BILL ANALYSIS Ó
SB 943
Page 1
Date of Hearing: July 5, 2011
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
SB 943 (Business, Professions and Economic Development) - As
Amended: June 13, 2011
SENATE VOTE : 39-0
SUBJECT : Healing arts.
SUMMARY : This bill makes several non-controversial, minor,
nonsubstantive or technical changes to various provisions
pertaining to health-related regulatory boards of the Department
of Consumer Affairs (DCA) and professions regulated primarily
under the Business and Professions Code (BPC). Specifically,
this bill :
1)Makes the following changes relating to the Dental Hygiene
Committee (DHC):
a) Provides that protection of the public shall be the
highest priority for the committee in exercising its
licensing, regulatory and disciplinary functions. Whenever
the protection of the public is inconsistent with other
interests sought to be promoted, the protection of the
public shall be paramount.
b) Clarifies that the practice of dental hygiene includes
periodontal record evaluation, administration of local
anesthesia, nitrous oxide-oxygen analgesia, and gingival
soft tissue curettage.
c) Specifies that fingerprint images that applicants for
licensure must submit shall be electronic, and changes
reference to code sections regarding fingerprints from
sections governing dentists to a section governing dental
hygienists.
d) Specifies that a person must complete an application and
pay all fees required by DHC, and complete DHC-approved
instruction in gingival soft tissue curettage, nitrous
oxide-oxygen analgesia and local anesthesia in order to
obtain an initial license.
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e) Extends the sunset date from January 1, 2012, to January
1, 2014, on the DHC's authority to grant licensure to
dental students who work in a practice that serves patients
insured by Denti-Cal, the Healthy Families Program or other
government programs, or that has a sliding scale fee based
on income, as specified.
f) Requires applicants for licensure as a registered dental
hygienist (RDH) in extended functions or an RDH in
alternative practice to complete an application form and
pay all application fees required by DHC in order to obtain
a license.
g) Specifies that applicants for licensure as an RDH in
alternative practice may have a degree from an institution
accredited by a regional accrediting agency recognized by
the United States Department of Education. Deletes a
provision that institutions may be recognized by the
Council on Postsecondary Accreditation.
h) Simplifies the phrase "dental health diagnosis" to read
"dental diagnosis," as it pertains to functions that an RDH
in alternative practice may perform.
i) Deletes a provision relating to a 2009 shift of funds
from the State Dental Auxiliary (SDA) Fund to the State
Dental Hygiene (SDH) Fund.
j) Allows the DHC to reprimand a licensee or order a
license placed on probation in addition to other
disciplinary actions.
aa) Allows DHC to collect "administrative penalties" in
addition to civil penalties.
bb) Makes additional technical, clarifying changes.
2)Makes the following changes relating to the Board of
Registered Nursing (BRN):
a) Limits the BRN's determination that military education
and experience establish competency to practice registered
nursing, to consider military education only.
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b) Amends an incorrect reference to code section regarding
authorized nurse practitioners.
3)Changes the mailing address to which people may send
questions, comments, or complaints, to reflect the Board of
Psychology's move to a new location in 2008.
4)Deletes, as a pathway to licensure as a physician assistant,
the successful completion in a medical school approved by the
Division of Licensing of a resident course of professional
instruction that meets specified requirements.
5)Makes clarifying changes to the grandfathering provisions for
practicing polysomnographic technologists.
6)Deletes an obsolete reference to a practical exam given by the
Board of Pharmacy prior to December 31, 2003.
7)Extends the sunset date on the Veterinary Medicine Practice
Act from January 1, 2012, until January 1, 2013.
8)Makes the following changes relating to the Board of
Behavioral Sciences (BBS):
a) Adds "couple and family therapy" to the list of
acceptable subjects that satisfy masters or doctoral degree
requirement for licensure applicants.
b) Amends references to the Bureau for Private
Postsecondary Education to reflect the Bureau's name
change.
c) Clarifies how required experiential hours may be
allocated between "face-to-face" counseling and
"client-centered advocacy."
d) Includes "clinical counselor intern" in the list of
interns or associates a marriage and family therapy (MFT)
corporation or licensed professional in private practice
may supervise or employ .
e) Increases the number of interns an MFT corporation or
licensed individual in private practice may employ at one
time from two per licensed therapist to three per licensed
therapist. Also increases the total number of interns a
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corporation may have at one time from 10 to 15. Changes
references to a professional corporation to clarify that
these provisions apply to an MFT corporation.
f) Includes MFTs and licensed educational psychologists
(LEPs) in the list of positions referenced in sections
regarding disciplinary action following revocation,
suspension or restriction of license.
