 3 months in appropriate locations that are necessary to transact its business.

This bill would remove the requirement that all examinations be written, and the authorization for exams to be supplemented by an oral or practical examination in subjects the board determines.

This bill would remove the minimum fee amount for the fee paid upon the filing of an application for a nurse anesthetist certificate that is fixed by the board.

Existing law generally authorizes a nurse practitioner to furnish drugs or devices when certain conditions are met, including that the nurse practitioner is functioning pursuant to standardized procedure, as defined, or protocol, as specified. Existing law makes the furnishing or ordering of drugs or devices by a nurse practitioner conditional on the issuance by the board of a number to an applicant who has successfully completed certain requirements. Existing law authorizes the board to issue a furnishing number upon initial application and, if approved by the board, prohibits requiring the applicant from having to make a separate application. Existing law authorizes the board to charge an applicant a fee to cover all necessary costs these provisions that is no more than $1,500 for an initial application or $1,000 for a renewal application, and to charge a penalty fee for failure to renew a furnishing number within the prescribed time that is no more than $500.

This bill would also include the completion of a transition to practice in another state, as described above, for purposes of that requirement.

This bill would delete the minimum fee amounts prescribed above.

(8)The bill would also make various nonsubstantive changes to various nursing related provisions.

Version:

The people of the State of California do enact as follows:SECTION 1.Section 2701 of the Business and Professions Code is amended to read:2701.

(a)There is in the Department of Consumer Affairs the Board of Registered Nursing consisting of nine members.

(b)For purposes of this chapter, board means the Board of Registered Nursing. Any reference in state law to the Board of Nurse Examiners of the State of California or the California Board of Nursing Education and Nurse Registration shall be construed to refer to the Board of Registered Nursing.

(c)The board shall have all authority vested in the previous board under this chapter. The board may enforce all disciplinary actions undertaken by the previous board.

(d)This section shall remain in effect only until January 1, 2031, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2031, deletes or extends that date.

SEC. 2.Section 2708 of the Business and Professions Code is amended to read:2708.

(a)The board shall appoint an executive officer who shall perform the duties delegated by the board and be responsible to the board for the accomplishment of those duties.

(b)The executive officer shall be a nurse currently licensed under this chapter and shall possess other qualifications as determined by the board.

(c)The executive officer shall not be a member of the board.

(d)The executive officer is authorized to adopt a decision entered by default and a stipulation for surrender of a license.

(e)This section shall remain in effect only until January 1, 2031, and as of that date is repealed, unless a later enacted statute that is enacted before January 1, 2031, deletes or extends that date.

SEC. 3.Section 2709 of the Business and Professions Code is amended to read:2709.

The board, for the purpose of transacting its business, shall meet at least once every three months in locations that are, to the extent practicable, geographically diverse.

SEC. 4.Section 2725 of the Business and Professions Code is amended to read:2725.

(a)In amending this section at the 197374 session, the Legislature recognizes that nursing is a dynamic field, the practice of which is continually evolving to include more sophisticated patient care activities. It is the intent of the Legislature in amending this section at the 197374 session to provide clear legal authority for functions and procedures that have common acceptance and usage. It is the legislative intent also to recognize the existence of overlapping functions between physicians and registered nurses and to permit additional sharing of functions within organized health care systems that provide for collaboration between physicians and registered nurses. These organized health care systems include, but are not limited to, health facilities licensed pursuant to Chapter 2 (commencing with Section 1250) of Division 2 of the Health and Safety Code, clinics, home health agencies, physicians offices, and public or community health services.

(b)The practice of nursing within the meaning of this chapter means those functions, including basic health care, that help people cope with difficulties in daily living that are associated with their actual or potential health or illness problems or the treatment thereof, and that require a substantial amount of scientific knowledge or technical skill, including all of the following:

(1)Direct and indirect patient care services that ensure the safety, comfort, personal hygiene, and protection of patients; and the performance of disease prevention and restorative measures.

(2)(A)Direct and indirect patient care services, including, but not limited to, the administration of medications and therapeutic agents, necessary to implement a treatment, disease prevention, or rehabilitative regimen ordered by and within the scope of licensure of a physician, dentist, podiatrist, nurse practitioner practicing pursuant to Section 2837.103 or 2837.104, certified nurse midwife practicing pursuant to Section 2746.5, 2746.51, or 2746.52, or clinical psychologist as defined by Section 1316.5 of the Health and Safety Code.

(B)Administration of medications and therapeutic agents, necessary to implement a treatment, disease prevention, or rehabilitative regimen as directed by an advanced practice registered nurse to the extent allowable within the advanced practice registered nurses scope of practice as established under Article 2.5 (commencing with Section 2746), Article 7 (commencing with Section 2825), Article 8 (commencing with Section 2834), or Article 9 (commencing with Section 2838).

(3)The performance of skin tests, immunization techniques, and the withdrawal of human blood from veins and arteries.

(4)Observation of signs and symptoms of illness, reactions to treatment, general behavior, or general physical condition, and (A) determination of whether the signs, symptoms, reactions, behavior, or general appearance exhibit abnormal characteristics, and (B) implementation, based on observed abnormalities, of appropriate reporting, or referral, or standardized procedures, or changes in treatment regimen in accordance with standardized procedures, or the initiation of emergency procedures.

(c)Standardized procedures, as used in this section, means either of the following:

(1)Policies and protocols developed by a health facility licensed pursuant to Chapter 2 (commencing with Section 1250) of Division 2 of the Health and Safety Code through collaboration among administrators and health professionals including physicians and nurses.

(2)Policies and protocols developed through collaboration among administrators and health professionals, including physicians and nurses, by an organized health care system which is not a health facility licensed pursuant to Chapter 2 (commencing with Section 1250) of Division 2 of the Health and Safety Code.

The policies and protocols shall be subject to any guidelines for standardized procedures that the Division of Licensing of the Medical Board of California and the Board of Registered Nursing may jointly promulgate. If promulgated, the guidelines shall be administered by the Board of Registered Nursing.

