BILL ANALYSIS Ó
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|Hearing Date:April 29, 2013 |Bill No:SB |
| |305 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: SB 305Author:Price
As Amended:April 25, 2013 Fiscal:Yes
SUBJECT: Healing arts: boards.
SUMMARY: Extends until January 1, 2018, the provisions establishing
the Naturopathic Medicine Committee and the Respiratory Care Board of
California, and extends the term of the executive officers of the
Respiratory Care Board of California and the California State Board of
Optometry. Specifies that the Osteopathic Medical Board of California
is subject to review by the appropriate policy committees of the
Legislature. Exempts individuals who have performed pulmonary
function tests in Los Angeles county facilities for at least 15 years,
from licensure as a respiratory care therapist. Specifies that any
board under the Department of Consumer Affairs is authorized to
receive certified records from a local or state agency to complete an
applicant or licensee investigation and authorizes them to provide
those records to the board.
Existing law:
1) Requires and board, bureau or program within the Department of
Consumer Affairs (DCA) to require an applicant for licensure to
furnish to the board a full set of fingerprints in order to conduct
a criminal history record check. (Business and Professions Code
(BPC) § 144)
2) Provides for the licensure and regulation of osteopathic physicians
and surgeons by the Osteopathic Medical Board of California (OMB)
(BPC § 2450)
3) Establishes the Naturopathic Medicine Committee, within the
Osteopathic Medical Board of California, under the DCA, and permits
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the committee to license and regulate naturopathic doctors until
January 1, 2014. (BPC § 3610 et seq.)
4) Specifies that the repeal of the Naturopathic Medicine Committee
subjects it to review by the appropriate policy committees of the
Legislature (BPC § 2450.3)
5) Provides for the licensure and regulation of optometrists by the
California State Board of Optometry and authorizes the California
Board of Optometry to employ an executive officer until January 1,
2014. (BPC § 3010 et seq.; 3014.6)
6) Provides for the licensure and regulation of respiratory care
practitioners by the Respiratory Care Board of California and
authorizes the board to employ and executive officer until January
1, 2014. (BPC § 3710 et seq.; 3716)
7) Specifies activities that are not prohibited by the Respiratory
Care Act including: (BPC § 3765)
a) The performance of respiratory care that is an integral part
of the program of study by students enrolled in approved
respiratory therapy training programs;
b) Self-care by the patient or the gratuitous care by a friend or
member of the family who does not represent or hold himself or
herself out to be a respiratory care practitioner;
c) The respiratory care practitioner from performing advances in
the art and techniques of respiratory care learned through formal
or specialized training;
d) The performance of respiratory care in an emergency situation
by paramedical personnel who have been formally trained in these
modalities and are duly licensed;
e) Respiratory care services in case of an emergency;
"emergency" includes an epidemic or public disaster;
f) Persons from engaging in cardiopulmonary research;
g) Formally trained licensees and staff of child day care
facilities from administering to a child inhaled medication; and
h) The performance by a person employed by a home medical device
retail facility or by a home health agency licensed by the State
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Department of Health Services of specific, limited, and basic
respiratory care or respiratory care related services that have
been authorized by the Respiratory Care Board.
This bill:
1) Revises the provisions of the Naturopathic Medicine Act as follows:
a) Extends, until January 1, 2018, the provisions establishing
the Naturopathic Medicine Committee.
b) Specifies that the Naturopathic Medicine Committee is subject
to be reviewed by the appropriate policy committees of the
Legislature.
2) Revises the provisions of the Optometry Act as follows:
a) Extends, until January 1, 2018, the term of the executive
officers of the California State Board of Optometry.
b) Specifies that the California State Board of Optometry is
subject to be reviewed by the appropriate policy committees of
the Legislature.
3) Revises the provisions of the Respiratory Care Act as follows:
a) Extends, until January 1, 2018, the provisions establishing
the Respiratory Care Board of California.
b) Extends, until January 1, 2018, the term of the executive
officers of the Respiratory Care Board of California.
c) Specifies that the Respiratory Care Board of California is
subject to be reviewed by the appropriate policy committees of
the Legislature.
d) Exempts individuals who have performed pulmonary function
tests in Los Angeles county facilities for at least 15 years,
from licensure as a respiratory care therapist.
4) Revises the provisions related to the Osteopathic Medical Board of
California as follows:
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a) Requires that the powers and duties of the Osteopathic Medical
Board of California would be subject to review by the appropriate
policy committees of the Legislature and requires that the review
of the Board be performed as if these provisions were scheduled
to be repealed January 1, 2018.
5) Specifies that any board under the DCA is authorized to receive
certified records from a local or state agency of all arrests and
convictions, certified records regarding probation, and any and all
other related documentation needed to complete an applicant or
licensee investigation.
6) Specifies that a local or state agency is authorized to provide
those records to a board upon receipt of such a request.
