Senate BillNo. 821


Introduced by Committee on Business, Professions and Economic Development (Senators Price (Chair), Block, Corbett, Emmerson, Galgiani, Hernandez, Hill, Padilla, Wyland, and Yee)

March 20, 2013


An act to amend Sections 1613, 1915, 1926.2, 3024, 3025, 3040, 3041.2, 3051, 3057.5, 3077, 3093, 3098, 3103, 3106, 3107, 3109, 3163, 4980.36, 4980.43, 4980.72, 4989.68, 4996.3, 4996.9, 4996.18, 4996.23, 4999.33, 4999.46, 4999.47, and 4999.60 of the Business and Professions Code, and to amend Section 14132 of the Welfare and Institutions Code, relating to healing arts.

LEGISLATIVE COUNSEL’S DIGEST

SB 821, as introduced, Committee on Business, Professions and Economic Development. Healing arts.

(1) Existing law, the Dental Practice Act, establishes the Dental Board of California, which was formerly known as the Board of Dental Examiners of California. Existing law requires the board to have and use a seal bearing its name. Existing law creates, within the jurisdiction of the board, a Dental Hygiene Committee of California, that is responsible for regulation of registered dental hygienists, registered dental hygienists in alternative practice, and registered dental hygienists in extended functions.

This bill would amend those provisions to remove an obsolete reference to the former board and to make other technical changes.

(2) Existing law, the Optometry Practice Act, provides for the licensure and regulation of optometrists by the State Board of Optometry. That act refers to the authorization to practice optometry issued by the board as a certificate of registration.

This bill would instead refer to that authorization issued by the board as an optometrist license and would make other technical and conforming changes.

(3) Existing law provides for the licensure and regulation of marriage and family therapists, licensed educational psychologists, licensed clinical social workers, and licensed professional clinical counselors by the Board of Behavioral Sciences.

Existing law requires all persons applying for marriage and family therapist licensure examinations to have specified hours of experience, not including experience gained by interns or trainees as independent contractors.

This bill would specify that experience for work reported on an IRS Form 1099 does not count towards the necessary experience.

Existing law also authorizes the board to issue a license to a person who, at the time of submitting an application for a license pursuant to this chapter, holds a valid license in good standing issued by a board of marriage counselor examiners, board of marriage and family therapists, or corresponding authority, of any state or country if certain conditions are met, considering hours of experience obtained outside of California during the 6-year period immediately preceding the date the applicant initially obtained the license.

This bill would instead require time actively licensed as a marriage and family therapist to be accepted at a rate of 100 hours per month up to a maximum of 1,200 hours if the applicant has fewer than 3,000 hours of qualifying supervised experience.

Existing law establishes a $75 delinquent renewal fee for a licensed educational psychologist and for clinical social workers.

This bill would instead specify that $75 is the maximum delinquent renewal fee.

Existing law requires an applicant for registration as an associate clinical social worker to meet specified requirements. Existing law also defines the application of social work principles and methods.

This bill would additionally require that all applicants and registrants be at all times under the supervision of a supervisor responsible for ensuring that the extent, kind, and quality of counseling performed is consistent with the training and experience of the person being supervised, and who is responsible to the board for compliance with all laws, rules, and regulations governing the practice of clinical social work. The bill would also specify that the practice of clinical social work includes the use, application, and integration of the coursework and experience required.

Existing law requires a licensed professional clinical counselor, to qualify for a clinical examination for licensure, to complete clinical mental health experience, as specified, including not more than 250 hours of experience providing counseling or crisis counseling on the telephone.

This bill instead would require not more than 375 hours of experience providing personal psychotherapy, crisis counseling, or other counseling services via telehealth.

(4) The bill would also make other technical, nonsubstantive changes.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

Section 1613 of the Business and Professions
2Code
is amended to read:

3

1613.  

The board shall have and use a seal bearing the name
4begin delete “Board of Dental Examiners of California.”end deletebegin insert “Dental Board of
5California.end insert
begin insertend insert

6

SEC. 2.  

Section 1915 of the Business and Professions Code is
7amended to read:

8

1915.  

No person other than a registered dental hygienist,
9registered dental hygienist in alternativebegin delete functionsend deletebegin insert practiceend insert, or
10registered dental hygienist in extended functions or a licensed
11dentist may engage in the practice of dental hygiene or perform
12dental hygiene procedures on patients, including, but not limited
13to, supragingival and subgingival scaling, dental hygiene
14assessment, and treatment planning, except for the following
15persons:

16(a) A student enrolled in a dental or a dental hygiene school
17who is performing procedures as part of the regular curriculum of
18that program under the supervision of the faculty of that program.

19(b) A dental assistant acting in accordance with the rules of the
20dental board in performing the following procedures:

21(1) Applying nonaerosol and noncaustic topical agents.

22(2) Applying topical fluoride.

23(3) Taking impressions for bleaching trays.

P4    1(c) A registered dental assistant acting in accordance with the
2rules of the dental board in performing the following procedures:

3(1) Polishing the coronal surfaces of teeth.

4(2) Applying bleaching agents.

5(3) Activating bleaching agents with a nonlaser light-curing
6device.

7(4) Applying pit and fissure sealant.

8(d) A registered dental assistant in extended functions acting in
9accordance with the rules of the dental board in applying pit and
10fissure sealants.

11(e) A registered dental hygienist, registered dental hygienist in
12alternative practice, or registered dental hygienist in extended
13functions licensed in another jurisdiction, performing a clinical
14demonstration for educational purposes.

15

SEC. 3.  

Section 1926.2 of the Business and Professions Code
16 is amended to read:

17

1926.2.  

(a) Notwithstanding any other provision of law, a
18registered dental hygienist in alternative practice may operate one
19mobile dental hygiene clinic registered as a dental hygiene office
20or facility. The owner or operator of the mobile dental hygiene
21clinic or unit shall be registered and operated in accordance with
22regulations established by the committee, which regulations shall
23not be designed to prevent or lessen competition in service areas,
24and shall pay the fees described in Section 1944.

25(b) A mobile service unit, as defined in subdivision (b) of
26Section 1765.105 of the Health and Safety Code, and a mobile
27unit operated by an entity that is exempt from licensure pursuant
28to subdivision (b), (c), or (h) of Section 1206 of the Health and
29Safety Code, are exempt from this articlebegin delete and Article 3.5
30(commencing with Section 1658)end delete
. Notwithstanding this exemption,
31the owner or operator of the mobile unit shall notify the committee
32within 60 days of the date on which dental hygiene services are
33first delivered in the mobile unit, or the date on which the mobile
34unit’s application pursuant to Section 1765.130 of the Health and
35Safety Code is approved, whichever is earlier.

36(c) A licensee practicing in a mobile unit described in
37subdivision (b) is not subject to subdivision (a) as to that mobile
38unit.

39

SEC. 4.  

Section 3024 of the Business and Professions Code is
40amended to read:

P5    1

3024.  