(d)This shall not be construed to require approval of standardized procedures by the Division of Licensing of the Medical Board of California, or by the Board of Registered Nursing.

(e)A state agency other than the board shall not define or interpret the practice of nursing for those licensed pursuant to the provisions of this chapter, or develop standardized procedures or protocols pursuant to this chapter, unless so authorized by this chapter, or specifically required under state or federal statute. State agency includes every state office, officer, department, division, bureau, board, authority, and commission.

SEC. 5.Section 2730 of the Business and Professions Code is amended to read:2730.

If a person does not represent or hold themselves out as a professional nurse licensed to practice in this state, and if they have an engagement, made in another state or country, requiring them to accompany and care for a patient temporarily residing in this state during the period of such engagement, a nurse legally qualified by another state or country may give nursing care to such patient in this state.

SEC. 6.Section 2737 of the Business and Professions Code is amended to read:2737.

An applicant for a license authorizing them to practice nursing in this state under this chapter, upon the filing of their application, shall pay the fee required by this chapter.

SEC. 7.Section 2740 of the Business and Professions Code is amended to read:2740.

All examinations shall be conducted by the persons and in the manner and under the rules and regulations as the board may prescribe.

The board shall finally pass or reject all applicants. Its actions shall be final and conclusive and not subject to review by any court or other authority.

SEC. 8.Section 2746.51 of the Business and Professions Code is amended to read:2746.51.

(a)Neither this chapter nor any other law shall be construed to prohibit a certified nurse-midwife from furnishing or ordering drugs or devices, including controlled substances classified in Schedule II, III, IV, or V under the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code), when all of the following apply:

(1)The drugs or devices are furnished or ordered incidentally to the provision of any of the following:

(A)The care and services described in Section 2746.5.

(B)Care rendered, consistent with the certified nurse-midwifes educational preparation or for which clinical competency has been established and maintained, to persons within a facility specified in subdivision (a), (b), (c), (d), (i), or (j) of Section 1206 of the Health and Safety Code, a clinic as specified in Section 1204 of the Health and Safety Code, a general acute care hospital as defined in subdivision (a) of Section 1250 of the Health and Safety Code, a licensed birth center as defined in Section 1204.3 of the Health and Safety Code, or a special hospital specified as a maternity hospital in subdivision (f) of Section 1250 of the Health and Safety Code.

(C)Care rendered in an out-of-hospital setting pursuant to subdivision (d) of Section 2746.5.

(2)The furnishing or ordering of drugs or devices by a certified nurse-midwife for services that do not fall within the scope of services specified in subdivision (a) of Section 2746.5 shall be furnished in accordance with, and specified in, the policies and protocols mutually agreed upon pursuant to paragraph (1) of subdivision (b) of Section 2746.5, which shall specify all of the following:

(A)Which certified nurse-midwife may furnish or order drugs or devices.

(B)Which drugs or devices may be furnished or ordered and under what circumstances.

(C)The method of periodic review of the certified nurse-midwifes competence, including peer review, and review of the provisions of the standardized procedure.

(3)If Schedule II or III controlled substances, as defined in Sections 11055 and 11056 of the Health and Safety Code, are furnished or ordered by a certified nurse-midwife for any condition, including, but not limited to, Schedule II or III controlled substances for services that fall within the scope of services specified in subdivision (a) of Section 2746.5, the controlled substances shall be furnished or ordered in accordance with policies and protocols mutually agreed upon pursuant to paragraph (1) of subdivision (b) of Section 2746.5. For Schedule II controlled substance protocols, the provision for furnishing the Schedule II controlled substance shall address the diagnosis of the illness, injury, or condition for which the Schedule II controlled substance is to be furnished.

(b)(1)The furnishing or ordering of drugs or devices by a certified nurse-midwife is conditional on the issuance by the board of a number to the applicant who has successfully completed the requirements of paragraph (2). The board may issue a furnishing number upon initial application for, and renewal application of, a certificate to practice nurse-midwifery and, if approved by the board, the applicant shall not be required to make a separate application. The number shall be included on all transmittals of orders for drugs or devices by the certified nurse-midwife. The board shall maintain a list of the certified nurse-midwives that it has certified pursuant to this paragraph and the number it has issued to each one. The board shall make the list available to the California State Board of Pharmacy upon its request. Every certified nurse-midwife who is authorized pursuant to this section to furnish or issue a drug order for a controlled substance shall register with the United States Drug Enforcement Administration and the Controlled Substance Utilization Review and Enforcement System (CURES) pursuant to Section 11165.1 of the Health and Safety Code.

(2)The board has certified in accordance with paragraph (1) that the certified nurse-midwife has satisfactorily completed a course in pharmacology covering the drugs or devices to be furnished or ordered under this section, including the risks of addiction and neonatal abstinence syndrome associated with the use of opioids. The board shall establish the requirements for satisfactory completion of this paragraph.

(3)Certified nurse-midwives who are certified by the board and hold an active furnishing number and who are registered with the United States Drug Enforcement Administration shall provide documentation of continuing education specific to the use of Schedule II controlled substances in settings other than a hospital based on standards developed by the board.

(c)Furnishing of drugs or devices by a certified nurse-midwife means the act of making a pharmaceutical agent or agents available to the patient. Use of the term furnishing in this section shall include the following:

(1)The ordering of a nonscheduled drug or device for services that fall within the scope of services specified in subdivision (a) of Section 2746.5.

(2)The ordering of a nonscheduled drug or device for services that fall outside the scope of services specified in subdivision (a) of Section 2746.5 in accordance with mutually agreed upon policies and protocols pursuant to paragraph (1) of subdivision (b) of Section 2746.5.

(3)The ordering of a Schedule IV or V drug for any condition, including, but not limited to, for care that falls within the scope of services specified in subdivision (a) of Section 2746.5.

(4)The ordering of a Schedule II or III drug in accordance with mutually agreed upon policies and protocols pursuant to paragraph (1) of subdivision (b) of Section 2746.5.

(5)Transmitting an order of a physician and surgeon.

