BILL NUMBER: SB 306	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JUNE 20, 2013
	AMENDED IN SENATE  MAY 7, 2013
	AMENDED IN SENATE  APRIL 18, 2013

INTRODUCED BY   Senator  Price   Torres 
   (Principal coauthor: Assembly Member  Gordon 
 Cooley  )

                        FEBRUARY 15, 2013

   An act to amend Sections  1000, 2530.2, 2531, 2531.75,
2533, 2570.19, 2602, and 2607.5   4170, 4180, and 4186
 of the Business and Professions Code, relating to 
healing arts   pharmacy  .


	LEGISLATIVE COUNSEL'S DIGEST


   SB 306, as amended,  Price   Torres  .
 Healing arts: boards.   Pharmacy: dangerous
drugs and dangerous devices: automated drug delivery systems. 

   Existing law, the Pharmacy Law, provides for the licensure and
regulation of pharmacies in this state by the California State Board
of Pharmacy. A violation of the Pharmacy Law is a crime.  
   Among other provisions, the Pharmacy Law prohibits a prescriber
from dispensing dangerous drugs or dangerous devices, as defined, to
patients in his or her office unless specified conditions are met.
Existing law defines a prescriber for purposes of this provision to
mean a person who holds a physician's and surgeon's certificate, or
one of other specified health care licenses or certificates, and who
is registered to engage in that practice with the appropriate board
of this state. Existing law authorizes certain health care
professionals, including a certified nurse-midwife or a nurse
practitioner, as specified, to hand to a patient of the supervising
physician and surgeon a properly labeled prescription drug
prepackaged by a physician and surgeon, a manufacturer, as defined,
or a pharmacist.  
   This bill would revise the conditions under which a prescriber may
dispense dangerous drugs and dangerous devices. The bill would
require a health care professional who is licensed as specified, or
his or her designee, to physically furnish the dangerous drug or
device to the patient, to be identified, except as specified, by the
drug or device manufacturer or wholesaler supplying the drug or
device as the recipient of the drug or device, and as the recipient
in all invoices, bills of lading, state or federal order forms, and
other documentation, and to provide the patient with an oral
consultation, as specified. The bill would revise the definition of a
prescriber to apply to a person who is licensed to prescribe and
dispense dangerous drugs, including, but not limited to, the licensed
health care professionals authorized pursuant to existing law. The
bill would also authorize a registered nurse who functions within a
licensed primary care clinic, federal or state government operated
clinic, community or free clinic to hand to a patient of the
supervising physician and surgeon a properly labeled prescription
drug prepackaged by a physician and surgeon, a manufacturer, as
defined, or a pharmacist.  
   Existing law authorizes clinics to purchase drugs at wholesale for
administration or dispensing, under the direction of a physician and
surgeon, to patients registered for care at the clinic. Existing law
also authorizes an automated drug delivery system, as defined, to be
located in any clinic licensed by the board, as specified. Existing
law requires an automated drug delivery system to collect, control,
and maintain all transaction information to accurately track the
movement of drugs into and out of the system for security, accuracy,
and accountability.  
    This bill would authorize an automated drug delivery to be
located in a group practice, as specified. The bill would authorize
specified entities, including a group practice, that uses an
automated drug delivery system, as described, to purchase drugs at
wholesale for administration or dispensing, under the direction of a
physician and surgeon or other prescriber when permitted by law, and
would make conforming and related changes.  
   The bill would also impose new conditions on an automated drug
delivery system. Among other requirements, the bill would require
that an automated drug delivery system be located within the clinic
or office of the group practice, that its contents be secure from
access or removal by unauthorized individuals, and that it maintain a
readily retrievable electronic record to identify all pharmacists,
registered pharmacy technicians, prescribers, and all other personnel
involved in the dispensing of a drug. The bill would also require
that the record of transactions conducted through the automated drug
delivery system be made available to authorized agents of the board.
The bill would authorize the board to adopt regulations permitting
the use of an automated drug delivery system that delivers dispensed
medications directly to a patient.  
   Because of violation of the bill's requirements would be a crime,
the bill would impose a state-mandated local program.  
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.  
   This bill would provide that no reimbursement is required by this
act for a specified reason.  
   The Chiropractic Act, enacted by an initiative measure, provides
for the regulation and licensing of chiropractors in this state by
the State Board of Chiropractic Examiners. Existing law specifies
that the law governing chiropractors is found in the act. 