The board may grant or refuse to grantbegin delete certificates of
2registrationend delete
begin insert an optometrist licenseend insert as provided in this chapter and
3may revoke or suspend thebegin delete certificate of registrationend deletebegin insert licenseend insert of any
4optometrist for any of the causes specified in this chapter.

5It shall have the power to administer oaths and to take testimony
6in the exercise of these functions.

7

SEC. 5.  

Section 3025 of the Business and Professions Code is
8amended to read:

9

3025.  

The board may make and promulgate rules and
10regulations governing procedure of the board, the admission of
11applicants for examination forbegin delete certificates of registration as
12optometristsend delete
begin insert a license as an optometristend insert, and the practice of
13optometry. Allbegin delete suchend deletebegin insert of thoseend insert rules and regulations shall be in
14accordance with and not inconsistent with the provisions of this
15chapter.begin delete Suchend deletebegin insert Theend insert rules and regulations shall be adopted, amended,
16or repealed in accordance with the provisions of the Administrative
17Procedure Act.

18

SEC. 6.  

Section 3040 of the Business and Professions Code is
19amended to read:

20

3040.  

It is unlawful for a person to engage in the practice of
21optometry or to display a sign or in any other way to advertise or
22hold himself or herself out as an optometrist without having first
23obtainedbegin delete a certificate of registrationend deletebegin insert an optometrist licenseend insert from
24the board under the provisions of this chapter or under the
25provisions of any former act relating to the practice of optometry.
26The practice of optometry includes the performing or controlling
27of any acts set forth in Section 3041.

28In any prosecution for a violation of this section, the use of test
29cards, test lenses, or of trial frames is prima facie evidence of the
30practice of optometry.

31

SEC. 7.  

Section 3041.2 of the Business and Professions Code
32 is amended to read:

33

3041.2.  

(a) The State Board of Optometry shallbegin insert,end insert by regulation,
34establish educational and examination requirements for licensure
35to insure the competence of optometrists to practice pursuant to
36subdivision (a) of Section 3041. Satisfactory completion of the
37educational and examination requirements shall be a condition for
38the issuance of an originalbegin delete certificate of registrationend deletebegin insert optometrist
39licenseend insert
under this chapter, on and after January 1, 1980. Only those
40optometrists who have successfully completed educational and
P6    1examination requirements as determined by the State Board of
2Optometry shall be permitted the use of pharmaceutical agents
3specified by subdivision (a) of Section 3041.

4(b) Nothing in this section shall authorize an optometrist issued
5an originalbegin delete certificateend deletebegin insert optometrist licenseend insert under this chapter before
6January 1, 1996, to use or prescribe therapeutic pharmaceutical
7agents specified in subdivision (d) of Section 3041 without
8otherwise meeting the requirements of Section 3041.3.

9

SEC. 8.  

Section 3051 of the Business and Professions Code is
10amended to read:

11

3051.  

All applicants for examination forbegin delete a certificate of
12registrationend delete
begin insert an optometrist licenseend insert in accordance with the
13educational and examination requirements adopted pursuant to
14Section 3023.1 shall show the board by satisfactory evidence that
15he or she has received education in child abuse detection and the
16detection of alcoholism and other chemical substance dependency.
17This section shall apply only to applicants who matriculate in a
18school of optometry on or after September 1, 1997.

19

SEC. 9.  

Section 3057.5 of the Business and Professions Code
20 is amended to read:

21

3057.5.  

Notwithstanding any other provision of this chapter,
22the board shall permit a graduate of a foreign university who meets
23all of the following requirements to take the examinations forbegin delete a
24certificate of registration asend delete
an optometristbegin insert licenseend insert:

25(a) Is over the age of 18 years.

26(b) Is not subject to denial of abegin delete certificateend deletebegin insert licenseend insert under Section
27 480.

28(c) Has a degree as a doctor of optometry issued by a university
29located outside of the United States.

30

SEC. 10.  

Section 3077 of the Business and Professions Code
31 is amended to read:

32

3077.  

As used in this sectionbegin insert,end insert “office” means any office or
33other place for the practice of optometry.

34(a) No person, singly or in combination with others, may have
35an office unless he or she isbegin delete registeredend deletebegin insert licensedend insert to practice
36optometry under this chapter.

37(b) An optometrist, or two or more optometrists jointly, may
38have one office without obtaining abegin delete furtherend deletebegin insert branch officeend insert license
39from the board.

P7    1(c) On and after October 1, 1959, no optometrist, and no two
2or more optometrists jointly, may have more than one office unless
3he or she or they comply with the provisions of this chapter as to
4an additional office. The additional office, for the purposes of this
5chapter, constitutes a branch office.

6(d) Any optometrist who has, or any two or more optometrists,
7jointly, who have, a branch office prior to January 1, 1957, and
8who desire to continue the branch office on or after that date shall
9notify the board in writing of that desire in a manner prescribed
10by the board.

11(e) On and after January 1, 1957, any optometrist, or any two
12or more optometrists, jointly, who desire to open a branch office
13shall notify the board in writing in a manner prescribed by the
14board.

15(f) On and after January 1, 1957, no branch office may be
16opened or operated without a branch office license. Branch office
17licenses shall be valid for the calendar year in or for which they
18are issued and shall be renewable on January 1st of each year
19thereafter. Branch office licenses shall be issued or renewed only
20upon the payment of the fee therefor prescribed by this chapter.

21On or after October 1, 1959, no more than one branch office
22license shall be issued to any optometrist or to any two or more
23optometrists, jointly.

24(g) Any failure to comply with the provisions of this chapter
25relating to branch offices or branch office licenses as to any branch
26office shall work the suspension of thebegin delete certificate of registrationend delete
27begin insert optometrist licenseend insert of each optometrist who, individually or with
28others, has a branch office.begin delete A certificate of registrationend deletebegin insert An
29optometrist licenseend insert
so suspended shall not be restored except upon
30compliance with those provisions and the payment of the fee
31prescribed by this chapter for restoration of abegin delete certificate of
32registrationend delete
begin insert licenseend insert after suspension for failure to comply with the
33provisions of this chapter relating to branch offices.

34(h) The holder or holders of a branch office license shall pay
35the annual renewal fee therefor in the amount required by this
36chapter between the first day of January and the first day of
37February of each year. The failure to pay the fee in advance on or
38before February 1st of each year during the time it is in force shall
39ipso facto work the suspension of the branch office license. The
40license shall not be restored except upon written application and
P8    1the payment of the penalty prescribed by this chapter, and, in
2addition, all delinquent branch office fees.

3(i) Nothing in this chapter shall limit or authorize the board to
4limit the number of branch offices that are in operation on October
51, 1959, and that conform to this chapter, nor prevent an
6optometrist from acquiring any branch office or offices of his or
7her parent. The sale after October 1, 1959, of any branch office
8shall terminate the privilege of operating the branch office, and
9no new branch office license shall be issued in place of the license
10issued for the branch office, unless the branch office is the only
11one operated by the optometrist or by two or more optometrists
12jointly.