(d)Drug order or order for purposes of this section means an order for medication or for a drug or device that is dispensed to or for an ultimate user, issued by a certified nurse-midwife as an individual practitioner, within the meaning of Section 1306.03 of Title 21 of the Code of Federal Regulations. Notwithstanding any other provision of law, (1) a drug order issued pursuant to this section shall be treated in the same manner as a prescription of the supervising physician; (2) all references to prescription in this code and the Health and Safety Code shall include drug orders issued by certified nurse-midwives; and (3) the signature of a certified nurse-midwife on a drug order issued in accordance with this section shall be deemed to be the signature of a prescriber for purposes of this code and the Health and Safety Code.

(e)Notwithstanding any other law, a certified nurse-midwife may directly procure supplies and devices, obtain and administer diagnostic tests, directly obtain and administer nonscheduled drugs, and dispense drugs pursuant to Section 4170, consistent with the provision of services that fall within the scope of services specified in subdivision (a) of Section 2746.5, order laboratory and diagnostic testing, and receive reports that are necessary to their practice as a certified nurse-midwife within their scope of practice, consistent with Section 2746.5.

SEC. 9.Section 2746.53 of the Business and Professions Code is amended to read:2746.53.

SEC. 10.Section 2760.1 of the Business and Professions Code is amended to read:2760.1.

(a)A registered nurse whose license has been revoked or suspended or who has been placed on probation, may petition the board for reinstatement or modification of penalty, including reduction or termination of probation, after a period not less than the following minimum periods has elapsed from the effective date of the decision ordering that disciplinary action, or if the order of the board or any portion of it is stayed by the board itself or by the superior court, from the date the disciplinary action is actually implemented in its entirety, or for a registered nurse whose initial license application is subject to a disciplinary decision, from the date the initial license was issued:

(1)(A)Except as otherwise provided in this section, at least three years for reinstatement of a license that was revoked, except that the board may, in its sole discretion, specify in its order a lesser period of time provided that the period shall be not less than one year.

(B)At least two years for early termination of a probation period of three years or more.

(C)At least one year for modification of a condition, or reinstatement of a license revoked for mental or physical illness, or termination of probation of less than three years.

(2)No minimum period applies for a license that was revoked by default for failure to submit a notice of defense.

(b)The board shall give notice to the Attorney General of the filing of the petition. The petitioner and the Attorney General shall be given timely notice by letter of the time and place of the hearing on the petition, and an opportunity to present both oral and documentary evidence and argument to the board. The petitioner shall at all times have the burden of proof to establish by clear and convincing evidence that they are entitled to the relief sought in the petition.

(c)The hearing may be continued from time to time as the board deems appropriate.

(d)(1)The petition may be heard by the board or the board may assign the petition to an administrative law judge of the Office of Administrative Hearings.

(2) If the board assigns the petition to an administrative law judge, the administrative law judge shall submit a proposed decision, as specified in Section 11517 of the Government Code, to the board for its consideration, which shall include reasons supporting the proposed decision.

(e)The board may grant or deny the petition, or may impose any terms and conditions that it reasonably deems appropriate as a condition of reinstatement or reduction of penalty.

(f)In considering a petition for reinstatement or modification of a penalty, the board or the administrative law judge shall evaluate and consider evidence of rehabilitation submitted by the petitioner using criteria specified in regulations promulgated by the board.

(g)The board may impose, or the administrative law judge may recommend, terms and conditions on the petitioner in reinstating a license, certificate, or permit or in modifying a penalty.

(h)The petitioner shall provide a current set of fingerprints accompanied by the necessary fingerprinting fee.

(i)No petition shall be considered while the petitioner is under sentence for any criminal offense, including any period during which the petitioner is on court-imposed probation or parole, or subject to an order of registration pursuant to Section 290 of the Penal Code. No petition shall be considered while there is an accusation or petition to revoke probation pending against the petitioner.

(j)Except in those cases where the petitioner has been disciplined pursuant to Section 822, the board may in its discretion deny without hearing or argument any petition that is filed pursuant to this section within a period of two years from the effective date of a prior decision following a hearing under this section.

SEC. 11.Section 2770.11 of the Business and Professions Code is amended to read:2770.11.

(a)Each registered nurse who requests participation in an intervention program shall agree to cooperate with the rehabilitation program designed by the committee and approved by the program manager. In developing the rehabilitation program, the committee shall determine whether a participant is required to practice nursing prior to completion of the program. Any failure to comply with a rehabilitation program may result in termination of the registered nurses participation in a program. The name and license number of a registered nurse who is terminated for any reason, other than successful completion, shall be reported to the boards enforcement program.

(b)If the program manager determines that a registered nurse, who is denied admission into the program or terminated from the program, presents a threat to the public or their own health and safety, the program manager shall report the name and license number, along with a copy of all intervention program records for that registered nurse, to the boards enforcement program. The board may use any of the records it receives under this subdivision in any disciplinary proceeding.

SEC. 12.Section 2785 of the Business and Professions Code is amended to read:2785.

The board shall prepare and maintain a list of approved schools of nursing in this state whose graduates, if they have the other necessary qualifications provided in this chapter, shall be eligible to apply for a license to practice nursing in this state. The board shall make the list available on its internet website.

SEC. 13.Section 2786 of the Business and Professions Code is amended to read:2786.

(a)(1)An approved school of nursing, or an approved nursing program, is one that has been approved by the board, gives the course of instruction approved by the board, covering not fewer than two academic years, is affiliated or conducted in connection with one or more hospitals, and is an institution of higher education. For purposes of this section, institution of higher education includes, but is not limited to, community colleges offering an associate of arts or associate of science degree and private postsecondary institutions offering an associate of arts, associate of science, or baccalaureate degree or an entry-level masters degree, and is an institution that is not subject to the California Private Postsecondary Education Act of 2009 (Chapter 8 (commencing with Section 94800) of Part 59 of Division 10 of Title 3 of the Education Code).

(2)An approved school of nursing or nursing program shall meet a minimum of 500 direct patient care clinical hours in a board-approved clinical setting with a minimum of 30 hours of supervised direct patient care clinical hours dedicated to each nursing area specified by the board.

