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AB-2850 Nurse assistant training programs: online and distance learning.(2017-2018)

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Date Published: 07/02/2018 02:00 PM
AB2850:v96#DOCUMENT

Amended  IN  Senate  July 02, 2018
Amended  IN  Senate  June 18, 2018
Amended  IN  Assembly  April 18, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 2850


Introduced by Assembly Member Rubio

February 16, 2018


An act to amend Section 1337.1 of, and to add Section 1337.15 to, the Health and Safety Code, relating to health facilities.


LEGISLATIVE COUNSEL'S DIGEST


AB 2850, as amended, Rubio. Nurse assistant training programs: online and distance learning.
Existing law establishes the State Department of Public Health and sets forth its powers and duties, including the licensing and administration of health facilities, as defined, including skilled nursing facilities and intermediate care facilities.
Existing law requires skilled nursing facilities and intermediate care facilities to adopt certified nurse assistant training programs approved by the department. Existing law requires a training program to include 60 hours of classroom training, as specified, which may be conducted within a facility or at an educational institution.
This bill would authorize the required classroom training to be offered through online or distance learning classes approved by the department.
This bill would also authorize a presently employed an experienced licensed or registered nurse, as specified, to provide instruction as part of a certified nurse assistant training program at a skilled nursing or intermediate care facility or in an educational institution, regardless of whether he or she holds a teaching credential to provide that instruction.
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) Over 1,100 people turn 65 years of age every day in California, and there are approximately 110,000 licensed skilled nursing beds in the state.
(b) About 25 percent of older adults will need nursing home care at some time in their lives.
(c) There is a shortage of qualified nurses available to meet the needs of patients in California health care facilities, particularly those patients in the state’s 1,200 skilled nursing facilities.
(d) California’s skilled nursing facilities currently face a challenge not only in recruiting qualified nursing staff, but also in retaining quality nursing staff.
(e) With over 65 percent of our residents on Medi-Cal, California’s skilled nursing facilities are an integral part of the health care continuum, with over 13.5 million Californians on Medi-Cal.
(f) The occupancy rate of California’s skilled nursing facilities is above the national average and is currently at 88 percent.
(g) Certified nurse assistants are an important component of skilled nursing facilities, but unfortunately the workforce in that area is stagnant and extremely limited in various counties.
(h) Over 1,600 additional certified nurse assistants in skilled nursing facilities will be needed to meet the increased minimum staffing level mandate by July 1, 2018.
(i) According to the Office of Statewide Health Planning and Development, in 2016, over 63 percent of skilled nursing facility direct care staff are certified nurse assistants, over 23 percent are licensed vocational nurses (LVNs), and over 9 percent are registered nurses (RNs).
(j) The California HealthCare Foundation has determined that: “... California may not have adequate numbers of nurses with appropriate skills. The result could be decreased patient access, higher health care costs, and lower quality of service.”
(k) The quality of patient care in California long-term care facilities is directly dependent upon the availability of an adequate supply of appropriately trained workers.

SEC. 2.

 Section 1337.1 of the Health and Safety Code is amended to read:

1337.1.
 A skilled nursing or intermediate care facility shall adopt an approved training program that meets standards established by the department. The approved training program shall consist of at least all of the following:
(a) An orientation program to be given to newly employed nurse assistants prior to providing direct patient care in skilled nursing or intermediate care facilities.
(b) (1) A precertification training program consisting of at least 60 classroom hours of training on basic nursing skills, patient safety and rights, the social and psychological problems of patients, and resident abuse prevention, recognition, and reporting pursuant to subdivision (e). The 60 classroom hours of training may be conducted within a skilled nursing or intermediate care facility or in an educational institution. A skilled nursing or intermediate care facility or an educational institution may conduct the 60 classroom hours of training in an online or distance learning course format, as approved by the department.
(2) In addition to the 60 classroom hours of training required under paragraph (1), the precertification training program shall consist of at least 100 hours of supervised and on-the-job training clinical practice. The 100 hours may consist of normal employment as a nurse assistant under the supervision of either the director of nurse training or a licensed nurse qualified to provide nurse assistant training who has no other assigned duties while providing the training.
(3) At least two hours of the 60 hours of classroom training shall address the special needs of persons with developmental and mental disorders, including intellectual disability, cerebral palsy, epilepsy, dementia, Parkinson’s disease, and mental illness. At least two hours of the 60 hours of classroom training shall address the special needs of persons with Alzheimer’s disease and related dementias.
(4) At least four hours of the 100 hours of supervised clinical training shall address the special needs of persons with developmental and mental disorders, including intellectual disability, cerebral palsy, epilepsy, Alzheimer’s disease and related dementias, and Parkinson’s disease.
(5) In a precertification training program subject to this subdivision, credit shall be given for the training received in an approved precertification training program adopted by another skilled nursing or intermediate care facility.
(6) This subdivision shall not apply to a skilled nursing or intermediate care facility that demonstrates to the department that it employs only nurse assistants with a valid certification.
(c) Continuing in-service training to ensure continuing competency in existing and new nursing skills.
(d) Each facility shall consider including training regarding the characteristics and method of assessment and treatment of acquired immune deficiency syndrome (AIDS).
(e) (1) The approved training program shall include, within the 60 hours of classroom training, a minimum of six hours of instruction on preventing, recognizing, and reporting instances of resident abuse utilizing those courses developed pursuant to Section 13823.93 of the Penal Code, and a minimum of one hour of instruction on preventing, recognizing, and reporting residents’ rights violations.
(2) A minimum of four hours of instruction on preventing, recognizing, and reporting instances of resident abuse, including instruction on preventing, recognizing, and reporting residents’ rights violations, shall be included within the total minimum hours of continuing education or in-service training required and in effect for certified nursing nurse assistants.

SEC. 3.

 Section 1337.15 is added to the Health and Safety Code, immediately following Section 1337.1, to read:

1337.15.
 (a) A person who provides instruction or training, at a skilled nursing or intermediate care facility or in an educational institution, as part of a certified nurse assistant precertification training program described in Section 1337.1 may be any licensed vocational nurse or registered nurse presently employed at a skilled nursing facility, acute care hospital, or other facility that primarily provides care for older adults, including a nurse working in a supervisory capacity that does not directly involve patient care. with no less than two years of nursing experience, of which no less than one year is in providing care and services to chronically ill or elderly patients in an acute care hospital, skilled nursing facility, intermediate care facility, home care, hospice care, or other long-term care setting.
(b) Notwithstanding any other law, a person described in subdivision (a) shall not be required to hold a teaching credential to provide instruction as part of a certified nurse assistant precertification training program described in Section 1337.1.