13Nothing in this chapter shall prevent an optometrist from owning,
14maintaining, or operating more than one branch office if he or she
15is in personal attendance at each of his or her offices 50 percent
16of the time during which the office is open for the practice of
17optometry.

18(j) The board shall have the power to adopt, amend, and repeal
19rules and regulations to carry out the provisions of this section.

20(k) Notwithstanding any other provision of this section, neither
21an optometrist nor an individual practice association shall be
22deemed to have an additional office solely by reason of the
23optometrist’s participation in an individual practice association or
24the individual practice association’s creation or operation. As used
25in this subdivision, the term “individual practice association” means
26an entity that meets all of the following requirements:

27(1) Complies with the definition of an optometric corporation
28in Section 3160.

29(2) Operates primarily for the purpose of securing contracts
30with health care service plans or other third-party payers that make
31available eye/vision services to enrollees or subscribers through a
32panel of optometrists.

33(3) Contracts with optometrists to serve on the panel of
34optometrists, but does not obtain an ownership interest in, or
35otherwise exercise control over, the respective optometric practices
36of those optometrists on the panel.

37Nothing in this subdivision shall be construed to exempt an
38optometrist who is a member of an individual practice association
39and who practices optometry in more than one physical location,
40from the requirement of obtaining a branch office license for each
P9    1of those locations, as required by this section. However, an
2optometrist shall not be required to obtain a branch office license
3solely as a result of his or her participation in an individual practice
4association in which the members of the individual practice
5association practice optometry in a number of different locations,
6and each optometrist is listed as a member of that individual
7practice association.

8

SEC. 11.  

Section 3093 of the Business and Professions Code
9 is amended to read:

10

3093.  

Before setting aside the revocation or suspension of any
11begin delete certificateend deletebegin insert optometrist license,end insert the board may require the applicant
12to pass the regular examination given for applicants forbegin delete certificates
13of registrationend delete
begin insert an optometrist licenseend insert.

14

SEC. 12.  

Section 3098 of the Business and Professions Code
15 is amended to read:

16

3098.  

When the holder uses the title of “Doctor” or “Dr.” as a
17prefix to hisbegin insert or herend insert name, without using the word “optometrist”
18as a suffix to hisbegin insert or herend insert name or in connection with it, or, without
19holding a diploma from an accredited school of optometry, the
20letters “Opt. D.” or “O.D.” as a suffix to hisbegin insert or herend insert name, it
21constitutes a cause to revoke or suspend hisbegin delete certificate of
22registrationend delete
begin insert or her optometrist licenseend insert.

23

SEC. 13.  

Section 3103 of the Business and Professions Code
24 is amended to read:

25

3103.  

It is unlawful to include in any advertisement relating
26to the sale or disposition of goggles, sunglasses, colored glasses
27or occupational eye-protective devices, any words or figures that
28advertise or have a tendency to advertise the practice of optometry.

29This section does not prohibit the advertising of the practice of
30optometry by abegin delete registeredend deletebegin insert licensedend insert optometrist in the manner
31permitted by law.

32

SEC. 14.  

Section 3106 of the Business and Professions Code
33 is amended to read:

34

3106.  

Knowingly making or signing anybegin delete certificateend deletebegin insert license,
35certificate,end insert
or other document directly or indirectly related to the
36practice of optometry that falsely represents the existence or
37nonexistence of a state of facts constitutes unprofessional conduct.

38

SEC. 15.  

Section 3107 of the Business and Professions Code
39 is amended to read:

P10   1

3107.  

It is unlawful to use or attempt to use any licensebegin insert or
2certificateend insert
issued by the board that has been purchased, fraudulently
3issued, counterfeited, or issued by mistake, as a valid licensebegin insert or
4certificateend insert
.

5

SEC. 16.  

Section 3109 of the Business and Professions Code
6 is amended to read:

7

3109.  

Directly or indirectly accepting employment to practice
8optometry from any person not having a valid, unrevoked license
9as an optometrist or from any company or corporation constitutes
10unprofessional conduct. Except as provided in this chapter, no
11optometrist may, singly or jointly with others, be incorporated or
12become incorporated when the purpose or a purpose of the
13corporation is to practice optometry or to conduct the practice of
14optometry.

15The terms “accepting employment to practice optometry” as
16used in this section shall not be construed so as to prevent a
17licensed optometrist from practicing optometry upon an individual
18patient.

19Notwithstanding the provisions of this section or the provisions
20of any other law, a licensed optometrist may be employed to
21practice optometry by a physician and surgeon who holds a
22begin delete certificateend deletebegin insert licenseend insert under this division and who practices in the
23specialty of ophthalmology or by a health care service plan
24pursuant to the provisions of Chapter 2.2 (commencing with
25Section 1340) of Division 2 of the Health and Safety Code.

26

SEC. 17.  

Section 3163 of the Business and Professions Code
27 is amended to read:

28

3163.  

Except as provided in Sectionbegin delete 3125end deletebegin insert 3078end insert, the name of
29an optometric corporation and any name or names under which it
30may be rendering professional services shall contain and be
31restricted to the name or the last name of one or more of the
32present, prospective, or former shareholders and shall include the
33words optometric corporation or wording or abbreviations denoting
34corporate existence, provided that the articles of incorporation
35shall be amended to delete the name of a former shareholder from
36the name of the corporation within two years from the date the
37former shareholder dies or otherwise ceases to be a shareholder.

38

SEC. 18.  

Section 4980.36 of the Business and Professions
39Code
is amended to read:

40

4980.36.  

(a) This section shall apply to the following:

P11   1(1) Applicants for licensure or registration who begin graduate
2study before August 1, 2012, and do not complete that study on
3or before December 31, 2018.

4(2) Applicants for licensure or registration who begin graduate
5study before August 1, 2012, and who graduate from a degree
6program that meets the requirements of this section.

7(3) Applicants for licensure or registration who begin graduate
8study on or after August 1, 2012.

9(b) To qualify for a license or registration, applicants shall
10possess a doctor’s or master’s degree meeting the requirements of
11this section in marriage, family, and child counseling, marriage
12and family therapy, couple and family therapy, psychology, clinical
13psychology, counseling psychology, or counseling with an
14emphasis in either marriage, family, and child counseling or
15marriage and family therapy, obtained from a school, college, or
16university approved by the Bureau for Private Postsecondary
17Education or accredited by either the Commission on the
18Accreditation of Marriage and Family Therapy Education or a
19regional accrediting agency recognized by the United States
20Department of Education. The board has the authority to make the
21final determination as to whether a degree meets all requirements,
22including, but not limited to, course requirements, regardless of
23accreditation or approval.

24(c) A doctor’s or master’s degree program that qualifies for
25licensure or registration shall do the following:

26(1) Integrate all of the following throughout its curriculum:

27(A) Marriage and family therapy principles.