(A)Additional clinical hours required by the program for nursing education preparation in each nursing area as specified by the board shall be identified and documented in the curriculum plan for each area.

(B)An approved school of nursing or nursing program shall not be required to track the minimum clinical hours by individual students.

(C)Any clinical practice hours that are not required to be in direct patient care and are provided using simulation experiences shall be based on the best practices published by the International Nursing Association for Clinical Simulation and Learning, the National Council of State Boards of Nursing, or the Society for Simulation in Healthcare, or based on any equivalent standards approved by the board.

(3)An approved school of nursing or nursing program may cover fewer than two academic years if approved to provide a course of instruction that prepares a licensed vocational nurse licensed under the Vocational Nursing Practice Act (commencing with Section 2840) for a license under this chapter.

(b)A school of nursing that is affiliated with an institution that is subject to the California Private Postsecondary Education Act of 2009 (Chapter 8 (commencing with Section 94800) of Part 59 of Division 10 of Title 3 of the Education Code), may be approved by the board to grant an associate of arts or associate of science degree to individuals who graduate from the school of nursing or to grant a baccalaureate degree in nursing with successful completion of an additional course of study as approved by the board and the institution involved.

(c)(1)The board shall determine by regulation the required subjects of instruction to be completed in an approved school of nursing for licensure as a registered nurse and shall include the minimum units of theory and clinical experience necessary to achieve essential clinical competency at the entry level of the registered nurse. The boards regulations shall be designed to require all schools to provide clinical instruction in all phases of the educational process, except as necessary to accommodate military education and experience as specified in Section 2786.1.

(2)Notwithstanding paragraph (1), whenever an agency or facility used by an approved nursing program for direct patient care clinical practice is no longer available or sufficient, the director of the approved nursing program may submit to a board nursing education consultant a request that the approved nursing program allow theory to precede clinical practice if all of the following conditions are met:

(A)No alternative agency or facility located within 25 miles of the impacted approved nursing program, campus, or location, as applicable, has a sufficient number of open placements that are available and accessible to the approved nursing program for direct patient care clinical practice hours in the same subject matter area. An approved program shall not be required to submit more than required under subparagraph (A) of paragraph (3) of subdivision (a) of Section 2786.3.

(B)Clinical practice takes place in the academic term immediately following theory.

(C)Theory is taught concurrently with clinical practice not in direct patient care if no direct patient care experiences are available.

(3)(A)The board shall annually collect, analyze, and report information related to the number of clinical placement slots that are available and the location of those clinical placement slots within the state, including, but not limited to, information concerning the total number of placement slots a clinical facility can accommodate and how many slots the programs that use the facility will need.

(B)The board shall utilize data from available regional or individual institution databases.

(C)The board shall publish the annual report on its internet website.

(4)(A)(i)The board shall annually collect, analyze, and report information related to the management of clinical placements and coordination with clinical facilities by approved schools of nursing or nursing programs.

(ii)The report shall include information relating to how approved schools of nursing or nursing programs collaborate and coordinate with other approved schools of nursing, nursing programs, or regional planning consortiums that utilize the same clinical facility.

(B)(i)The board shall publish the annual report on its internet website.

(ii)Notwithstanding Section 10231.5 of the Government Code, the board shall annually submit the report under this subparagraph to the Legislature.

(iii)A report to be submitted under this subparagraph shall be submitted in compliance with Section 9795 of the Government Code.

(d)The board shall perform or cause to be performed an analysis of the practice of the registered nurse no less than every five years. Results of the analysis shall be utilized to assist in the determination of the required subjects of instruction, validation of the licensing examination, and assessment of the current practice of nursing.

(e)(1)The executive officer shall develop a uniform method for evaluating requests and granting approvals pursuant to this section.

(2)The executive officer may revise the uniform method developed pursuant to this subdivision, as necessary. The development or revision of the uniform method shall be exempt from the requirements of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).

(3)The boards nursing education consultants shall use the uniform method to evaluate requests and grant approvals pursuant to this section.

(4)The board shall post the approved method and any revisions on the boards website.

(f)(1)Graduation requirements for an approved school of nursing, or an approved nursing program, shall include one hour of direct participation in an implicit bias training which shall include all of the following:

(A)Identification of previous or current unconscious biases and misinformation.

(B)Identification of personal, interpersonal, institutional, structural, and cultural barriers to inclusion.

(C)Corrective measures to decrease implicit bias at the interpersonal and institutional levels, including ongoing policies and practices for that purpose.

(D)Information on the effects, including, but not limited to, ongoing personal effects, of historical and contemporary exclusion and oppression of minority communities.

(E)Information about cultural identity across racial or ethnic groups.

(F)Information about communicating more effectively across identities, including racial, ethnic, religious, and gender identities.

(G)Discussion on power dynamics and organizational decisionmaking.

(H)Discussion on health inequities within the perinatal care field, including information on how implicit bias impacts maternal and infant health outcomes.

(I)Perspectives of diverse, local constituency groups and experts on particular racial, identity, cultural, and provider-community relations issues in the community.

(J)Information on reproductive justice.

(2)This subdivision shall not be construed to do any of the following:

(A)Affect the requirements for licensure under this chapter.

(B)Require a curriculum revision.

(C)Affect licensure by endorsement under this chapter.

SEC. 14.Section 2786.3 of the Business and Professions Code is amended to read:2786.3.

(a)Until the end of the 202324 academic year, or whenever the Governor declares a state of emergency for a county in which an agency or facility used by an approved nursing program for direct patient care clinical practice is no longer available, the director of the approved nursing program may submit to a board nursing education consultant requests to do any of the following:

(1)Utilize a clinical setting until the end of the academic term without the following:

(A)Approval by the board.

(B)Written agreements with the clinical facility.

(C)Submitting evidence of compliance with board regulations relating to the utilization of clinical settings, except as necessary for a board nursing education consultant to ensure course objectives and faculty responsibilities will be met.