   This bill would require that the powers and duties of the board,
as provided, be subject to review by the appropriate policy
committees of the Legislature. The bill would require that the review
of the board be performed as if these provisions were scheduled to
be repealed on January 1, 2018.  
   Existing law, the Speech-Language Pathologists and Audiologists
and Hearing Aid Dispensers Licensure Act, provides for the licensure
and regulation of speech-language pathologists, audiologists, and
hearing aid dispensers by the Speech-Language Pathology and Audiology
and Hearing Aid Dispensers Board. The act authorizes the board to
appoint an executive officer. Existing law repeals these provisions
on January 1, 2014, and subjects the board to review by the Joint
Committee on Boards, Commissions, and Consumer Protection. 

   This bill would extend the operation of these provisions until
January 1, 2018, and provide that the repeal of these provisions
subjects the board to review by the appropriate policy committees of
the Legislature.  
   The Speech-Language Pathologists and Audiologists and Hearing Aid
Dispensers Licensure Act also authorizes the board to refuse to
issue, or issue subject to terms and conditions, a license on
specified grounds, including, among others, securing a license by
fraud or deceit.  
   This bill would additionally authorize the board to refuse to
issue, or issue subject to terms and conditions, a license for a
violation of a term or condition of a probationary order of a license
issued by the board, as provided.  
   Existing law, the Occupational Therapy Practice Act, provides for
the licensure and regulation of occupational therapists, as defined,
by the California Board of Occupational Therapy. Existing law repeals
those provisions on January 1, 2014, and subjects the board to
review by the Joint Committee on Boards, Commissions, and Consumer
Protection.  
   This bill would extend the operation of these provisions until
January 1, 2018, and provide that the repeal of these provisions
subjects the board to review by the appropriate policy committees of
the Legislature.  
   Existing law, the Physical Therapy Practice Act, provides for the
licensure and regulation of physical therapists by the Physical
Therapy Board of California. The act authorizes the board to appoint
an executive officer. Existing law repeals these provisions on
January 1, 2014.  
    This bill would extend the operation of these provisions until
January 1, 2018. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program:  no   yes  .


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1   .    Section 4170 of the 
 Business and Professions Code   is amended to read:

   4170.  (a) No prescriber shall dispense  dangerous  drugs
or dangerous devices to patients in his or her office or place of
practice unless all of the following conditions are met:
   (1) The dangerous drugs or dangerous devices are dispensed to the
prescriber's own  patient, and the drugs or dangerous devices
are not furnished by a nurse or physician attendant  
patient. A health care professional who is licensed as described in
this section, or his or her designee,   shall physically
furnish the dangerous drug or device to the patient  .
   (2) The dangerous drugs or dangerous devices are necessary in the
treatment of the condition for which the prescriber is attending the
patient.
   (3) The prescriber does not keep a pharmacy, open shop, or
drugstore, advertised or otherwise, for the retailing of dangerous
drugs, dangerous devices, or poisons.
   (4) The prescriber fulfills all of the labeling requirements
imposed upon pharmacists by Section 4076, all of the recordkeeping
requirements of this chapter, and all of the packaging requirements
of good pharmaceutical practice, including the use of childproof
containers. 
   (5) The prescriber does not use a dispensing device unless he or
she personally owns the device and the contents of the device, and
personally dispenses the dangerous drugs or dangerous devices to the
patient packaged, labeled, and recorded in accordance with paragraph
(4).  
   (5) Unless the prescriber is employed by or under contract to a
clinic or group practice that is licensed by the board pursuant to
Section 4180, the prescriber is identified by the drug manufacturer
or wholesaler supplying the drugs as the recipient of the drugs and
identified by name and registration number as the recipient in all
invoices, bills of lading, state or federal order forms, and other
documentation. As the recipient of the drugs, the prescriber is
responsible for ensuring that the drugs are securely and safely
stored prior to dispensing and is responsible for maintaining all
required records regarding the receipt, storage, and dispensing or
other disposition of all drugs and devices. 
   (6) The prescriber, prior to dispensing, offers to give a written
prescription to the patient that the patient may elect to have filled
by the prescriber or by any pharmacy.
   (7) The prescriber provides the patient with written disclosure
that the patient has a choice between obtaining the prescription from
the dispensing prescriber or obtaining the prescription at a
pharmacy of the patient's choice. 
   (8) The prescriber provides the patient with an oral consultation
regarding issues that the prescriber, in his or her professional
judgment, deems necessary to ensure the safe and effective use of the
prescribed drug or device. The oral consultation shall include all
subjects that pharmacists are required to discuss pursuant to
regulations adopted by the board pursuant to Section 4005. 