28(B) The principles of mental health recovery-oriented care and
29methods of service delivery in recovery-oriented practice
30environments, among others.

31(C) An understanding of various cultures and the social and
32psychological implications of socioeconomic position, and an
33understanding of how poverty and social stress impact an
34individual’s mental health and recovery.

35(2) Allow for innovation and individuality in the education of
36marriage and family therapists.

37(3) Encourage students to develop the personal qualities that
38are intimately related to effective practice, including, but not
39limited to, integrity, sensitivity, flexibility, insight, compassion,
40and personal presence.

P12   1(4) Permit an emphasis or specialization that may address any
2one or more of the unique and complex array of human problems,
3symptoms, and needs of Californians served by marriage and
4family therapists.

5(5) Provide students with the opportunity to meet with various
6consumers and family members of consumers of mental health
7services to enhance understanding of their experience of mental
8illness, treatment, and recovery.

9(d) The degree described in subdivision (b) shall contain no less
10than 60 semester or 90 quarter units of instruction that includes,
11but is not limited to, the following requirements:

12(1) Both of the following:

13(A) No less than 12 semester or 18 quarter units of coursework
14in theories, principles, and methods of a variety of
15psychotherapeutic orientations directly related to marriage and
16family therapy and marital and family systems approaches to
17treatment and how these theories can be applied therapeutically
18with individuals, couples, families, adults, including elder adults,
19children, adolescents, and groups to improve, restore, or maintain
20healthy relationships.

21(B) Practicum that involves direct client contact, as follows:

22(i) A minimum of six semester or nine quarter units of practicum
23in a supervised clinical placement that provides supervised
24fieldwork experience.

25(ii) A minimum of 150 hours of face-to-face experience
26counseling individuals, couples, families, or groups.

27(iii) A student must be enrolled in a practicum course while
28counseling clients, except as specified in subdivision (c) of Section
294980.42.

30(iv) The practicum shall provide training in all of the following
31areas:

32(I) Applied use of theory and psychotherapeutic techniques.

33(II) Assessment, diagnosis, and prognosis.

34(III) Treatment of individuals and premarital, couple, family,
35and child relationships, including trauma and abuse, dysfunctions,
36healthy functioning, health promotion, illness prevention, and
37working with families.

38(IV) Professional writing, including documentation of services,
39treatment plans, and progress notes.

P13   1(V) How to connect people with resources that deliver the
2quality of services and support needed in the community.

3(v) Educational institutions are encouraged to design the
4practicum required by this subparagraph to include marriage and
5family therapy experience in low-income and multicultural mental
6health settings.

7(vi) In addition to the 150 hours required in clause (ii), 75 hours
8of either of the following:

9(I) Client-centered advocacy, as defined in Section 4980.03.

10(II) Face-to-face experience counseling individuals, couples,
11families, or groups.

12(2) Instruction in all of the following:

13(A) Diagnosis, assessment, prognosis, and treatment of mental
14disorders, including severe mental disorders, evidence-based
15practices, psychological testing, psychopharmacology, and
16promising mental health practices that are evaluated in peer
17reviewed literature.

18(B) Developmental issues from infancy to old age, including
19instruction in all of the following areas:

20(i) The effects of developmental issues on individuals, couples,
21and family relationships.

22(ii) The psychological, psychotherapeutic, and health
23implications of developmental issues and their effects.

24(iii) Aging and its biological, social, cognitive, and
25psychological aspects.

26(iv) A variety of cultural understandings of human development.

27(v) The understanding of human behavior within the social
28context of socioeconomic status and other contextual issues
29affecting social position.

30(vi) The understanding of human behavior within the social
31context of a representative variety of the cultures found within
32California.

33(vii) The understanding of the impact that personal and social
34insecurity, social stress, low educational levels, inadequate housing,
35and malnutrition have on human development.

36(C) The broad range of matters and life events that may arise
37within marriage and family relationships and within a variety of
38California cultures, including instruction in all of the following:

begin delete

39(i) Child and adult abuse assessment and reporting.

end delete
begin insert

P14   1(i) A minimum of seven contact hours of training or coursework
2in child abuse assessment and reporting as specified in Section
328, and any regulations promulgated thereunder.

end insert

4(ii) Spousal or partner abuse assessment, detection, intervention
5strategies, and same-gender abuse dynamics.

6(iii) Cultural factors relevant to abuse of partners and family
7members.

8(iv) Childbirth, child rearing, parenting, and stepparenting.

9(v) Marriage, divorce, and blended families.

10(vi) Long-term care.

11(vii) End of life and grief.

12(viii) Poverty and deprivation.

13(ix) Financial and social stress.

14(x) Effects of trauma.

15(xi) The psychological, psychotherapeutic, community, and
16health implications of the matters and life events described in
17clauses (i) to (x), inclusive.

18(D) Cultural competency and sensitivity, including a familiarity
19with the racial, cultural, linguistic, and ethnic backgrounds of
20persons living in California.

21(E) Multicultural development and cross-cultural interaction,
22including experiences of race, ethnicity, class, spirituality, sexual
23orientation, gender, and disability, and their incorporation into the
24psychotherapeutic process.

25(F) The effects of socioeconomic status on treatment and
26available resources.

27(G) Resilience, including the personal and community qualities
28that enable persons to cope with adversity, trauma, tragedy, threats,
29or other stresses.

30(H) Human sexuality, including the study of physiological,
31psychological, and social cultural variables associated with sexual
32behavior and gender identity, and the assessment and treatment of
33psychosexual dysfunction.

34(I) Substance use disorders, co-occurring disorders, and
35addiction, including, but not limited to, instruction in all of the
36following:

37(i) The definition of substance use disorders, co-occurring
38disorders, and addiction. For purposes of this subparagraph,
39“co-occurring disorders” means a mental illness and substance
40abuse diagnosis occurring simultaneously in an individual.

P15   1(ii) Medical aspects of substance use disorders and co-occurring
2disorders.

3(iii) The effects of psychoactive drug use.

4(iv) Current theories of the etiology of substance abuse and
5addiction.

6(v) The role of persons and systems that support or compound
7 substance abuse and addiction.

8(vi) Major approaches to identification, evaluation, and treatment
9of substance use disorders, co-occurring disorders, and addiction,
10including, but not limited to, best practices.

11(vii) Legal aspects of substance abuse.

12(viii) Populations at risk with regard to substance use disorders
13and co-occurring disorders.

14(ix) Community resources offering screening, assessment,
15treatment, and followup for the affected person and family.

16(x) Recognition of substance use disorders, co-occurring
17disorders, and addiction, and appropriate referral.

18(xi) The prevention of substance use disorders and addiction.

19(J) California law and professional ethics for marriage and
20family therapists, including instruction in all of the following areas
21of study:

22(i) Contemporary professional ethics and statutory, regulatory,
23and decisional laws that delineate the scope of practice of marriage
24and family therapy.