(2)Utilize preceptorships until the end of the academic term without having to maintain written policies relating to the following:

(A)Identification of criteria used for preceptor selection.

(B)Provision for a preceptor orientation program that covers the policies of the preceptorship and preceptor, student, and faculty responsibilities.

(C)Identification of preceptor qualifications for both the primary and the relief preceptor.

(D)Description of responsibilities of the faculty, preceptor, and student for the learning experiences and evaluation during preceptorship.

(E)Maintenance of preceptor records that includes names of all current preceptors, registered nurse licenses, and dates of preceptorships.

(F)Plan for an ongoing evaluation regarding the continued use of preceptors.

(3)Request that the approved nursing program be allowed to reduce the required number of direct patient care hours to 200 hours in medical-surgical, maintaining at minimum 30 hours of supervised direct patient care clinical hours dedicated to each remaining nursing specialty area specified by the board if all of the following conditions are met:

(A)No alternative agency or facility has a sufficient number of open placements that are available and accessible within 25 miles of the approved nursing program for direct patient care clinical practice hours in the same subject matter area. An approved nursing program shall submit, and not be required to provide more than, the following:

(i)The list of alternative agencies or facilities listed within 25 miles of the impacted approved nursing program, campus, or location, as applicable, using the facility finder on the Department of Health Care Access and Information website.

(ii)The list of courses impacted by the loss of clinical placements and the academic term the courses are offered.

(iii)Whether each of the listed alternative agencies or facilities would meet the course objectives for the courses requiring placements.

(iv)Whether the approved nursing program has contacted each of the listed alternative agencies or facilities about the availability of clinical placements. The approved nursing program shall not be required to contact a clinical facility that would not meet course objectives.

(v)The date of contact or attempted contact.

(vi)The number of open placements at each of the listed alternative agencies or facilities that are available for the academic term for each course. If an alternative agency or facility does not respond within 48 hours, the approved nursing program may list the alternative agency or facility as unavailable. If the alternative agency or facility subsequently responds prior to the submission of the request to a board nursing education consultant, the approved nursing program shall update the list to reflect the response.

(vii)Whether the open and available placements are accessible to the students and faculty. An open and available placement is accessible if there are no barriers that otherwise prohibit a student from entering the facility, including, but not limited to, the lack of personal protective equipment or cost-prohibitive infectious disease testing. An individuals personal unwillingness to enter an alternative agency or facility does not make a placement inaccessible.

(viii)The total number of open and available placements that are accessible to the students and faculty compared to the total number of placements needed.

(B)The substitute clinical practice hours not in direct patient care provide a learning experience, as defined by the board consistent with Section 2708.1, that is at least equivalent to the learning experience provided by the direct patient care clinical practice hours.

(C)The temporary reduction provided in paragraph (3) shall cease as soon as practicable or by the end of the academic term, whichever is sooner.

(D)The substitute clinical practice hours not in direct patient care that are simulation experiences are based on the best practices published by the International Nursing Association for Clinical Simulation and Learning, the National Council of State Boards of Nursing, the Society for Simulation in Healthcare, or equivalent standards approved by the board.

(E)A maximum of 25 percent of the direct patient care hours specified in paragraph (3) in geriatrics and medical-surgical may be completed via telehealth.

(b)If the conditions in paragraph (1), (2), or (3) of subdivision (a), as applicable to the request, are met, a board nursing education consultant shall approve the request. If an approved nursing program fails to submit information satisfactory to the board nursing education consultant, or fails to meet the conditions specified, the board nursing education consultant shall deny the request. If the request is not approved or denied on or before 5:00 p.m. on the date seven business days after receipt of the request, the request shall be deemed approved.

(c)(1)Within 30 days of the effective date of this section, the boards executive officer shall develop a uniform method for evaluating requests and granting approvals pursuant to this section.

(2)The executive officer may revise the uniform method developed pursuant to this subdivision from time to time, as necessary. The development or revision of the uniform method shall be exempt from the requirements of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Title 2 of the Government Code).

(3)The boards nursing education consultants shall use the uniform method to evaluate requests and grant approvals pursuant to this section.

(4)The board shall post the uniform method and any revisions on the boards website.

SEC. 15.Section 2787 of the Business and Professions Code is amended to read:2787.

If the board requires the approval of the faculty or directors in regulations promulgated pursuant to Section 2786, all of the following apply:

(a)The board may approve an individual to serve as a member of the faculty, director, or assistant director of an approved school of nursing or nursing program.

(b)The board shall approve an applicant for individual approval if the applicant submits a completed application in the form prescribed by the board demonstrating that the applicant meets the requirements established by the board for faculty, directors, and assistant directors of an approved school of nursing or nursing program.

(c)The individual faculty approval under this section shall be valid for five years and may be renewed if the individual demonstrates to the board that they continue to meet the requirements established by the board for faculty of an approved school of nursing or nursing program.

(d)The board shall display an approved individuals faculty, director, or assistant director approval status, including the approved faculty level and content areas, if applicable, and the status of their nursing license through an online search tool administered by the department.

(e)(1)If an applicant for approval under this section has a faculty position and does not meet a requirement established by the board for a different position, the board may accept a remediation plan submitted by an approved school of nursing or nursing program to help the applicant meet the requirement.

(2)If the board accepts the plan submitted under paragraph (1), the board may approve the applicant to instruct in theory under the mentorship and supervision of the content expert identified in the plan for up to one year.

(f)(1)If an applicant for approval as an assistant director or director under this section does not have a faculty position and does not meet a requirement established by the board for that position, the board may accept a remediation plan submitted by an approved school of nursing or nursing program to help the applicant meet the requirement.

(2)If the board accepts the plan submitted under paragraph (1), the board may approve the applicant to serve in the role of the assistant director under the mentorship of a board-approved director or assistant director while completing the remediation plan for up to one year. This mentorship shall not be construed to require the physical presence of the mentor, but shall include collaboration and availability via information and communication technologies.