   (8) 
    (   9)  A certified nurse-midwife who functions
pursuant to a standardized procedure or protocol described in
Section 2746.51, a nurse practitioner who functions pursuant to a
standardized procedure described in Section 2836.1, or protocol, a
physician assistant who functions pursuant to Section 3502.1,  a
registered nurse who functions pursuant to Section 2725.1  , or
a naturopathic doctor who functions pursuant to Section 3640.5, may
hand to a patient of the supervising physician and surgeon a properly
labeled prescription drug prepackaged by a physician and surgeon, a
manufacturer as defined in this chapter, or a pharmacist. 
Nothing in this section shall preclude the use of an  
automated   drug   delivery   system
described in Section 4186. 
   (b) The Medical Board of California, the State Board of Optometry,
the Bureau of Naturopathic Medicine, the Dental Board of California,
the Osteopathic Medical Board of California, the Board of Registered
Nursing, the Veterinary Medical Board, and the Physician Assistant
Committee shall have authority with the California State Board of
Pharmacy to ensure compliance with this section, and those boards are
specifically charged with the enforcement of this chapter with
respect to their respective licensees.
   (c) "Prescriber," as used in this section, means  a person who
is licensed to prescribe and dispense dangerous drugs and devices,
including, but not limited to,  a  person, 
 person  who holds a physician's and surgeon's certificate,
a license to practice optometry, a license to practice naturopathic
medicine, a license to practice dentistry, a license to practice
veterinary medicine, or a certificate to practice podiatry, and who
is duly registered by the Medical Board of California, the State
Board of Optometry, the Bureau of Naturopathic Medicine, the Dental
Board of California, the Veterinary Medical Board, or the Board of
Osteopathic Examiners of this state. 
   (d) This section shall not prevent a group practice, licensed
pursuant to Section 4180, from owning an inventory of dangerous drugs
and devices and dispensing the drugs and devices from the inventory
owned by the group practice provided that the following conditions
are met:  
   (1) Each prescriber dispenses dangerous drugs or devices only to
the patients seen or treated by that prescriber, and not to the
patient of any other prescriber in the group practice, and the drugs
or devices are packaged, labeled, and recorded in accordance with
paragraph (4) of subdivision (a).  
   (2) The group practice identifies a responsible prescriber within
the group practice who shall be named by the drug manufacturer or
wholesaler supplying the drugs as the recipient of the drugs on all
invoices, bills of lading, state or federal order forms, and other
documentation, and who shall be responsible for the record-keeping
and storage of the drug inventory.  
   (3) Records are maintained by each prescriber to identify the
identity of the patient and the name, strength, quantity, and
directions for use for each dangerous drug dispensed by the
prescriber to his or her patient.  
   (4) A daily dispensing log or some other paper or electronic
record is created each day, and maintained by the group practice, to
identify both of the following:  
   (A) A daily starting inventory of all dangerous drugs that are
jointly owned by the prescribers who comprise the group practice.
 
   (B) The name, strength, and quantity of all dangerous drugs
dispensed by each prescriber.  
   (e) A prescriber employed by, or under contract to, a clinic or
group practice licensed under Section 4180 may dispense drugs that
are owned by the clinic or group practice.  
   (f) (1) For purposes of this section, a dangerous drug is owned if
it is delivered to the possession of a prescriber, clinic, or group
practice, and each prescriber, clinic, or group practice has
responsibility for the security and recordkeeping associated with
possession of the dangerous drugs, regardless of the person or entity
responsible for payment for the dangerous drug inventory.  