25(ii) The therapeutic, clinical, and practical considerations
26involved in the legal and ethical practice of marriage and family
27therapy, including, but not limited to, family law.

28(iii) The current legal patterns and trends in the mental health
29professions.

30(iv) The psychotherapist-patient privilege, confidentiality, the
31patient dangerous to self or others, and the treatment of minors
32with and without parental consent.

33(v) A recognition and exploration of the relationship between
34a practitioner’s sense of self and human values and his or her
35professional behavior and ethics.

36(vi) Differences in legal and ethical standards for different types
37of work settings.

38(vii) Licensing law and licensing process.

39(e) The degree described in subdivision (b) shall, in addition to
40meeting the requirements of subdivision (d), include instruction
P16   1in case management, systems of care for the severely mentally ill,
2public and private services and supports available for the severely
3mentally ill, community resources for persons with mental illness
4and for victims of abuse, disaster and trauma response, advocacy
5for the severely mentally ill, and collaborative treatment. This
6instruction may be provided either in credit level coursework or
7through extension programs offered by the degree-granting
8institution.

9(f) The changes made to law by this section are intended to
10improve the educational qualifications for licensure in order to
11better prepare future licentiates for practice, and are not intended
12to expand or restrict the scope of practice for marriage and family
13therapists.

14

SEC. 19.  

Section 4980.43 of the Business and Professions
15Code
is amended to read:

16

4980.43.  

(a) Prior to applying for licensure examinations, each
17applicant shall complete experience that shall comply with the
18following:

19(1) A minimum of 3,000 hours completed during a period of at
20least 104 weeks.

21(2) Not more than 40 hours in any seven consecutive days.

22(3) Not less than 1,700 hours of supervised experience
23completed subsequent to the granting of the qualifying master’s
24or doctoral degree.

25(4) Not more than 1,300 hours of supervised experience obtained
26prior to completing a master’s or doctoral degree.

27The applicant shall not be credited with more than 750 hours of
28counseling and direct supervisor contact prior to completing the
29master’s or doctoral degree.

30(5) No hours of experience may be gained prior to completing
31either 12 semester units or 18 quarter units of graduate instruction
32and becoming a trainee except for personal psychotherapy.

33(6) No hours of experience may be gained more than six years
34prior to the date the application for examination eligibility was
35filed, except that up to 500 hours of clinical experience gained in
36the supervised practicum required by subdivision (c) of Section
374980.37 and subparagraph (B) of paragraph (1) of subdivision (d)
38of Section 4980.36 shall be exempt from this six-year requirement.

39(7) Not more than a combined total of 1,000 hours of experience
40in the following:

P17   1(A) Direct supervisor contact.

2(B) Professional enrichment activities. For purposes of this
3chapter, “professional enrichment activities” include the following:

4(i) Workshops, seminars, training sessions, or conferences
5directly related to marriage and family therapy attended by the
6applicant that are approved by the applicant’s supervisor. An
7applicant shall have no more than 250 hours of verified attendance
8at these workshops, seminars, training sessions, or conferences.

9(ii) Participation by the applicant in personal psychotherapy,
10which includes group, marital or conjoint, family, or individual
11psychotherapy by an appropriately licensed professional. An
12applicant shall have no more than 100 hours of participation in
13personal psychotherapy. The applicant shall be credited with three
14hours of experience for each hour of personal psychotherapy.

15(8) Not more than 500 hours of experience providing group
16therapy or group counseling.

17(9) For all hours gained on or after January 1, 2012, not more
18than 500 hours of experience in the following:

19(A) Experience administering and evaluating psychological
20tests, writing clinical reports, writing progress notes, or writing
21process notes.

22(B) Client centered advocacy.

23(10) Not less than 500 total hours of experience in diagnosing
24and treating couples, families, and children. For up to 150 hours
25of treating couples and families in conjoint therapy, the applicant
26shall be credited with two hours of experience for each hour of
27therapy provided.

28(11) Not more than 375 hours of experience providing personal
29psychotherapy, crisis counseling, or other counseling services via
30telehealth in accordance with Section 2290.5.

31(12) It is anticipated and encouraged that hours of experience
32will include working with elders and dependent adults who have
33physical or mental limitations that restrict their ability to carry out
34normal activities or protect their rights.

35This subdivision shall only apply to hours gained on and after
36January 1, 2010.

37(b) All applicants, trainees, and registrants shall be at all times
38under the supervision of a supervisor who shall be responsible for
39ensuring that the extent, kind, and quality of counseling performed
40is consistent with the training and experience of the person being
P18   1supervised, and who shall be responsible to the board for
2compliance with all laws, rules, and regulations governing the
3practice of marriage and family therapy. Supervised experience
4shall be gained by interns and traineesbegin delete eitherend deletebegin insert onlyend insert as an employee
5or as a volunteer. The requirements of this chapter regarding
6gaining hours of experience and supervision are applicable equally
7to employees and volunteers.begin delete Experience shall not be gained by
8interns or trainees as an independent contractor.end delete
begin insert Work performed
9by an intern or trainee as an independent contractor or reported
10on an IRS Form 1099 shall not satisfy the requirements of this
11chapter regarding gaining hours of supervised experience.end insert

12(1) If employed, an intern shall provide the board with copies
13of the corresponding W-2 tax forms for each year of experience
14claimed upon application for licensure.

15(2) If volunteering, an intern shall provide the board with a letter
16from his or her employer verifying the intern’s employment as a
17volunteer upon application for licensure.

18(c) Except for experience gained pursuant to subparagraph (B)
19of paragraph (7) of subdivision (a), supervision shall include at
20least one hour of direct supervisor contact in each week for which
21experience is credited in each work setting, as specified:

22(1) A trainee shall receive an average of at least one hour of
23direct supervisor contact for every five hours of client contact in
24each setting.

25(2) An individual supervised after being granted a qualifying
26degree shall receive at least one additional hour of direct supervisor
27contact for every week in which more than 10 hours of client
28contact is gained in each setting. No more than five hours of
29supervision, whether individual or group, shall be credited during
30any single week.

31(3) For purposes of this section, “one hour of direct supervisor
32contact” means one hour per week of face-to-face contact on an
33individual basis or two hours per week of face-to-face contact in
34a group.

35(4) Direct supervisor contact shall occur within the same week
36as the hours claimed.

37(5) Direct supervisor contact provided in a group shall be
38provided in a group of not more than eight supervisees and in
39segments lasting no less than one continuous hour.

P19   1(6) Notwithstanding paragraph (3), an intern working in a
2governmental entity, a school, a college, or a university, or an
3institution that is both nonprofit and charitable may obtain the
4required weekly direct supervisor contact via two-way, real-time
5videoconferencing. The supervisor shall be responsible for ensuring
6that client confidentiality is upheld.

7(7) All experience gained by a trainee shall be monitored by the
8supervisor as specified by regulation.

