Sign Up for Updates

California Legislation

CNA RNs rally at the California State Capitol, Sacramento, CA.

Bills of the 2014 Legislative Session

BREAKING NEWS: RN-backed bills on patient choice and charity care advance in Sacramento.

CNA Sponsored: AB 503, AB 2533, and SB 1269. Additional bills: SB 1182 and SB 1005

Urge CA legislators to support these important reforms for patient safety

  • AB 2533 (Ammiano) Patient Choice. This bill requires plans and insurers to arrange care from out-of-network providers at no extra cost to enrollees if the enrollees are unable to obtain medically necessary covered services in a timely manner in their network. The bill would also require California Department of Insurance (CDI) to promulgate timely access regulations and to review and updated the regulations every three years to determine if updates are necessary. The bill further requires health care service plans and insurers to annually report denials of care and complaints regarding timely access to Department of Managed Health Care (DMHC) and to CDI and post reports on their website.

    Download a fact sheet on this bill (PDF).
  • SB 1269 (Beall) Observation Services Standards. This bill would limit the period of time a patient may be placed in observation to 24 hours making it consistent with time limitations imposed on other outpatient settings. It would require hospitals to obtain approval from the state to provide care in “observation units” which would have to meet the same staffing standards, including licensed nurse-to-patient ratios, as emergency rooms. Additionally, it would require hospitals to provide notice to patients that observation services are “outpatient” services and third-party reimbursement may be impacted, and require hospitals to report observation services to the Office of Statewide Health Planning and Development.

    Download a fact sheet on this bill (PDF).
  • SB 1182 (Leno) Expanding Rate Review of Insurance Premium Increases to Large Groups. Rate Review for Large Groups Mandates that Large Group health insurance plans (self-insured or HMOs) file rate information with the Department of Insurance (self-insured plans), or the Department of Managed Health Care (HMOs) at least 60 days prior to implementing a rate increase that exceeds 5% of the prior year’s rate. Insurers must give Large Group purchasers their utilization data, if asked.
  • SB 1005 (Lara) Expanding Medi-Cal to Income-Qualified Undocumented Immigrants. Expands Medi-Cal benefits to undocumented immigrants who would otherwise not qualify.

Urge CA legislators to support these important reforms for patient safety

CNA Sponsored: SB 1299 and AB 2616

SB 1299 (Padilla) Workplace Violence. To address the growing problem of workplace violence in California hospitals, this bill would direct CalOSHA to develop a regulatory standard on workplace violence requiring hospitals establish workplace violence prevention plans that include strong provisions to protect health care workers and other facility personnel from aggressive and violent behavior, including interactive personnel education and training; systems to assess and improve factors that contribute to violence in the hospital, including sufficiency of security and staffing; provisions protecting an employee’s right to seek help from law enforcement; and, requirements for hospitals to document and report incidents of violence to Cal/OSHA.  The bill would also require Cal/OSHA to post a report on its website containing information regarding violent incidents at hospitals and to make recommendations on how to prevent violent incidents at hospitals.

Download a fact sheet on this bill (PDF).

AB 2616 (Skinner) seeks to establish a rebuttal presumption for workers’ compensation when an acute care hospital employee who provides direct patient care contracts a methicillin-resistant Staphylococcus aureus (MRSA) skin infection and presumes these ailments were contracted through employment.  AB 2616 seeks to cover MRSA skin infections and covers employees post-employment for 60 days. CNA feels strongly that registered nurses and healthcare workers must be protected after providing critical services to their communities. We believe this can best be accomplished by providing these workers with rebuttal presumption for workers’ compensation for healthcare workers who contract MRSA skin infections.

Download a fact sheet on this bill.


SB 1132 (Mitchell/Leno) Fracking. This bill would impose a moratorium of indefinite length on well stimulation treatments in the state until after a scientific study is conducted with stakeholders and completed with public participation and that the final study poses no risk to, or impairment of, the public health and welfare or the environmental and economic sustainability of the state.

SB 1239 (Wolk) School RNs. Allows the governing board of a school district to bill a pupil's health insurer or the Medi-Cal program, or both, for the cost of providing an LVN or RN to deliver health care services provided to the pupil. Requires the governing board of a school district eligible to receive concentration grants, to employ at least one school nurse as a supervisor of health.

SB 1381 (GMO) Evans. Enacts "The California Right to Know Genetically Engineered Food Act" to require the labeling of all genetically engineered foods sold within California.


AB 2183 (Bocanegra) Excelsior College: Nursing Program. This billwould require the Board of Registered Nursing (BRN) to adopt specific criteria for determining the equivalency of courses of instruction when assessing the qualifications of out-of-state applicants for licensure by endorsement. This bill would undermine our state’s current licensure standards.

SB 993 (Mitchell) Dieticians. The bill creates an expansion of the scope of authority of registered dietitians in licensed health care facilities by allowing them to independently modify a patients dietary order without physician sign-off.

SB 1238 (Hernandez) Observation standards. This bill diverges from current regulations by creating several exceptions to the 24-hour admission or discharge requirement. Specifically, under SB 1238, an outpatient may remain on outpatient status for longer than 24 hours for multiple reasons, including a conflict with Medicare reimbursement rules, and “other specified circumstances, as determined medically appropriate by the department.”


AB 1841 (Mullin) Medical Assistants. Without CNA intervention, this bill would have required MAs to dispense medications to patients in clinics. With CNA amendments, the bill has been significantly amended to only clarify/allow a MA to perform supportive functions. In this bill, it is clarified that MAs are only allowed to hand over medication to a patient AFTER the furnisher/prescriber has properly selected, verified the dose and patient name including conducting all of the necessary education, counseling.

AB 1890 (Chau) Athletic Trainers - Without CNA intervention, this bill would have licensed athletic trainers and would have endowed them with a scope of practice to treat, clinically evaluate, assess, rehabilitate, and recondition “patients.” The bill now only gives Athletic Trainers title protection. 

SB 850 (Block) Community Colleges granting BSNs. Without CNA intervention, the bill would have allowed Community Colleges to grant BSN degrees in a variety of fields of study which included nursing. With CNA amendments, the bill excludes the field of nursing. This has been a long standing fight with the hospital association and the IOM report advancing magnet status through forcing the future nursing workforce to be BSN educated, thus disenfranchising other groups of nursing students out of the same opportunity to become RNs through the much more affordable and attainable ADN option.

Celebrate 15 Years of California's Nurse to Patient Ratios!

Nurses fought long and hard for nurse to patient ratios because nurses care for their patients. Listen as RNs who were directly involved in the struggle for ratios talk about the fight, and the excitement of winning one of the landmark patient gains in the country…and the ONLY patient ratios law in the United States.

Governor Gray Davis signed ratios into law in California in 1999. They were finally implemented in 2004 after a long fight to win safe staffing and quality patient care. Nurses even took on Gov. Schwarzenegger and won. Their story of persistence in the face of adversity is one of the great political tales of our time.

Find out more about CNA/NNOC/NNU's National Campaign for Safe RN-to-Patient Staffing Ratios.


Please also see:

CNA Endorsements (Supported Candidates)

NNU Legislation (Supported Bills)

See how your members of Congress vote on a variety of issues



Back to Legislation »