   (2) For the purposes of this section, "group practice" means more
than one prescriber practicing under a single professional
corporation or license, including a medical group or risk-bearing
organization as defined in the Knox-Keene Health Care Service Plan
Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2
of the Health and Safety Code). 
   SEC.   2.    Section 4180 of the  
Business and Professions Code   is amended to read: 
   4180.  (a) (1) Notwithstanding any provision of this chapter, any
of the following  clinics   entities  may
purchase drugs at wholesale for administration or dispensing, under
the direction of a physician and surgeon,  or other prescriber
when permitted by law,  to patients registered for care at the
clinic:
   (A) A licensed nonprofit community clinic or free clinic as
defined in paragraph (1) of subdivision (a) of Section 1204 of the
Health and Safety Code.
   (B) A primary care clinic owned or operated by a county as
referred to in subdivision (b) of Section 1206 of the Health and
Safety Code.
   (C) A clinic operated by a federally recognized Indian tribe or
tribal organization as referred to in subdivision (c) of Section 1206
of the Health and Safety Code.
   (D) A clinic operated by a primary care community or free clinic,
operated on separate premises from a licensed clinic, and that is
open no more than 20 hours per week as referred to in subdivision (h)
of Section 1206 of the Health and Safety Code.
   (E) A student health center clinic operated by a public
institution of higher education as referred to in subdivision (j) of
Section 1206 of the Health and Safety Code.
   (F) A nonprofit multispecialty clinic as referred to in
subdivision (  l  ) of Section 1206 of the Health and Safety
Code. 
   (G) A group practice, as defined in Section 4170, that uses an
automated drug delivery system, as described in Section 4186. 
   (2) The clinic  or group practice  shall keep records of
the kind and amounts of drugs purchased, administered, and dispensed,
and the records shall be available and maintained for a minimum of
three years for inspection by all properly authorized personnel.
   (b) No clinic  or group practice  shall be entitled to
the benefits of this section until it has obtained a license from the
board. A separate license shall be required for each clinic
location. A clinic  or group practice  shall notify the
board of any change in the  clinic's  address 
of the clinic or group practice  on a form furnished by the
board.
  SEC.   3.    Section 4186 of the  
Business and Professions Code   is amended to read: 
   4186.  (a)  Automated   An automated 
drug delivery  systems   system  , as
defined in subdivision  (h)   (i)  , may be
located in any clinic  or group practice  licensed by the
board  pursuant to   as described in 
Section 4180.  If 
    (b)     (1)     If 
an automated drug delivery system is located in a clinic, the clinic
shall develop and implement written policies and procedures to ensure
safety, accuracy, accountability, security, patient confidentiality,
and maintenance of the quality, potency, and purity of drugs. All
policies and procedures shall be maintained at the location where the
automated drug system is being used. 
   (2) If an automated drug delivery system is located in a group
practice, the group practice shall develop and implement written
policies and procedures to ensure safety, accuracy, accountability,
security, patient confidentiality, and maintenance of the quality,
potency, and purity of drugs. All prescribers who will be dispensing
drugs from the automated drug delivery system and all health care
professionals and delegated personnel authorized to stock, refill, or
retrieve the drugs inventory from the automated drug delivery system
shall be required to comply with the policies and procedures
developed by the group practice. All policies and procedures shall be
maintained at the location where the automated drug system is being
used.  
   (b) 
    (   c)  Drugs shall be removed from the
automated drug delivery system only upon authorization by a
pharmacist  or prescriber  after the pharmacist  or
prescriber  has reviewed the prescription and the patient's
profile for potential contraindications and adverse drug reactions.
Drugs removed from the automated drug delivery system shall be
provided to the patient by a health professional licensed pursuant to
this division  or an individual operating under the supervision
of the prescriber  . 
   (c) 
    (  d)  The stocking of an automated drug
delivery system shall be performed by a pharmacist  or, in a
clinic or group practice, by a prescriber or a designee of the
prescriber  . 
   (d) 
    (   e)  Review of the drugs contained within,
and the operation and maintenance of, the automated drug delivery
system shall be the responsibility of the clinic  in a clinic
setting or by the responsible prescriber in a group practice  .
The review shall be conducted on a monthly basis by a pharmacist 
or responsible prescriber  and shall include a physical
inspection of the drugs in the automated drug delivery system, an
inspection of the automated drug delivery system machine for
cleanliness, and a review of all transaction records in order to
verify the security and accountability of the system. 
   (e) 
    (   f)  The automated drug delivery system used
at the clinic  or group practice  shall provide for patient
consultation pursuant to Section 1707.2 of Title 16 of the
California Code of Regulations with a pharmacist via a
telecommunications link that has two-way audio and video  ,
unless a consultation is provided by the prescriber pursuant to
paragraph (8) of subdivision (a) of Section 4170  . 
   (f) The 
    (g)     A  pharmacist operating the
automated drug delivery system shall be located 
 licensed  in California. 
   (g) 
    (   h)  Drugs dispensed from the automated drug
delivery system shall comply with the labeling requirements in
Section 4076. 
   (h) 
    (   i)  For purposes of this section, an
"automated drug delivery system" means a mechanical system controlled
remotely by a pharmacist  , or, if used to facilitate prescriber
dispensing by a prescriber,  that performs operations or
activities, other than compounding or administration, relative to the
storage, dispensing, or distribution of prepackaged dangerous drugs
or dangerous devices. An automated drug delivery system shall
collect, control, and maintain all transaction information to
accurately track the movement of drugs into and out of the system for
security, accuracy, and  accountability.  
accountability and shall meet all of the following requirements:
 