9(d) (1) A trainee may be credited with supervised experience
10completed in any setting that meets all of the following:

11(A) Lawfully and regularly provides mental health counseling
12or psychotherapy.

13(B) Provides oversight to ensure that the trainee’s work at the
14setting meets the experience and supervision requirements set forth
15in this chapter and is within the scope of practice for the profession
16as defined in Section 4980.02.

17(C) Is not a private practice owned by a licensed marriage and
18family therapist, a licensed psychologist, a licensed clinical social
19worker, a licensed physician and surgeon, or a professional
20corporation of any of those licensed professions.

21(2) Experience may be gained by the trainee solely as part of
22the position for which the trainee volunteers or is employed.

23(e) (1) An intern may be credited with supervised experience
24completed in any setting that meets both of the following:

25(A) Lawfully and regularly provides mental health counseling
26or psychotherapy.

27(B) Provides oversight to ensure that the intern’s work at the
28setting meets the experience and supervision requirements set forth
29in this chapter and is within the scope of practice for the profession
30as defined in Section 4980.02.

31(2) An applicant shall not be employed or volunteer in a private
32practice, as defined in subparagraph (C) of paragraph (1) of
33subdivision (d), until registered as an intern.

34(3) While an intern may be either a paid employee or a
35volunteer, employers are encouraged to provide fair remuneration
36to interns.

37(4) Except for periods of time during a supervisor’s vacation or
38sick leave, an intern who is employed or volunteering in private
39practice shall be under the direct supervision of a licensee that has
40satisfied the requirements of subdivision (g) of Section 4980.03.
P20   1The supervising licensee shall either be employed by and practice
2at the same site as the intern’s employer, or shall be an owner or
3shareholder of the private practice. Alternative supervision may
4be arranged during a supervisor’s vacation or sick leave if the
5supervision meets the requirements of this section.

6(5) Experience may be gained by the intern solely as part of the
7position for which the intern volunteers or is employed.

8(f) Except as provided in subdivision (g), all persons shall
9register with the board as an intern in order to be credited for
10postdegree hours of supervised experience gained toward licensure.

11(g) Except when employed in a private practice setting, all
12postdegree hours of experience shall be credited toward licensure
13so long as the applicant applies for the intern registration within
1490 days of the granting of the qualifying master’s or doctoral
15degree and is thereafter granted the intern registration by the board.

16(h) Trainees, interns, and applicants shall not receive any
17remuneration from patients or clients, and shall only be paid by
18their employers.

19(i) Trainees, interns, and applicants shall only perform services
20at the place where their employers regularly conduct business,
21which may include performing services at other locations, so long
22as the services are performed under the direction and control of
23their employer and supervisor, and in compliance with the laws
24and regulations pertaining to supervision. Trainees and interns
25shall have no proprietary interest in their employers’ businesses
26and shall not lease or rent space, pay for furnishings, equipment
27or supplies, or in any other way pay for the obligations of their
28employers.

29(j) Trainees, interns, or applicants who provide volunteered
30services or other services, and who receive no more than a total,
31from all work settings, of five hundred dollars ($500) per month
32as reimbursement for expenses actually incurred by those trainees,
33interns, or applicants for services rendered in any lawful work
34setting other than a private practice shall be considered an
35employee and not an independent contractor. The board may audit
36applicants who receive reimbursement for expenses, and the
37applicants shall have the burden of demonstrating that the payments
38received were for reimbursement of expenses actually incurred.

39(k) Each educational institution preparing applicants for
40 licensure pursuant to this chapter shall consider requiring, and
P21   1shall encourage, its students to undergo individual, marital or
2conjoint, family, or group counseling or psychotherapy, as
3appropriate. Each supervisor shall consider, advise, and encourage
4his or her interns and trainees regarding the advisability of
5undertaking individual, marital or conjoint, family, or group
6counseling or psychotherapy, as appropriate. Insofar as it is deemed
7appropriate and is desired by the applicant, the educational
8institution and supervisors are encouraged to assist the applicant
9in locating that counseling or psychotherapy at a reasonable cost.

10

SEC. 20.  

Section 4980.72 of the Business and Professions
11Code
is amended to read:

12

4980.72.  

(a) This section applies to persons who are licensed
13outside of California and apply for licensure on or after January
141, 2014.

15(b) The board may issue a license to a person who, at the time
16of submitting an application for a license pursuant to this chapter,
17holds a valid license in good standing issued by a board of marriage
18counselor examiners, board of marriage and family therapists, or
19corresponding authority, of any state or country, if all of the
20following conditions are satisfied:

21(1) The applicant’s education is substantially equivalent, as
22defined in Section 4980.78. The applicant’s degree title need not
23be identical to that required by Section 4980.36 or 4980.37.

24(2) The applicant complies with Section 4980.76, if applicable.

25(3) The applicant’s supervised experience is substantially
26equivalent to that required for a license under this chapter.begin delete The
27board shall consider hours of experience obtained outside of
28California during the six-year period immediately preceding the
29date the applicant initially obtained the license described above.end delete

30begin insert If the applicant has less than 3,000 hours of qualifying supervised
31experience, time actively licensed as a marriage and family
32therapist shall be accepted at a rate of 100 hours per month up to
33a maximum of 1,200 hours.end insert

34(4) The applicant passes the California law and ethics
35examination.

36(5) The applicant passes a clinical examination designated by
37the board. An applicant who obtained his or her license or
38registration under another jurisdiction may apply for licensure with
39the board without taking the clinical examination if both of the
40following conditions are met:

P22   1(A) The applicant obtained a passing score on the licensing
2examination set forth in regulation as accepted by the board.

3(B) The applicant’s license or registration in that jurisdiction is
4in good standing at the time of his or her application and has not
5been revoked, suspended, surrendered, denied, or otherwise
6restricted or encumbered as a result of any disciplinary proceeding
7brought by the licensing authority of that jurisdiction.

8

SEC. 21.  

Section 4989.68 of the Business and Professions
9Code
is amended to read:

10

4989.68.  

(a) The board shall assess the following fees relating
11to the licensure of educational psychologists:

12(1) The application fee for examination eligibility shall be one
13hundred dollars ($100).

14(2) The fee for issuance of the initial license shall be a maximum
15amount of one hundred fifty dollars ($150).

16(3) The fee for license renewal shall be a maximum amount of
17one hundred fifty dollars ($150).

18(4) The delinquency fee shall bebegin insert a maximum amount ofend insert
19 seventy-five dollars ($75). A person who permits his or her license
20to become delinquent may have it restored only upon payment of
21all the fees that he or she would have paid if the license had not
22become delinquent, plus the payment of any and all delinquency
23fees.

24(5) The written examination fee shall be one hundred dollars
25($100). An applicant who fails to appear for an examination, once
26having been scheduled, shall forfeit any examination fees he or
27she paid.