(3)A remediation plan to satisfy the two years of teaching experience in a prelicensure or postlicensure registered nursing program or its equivalence may be accepted if the applicant holds an active license under this chapter, has experience working in direct patient care as a registered nurse full time for one year, and holds a masters degree or higher degree from an accredited college or university which includes coursework in nursing, education, or administration.

(g)If required by the board for directors and assistant directors of an approved school of nursing or nursing program, an approved school of nursing or nursing program shall continue to report to the board changes in the nursing programs director and assistant director of nursing positions.

(h)An approved school of nursing or nursing program shall not be required to report to the board any of the following faculty changes:

(1)A change in a faculty members teaching area.

(2)An offer of employment for a faculty member position.

(3)Termination of employment of a faculty member.

(i)This section does not modify any limitations on the powers of the board related to the faculty approval of accredited schools of nursing and nursing programs as specified in subdivision (b) of Section 2786.2.

SEC. 16.Section 2788 of the Business and Professions Code is amended to read:2788.

It shall be the duty of the board, through its executive officer, to inspect all schools of nursing in this state at the times the board shall deem necessary.

(a)The inspection criteria shall be consistent with the 2020 Nursing Education Approval Guidelines established by the National Council of State Boards of Nursing, or its successor, as approved by the board.

(b)Written reports of the executive officers visits shall be made to the board, which shall thereupon approve those schools of nursing that meet the requirements provided by the board.

(c)Upon receiving the report of the executive officer, if the board determines that any approved school of nursing is not maintaining the standard required by the board, notice thereof in writing specifying the defect or defects shall be immediately given to the school. If the defects are not corrected within a reasonable time, the school of nursing may be removed from the approved list and notice thereof in writing given to it.

SEC. 17.Section 2796 of the Business and Professions Code is amended to read:2796.

It is unlawful for any person or persons not licensed or certified as provided in this chapter to use the title registered nurse, the letters R.N. or RN, or the words graduate nurse, trained nurse, or nurse anesthetist.

It is unlawful for any person or persons not licensed or certified as provided in this chapter to impersonate a professional nurse or pretend to be licensed to practice professional nursing as provided in this chapter.

SEC. 18.Section 2811.5 of the Business and Professions Code is amended to read:2811.5.

(a)(1)Each person renewing their license under Section 2811 shall submit proof satisfactory to the board that, during the preceding two-year period, they have been informed of the developments in the registered nurse field or in any special area of practice engaged in by the licensee, occurring since the last renewal thereof, either by pursuing a course or courses of continuing education in the registered nurse field or relevant to the practice of the licensee, and approved by the board, or by other means deemed equivalent by the board.

(2)Beginning January 1, 2029, both of the following shall apply with respect to the proof required by paragraph (1):

(A)The board shall require each licensee to submit the proof at the time of renewal.

(B)The proof shall include, but not be limited to, documentation verifying the completion of continuing education requirements during the preceding renewal period or the preceding two years.

(b)Notwithstanding Section 10231.5 of the Government Code, the board, in compliance with Section 9795 of the Government Code, shall do the following:

(1)By January 1, 2019, deliver a report to the appropriate legislative policy committees detailing a comprehensive plan for approving and disapproving continuing education opportunities.

(2)By January 1, 2020, report to the appropriate legislative committees on its progress implementing this plan.

(c)For purposes of this section, the board shall, by regulation, establish standards for continuing education. The standards shall be established in a manner to ensure that a variety of alternative forms of continuing education are available to licensees, including, but not limited to, online, academic studies, in-service education, institutes, seminars, lectures, conferences, workshops, extension studies, and home study programs. The standards shall take cognizance of specialized areas of practice, and content shall be relevant to the practice of nursing and shall be related to the scientific knowledge or technical skills required for the practice of nursing or be related to direct or indirect patient or client care. The continuing education standards established by the board shall not exceed 30 hours of direct participation in a course or courses approved by the board, or its equivalent in the units of measure adopted by the board.

(d)The board shall audit continuing education providers at least once every five years to ensure adherence to regulatory requirements, and shall withhold or rescind approval from any provider that is in violation of the regulatory requirements.

(e)The board shall encourage continuing education in spousal or partner abuse detection and treatment. In the event the board establishes a requirement for continuing education coursework in spousal or partner abuse detection or treatment, that requirement shall be met by each licensee within no more than four years from the date the requirement is imposed.

(f)In establishing standards for continuing education, the board shall consider including a course in the special care needs of individuals and their families, including, but not limited to, all of the following:

(1)Pain and symptom management, including palliative care.

(2)The psychosocial dynamics of death.

(3)Dying and bereavement.

(4)Hospice care.

(g)(1)In establishing standards for continuing education, the board shall consider including a course in menopausal mental or physical health.

(2)In establishing standards for continuing education, the board shall consider including a course in maternal mental health.

(h)This section shall not apply to licensees during the first two years immediately following their initial licensure in California or any other governmental jurisdiction, except that, beginning January 1, 2023, those licensees shall complete one hour of direct participation in an implicit bias course offered by a continuing education provider approved by the board that meets all the same requirements outlined in paragraph (1) of subdivision (f) of Section 2786, including, but not limited to, the identification of the licensees previous or current unconscious biases and misinformation and corrective measures to decrease implicit bias at the interpersonal and institutional levels, including ongoing policies and practices for that purpose.

(i)The board may, in accordance with the intent of this section, make exceptions from continuing education requirements for licensees residing in another state or country, or for reasons of health, military service, or other good cause.

(j)For the purpose of fulfilling the requirements of subdivision (a), the following apply:

(1)A nurse practitioner who provides primary care to a patient population of which over 25 percent are 65 years of age or older shall certify that they have completed at least 20 percent of all existing mandatory continuing education hours in a course in the field of gerontology, the special care needs of patients with dementia, or the care of older patients at the time of renewal.

(2)Beginning July 1, 2027, a nurse practitioner who provides care to a patient population composed of adult women under 65 years of age who completes one or more continuing education courses in perimenopause, menopause, or postmenopausal care shall receive two hours for each hour of a completed course, not to exceed six hours, if the following are met:

(A)The course or course provider is accredited by one of the following:

(i)American Nurses Credentialing Center.