   (1) The system shall be located within the clinic or office of the
group practice, and its contents shall be secure from access or
removal by unauthorized individuals.  
   (2) A policy and procedure manual shall be developed and
maintained and shall include the type or name of the system including
a serial number or other identifying nomenclature and a description
of the security provisions, stocking processes, and other
documentation practices of the clinic or group practice.  
   (3) The system shall have a method to ensure security of the
system to prevent unauthorized access to dangerous drugs or devices
contained within the system. The method may include the use of
electronic passwords, biometric identification, including optic
scanning or fingerprint, or other coded identification.  
   (4) The clinic or group practice shall employ a process of filling
and stocking the system with drugs. The stocking or restocking of a
drug shall only be completed by a pharmacist, prescriber, or
personnel designated by the pharmacist or prescriber and all of the
following shall apply:  
   (A) The cartridges or containers to be stocked or restocked shall
be provided by a licensed wholesale drug distributor or repackaged by
the pharmacy or prescriber in compliance with state and federal law.
The licensed wholesale drug distributor shall have a method of
receiving and disposing of rejected, expired, or unused medications
consistent with state or federal law.  
   (B) The individual cartridge or container shall be transported to
the dispensing site in a secure, tamper-evident package.  
   (C) The system shall use a bar code verification, electronic
verification, weight verification, radio frequency identification, or
similar process to ensure that the cartridge or container is
accurately stocked or restocked into the automated system. The system
shall provide for alerts to the responsible pharmacist or prescriber
if a cartridge or container is not recorded in the automated system.
 
   (D) The pharmacist or prescriber responsible for the dispensed
drug shall be responsible if the cartridge or container is stocked or
restocked incorrectly by the personnel designated to load the
cartridges or containers.  
   (5) The system shall maintain an electronic or hard copy record of
medication filled into the system, including the product
identification, lot number, and expiration date.  
   (6) The system shall maintain a readily retrievable electronic
record to identify all pharmacists, registered pharmacy technicians,
prescribers, and all other personnel involved in the dispensing of a
drug.  
   (7) The system shall be able to comply with product recalls
generated by any manufacturer or distributor and shall have a process
in place to isolate affected lot numbers.  
   (8) The record of transactions conducted through the automated
drug delivery system shall be available to authorized agents of the
board. The record of transactions shall, only to the extent
authorized or permitted by state or federal law, include the
following:  
   (A) Name of the patient.  
   (B) Name, strength, and dosage form of the drug product dispensed.
 
   (C) Quantity of drug dispensed.  
   (D) Date and time of dispensing. 
   (E) Prescription number or other unique serial number assigned to
the transaction.  
   (F) Name of prescriber.  
   (G) Identity of the pharmacist who approved the prescription, or
of the prescriber.  
   (H) Identity of the person to whom the drug was released. 

   (9) Unless the prescriber provides consultation pursuant to
regulations adopted by the board pursuant to Section 4005, the system
shall provide patients with telephonic access to consultation by a
California-licensed pharmacist.  
   (10) In the case of dangerous drugs that require reconstitution,
the prescriber or his or her designee shall reconstitute the
medication for the patient.  
   (j) The board is authorized to adopt regulations authorizing the
use of an automated drug delivery system that delivers dispensed
medications directly to a patient. The regulations shall be based, in
part, upon the board's assessment of the safety of the systems.