28(6) The fee for rescoring a written examination shall be twenty
29dollars ($20).

30(7) The fee for issuance of a replacement registration, license,
31or certificate shall be twenty dollars ($20).

32(8) The fee for issuance of a certificate or letter of good standing
33shall be twenty-five dollars ($25).

34(9) The fee for issuance of a retired license shall be forty dollars
35($40).

36(b) With regard to all license, examination, and other fees, the
37board shall establish fee amounts at or below the maximum
38amounts specified in this chapter.

P23   1

SEC. 22.  

Section 4996.3 of the Business and Professions Code,
2as amended by Section 55 of Chapter 799 of the Statutes of 2012,
3is amended to read:

4

4996.3.  

(a) The board shall assess the following fees relating
5to the licensure of clinical social workers:

6(1) The application fee for registration as an associate clinical
7social worker shall be seventy-five dollars ($75).

8(2) The fee for renewal of an associate clinical social worker
9registration shall be seventy-five dollars ($75).

10(3) The fee for application for examination eligibility shall be
11one hundred dollars ($100).

12(4) The fee for the clinical examination shall be one hundred
13dollars ($100). The fee for the California law and ethics
14examination shall be one hundred dollars ($100).

15(A) An applicant who fails to appear for an examination, after
16having been scheduled to take the examination, shall forfeit the
17examination fees.

18(B) The amount of the examination fees shall be based on the
19actual cost to the board of developing, purchasing, and grading
20each examination and the actual cost to the board of administering
21each examination. The written examination fees shall be adjusted
22periodically by regulation to reflect the actual costs incurred by
23the board.

24(5) The fee for rescoring an examination shall be twenty dollars
25($20).

26(6) The fee for issuance of an initial license shall be a maximum
27of one hundred fifty-five dollars ($155).

28(7) The fee for license renewal shall be a maximum of one
29hundred fifty-five dollars ($155).

30(8) The fee for inactive license renewal shall be a maximum of
31seventy-seven dollars and fifty cents ($77.50).

32(9) The renewal delinquency fee shall bebegin insert a maximum ofend insert
33 seventy-five dollars ($75). A person who permits his or her license
34to expire is subject to the delinquency fee.

35(10) The fee for issuance of a replacement registration, license,
36or certificate shall be twenty dollars ($20).

37(11) The fee for issuance of a certificate or letter of good
38standing shall be twenty-five dollars ($25).

39(12) The fee for issuance of a retired license shall be forty dollars
40($40).

P24   1(b) With regard to license, examination, and other fees, the
2board shall establish fee amounts at or below the maximum
3amounts specified in this chapter.

4(c) This section shall become operative on January 1, 2014.

5

SEC. 23.  

Section 4996.9 of the Business and Professions Code
6 is amended to read:

7

4996.9.  

The practice of clinical social work is defined as a
8service in which a special knowledge of social resources, human
9capabilities, and the part that unconscious motivation plays in
10determining behavior, is directed at helping people to achieve more
11adequate, satisfying, and productive social adjustments. The
12application of social work principles and methods includes, but is
13not restricted to, counseling and using applied psychotherapy of
14a nonmedical nature with individuals, families, or groups; providing
15information and referral services; providing or arranging for the
16provision of social services; explaining or interpreting the
17psychosocial aspects in the situations of individuals, families, or
18groups; helping communities to organize, to provide, or to improve
19social or health services;begin delete orend delete doing research related to social workbegin insert;
20and the use, application, and integration of the coursework and
21experience required by Sections 4996.2 and 4996.23end insert
.

22Psychotherapy, within the meaning of this chapter, is the use of
23psychosocial methods within a professional relationship, to assist
24the person or persons to achieve a better psychosocial adaptation,
25to acquire greater human realization of psychosocial potential and
26adaptation,begin insert andend insert to modify internal and external conditions which
27affect individuals, groups, or communities in respect to behavior,
28emotions, and thinking, in respect to their intrapersonal and
29interpersonal processes.

30

SEC. 24.  

Section 4996.18 of the Business and Professions
31Code
is amended to read:

32

4996.18.  

(a) A person who wishes to be credited with
33experience toward licensure requirements shall register with the
34board as an associate clinical social worker prior to obtaining that
35experience. The application shall be made on a form prescribed
36by the board.

37(b) An applicant for registration shall satisfy the following
38requirements:

39(1) Possess a master’s degree from an accredited school or
40department of social work.

P25   1(2) Have committed no crimes or acts constituting grounds for
2denial of licensure under Section 480.

3(3) Commencing January 1, 2014, have completed training or
4 coursework, which may be embedded within more than one course,
5in California law and professional ethics for clinical social workers,
6including instruction in all of the following areas of study:

7(A) Contemporary professional ethics and statutes, regulations,
8and court decisions that delineate the scope of practice of clinical
9social work.

10(B) The therapeutic, clinical, and practical considerations
11involved in the legal and ethical practice of clinical social work,
12including, but not limited to, family law.

13(C) The current legal patterns and trends in the mental health
14professions.

15(D) The psychotherapist-patient privilege, confidentiality,
16dangerous patients, and the treatment of minors with and without
17parental consent.

18(E) A recognition and exploration of the relationship between
19a practitioner’s sense of self and human values, and his or her
20professional behavior and ethics.

21(F) Differences in legal and ethical standards for different types
22of work settings.

23(G) Licensing law and process.

24(c) An applicant who possesses a master’s degree from a school
25or department of social work that is a candidate for accreditation
26by the Commission on Accreditation of the Council on Social
27Work Education shall be eligible, and shall be required, to register
28as an associate clinical social worker in order to gain experience
29toward licensure if the applicant has not committed any crimes or
30acts that constitute grounds for denial of licensure under Section
31480. That applicant shall not, however, be eligible for examination
32until the school or department of social work has received
33accreditation by the Commission on Accreditation of the Council
34on Social Work Education.

begin insert

35(d) All applicants and registrants shall be at all times under the
36supervision of a supervisor who shall be responsible for ensuring
37that the extent, kind, and quality of counseling performed is
38consistent with the training and experience of the person being
39supervised, and who shall be responsible to the board for
P26   1compliance with all laws, rules, and regulations governing the
2practice of clinical social work.

end insert
begin delete

3(d)

end delete

4begin insert(e)end insert Any experience obtained under the supervision of a spouse
5or relative by blood or marriage shall not be credited toward the
6required hours of supervised experience. Any experience obtained
7under the supervision of a supervisor with whom the applicant has
8a personal relationship that undermines the authority or
9effectiveness of the supervision shall not be credited toward the
10required hours of supervised experience.

begin delete

11(e)

end delete

12begin insert(f)end insert An applicant who possesses a master’s degree from an
13accredited school or department of social work shall be able to
14apply experience the applicant obtained during the time the
15accredited school or department was in candidacy status by the
16 Commission on Accreditation of the Council on Social Work
17Education toward the licensure requirements, if the experience
18meets the requirements of Section 4996.23. This subdivision shall
19apply retroactively to persons who possess a master’s degree from
20an accredited school or department of social work and who
21obtained experience during the time the accredited school or
22department was in candidacy status by the Commission on
23Accreditation of the Council on Social Work Education.