FISCAL EFFECT: Unknown. This bill has been keyed fiscal by
Legislative Counsel.
COMMENTS:
1. Purpose. This bill is one of six "sunset review bills" authored by
the Chair of this Committee.
Unless legislation is carried this year to extend the sunset dates
for the Naturopathic Medicine Committee, the Respiratory Care Board
of California and the California State Board of Optometry, they
will be repealed on January 1, 2014. Because it was created via
initiative act, the Osteopathic Medical Board of California does
not have a sunset date. This bill will specify that as of January
1, 2018, the Osteopathic Medical Board of California will be
reviewed consistent with other healing arts boards under the DCA
that are subject to a 4 year sunset review period. This bill will
exempt certain employees from going through the laborious process
of becoming certified respiratory therapists when they have been
safely and reliably performing services for over 15 years at LA
County safety net hospitals. This bill will allow all DCA boards
to receive certified records from a local or state agency of all
arrests and convictions, certified records regarding probation, and
any and all other related documentation needed to complete an
applicant or licensee investigation.
2. Oversight Hearings and Sunset Review of Licensing Boards and
Commission of DCA. In 2013, this Committee conducted oversight
hearings to review 14 regulatory boards within the DCA. The
Committee began its review of these licensing agencies in March and
conducted three days of hearings. This bill, and the accompanying
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sunset bills, is intended to implement legislative changes as
recommended in the Committee's Background/Issue Papers for all of
the agencies reviewed by the Committee this year.
3. Review of the Naturopathic Medicine Committee (NMC), Issues
Identified and Recommended Changes. Although the Committee
addressed several issues regarding the NMC during it review of this
Committee, the only statutory change necessary was the extension of
their sunset dates.
a) Issue : Should the current NMC continue to license
and regulate Naturopathic
Doctors?
Background : The health and safety of consumers is protected by
well-regulated professions. The NMC is charged with protecting
the consumer from unprofessional and unsafe licensees. It
appears that the NMC has had significant difficulty operating as
an effective and efficient regulatory body for the profession
that falls under its purview. Many of the issues are related to
a lack of staff. Immediate attention should be paid to
increasing the staff of the NMC and focusing on salient
enforcement tasks.
Recommendation : The Committee staff recommended that NDs
continue to be regulated by the current NMC in order to protect
the interests of consumers and be reviewed once again in four
years. [The current language in this measure reflects this
recommended change.]
4. Review of the Respiratory Care Board of California (RCB), Issues
Identified and Recommended Changes. The following are some of the
pertaining to the RCB in which statutory changes were considered
necessary, or areas of concern reviewed and discussed by the
Committee during the review of the RCB, along with background
information concerning each particular issue. Recommendations were
made by Committee staff and members regarding the particular issues
or problem areas which needed to be addressed.
a) Issue : Difficulty for RCB and Other Board in Obtaining Local
Agency Records.
Background : It is customary for most boards and bureaus to
obtain complete arrest, conviction and other related
documentation as part of an applicant's or licensee's
investigation. As such, boards rely on various authorities and
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local law enforcement agencies to provide documentation. Lately
the RCB, as well as others at the DCA, have been refused access
to records, with local government agencies justifying this
refusal based on the RCB's perceived lack of authorization to
obtain records without approval by the individual in question.
This situation causes delays in investigations and can even
potentially prevent the RCB from taking appropriate disciplinary
action.
The RCB states that it is crucial to its consumer safety mission
to be able to access all arrest, court and other related
documentation through the course of an applicant or licensee
investigation. The RCB believes that requiring an authorization
to release such information impedes the ability of licensing
entities to efficiently take appropriate disciplinary action or
thoroughly investigate applicants.
The RCB cites a recent example where a local agency required the
RCP's staff to obtain authorization from the licensee for the RCB
to access the information. In that case, the RCB ended up
getting the records from the district attorney. The RCP also
states that it has had issues with some local agencies requiring
a fee from the RCB prior to their releasing of records which also
slows down the process. In one situation, a local government
agency provided the following language to the RCB when it refused
to produce records:
"The arrest record(s) cannot be released pursuant to Section
432.7(g)(1) of the Labor Code which reads that "no peace officer
or employee of a law enforcement agency with access to criminal
offender record information maintained by a local law enforcement
criminal justice agency shall knowingly disclose, with intent to
affect a person's employment, any information contained therein
pertaining to an arrest or detention or proceeding that did not
result in a conviction, including information pertaining to a
referral to, and participation in, any pretrial or post trial
diversion program, to any person not authorized by law to receive
that information."
Recommendation : Committee staff recommended that Section 144.5
be added to the Business and Professions Code as follows:
Notwithstanding any other provision of law, a board described in
Section 144 is authorized to receive certified records from a
local or state agency of all arrests and convictions, certified
records regarding probation, and any and all other related
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documentation needed to complete an applicant or licensee
investigation. The local or state agency is authorized to
provide those records to the board upon receipt of such a
request.