g) Clarifies that BBS may suspend or revoke a license based
upon disciplinary action in this state, in addition to
other states and territories.
h) Clarifies a provision regarding acts beyond the scope of
one's competence as a social worker.
i) Clarifies that BBS may take disciplinary action based on
revocation of a license to practice clinical social work,
among revocation of other licenses, certificates, or
registrations.
j) Adds licensed professional clinical counselors to the
list of qualified members of professional groups that shall
not be prevented from doing work of a psychosocial nature.
aa) Includes clinical counselor intern in the list of
interns or associates a licensed clinical social worker
(LCSW) corporation or licensed professional in private
practice may supervise or employ.
bb) Increases the number of interns an LCSW corporation or
licensed individual in private practice may employ at one
time from two per licensed therapist to three per each
employee or shareholder who has satisfied specified
requirements. Also increases total number of interns a
corporation may have at one time from 10 to 15.
cc) Consolidates provisions regarding BBS authority to
suspend or revoke a license or registration.
dd) Consolidates provisions regarding the number of interns
or employees certain licensed individuals may supervise at
one time.
EXISTING LAW
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1)Provides for the licensing and regulation of various
professions and businesses by several boards, committees,
bureaus, and a commission within DCA under various BPC
licensing acts.
2)Contains the following provisions relating to the DHC:
a) Establishes DHC within the Dental Board of California
(DBC) to regulate the practice of RDHs.
b) Requires an applicant for licensure as an RDH to provide
fingerprints to state and federal criminal justice
agencies. Requires DHC to submit fingerprint images to the
Department of Justice (DOJ) for the purposes of criminal
record information. Specifies that DOJ charges a fee to
cover processing.
c) Establishes the authority of DHC for licensure of RDHs
in extended functions pursuant to certain requirements.
Establishes the authority of DHC for licensure of RDHs in
alternative practice pursuant to certain requirements,
including completion of a bachelor's degree or equivalent
from a higher education institution accredited by a
national agency recognized by the Council on Postsecondary
Accreditation.
d) Clarifies that an RDH in alternative practice shall not
infer, purport or advertise that he or she is in any way
able to provide dental services or make any type of dental
health diagnosis beyond evaluating hygiene status.
e) Requires that a percentage of funds in the SDA Fund be
transferred to the SDH Fund based on the number of RDHs,
RDHs in extended functions or RDHs in alternative practice
licensed on June 30, 2009.
f) Authorizes DHC to suspend, revoke or decline a license
if the time for appeal has elapsed, if the judgment of a
conviction has been affirmed on appeal, or if an order
granting probation is made that suspends the sentence.
g) Specifies that unprofessional conduct for an RDH
includes being convicted of a charge violating any federal
statute or rules or any state statute or rules regarding
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controlled substances.
h) Specifies that a licensee who fails or refuses to comply
with a request for a patient's dental hygiene records,
accompanied by that patient's written authorization, within
15 days of receiving the request and authorization, must
pay DHC a $250 civil penalty, up to $5,000, for each day
the documents have not been produced.
i) Specifies that a health care facility that fails or
refuses to comply with a request for a patient's dental
hygiene records accompanied by that patient's written
authorization, within 30 days of receiving the request and
authorization, must pay DHC a $250 civil penalty, up to
$5,000, for each day the documents have not been produced.
Clarifies that the civil penalties shall be in accordance
with the Administrative Procedures Act (ADA).
3)Contains the following provisions relating to the BRN:
a) Establishes the Nursing Practice Act (NPA), enforced by
the BRN, to regulate the practice of nursing in California.
b) Requires applicants for licensure as an RN to meet
certain educational requirements, to have completed
specified courses of instruction, and to not be subject to
denial of licensure under specified circumstances.
Applicants who have served on active duty in the medical
corps in the United States Armed Forces may submit a record
of specified training to the BRN for evaluation in order to
satisfy the courses of instruction requirement. If the
applicant satisfies the other general licensure
requirements and if the BRN determines
4)Requires all licensees and registrants of the Board of
Psychology to post a notice to consumers in a conspicuous
location in their principal psychological business office
informing consumers that the Board of Psychology receives and
responds to questions and complaints regarding the practice of
psychology and provides information on how to contact the
Board, including a designated mailing address.
5)Contains the following provisions relating to the Board of
Pharmacy:
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a) Provides for the licensure and regulation of pharmacies,
pharmacists and wholesalers of dangerous drugs or devices
by the Board.
b) Requires an applicant to pass a practical exam given by
the Board prior to December 31, 2003.