   SEC.   4.    No reimbursement is required by
this act pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.  
  SECTION 1.    Section 1000 of the Business and
Professions Code is amended to read:
   1000.  The law governing practitioners of chiropractic is found in
an initiative act entitled "An act prescribing the terms upon which
licenses may be issued to practitioners of chiropractic, creating the
State Board of Chiropractic Examiners and declaring its powers and
duties, prescribing penalties for violation hereof, and repealing all
acts and parts of acts inconsistent herewith," adopted by the
electors November 7, 1922. Notwithstanding any other law, the powers
and duties of the State Board of Chiropractic Examiners, as set forth
in this article and under the act creating the board, shall be
subject to review by the appropriate policy committees of the
Legislature. The review shall be performed as if this chapter were
scheduled to be repealed as of January 1, 2018.  
  SEC. 2.    Section 2530.2 of the Business and
Professions Code is amended to read:
   2530.2.  As used in this chapter, unless the context otherwise
requires:
   (a) "Board" means the Speech-Language Pathology and Audiology and
Hearing Aid Dispensers Board.
   (b) "Person" means any individual, partnership, corporation,
limited liability company, or other organization or combination
thereof, except that only individuals can be licensed under this
chapter.
   (c) A "speech-language pathologist" is a person who practices
speech-language pathology.
   (d) The practice of speech-language pathology means all of the
following:
   (1) The application of principles, methods, instrumental
procedures, and noninstrumental procedures for measurement, testing,
screening, evaluation, identification, prediction, and counseling
related to the development and disorders of speech, voice, language,
or swallowing.
   (2) The application of principles and methods for preventing,
planning, directing, conducting, and supervising programs for
habilitating, rehabilitating, ameliorating, managing, or modifying
disorders of speech, voice, language, or swallowing in individuals or
groups of individuals.
   (3) Conducting hearing screenings.
   (4) Performing suctioning in connection with the scope of practice
described in paragraphs (1) and (2), after compliance with a medical
facility's training protocols on suctioning procedures.
   (e) (1) Instrumental procedures referred to in subdivision (d) are
the use of rigid and flexible endoscopes to observe the pharyngeal
and laryngeal areas of the throat in order to observe, collect data,
and measure the parameters of communication and swallowing as well as
to guide communication and swallowing assessment and therapy.
   (2) Nothing in this subdivision shall be construed as a diagnosis.
Any observation of an abnormality shall be referred to a physician
and surgeon.
   (f) A licensed speech-language pathologist shall not perform a
flexible fiberoptic nasendoscopic procedure unless he or she has
received written verification from an otolaryngologist certified by
the American Board of Otolaryngology that the speech-language
pathologist has performed a minimum of 25 flexible fiberoptic
nasendoscopic procedures and is competent to perform these
procedures. The speech-language pathologist shall have this written
verification on file and readily available for inspection upon
request by the board. A speech-language pathologist shall pass a
flexible fiberoptic nasendoscopic instrument only under the direct
authorization of an otolaryngologist certified by the American Board
of Otolaryngology and the supervision of a physician and surgeon.
   (g) A licensed speech-language pathologist shall only perform
flexible endoscopic procedures described in subdivision (e) in a
setting that requires the facility to have protocols for emergency
medical backup procedures, including a physician and surgeon or other
appropriate medical professionals being readily available.
   (h) "Speech-language pathology aide" means any person meeting the
minimum requirements established by the board, who works directly
under the supervision of a speech-language pathologist.
   (i) (1) "Speech-language pathology assistant" means a person who
meets the academic and supervised training requirements set forth by
the board and who is approved by the board to assist in the provision
of speech-language pathology under the direction and supervision of
a speech-language pathologist who shall be responsible for the
extent, kind, and quality of the services provided by the
speech-language pathology assistant.
   (2) The supervising speech-language pathologist employed or
contracted for by a public school may hold a valid and current
license issued by the board, a valid, current, and professional clear
clinical or rehabilitative services credential in language, speech,
and hearing issued by the Commission on Teacher Credentialing, or
other credential authorizing service in language, speech, and hearing
issued by the Commission on Teacher Credentialing that is not issued
on the basis of an emergency permit or waiver of requirements. For
purposes of this paragraph, a "clear" credential is a credential that
is not issued pursuant to a waiver or emergency permit and is as
otherwise defined by the Commission on Teacher Credentialing. Nothing
in this section referring to credentialed supervising
speech-language pathologists expands existing exemptions from
licensing pursuant to Section 2530.5.
   (j) An "audiologist" is one who practices audiology.
   (k) "The practice of audiology" means the application of
principles, methods, and procedures of measurement, testing,
appraisal, prediction, consultation, counseling, instruction related
to auditory, vestibular, and related functions and the modification
of communicative disorders involving speech, language, auditory
behavior or other                                           aberrant
behavior resulting from auditory dysfunction; and the planning,
directing, conducting, supervising, or participating in programs of
identification of auditory disorders, hearing conservation, cerumen
removal, aural habilitation, and rehabilitation, including, hearing
aid recommendation and evaluation procedures including, but not
limited to, specifying amplification requirements and evaluation of
the results thereof, auditory training, and speech reading, and the
selling of hearing aids.
   (l) A "dispensing audiologist" is a person who is authorized to
sell hearing aids pursuant to his or her audiology license.
   (m) "Audiology aide" means any person meeting the minimum
requirements established by the board. An audiology aid may not
perform any function that constitutes the practice of audiology
unless he or she is under the supervision of an audiologist. The
board may by regulation exempt certain functions performed by an
industrial audiology aide from supervision provided that his or her
employer has established a set of procedures or protocols that the
aide shall follow in performing these functions.
   (n) "Medical board" means the Medical Board of California.
   (o) A "hearing screening" performed by a speech-language
pathologist means a binary puretone screening at a preset intensity
level for the purpose of determining if the screened individuals are
in need of further medical or audiological evaluation.
   (p) "Cerumen removal" means the nonroutine removal of cerumen
within the cartilaginous ear canal necessary for access in
performance of audiological procedures that shall occur under
physician and surgeon supervision. Cerumen removal, as provided by
this section, shall only be performed by a licensed audiologist.
Physician and surgeon supervision shall not be construed to require
the physical presence of the physician, but shall include all of the
following:
   (1) Collaboration on the development of written standardized
protocols. The protocols shall include a requirement that the
supervised audiologist immediately refer to an appropriate physician
any trauma, including skin tears, bleeding, or other pathology of the
ear discovered in the process of cerumen removal as defined in this
subdivision.
   (2) Approval by the supervising physician of the written
standardized protocol.
   (3) The supervising physician shall be within the general
vicinity, as provided by the physician-audiologist protocol, of the
supervised audiologist and available by telephone contact at the time
of cerumen removal.
   (4) A licensed physician and surgeon may not simultaneously
supervise more than two audiologists for purposes of cerumen removal.
 