[The current language in this measure reflects this recommended
change.]
b) Issue : Pulmonary Function Technologists (PFTs).
Background: When the RCB was instituted, several unlicensed
individuals, including those who solely performed pulmonary
function tests were grandfathered and issued a license as a RCB.
However, the requirement to be grandfathered was not communicated
to PFTs who were employed at certain Los Angeles County
safety-net hospitals. As a result, these employees continued to
practice for several years without knowledge that their practice
was illegal. In the late 1990's the RCB was made aware of the
issue and it was reviewed during the 2002 sunset review of the
RCB. At that time, the Joint Legislative and Sunset Review
Committee asked the RCB to examine the issue of unlicensed
professionals who were performing pulmonary function tests. The
RCB attempted to seek legislation to exempt certain pulmonary
function testing from being regulated. However, the RCB was
unable to get DCA approval to pursue legislation. During the
2013 sunset review process, staff from the RCB worked with
Committee staff to draft language that would exempt these
skilled professionals who have performed pulmonary function
testing for over 15 years from the licensure requirements of the
RCB. In addition, the RCB agreed to continue examining the issue
of regulating all unlicensed professionals in its 2013 strategic
plan.
Recommendation : The Committee staff recommended that BPC § 3765
be amended to exempt pulmonary function technologists at Los
Angeles County hospitals who have performed pulmonary function
testing for at least 15 years, from the requirement of becoming a
licensed Respiratory Care Therapist. [The current language in
this measure reflects this recommended change.]
c) Issue : Should the current RCB continue to license and
regulate Respiratory Care
Therapists?
Background: The health and safety of consumers is protected by
well-regulated professions. The RCB is charged with protecting
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the consumer from unprofessional and unsafe licensees.
Recommendation : The Committee staff found that the RCB has shown
the ability to Respiratory Care Therapists. As such, the
Committee staff recommended that Respiratory Care Therapists
continue to be regulated by the current RCB and be renewed again
in four years. [The current language in this measure reflects
this recommended change.]
1. Review of the California Board of Optometry (CBO), Issues
Identified and Recommended Changes. Although the Committee
addressed several issues regarding the CBO during its review, the
only statutory change necessary was the extension of their sunset
dates.
a) Issue : Should the current CBO continue to license and
regulate Optometrists?
Background: The health and safety of consumers is protected by
well-regulated professions. The CBO is charged with protecting
the consumer from unprofessional and unsafe licensees.
Recommendation : The Committee staff found that despite a lack of
staff, the CBO has shown the ability to regulate Optometrists.
As such, the Committee staff recommended that Optometrists
continue to be regulated by the current CBO and be renewed again
in four years. [The current language in this measure reflects
this recommended change.]
6. Review of the Osteopathic Medical Board of California (OMB), Issues
Identified and Recommended Changes. Although the Committee
addressed several issues regarding the OMB during its review, the
only statutory change necessary was the extension of their sunset
dates.
a) Issue : Should the current OMB continue to license and
regulate Osteopathic Physicians and Surgeons ?
Background: The health and safety of consumers is protected by
well-regulated professions. The OMB is charged with protecting
the consumer from unprofessional and unsafe licensees. It
appears that the OMB has had difficulty operating as an effective
and efficient regulatory body primarily due to a lack of staff.
Immediate attention should be paid to increasing the staff of the
OMB and focusing on salient enforcement tasks.
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Recommendation : The Committee staff recommended that Osteopathic
Physicians and Surgeons continue to be regulated by the current
OMB in order to protect the interests of consumers and be
reviewed once again in four years. [The current language in this
measure reflects this recommended change.]
7. Current Related Legislation. SB 304 (Price, 2013). Makes various
changes to the Medical Practice Act and to the Medical Board of
California. ( Note : This bill will also be heard before the BP&ED
Committee during today's hearing)
SB 306 (Price, 2013). Extends until January 1, 2018, the provisions
establishing the State Board of Chiropractic Examiners, Speech
Language Pathology and Audiology and Hearing Aid Dispensers Board
the Physical Therapy Board of California and the California Board
of Occupational Therapy and extends the terms of the executive
officers of the Physical Therapy Board of California and the Speech
Language Pathology and Audiology and Hearing Aid Dispensers Board.
