Patients suffer when hospitals break the law


February 7, 2019 (805) 312-0024

Patients suffer when hospitals break the law.
Determined, Senator Connie M. Leyva reintroduces a bill to improve hospital patient safety.

Sacramento, CA—Today, State Senator Connie M. Leyva (D–Chino) introduced SB 227, co-sponsored by SEIU Local 121RN, SEIU California State Council and United Nurses Associations of California / Union of Health Care Professionals (UNAC / UHCP). Like last year’s SB 1288, this year’s bill will mandate unannounced inspections of hospitals with a special focus on adherence to California’s nurse-to-patient ratios as regulated by Title 22. This bill will also levy penalties on hospitals that continue to disregard these regulations.

“In our rapidly changing healthcare world, California’s Nurses continue to make patient safety our number one priority, both in our contracts with area hospitals and in these efforts to create a strong enforcement mechanism for existing state regulations,” said SEIU Local 121RN President Gayle Batiste, RN, CNOR at Northridge Hospital Medical Center. “Nurses are determined to ensure California no longer tolerates the flimsy enforcement that has emboldened hospitals to view Title 22 regulations as ‘recommendations’ or ‘guidelines.’ They are not recommendations. They are bare minimums.”

RNs—who referred to SB 1288 last year as the “Stop Repeat Offender Hospitals” bill—say they’re more committed than ever to push against the false narrative and aggressive lobbying that hospital administrators engaged in last year to promote the myth that our hospitals don’t experience unsafe staffing levels.

• California leads the nation with its groundbreaking regulations protecting patients and Registered Nurses—but, the enforcement of those regulations is virtually nonexistent, rendering them meaningless in too many hospitals.
• Unlike other healthcare settings, such as long-term care facilities, hospitals face no financial penalties for violations of staffing ratios.
• A penalty only kicks in when it’s too late: when there’s a violation that caused, or is likely to cause, serious injury or death to a patient.
• If there is no serious injury or death, the California Department of Public Health (CDPH) simply requests that hospitals submit a “plan of correction” (which many hospitals copy/paste from their last submitted plan).
• CDPH testified in 2013 that it does not routinely follow up on hospitals’ plans of corrections.
• Nurse-to-patient ratio laws have gone two decades without any enforcement mechanism to curb repeat offenders.

It’s time to ensure that a person doesn’t have to die before a fine is imposed.

“SB 227 will help to improve patient health and safety by ensuring hospitals in California comply with legally mandated nurse-to-patient staffing ratios,” said Senator Connie M. Leyva (D-Chino). “The stakes for patients are very high and, in order to protect them, CDPH must fully enforce existing law. I thank SEIU California, SEIU Local 121RN and UNAC / UHCP for jointly sponsoring SB 227 and working with me to help protect patients.”


Service Employees International Union, Local 121RN represents nearly 9,000 registered nurses and other healthcare professionals at 27 hospitals and facilities in Los Angeles and surrounding counties. This member-led organization is committed to supporting optimum working conditions that allow nurses to provide quality patient care and safety.

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ACA Repeal: Millions Will Lose Coverage, Hundreds of Thousands Will Lose Jobs

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From the UCLA Center for Health Policy Research.

ACA Repeal = Millions will lose coverage + Hundreds of thousands will lose jobs

Up to 3.7 million insured in California’s Medicaid expansion and a further 1.2 million Californians receiving subsidies to buy affordable health insurance in Covered California are at risk if current Republican plans to repeal the Affordable Care Act are enacted, according to a set of new studies and county fact sheets from the UC Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research.

Millions of Californians stand to lose from ACA repeal in some way — either through lost access to affordable coverage or to jobs created by health insurance expansion.

“Fallout from Republican changes to the health care system could be even more harmful if the administration changes the way Medi-Cal benefits are calculated or if coverage features are reduced,” said Miranda Dietz, researcher at the UC Berkeley Labor Center and lead author of one study.

Read the press release: Millions in California will lose coverage and hundreds of thousands of jobs will be lost if ACA is repealed — new studies, county fact sheets

Read the publication: ACA Repeal in California: Who Stands to Lose?


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What you Should Know About the BRN Diversion Program


What is the Diversion Program?

The Board of Registered Nursing (BRN) is one of several professional regulatory boards and bureaus that exist within the Department of Consumer Affairs. The BRN has the primary responsibility of licensing and regulating registered nurses in California. The BRN’sresponsibilities come from the Nursing Practice Act, which is composed of California statutes that give the BRN, among other functions, the authority to manage a Diversion Program for registered nurses.

The Diversion Program is a voluntary, confidential program for registered nurses whose practice may be impaired due to substance use disorder or mental illness. The goal of the Diversion Program is to protect the public by early identification of impaired registered nurses and by providing these nurses access to appropriate intervention programs and treatment services. Public safety is protected by suspension of practice, when needed, and by careful monitoring of the nurse.

What Service Does the Program Provide?

  • Confidential consultation when considering entering the program
  • Assessment and referral for appropriate detoxification or treatment
  • Development of a rehabilitation plan for substance use disorders or mental illness
  • Consultation with employers to assure a safe and smooth transition back to nursing practice for the nurse participant
  • Random body fluid testing
  • Referrals to local support services
  • Encouragement, support, and guidance for the registered nurse in recovery as an effective alternative to disciplinary action, and determination that the registered nurse is able to resume nursing practice

Why is the Program Needed?