6)Contains the following provisions relating to BBS:
a) Licenses and regulates the practice of MFTs, MFT
interns, LEPs, LCSWs and associate social workers (ASWs) by
the BBS. Beginning January 1, 2012, BBS will also license
professional clinical counselors (LPCCs).
b) Specifies the following as subjects that satisfy masters
or doctoral degree requirements for licensure: marriage,
family and child counseling; marriage and family therapy;
psychology; clinical psychology; counseling psychology;
and, counseling with an emphasis in marriage, family and
child counseling or marriage and family therapy.
c) Specifies that the practicum required for licensure must
include a minimum of 225 hours of face-to-face experience
counseling individuals, couples, families or groups.
d) Prohibits a licensed professional MFT in practice or a
MFT corporation from supervising more than two individuals
registered as either an MFT intern or ASW. Prohibits a
licensed professional MFT in private practice from
employing more than two MFT interns or ASWs. Prohibits a
MFT corporation from employing more than 10 MFT interns or
ASWs.
e) Authorizes BBS to deny an application or suspend or
revoke a license or registration for a clinical social
worker, professional clinical counselor or an LEP.
f) Authorizes BBS to suspend or revoke a license based upon
disciplinary action in another state or territory of the
U.S. or by a government agency.
g) Authorizes BBS to deny a license or registration, or
suspend or revoke the license or registration of a licensee
based on unprofessional conduct, including acting beyond
the scope of one's competence as an LCSW.
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h) Prohibits members of certain professional groups from
holding themselves out to the public for certain
psychological work.
i) Prohibits a LCSW in private practice or a LCSW
corporation from supervising more than two individuals
registered as either a MFT intern or ASW. Prohibits a LCSW
in private practice from employing more than two MFT
interns or ASWs. Prohibits a LCSW corporation from
employing more than 10 MFT interns or ASWs.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office, "This
bill?consolidates a number of non-controversial provisions
related to various regulatory programs and professions governed
by the Business and Professions Code. Consolidating the
provisions in one bill is designed to relieve the various
licensing boards, bureaus and professions from the necessity and
burden of having separate measures for a number of
non-controversial revisions.
"Many of the provisions of this bill are minor, technical and
updating changes, while other provisions are substantive
consensus changes intended to improve the ability of various
licensing programs and other entities to efficiently and
effectively administer their respective laws.
"As a Committee bill, this measure is jointly authored by each
of the members of the Committee. As such, by its very nature,
it is a consensus bill. If controversy or opposition should
arise regarding any provision in this bill that cannot be
resolved, then that provision will be removed from the bill.
This will eliminate the chance of placing any of the other
provisions in jeopardy."
Background . The following is information from the author's
office providing background and reasons for the more significant
and substantive provisions in this measure.
Hygienists were initially licensed under the Committee on Dental
Auxiliaries (COMDA) which was under the jurisdiction of the DBC.
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SB 853 (Perata), Chapter 31, Statutes of 2008, brought
hygienists under the jurisdiction of the DHC, which is an
autonomous committee. However, there are still some references
to COMDA and the DBC having jurisdiction for DHC. The intent of
the law was to create an autonomous committee responsible for
promulgating its own regulations and conduct and developing
examinations, licensing and enforcement. This bill makes
changes to include clarifying language, address licensee's
responsibilities and requirements and improve consumer
protection.
The BRN was established in 1905, and is responsible for
implementation and enforcement of the NPA, the laws and
regulations related to nursing education, licensure, practice,
and discipline. The BRN implements regulatory programs and
performs a variety of activities to protect consumers. These
programs and activities include setting RN educational standards
for pre-licensure and advanced practice nursing programs,
approving California RN programs, issuing and renewing RN
licenses, issuing certificates for advanced practice nurses and
public health nurses, taking disciplinary action for violation
of the NPA, and managing a diversion program for RNs whose
practice may be impaired due to chemical dependency or mental
illness.
According to BRN, experience is not one of the required criteria
for licensure, upon passing the licensure examination, so use of
the term to determine the qualifications of military persons is
misleading. Current language is outdated and inconsistent with
other code sections. Experience, as it pertains to the
requirements for licensure, is inappropriate terminology, as
everyone, including military personnel, is required to meet the
qualifications outlined in statute. This bill removes the term
"experience" and allows "military education" to be used to
determine qualification as a licensee in California.
According to BBS, many of the provisions contained in this bill
add clarity and consistency to licensing law. Several of the
proposed amendments are needed as a result of new legislation
establishing the licensure and regulation of LPCCs by the BBS,
which went into effect January 1, 2010.