  SEC. 3.    Section 2531 of the Business and
Professions Code is amended to read:
   2531.  (a) There is in the Department of Consumer Affairs the
Speech-Language Pathology and Audiology and Hearing Aid Dispensers
Board in which the enforcement and administration of this chapter are
vested. The Speech-Language Pathology and Audiology and Hearing Aid
Dispensers Board shall consist of nine members, three of whom shall
be public members.
   (b) This section shall remain in effect only until January 1,
2018, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2018, deletes or extends
that date. Notwithstanding any other law, the repeal of this section
renders the board subject to review by the appropriate policy
committees of the Legislature.  
  SEC. 4.    Section 2531.75 of the Business and
Professions Code is amended to read:
   2531.75.  (a) The board may appoint a person exempt from civil
service who shall be designated as an executive officer and who shall
exercise the powers and perform the duties delegated by the board
and vested in him or her by this chapter.
   (b) This section shall remain in effect only until January 1,
2018, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2018, deletes or extends
that date.  
  SEC. 5.    Section 2533 of the Business and
Professions Code is amended to read:
   2533.  The board may refuse to issue, or issue subject to terms
and conditions, a license on the grounds specified in Section 480, or
may suspend, revoke, or impose terms and conditions upon the license
of any licensee for any of the following:
   (a) Conviction of a crime substantially related to the
qualifications, functions, and duties of a speech-language
pathologist or audiologist or hearing aid dispenser, as the case may
be. The record of the conviction shall be conclusive evidence
thereof.
   (b) Securing a license by fraud or deceit.
   (c) (1) The use or administering to himself or herself, of any
controlled substance; (2) the use of any of the dangerous drugs
specified in Section 4022, or of alcoholic beverages, to the extent,
or in a manner as to be dangerous or injurious to the licensee, to
any other person, or to the public, or to the extent that the use
impairs the ability of the licensee to practice speech-language
pathology or audiology safely; (3) more than one misdemeanor or any
felony involving the use, consumption, or self-administration of any
of the substances referred to in this section; or (4) any combination
of paragraph (1), (2), or (3). The record of the conviction shall be
conclusive evidence of unprofessional conduct.
   (d) Advertising in violation of Section 17500. Advertising an
academic degree that was not validly awarded or earned under the laws
of this state or the applicable jurisdiction in which it was issued
is deemed to constitute a violation of Section 17500.
   (e) Committing a dishonest or fraudulent act that is substantially
related to the qualifications, functions, or duties of a licensee.
   (f) Incompetence, gross negligence, or repeated negligent acts.
   (g) Other acts that have endangered or are likely to endanger the
health, welfare, and safety of the public.
   (h) Use by a hearing aid dispenser of the term "doctor" or
"physician" or "clinic" or "audiologist," or any derivation thereof,
except as authorized by law.
   (i) The use, or causing the use, of any advertising or promotional
literature in a manner that has the capacity or tendency to mislead
or deceive purchasers or prospective purchasers.
   (j) Any cause that would be grounds for denial of an application
for a license.
   (k) Violation of Section 1689.6 or 1793.02 of the Civil Code.
   (l) Violation of a term or condition of a probationary order of a
license issued by the board pursuant to Chapter 5 (commencing with
Section 11500) of Part 1 of Division 3 of Title 2 of the Government
Code.  
  SEC. 6.    Section 2570.19 of the Business and
Professions Code is amended to read:
   2570.19.  (a) There is hereby created a California Board of
Occupational Therapy, hereafter referred to as the board. The board
shall enforce and administer this chapter.
   (b) The members of the board shall consist of the following:
   (1) Three occupational therapists who shall have practiced
occupational therapy for five years.
   (2) One occupational therapy assistant who shall have assisted in
the practice of occupational therapy for five years.
   (3) Three public members who shall not be licentiates of the
board, of any other board under this division, or of any board
referred to in Section 1000 or 3600.
   (c) The Governor shall appoint the three occupational therapists
and one occupational therapy assistant to be members of the board.
The Governor, the Senate Committee on Rules, and the Speaker of the
Assembly shall each appoint a public member. Not more than one member
of the board shall be appointed from the full-time faculty of any
university, college, or other educational institution.
   (d) All members shall be residents of California at the time of
their appointment. The occupational therapist and occupational
therapy assistant members shall have been engaged in rendering
occupational therapy services to the public, teaching, or research in
occupational therapy for at least five years preceding their
appointments.
   (e) The public members may not be or have ever been occupational
therapists or occupational therapy assistants or in training to
become occupational therapists or occupational therapy assistants.
The public members may not be related to, or have a household member
who is, an occupational therapist or an occupational therapy
assistant, and may not have had, within two years of the appointment,
a substantial financial interest in a person regulated by the board.

