Today's Law As Amended


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AB-1407 Nurses: implicit bias courses.(2021-2022)



As Amends the Law Today


SECTION 1.

 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 less  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 master’s 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.
(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 board’s 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 place the annual report on its internet website.
(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 Title 2 of the Government Code).
(3) The board’s 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 board’s website.
(f) (e)  (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. 2.

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

2811.5.
 (a) 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.
(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) 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) (e)  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.
(h) 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.

SEC. 3.

 Section 123630.5 is added to the Health and Safety Code, to read:

123630.5.
 (a) A hospital, as defined in subdivision (a) of Section 1250, shall implement an evidence-based implicit bias program, as described in subdivision (b) of Section 123630.3, as part of its new graduate training program that hires and trains new nursing program graduates.
(b) If the hospital hires and trains new nursing program graduates who are subject to subdivision (c) of Section 123630.3, compliance by the hospital with Section 123630.3 shall meet the requirements of subdivision (a) only with respect to those new nursing program graduates subject to subdivision (c) of Section 123630.3.