(ii)American Association of Nurse Practitioners.

(iii)Accreditation Council for Continuing Medical Education.

(iv)Joint Accreditation for Interprofessional Continuing Education.

(v)The successor organization to an organization specified under this subparagraph.

(B)If the course covers multiple topics, the additional hours are only granted for the hours specified by the course provider as covering perimenopause, menopause, or postmenopausal care.

SEC. 19.Section 2830.7 of the Business and Professions Code is amended to read:2830.7.

The amount of the fees prescribed by this chapter in connection with the issuance of certificates as nurse anesthetists is that fixed by the following schedule:

(a)The fee to be paid upon the filing of an application for a certificate shall be fixed by the board at not more than one thousand five hundred dollars ($1,500).

(b)The biennial fee to be paid upon the application for a renewal of a certificate shall be fixed by the board at not more than one thousand dollars ($1,000).

(c)The penalty fee for failure to renew a certificate within the prescribed time shall be 50 percent of the renewal fee in effect on the date of the renewal of the license, but not more than five hundred dollars ($500).

(d)The fee to be paid for a temporary certificate shall be fixed by the board at not more than five hundred dollars ($500).

SEC. 20.Section 2835 of the Business and Professions Code is amended to read:2835.

No person shall advertise or hold themselves out as a nurse practitioner, or use the letters N.P. or NP, who is not a nurse licensed under this chapter and does not, in addition, meet the standards for a nurse practitioner established by the board.

SEC. 21.Section 2836.3 of the Business and Professions Code is amended to read:2836.3.

(a)The furnishing of drugs or devices by nurse practitioners is conditional on issuance by the board of a number to the nurse applicant who has successfully completed the requirements of subdivision (g) of Section 2836.1. The board may issue a furnishing number upon initial application for, and renewal application of, qualification or certification as a nurse practitioner and, if approved by the board, the applicant shall not be required to make a separate application. The number shall be included on all transmittals of orders for drugs or devices by the nurse practitioner. The board shall make the list of numbers issued available to the Board of Pharmacy. The board may charge the applicant a fee to cover all necessary costs to implement this section, that shall be not more than one thousand five hundred dollars ($1,500) for an initial application for qualification or certification as a nurse practitioner, nor more than one thousand dollars ($1,000) for an application for renewal of qualification or certification as a nurse practitioner.

(b)The number shall be renewable at the time of the applicants registered nurse license renewal.

(c)The board may revoke, suspend, or deny issuance of the numbers for incompetence or gross negligence in the performance of functions specified in Sections 2836.1 and 2836.2.

SEC. 22.Section 2837.103 of the Business and Professions Code is amended to read:2837.103.

(a)(1)Notwithstanding any other law, a nurse practitioner may perform the functions specified in subdivision (c) pursuant to that subdivision, in a setting or organization specified in paragraph (2) pursuant to that paragraph, if the nurse practitioner has successfully satisfied the following requirements:

(A)Passed a national nurse practitioner board certification examination and, if applicable, any supplemental examination developed pursuant to paragraph (4) of subdivision (a) of Section 2837.105.

(B)Holds a certification as a nurse practitioner from a national certifying body accredited by the National Commission for Certifying Agencies or the American Board of Nursing Specialties and recognized by the board.

(C)Provides documentation that educational training was consistent with standards established by the board pursuant to Section 2836 and any applicable regulations as they specifically relate to requirements for clinical practice hours. Online educational programs that do not include mandatory clinical hours shall not meet this requirement.

(D)Has completed a transition to practice in California, or another state identified by the board pursuant to clause (v), of a minimum of three full-time equivalent years of practice or 4600 hours. A nurse practitioner who has been practicing as a nurse practitioner in direct patient care for a minimum of three full-time equivalent years or 4,600 hours within the last five years, as indicated on the application, may be deemed to have satisfied this requirement. For purposes of this subparagraph:

(i)Proof of completion of one transition to practice shall be provided to the board, on a form prescribed by the board, as an attestation from either a physician and surgeon licensed in this state, a certified nurse practitioner practicing pursuant to this section, or a certified nurse practitioner practicing pursuant to Section 2837.104.

(ii)A licensed physician and surgeon or a certified nurse practitioner who attests to the completion of a transition to practice is not required to specialize in the same category as the applicant pursuant to Section 2836.

(iii)A licensed physician and surgeon or a certified nurse practitioner practicing pursuant to this section or Section 2837.104 who attests to the completion of a transition to practice is not required to verify competence, clinical expertise, or any other standards related to the practice of the applicant and shall only attest to the completion of the transition to practice, as defined in Section 2837.101.

(iv)A licensed physician and surgeon or a certified nurse practitioner practicing pursuant to this section or Section 2837.104 who attests to the completion of a transition to practice shall not be subject to civil, criminal, administrative, disciplinary, employment, credentialing, professional discipline, contractual liability, or medical staff action, sanction, or penalty or other liability for providing an attestation or refusing to provide an attestation pursuant to this section unless the attestation was produced fraudulently.

(v)For purposes of a transition to practice completed in another state, the board shall do all of the following:

(I)On or before January 1, 2028, identify states where practice experience would meet or exceed the requirements under this article if obtained in this state.

(II)Maintain a list of the identified states on the boards website.

(III)Establish a process for identifying changes to the relevant laws in the identified states.

(IV)Periodically review the list of the identified states and add or remove states from the list as necessary.

(2)A nurse practitioner who meets all of the requirements of paragraph (1) may practice, including, but not limited to, performing the functions authorized pursuant to subdivision (c), in one of the following settings or organizations in which one or more physicians and surgeons practice with the nurse practitioner without standardized procedures:

(A)A clinic, as defined in Section 1200 of the Health and Safety Code.

(B)A health facility, as defined in Section 1250 of the Health and Safety Code, except for the following:

(i)A correctional treatment center, as defined in paragraph (1) of subdivision (j) of Section 1250 of the Health and Safety Code.

(ii)A state hospital, as defined in Section 4100 of the Welfare and Institutions Code.