   (f) The Governor shall appoint two board members for a term of one
year, two board members for a term of two years, and one board
member for a term of three years. Appointments made thereafter shall
be for four-year terms, but no person shall be appointed to serve
more than two consecutive terms. Terms shall begin on the first day
of the calendar year and end on the last day of the calendar year or
until successors are appointed, except for the first appointed
members who shall serve through the last calendar day of the year in
which they are appointed, before commencing the terms prescribed by
this section. Vacancies shall be filled by appointment for the
unexpired term. The board shall annually elect one of its members as
president.
   (g) The board shall meet and hold at least one regular meeting
annually in the Cities of Sacramento, Los Angeles, and San Francisco.
The board may convene from time to time until its business is
concluded. Special meetings of the board may be held at any time and
place designated by the board.
   (h) Notice of each meeting of the board shall be given in
accordance with the Bagley-Keene Open Meeting Act (Article 9
(commencing with Section 11120) of Chapter 1 of Part 1 of Division 3
of Title 2 of the Government Code).
   (i) Members of the board shall receive no compensation for their
services, but shall be entitled to reasonable travel and other
expenses incurred in the execution of their powers and duties in
accordance with Section 103.
   (j) The appointing power shall have the power to remove any member
of the board from office for neglect of any duty imposed by state
law, for incompetency, or for unprofessional or dishonorable conduct.

   (k) This section shall remain in effect only until January 1,
2018, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2018, deletes or extends
that date. Notwithstanding any other law, the repeal of this section
renders the board subject to review by the appropriate policy
committees of the Legislature.  
  SEC. 7.    Section 2602 of the Business and
Professions Code is amended to read:
   2602.  The Physical Therapy Board of California, hereafter
referred to as the board, shall enforce and administer this chapter.
   This section shall remain in effect only until January 1, 2018,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2018, deletes or extends that date.
   Notwithstanding any other provision of law, the repeal of this
section renders the board subject to review by the appropriate policy
committees of the Legislature.  
  SEC. 8.    Section 2607.5 of the Business and
Professions Code is amended to read:
   2607.5.  (a) The board may appoint a person exempt from civil
service who shall be designated as an executive officer and who shall
exercise the powers and perform the duties delegated by the board
and vested in him or her by this chapter.
   (b) This section shall remain in effect only until January 1,
2018, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2018, deletes or extends
that date.