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AB-2140 Home health agencies: waiver program: nurses.(2017-2018)

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Date Published: 02/12/2018 09:00 PM
AB2140:v99#DOCUMENT


CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Assembly Bill No. 2140


Introduced by Assembly Member Maienschein

February 12, 2018


An act to add Section 1734.2 to the Health and Safety Code, relating to home health services.


LEGISLATIVE COUNSEL'S DIGEST


AB 2140, as introduced, Maienschein. Home health agencies: waiver program: nurses.
Existing law requires a private or public organization to obtain a license from the State Department of Public Health before providing, or arranging for the provision of, skilled nursing services in the home. Existing law requires that applicants for certification as a home health aide complete a training program and obtain a criminal record clearance.
This bill would require the department, on or before March 1, 2019, to begin collaborating with stakeholders to create a waiver program, as specified, to permit home health agencies to obtain a waiver of the one year prior professional nursing requirements imposed by the department in regulation. The bill would require the department to implement the program on or before January 1, 2020. The bill would require the waiver, if granted, to apply to all registered nurses and licensed vocational nurses employed by the home health agency.
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) Home health agencies provide essential health care services to individuals in their place of residence.
(b) Section 74707 of Title 22 of the California Code of Regulations requires registered nurses and licensed vocational nurses providing services in a patient’s place of residence through a home health agency to have one year of prior professional nursing experience.
(c) Due to the low reimbursement rates for home health services, home health agencies struggle to find quality registered nurses and licensed vocational nurses.
(d) Pursuant to Section 74689 of Title 22 of the California Code of Regulations the department allows home health agencies to apply for a waiver allowing the one-year prior professional nursing experience to be waived as long as the home health agency outlines an approved training program for the individual nurse.
(e) The State Department of Public Health has 60 days from the date of submission to act on the waiver request. During this period, the nurse cannot provide care to a patient. This leads to a shortage of needed services and nurses who are unable to get paid.
(f) The waiver program is complicated and must be completed on a nurse by nurse basis. This often leads to the nurse finding other employment while the home health agency awaits action on the waiver.

SEC. 2.

 Section 1734.2 is added to the Health and Safety Code, to read:

1734.2.
 (a) Commencing on or before January 1, 2020, the department shall implement a Universal Flex Waiver Program. The program shall permit home health agencies to apply for a waiver of the one year prior professional experience required by the department pursuant to Section 74707 of Title 22 of the California Code of Regulations for all registered nurses and licensed vocational nurses employed by the home health agency.
(b) To obtain a waiver, a home health agency shall submit an application, as determined by the department, which shall include an explanation of the agency’s training program for each service a nurse is required to perform in the home health setting, including, but not limited to, all of the following:
(1) Skilled observation and assessment, including vital signs.
(2) Medication administration.
(3) Respiratory care, including tracheostomy care, nebulizer treatments, percussion, nasal suctioning, ventilator care, oxygen saturation readings, and oxygen administration.
(4) Gastrostomy/nasogastric care, including gastrostomy tube feeding, nasogastric tube feeding, gastrostomy tube site care, gastrostomy tube changes, and medication administration via nasogastric tube.
(5) Bowel care, including enemas, disimpaction, suppository administration, and Harris flushes.
(6) Personal care.
(7) Wound care, decubitus care, and general skin care.
(8) Intravenous (IV) care, including peripherally inserted central catheter (PICC) line care, IV port care, intravenous medication and fluid administration, heparin lock care and insertion.
(9) Care for urinary devices, including Foley catheter care and changes, suprapubic catheter care and changes, and urinary catheter flushes.
(10) Ostomy care (urostomies, colostomies, ileostomies), including device care and flushes.
(11) Collection of lab specimens, including collecting blood, urine, stool, sputum, and wound culture samples, and International Normalized Ratio (INR) collection using a portable device.
(12) Diabetic care, including blood glucose collection and insulin administration.
(c) Commencing on or before March 1, 2019, the department shall collaborate with stakeholders to create the program and the application required pursuant to subdivision (b).
(d) The department shall approve a waiver application within 60 days of submission. Approval or denial shall be provided to the home health agency in writing.
(e) If a home health agency is granted a waiver pursuant to this section, that waiver shall apply to all registered nurses and licensed vocational nurses that are employed by that agency and the agency shall not be required to obtain waivers for individual registered nurses or licensed vocational nurses.