(C)A facility described in Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code.

(D)A medical group practice, including a professional medical corporation, as defined in Section 2406, another form of corporation controlled by physicians and surgeons, a medical partnership, a medical foundation exempt from licensure, or another lawfully organized group of physicians and surgeons that provides health care services.

(E)A home health agency, as defined in Section 1727 of the Health and Safety Code.

(F)A hospice facility licensed pursuant to Chapter 8.5 (commencing with Section 1745) of Division 2 of the Health and Safety Code.

(3)In health care agencies that have governing bodies, as defined in Division 5 of Title 22 of the California Code of Regulations, including, but not limited to, Sections 70701 and 70703 of Title 22 of the California Code of Regulations, the following apply:

(A)A nurse practitioner shall adhere to all applicable bylaws.

(B)A nurse practitioner shall be eligible to serve on medical staff and hospital committees.

(C)A nurse practitioner shall be eligible to attend meetings of the department to which the nurse practitioner is assigned. A nurse practitioner shall not vote at department, division, or other meetings unless the vote is regarding the determination of nurse practitioner privileges with the organization, peer review of nurse practitioner clinical practice, whether a licensees employment is in the best interest of the communities served by a hospital pursuant to Section 2401, or the vote is otherwise allowed by the applicable bylaws.

(b)An entity described in subparagraphs (A) to (F), inclusive, of paragraph (2) of subdivision (a) shall not interfere with, control, or otherwise direct the professional judgment of a nurse practitioner functioning pursuant to this section in a manner prohibited by Section 2400 or any other law.

(c)In addition to any other practices authorized by law, a nurse practitioner who meets the requirements of paragraph (1) of subdivision (a) may perform the following functions without standardized procedures in accordance with their education and training:

(1)Conduct an advanced assessment.

(2)(A)Order, perform, and interpret diagnostic procedures.

(B)For radiologic procedures, a nurse practitioner can order diagnostic procedures and utilize the findings or results in treating the patient. A nurse practitioner may perform or interpret clinical laboratory procedures that they are permitted to perform under Section 1206 and under the federal Clinical Laboratory Improvement Act (CLIA).

(3)Establish primary and differential diagnoses.

(4)Prescribe, order, administer, dispense, procure, and furnish therapeutic measures, including, but not limited to, the following:

(A)Diagnose, prescribe, and institute therapy or referrals of patients to health care agencies, health care providers, and community resources.

(B)Prescribe, administer, dispense, and furnish pharmacological agents, including over-the-counter, legend, and controlled substances.

(C)Plan and initiate a therapeutic regimen that includes ordering and prescribing nonpharmacological interventions, including, but not limited to, durable medical equipment, medical devices, nutrition, blood and blood products, and diagnostic and supportive services, including, but not limited to, home health care, hospice, and physical and occupational therapy.

(5)After performing a physical examination, certify disability pursuant to Section 2708 of the Unemployment Insurance Code.

(6)Delegate tasks to a medical assistant pursuant to Sections 1206.5, 2069, 2070, and 2071, and Article 2 (commencing with Section 1366) of Chapter 3 of Division 13 of Title 16 of the California Code of Regulations.

(d)A nurse practitioner practicing under this section and not working under standardized procedures shall inform all new patients in a language understandable to the patient that a nurse practitioner is not a physician and surgeon.

(e)A nurse practitioner shall not be required to tell a patient the patient has a right to see a physician and surgeon.

(f)A nurse practitioner practicing under this section and not working under standardized procedures shall post a notice in a conspicuous location accessible to public view that the nurse practitioner is regulated by the Board of Registered Nursing. The notice shall include the boards telephone number and the internet website where the nurse practitioners license may be checked and complaints against the nurse practitioner may be made.

(g)A nurse practitioner shall refer a patient to a physician and surgeon or other licensed health care provider if a situation or condition of a patient is beyond the scope of the education and training of the nurse practitioner.

(h)A nurse practitioner practicing under this section shall have professional liability insurance appropriate for the practice setting.

(i)Any health care setting operated by the Department of Corrections and Rehabilitation is exempt from this section.

SEC. 23.Section 2838.2 of the Business and Professions Code is amended to read:2838.2.

(a)A clinical nurse specialist is a registered nurse with advanced education, who participates in expert clinical practice, education, research, consultation, and clinical leadership as the major components of their role.

(b)The board may establish categories of clinical nurse specialists and the standards required to be met for nurses to hold themselves out as clinical nurse specialists in each category. The standards shall take into account the types of advanced levels of nursing practice that are or may be performed and the clinical and didactic education, experience, or both needed to practice safety at those levels. In setting the standards, the board shall consult with clinical nurse specialists, physicians and surgeons appointed by the Medical Board of California with expertise with clinical nurse specialists, and health care organizations that use clinical nurse specialists.

(c)A registered nurse who meets one of the following requirements may apply to become a clinical nurse specialist:

(1)Possession of a masters degree in a clinical field of nursing.

(2)Possession of a masters degree in a clinical field related to nursing with coursework in the components referred to in subdivision (a).

(3)On or before July 1, 1998, meets the following requirements:

(A)Current licensure as a registered nurse.

(B)Performs the role of a clinical nurse specialist as described in subdivision (a).

(C)Meets any other criteria established by the board.

(d)(1)A nonrefundable fee not to exceed one thousand five hundred dollars ($1,500) shall be paid by a registered nurse applying to be a clinical nurse specialist for the evaluation of their qualifications to use the title clinical nurse specialist.

(2)The fee to be paid for a temporary certificate to practice as a clinical nurse specialist shall be not more than fifty dollars ($50).

(3)A biennial renewal fee shall be paid upon submission of an application to renew the clinical nurse specialist certificate and shall be established by the board at no more than one thousand dollars ($1,000).

(4)The penalty fee for failure to renew a certificate within the prescribed time shall be 50 percent of the renewal fee in effect on the date of the renewal of the license, but not more than five hundred dollars ($500).

(5)The fees authorized by this subdivision shall not exceed the amount necessary to cover the costs to the board to administer this section.