This bill also subjects the boards to be reviewed by the
appropriate policy committees of the Legislature. ( Note : This bill
will also be heard before the BP&ED Committee during today's
hearing)
SB 307 (Price, 2013) Extends, until January 1, 2018, the term of
the Veterinary Medicine Board, which provides for the licensure and
registration of veterinarians and registered veterinary technicians
and the regulation of the practice of veterinary medicine by the
Veterinary Medical Board. ( Note : This bill will also be heard
before the BP&ED Committee during today's hearing)
SB 308 (Price, 2013) Extends, until January 1, 2018, the term of
the Interior Design Law. Specifies that a certified interior
designer provides plans and documents that collaborates with other
design professionals. Requires a certified interior designer to
use a written contract when contracting to provide interior design
services to a client. Extends, until January 1, 2018, the State
Board of Guide Dogs for the Blind and extends an arbitration
procedure for the purpose of resolving disputes between a guide dog
user and a licensed guide dog school.
Extends until January 1, 2018, the State Board of Barbering and
Cosmetology and requires a school to be approved by the board
before it is approved by the Bureau for Private Postsecondary
Education. The bill would also authorize the board to revoke,
suspend, or deny its approval of a school on specified grounds.
( Note : This bill will also be heard before the BP&ED Committee
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during today's hearing)
SB 309 (Price, 2013) Extends the term of the State Athletic
Commission, which is responsible for licensing and regulating
boxing, kickboxing, and martial arts matches and is required to
appoint an executive officer until January 1, 2018. ( Note : This
bill will also be heard before the BP&ED Committee during today's
hearing)
8. Arguments in Support. SEIU California supports the bill. In their
letter they write, "The affected pulmonary technicians at the Los
Angeles County + University of Southern California Healthcare
Network and Harbor-University of California Los Angeles Medical
Center average 25 years' worth of experience in pulmonary function
testing at the two largest public hospitals in Southern California.
These professionals are an integral part of the care team.
According to the Los Angeles County Department of Health, this
group began their careers in pulmonary function testing prior to
the California Respiratory Care Board's requirement for licensure,
and worked for decades before DHS determined that the affected
employees ere technically practicing without appropriate licensure.
Despite their years of service and contributions to the delivery
of health care, they have been temporarily reassigned to different
roles pending resolution of the matter. SB 305 would narrowly
apply to this cohort and remedy this oversight by providing that
they can resume their work in pulmonary function testing. Failure
to do so would adversely impact the quality of access of patients."
The Naturopathic Medicine Committee supports SB 305. They
indicate, "The NMC has nursed the growing profession of
naturopathic medicine in California?Licensure and regulation of
naturopathic doctors ensures that only those individuals who meet
all the education and competency standards explicit in [the
Naturopathic Practice Act] are eligible for a license, and that
those who are granted a license continue to meet the ongoing
continuing medical education requirements outlined in statute."
The California Naturopathic Doctors Association also supports the
bill. They note, "Licensure and regulation of the California
naturopathic doctor profession by the Naturopathic Medicine
Committee provides the citizens of California safe access to
well-trained primary care providers that specialize in cost-saving,
effective, natural medicine focused healthcare."
The Osteopathic Physicians and Surgeons of California support SB
305. They state, "With more than 6500 osteopathic physicians
currently licensed by the State of California, and growing by
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approximately 10% annually, it is appropriate for the OMBC to
continue serving in its role of consumer protection."
The California Optometric Association supports the bill. They
note, "COA strongly supports the State Board of Optometry and its
endeavors to protect Californians and ensure they receive high
standards of eye care."
The California State Board of Optometry indicates their support
when they state, "Please vote yes on SB 305, which will continue
the oversight duties of the Board of Optometry and ensure consumer
protection in the area of vision care."
The National Board of Examiners in Optometry indicates that it
provides the assessments for entry into the practice of optometry
for those optometrists seeking licensure in California as well as
51 other jurisdictions. The significant time, effort, commitment
and expertise required to develop the Parts I, II, III and TMOD
examinations render its assessments particularly valuable and
relevant as part of the process that the California Board of
Optometry uses for granting a license to practice optometry."
Western University of Health Sciences supports SB 305. In their
letter they write, "The functions of the State Board of Optometry
are essential to the residents of the State of California to ensure
access to high quality eye care. The State Board is essential for
licensure and regulation of doctors of optometry."
The Association of Regulatory Boards of Optometry supports the
bill. In their letter they write, "In ARBO's experience, the
health and safety of Californians will be well served by SB 305.
The vision care services provided by doctors of optometry both
expand the range of options and increase access to vision care
services for all Californians. Optometrists have the education,
training and skills required for vision care within the
legislatively specified scope of practice. SB 305 will reduce
costs for Californians and increase both the quantity and quality
of their health care."
SUPPORT AND OPPOSITION:
Support:
Association of Regulatory Boards of Optometry
California Naturopathic Doctors Association
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California Optometric Association
California State Board of Optometry
National Board of Examiners in Optometry
Osteopathic Physicians & Surgeons of California
SEIU California
Western University of Health Sciences
Opposition:
None on file as of April 24, 2013
Consultant:Le Ondra Clark, Ph.D.