A growing number of graduate programs nationwide have begun
offering degrees in couple and family therapy. This degree
title reflects a growing trend to acknowledge a greater
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diversity of relationships with which MFTs work. A degree in
couple and family therapy is currently not listed in statute as
one of the degrees the BBS may accept in order to qualify for an
MFT license. This bill adds the degree title "Couple and Family
Therapy" to the list of degrees titles that are accepted to
qualify for MFT licensure.
Current law requires that a qualifying degree for licensure
include practicum that includes a minimum of 225 hours of
face-to-face experience counseling individuals, couples,
families or groups, and states that up to 75 of these house may
be gained performing client centered advocacy. However, client
centered advocacy, as defined in current law, does not consist
of face-to-face contact. In order to clarify the type of
experience required, this bill separates the 225 hours into 150
hours of face-to-face experience and 75 hours of either client
centered advocacy or face-to-face experience.
Last year, BBS voted to limit the number of registrants a
supervisor can supervise in a private practice setting. Current
MFT and LCSW law now limits the number of registrants that a
licensed professional in private practice may supervise or
employ to two individuals registered either as an MFT intern or
an ASW. Additionally, an MFT, LCSW, or LPCC corporation may
currently employ no more than ten individuals registered either
as MFT interns or ASWs at any one time. There is currently no
limit on the number of clinical counselor interns that may be
supervised in private practice. This bill imposes a limitation
of three registrants for a supervisor in private practice.
Additionally, the corporation may currently employ no more than
fifteen individuals registered by BBS at any one time. This
bill adds a section in order to apply these same limitations to
LPCCs.
Current law discusses grounds for denial of application or
disciplinary action for unprofessional conduct by MFTs, LEPs and
LCSWs. Current code sections for each leave out action against
its own license as grounds for disciplinary conduct.
Additionally, there is no equivalent section in LPCC law stating
that action against a BBS license or registration constitutes
grounds for disciplinary action against an LPCC license or
registration. For consistency, this bill lists all four of the
BBS license types to clarify the intention that disciplinary
action against any one of the BBS license types would constitute
grounds for disciplinary action against any other of the BBS
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licenses if an individual held more than one license.
Current law pertaining to LCSWs states that holding one's self
out as being able to perform any service beyond the scope of
one's license is unprofessional conduct. However, the
equivalent code sections in MFT, LEP, and LPCC law state that it
is considered unprofessional conduct to perform any professional
services beyond the scope of one's competence. This bill
includes scope of competence for LCSWs in order to make it
consistent with MFT, LEP, and LPCC code.
Current law allows certain other professional groups to practice
work of a psychosocial nature as long as they don't hold
themselves out to be an LCSW. LPCCs are not included in the
list. This bill adds LPCCs to the list of professional groups
allowed to practice work of a psychosocial nature.
SB 132 (Denham), Chapter 635, Statutes of 2009, established a
certification program for sleep professionals assisting
physicians in the practice of sleep medicine, administered by
the Medical Board of California (MBC). In order to prevent a
flood of applications for initial certification, a
grandfathering provision was added to allow current
practitioners who "submit proof to the board that he or she has
been practicing polysomnography for at least five years in a
manner that is acceptable to the board" to be certified.
There is concern that the grandfathering provision lacks clarity
and is ambiguous, resulting in confusion as to whether current
practitioners can be grandfathered in. There is also concern
that lack of clarity will result in a large number of initial
certification requests to the MBC from current practitioners in
good standing, as well as a potential shortage of practitioners
in hospitals and clinics while these individuals wait to have
their application processed. A limited grandfathering provision
for practitioners "practicing polysomnography for at least five
years in a manner that is acceptable to the board" will ensure
that there is not a disruption in patient access to sleep
medicine services from the lack of a grandfathering provision.
Support . The Board of Behavioral Sciences states, "This bill
will allow the Board to maintain clear and effective statutes."
Related legislation . SB 944 (Business, Professions and Economic
Development) makes several changes to various provisions
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pertaining to the non-health related regulatory boards of DCA.
This bill is pending in Assembly Appropriations Committee.
Previous legislation . SB 1489 (Business, Professions and
Economic Development), Chapter 653, Statutes of 2010, makes
technical changes to various provisions of the health-related
regulatory boards of DCA.
SB 1491(Business, Professions and Economic Development), Chapter
415, Statutes of 2010 Amends various provisions pertaining to
the non-health related regulatory boards under DCA.
REGISTERED SUPPORT / OPPOSITION :
Support
Board of Behavioral Sciences
Opposition
None on file.
Analysis Prepared by : Angela Mapp / B.,P. & C.P. / (916)
319-3301