Registered nurses are not immune from the diseases of substance use disorder or mental illness. Experts estimate that at least 10% of the general population will have a problem with alcohol or drugs at some point in their lives. Health care professionals, including registered nurses, may be particularly susceptible to substance abuse problems due to the stresses of working in a health care environment and due to an increased opportunity to obtain controlled substances.

Many registered nurses who experience problems with substance use disorders are able to find the help and support they need to stay clean and sober without BRN involvement.

Mental illness, although not as prevalent, is also a disease that may affect a registered nurse’s ability to practice safely. For example, untreated major depression can seriously impair an individual.

Unfortunately, most people suffering from substance use disorder or mental illness deny the problem. Many times they are the last to recognize and admit that they need help. If mental illness or substance use disorder problems are left untreated, they may eventually jeopardize patient health and safety. They can also threaten the life of the person afflicted.

In these cases, it becomes imperative that those individuals who detect substance abuse or mental health problems in a registered nurse take action. Without intervention, diseases have predictable courses and outcomes. The BRN’s Diversion Program aims to identify symptoms, intervene, and change the outcomes.

The Diversion Program also provides an effective alternative to the traditional disciplinary process.

Who is Eligible?

Registered Nurses Who:

  • are licensed and reside in California
  • are mentally ill or abuse alcohol or drugs to the extent that their nursing practice may be affected, and
  • voluntarily agree to enter the program and provide consent for appropriate medical or psychiatric evaluations

Registered Nurses are Ineligible for the Program if They Have:

  • previously been disciplined by the Board for substance abuse or mental illness,
  • been terminated previously from this program, any other diversion program for non-compliance,
  • sold drugs, or
  • caused patient harm or death

How Does an RN Get Into the Program?

Nurses enter the program in one of two ways:

  • Self-Referral – Registered nurses who would like assistance may contact the program directly.
  • Board-Referral – Registered nurses are referred to the Diversion Program by the BRN as a result of a complaint indicating the RN may be impaired due to substance use disorder or mental illness. If a nurse chooses not to enter the program, the complaint is referred to the Enforcement Program for investigation and possible disciplinary action.

Is the Diversion Program Successful?

Yes! Over 1,900 registered nurses have successfully completed the program. To complete the Diversion Program, a nurse with a substance use disorder must demonstrate a change in lifestyle that supports continuing recovery and have a minimum of 24 consecutive months of clean, random, body-fluid tests. A nurse with a history of mental illness must demonstrate the ability to identify the symptoms or triggers of the disease and be able to take immediate action to prevent an escalation of the disease.

The success of the Diversion Program is due to close monitoring of participants for an average of three years, but more importantly, it is attributable to the encouragement, support and guidance provided to nurses by other nurses.

Is the Program Confidential?

Diversion Program staff are available for confidential consultation regarding possible referral to the Diversion Program.

The confidentiality of participants is protected by law. Once a nurse enters the program, the information gathered to assist in developing a rehabilitation plan, and all other information in their record, is confidential.

When a nurse successfully completes the Diversion Program, the Diversion Program records are destroyed. If a nurse does not successfully complete the program, the original complaint, if any, is investigated by the Board’s Enforcement Program. (As of January 1, 2000, Diversion Program records may be forwarded to the Board’s Enforcement Program if a registered nurse who is terminated from the Diversion Program presents a threat to the public or his or her own health and safety.

Where Can I Get Additional Information About the Diversion Program?

For general program information, to schedule intake appointments or interventions, and for questions regarding monitoring nurses in the program, call 1-800-522-9198.

For questions regarding the Diversion Program or the Board of Registered Nursing’s role in protecting public safety and identifying impaired practitioners, contact the Board’s Diversion and Probation Programs Manager and staff at (916) 322-3350.

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BreEZe Is Not a Breeze

By Ingela Dahlgren, RN, SEIU Nurse Alliance of California Executive Director

At the Board of Registered Nursing meeting on February 6, we found out that there have been extensive problems with the new electronic processing system for licensing that was installed in the fall of 2013. The new system – BreEZe – should have been more efficient and reliable than the old system.

Kathy Hughes, Jeannie King, Grace Corse, and I attended the meeting and listened to a nursing student pleading to know when he was going to be allowed to take the NCLEX exam. He said that he had been waiting for months and had two job offers that would start in March. The Board said it could not fast track anybody as that would put everybody else further behind, estimating that there are about 1000 licensing/renewal cases on the backlog. This is not acceptable.

The Board states that their mission is to protect the public, but how can it do that if experienced nurses cannot practice without being able to renew their licenses? What kind of impression does the Board give our new nursing students when they cannot even process their requests to sit for exams?

Twelfth District Assemblymember Kristin Olsen wrote a letter to the Joint Legislative Audit Committee requesting an audit of policies and procedures on the planning, development, and implementation of BreEZe. You can read her letter here.

Our hope is that the Board will hire some extra staff to get through the backlog and have the vendor of the BreEZe fix the system ASAP. Please let me know what kind of problems you and your coworkers have experienced.

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