Report 2019-120 Recommendation 5 Responses

Report 2019-120: Board of Registered Nursing: It Has Failed to Use Sufficient Information When Considering Enrollment Decisions for New and Existing Nursing Programs (Release Date: July 2020)

Recommendation #5 To: Registered Nursing, Board of

To ensure that BRN is using up-to-date, accurate, and objective information to inform the governing board's enrollment decisions and to assess clinical capacity for student placements, by April 1, 2021, BRN should do the following: revise its regulations to require nursing programs to report any changes they make to their use of clinical facilities within 90 days of making a change and report annually if the program has made no changes.

Annual Follow-Up Agency Response From October 2022

A regulation package amending CCR, Title 16, section 1427 was approved by Office of Administrative Law pursuant to section 11349.3 of the Government Code. This regulatory action becomes effective on January 1, 2023. This update now requires nursing programs to report changes made to the use of their clinical facilities within 90 days of making the change and to report annually by December 31 of each year that the Board's report is accurate and notify the Board of any required corrections or additions.

A regulation package amending CCR, Title 16, section 1432 was approved by Office of Administrative Law pursuant to section 11349.3 of the Government Code. This regulatory action becomes effective on January 1, 2023. This rulemaking package makes three substantial changes. First, in 16 CCR 1423 the board makes concealing material facts from the board a cause for denial of an application or revocation of an approved program. Second, in section 1432, the board requires nursing programs applying to add new locations to use an existing form (EDP-I-01 Rev 3/10), updated in this rulemaking package to EDP-1-01 Rev 10/22. Third, in section 1432, the board requires nursing programs to apply for approval for any increase in enrollment numbers. The board also makes non-substantive edits to Section 1421(a) to update the name of the Form EDP-I-01.

California State Auditor's Assessment of Annual Follow-Up Status: Fully Implemented

We reviewed the revised regulations and the final approval by the Office of Administrative Law. The revised regulations implement our recommendation.

Annual Follow-Up Agency Response From July 2022

A regulation package proposing to amend CCR, Title 16, section 1427 is in process and as written will require nursing programs to report changes made to the use of their clinical facilities within 90 days of making the change and to report annually if the program has made no changes. On May 12, 2022, to provide further clarification, the Board withdrew the package from OAL and continued to work with DCA and OAL to update the text. The modified text for CCR, Title 16, section 1427 as noticed was approved by the Board on June 23, 2022, and the Board directed staff to take all steps necessary to complete the rulemaking process, including authorizing the Executive Officer to make any non-substantive changes to the proposed regulations necessary to complete rulemaking process and filing the final rulemaking package with OAL.

A regulation package proposing to amend CCR, Title 16, section 1432 was submitted to OAL for publication on November 12, 2021. A public hearing was held on January 20, 2022, with comments and responses being compiled. The updated regulation that addresses changes to an approved program, clarifies the process for approval of a new campus or location and specifies the need for prior Board approval for any increase in total annual enrollment, or any change in the frequency, timing, or number of new student admissions for each Board approved nursing program or degree option.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

Annual Follow-Up Agency Response From October 2021

The regulation packages proposing to amend CCR, Title 16, sections 1427 and 1432 to require nursing programs to report any changes they make to their use of clinical facilities within 90 days of making the change and report annually if the program has made no changes continues to be in process with the Department of Consumer Affairs and the Board of Registered Nursing.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

1-Year Agency Response

A regulation package is currently being reviewed by DCA. This regulation package proposes to amend CCR, Title 16, sections 1427 and 1432 to require nursing programs to report any changes they make to their use of clinical facilities within 90 days of making the change and report annually if the program has made no changes.

California State Auditor's Assessment of 1-Year Status: Pending

6-Month Agency Response

The BRN commenced the promulgation of a regulation package which proposes to amend CCR, Title 16, sections 1427 and 1432 to require nursing programs to report any changes they make to their use of clinical facilities within 90 days of making the change and report annually if the program has made no changes.

California State Auditor's Assessment of 6-Month Status: Pending

60-Day Agency Response

BRN has amended the EDP-P-18 and EDP-I-15 forms to capture annual capacity estimates from clinical facilities, as well as annual clinical placement needs of programs. The BRN has updated the Director's Handbook to include the updated EDP-P-18 and clinical facility approval - instruction (EDP-I-15) forms. The updated EDP-I-15 form outlines the process for notifying the BRN within 90 days of any changes in clinical placements including the cancellation of a clinical rotation and the request for annual verification of clinical placements.

Additionally, BRN is exploring if the regulatory changes referenced above can be included in a current regulations package already in development. If this is not possible, BRN will commence a new regulations package on or before April 1, 2021.

California State Auditor's Assessment of 60-Day Status: Pending

All Recommendations in 2019-120

Agency responses received are posted verbatim.