begin delete

24(f)

end delete

25begin insert(g)end insert An applicant for registration or licensure trained in an
26educational institution outside the United States shall demonstrate
27to the satisfaction of the board that he or she possesses a master’s
28of social work degree that is equivalent to a master’s degree issued
29from a school or department of social work that is accredited by
30the Commission on Accreditation of the Council on Social Work
31Education. These applicants shall provide the board with a
32comprehensive evaluation of the degree and shall provide any
33other documentation the board deems necessary. The board has
34the authority to make the final determination as to whether a degree
35meets all requirements, including, but not limited to, course
36requirements regardless of evaluation or accreditation.

begin delete

37(g)

end delete

38begin insert(h)end insert A registrant shall not provide clinical social work services
39to the public for a fee, monetary or otherwise, except as an
40employee.

begin delete

P27   1(h)

end delete

2begin insert(i)end insert A registrant shall inform each client or patient prior to
3performing any professional services that he or she is unlicensed
4and is under the supervision of a licensed professional.

5

SEC. 25.  

Section 4996.23 of the Business and Professions
6Code
is amended to read:

7

4996.23.  

The experience required by subdivision (c) of Section
84996.2 shall meet the following criteria:

9(a) All persons registered with the board on and after January
101, 2002, shall have at least 3,200 hours of post-master’s degree
11supervised experience providing clinical social work services as
12permitted by Section 4996.9. At least 1,700 hours shall be gained
13under the supervision of a licensed clinical social worker. The
14remaining required supervised experience may be gained under
15the supervision of a licensed mental health professional acceptable
16to the board as defined by a regulation adopted by the board. This
17experience shall consist of the following:

18(1) A minimum of 2,000 hours in clinical psychosocial
19diagnosis, assessment, and treatment, including psychotherapy or
20counseling.

21(2) A maximum of 1,200 hours in client-centered advocacy,
22consultation, evaluation, and research.

23(3) Of the 2,000 clinical hours required in paragraph (1), no less
24than 750 hours shall be face-to-face individual or group
25psychotherapy provided to clients in the context of clinical social
26work services.

27(4) A minimum of two years of supervised experience is required
28to be obtained over a period of not less than 104 weeks and shall
29have been gained within the six years immediately preceding the
30date on which the application for licensure was filed.

31(5) Experience shall not be credited for more than 40 hours in
32any week.

33(b) “Supervision” means responsibility for, and control of, the
34quality of clinical social work services being provided.
35Consultation or peer discussion shall not be considered to be
36supervision.

37(c) (1) Prior to the commencement of supervision, a supervisor
38shall comply with all requirements enumerated in Section 1870 of
39Title 16 of the California Code of Regulations and shall sign under
P28   1penalty of perjury the “Responsibility Statement for Supervisors
2of an Associate Clinical Social Worker” form.

3(2) Supervised experience shall include at least one hour of
4direct supervisor contact for a minimum of 104 weeks. For
5purposes of this subdivision, “one hour of direct supervisor contact”
6means one hour per week of face-to-face contact on an individual
7basis or two hours of face-to-face contact in a group conducted
8within the same week as the hours claimed.

9(3) An associate shall receive at least one additional hour of
10direct supervisor contact for every week in which more than 10
11hours of face-to-face psychotherapy is performed in each setting
12in which experience is gained. No more than five hours of
13supervision, whether individual or group, shall be credited during
14any single week.

15(4) Group supervision shall be provided in a group of not more
16than eight supervisees and shall be provided in segments lasting
17no less than one continuous hour.

18(5) Of the 104 weeks of required supervision, 52 weeks shall
19be individual supervision, and of the 52 weeks of required
20individual supervision, not less than 13 weeks shall be supervised
21by a licensed clinical social worker.

22(6) Notwithstanding paragraph (2), an associate clinical social
23worker working for a governmental entity, school, college, or
24university, or an institution that is both a nonprofit and charitable
25institution, may obtain the required weekly direct supervisor
26contact via live two-way videoconferencing. The supervisor shall
27be responsible for ensuring that client confidentiality is preserved.

28(d) The supervisor and the associate shall develop a supervisory
29plan that describes the goals and objectives of supervision. These
30goals shall include the ongoing assessment of strengths and
31limitations and the assurance of practice in accordance with the
32laws and regulations. The associate shall submit to the board the
33initial original supervisory plan upon application for licensure.

34(e) Experience shall only be gained in a setting that meets both
35of the following:

36(1) Lawfully and regularly provides clinical social work, mental
37health counseling, or psychotherapy.

38(2) Provides oversight to ensure that the associate’s work at the
39setting meets the experience and supervision requirements set forth
P29   1in this chapter and is within the scope of practice for the profession
2as defined in Section 4996.9.

3(f) Experience shall not be gained until the applicant has been
4registered as an associate clinical social worker.

5(g) Employment in a private practice as defined in subdivision
6(h) shall not commence until the applicant has been registered as
7an associate clinical social worker.

8(h) A private practice setting is a setting that is owned by a
9licensed clinical social worker, a licensed marriage and family
10 therapist, a licensed psychologist, a licensed physician and surgeon,
11or a professional corporation of any of those licensed professions.

begin insert

12(i) Work performed by an associate as an independent
13contractor or reported on an IRS Form 1099 shall not satisfy the
14requirements of this chapter regarding gaining hours of supervised
15experience.

end insert
begin delete

16(i)

end delete

17begin insert(j)end insert If volunteering, the associate shall provide the board with a
18letter from his or her employer verifying his or her voluntary status
19upon application for licensure.

begin delete

20(j)

end delete

21begin insert(k)end insert If employed, the associate shall provide the board with copies
22of his or her W-2 tax forms for each year of experience claimed
23upon application for licensure.

begin delete

24(k)

end delete

25begin insert(l)end insert While an associate may be either a paid employee or
26volunteer, employers are encouraged to provide fair remuneration
27to associates.

begin delete

28(l)

end delete

29begin insert(m)end insert An associate shall not do the following:

30(1) Receive any remuneration from patients or clients and shall
31only be paid by his or her employer.

32(2) Have any proprietary interest in the employer’s business.

33(3) Lease or rent space, pay for furnishings, equipment, or
34supplies, or in any other way pay for the obligations of his or her
35employer.

begin delete

36(m)

end delete

37begin insert(n)end insert An associate, whether employed or volunteering, may obtain
38supervision from a person not employed by the associate’s
39employer if that person has signed a written agreement with the
P30   1employer to take supervisory responsibility for the associate’s
2social work services.

begin delete

3(n)

end delete

4begin insert(o)end insert Notwithstanding any other provision of law, associates and
5applicants for examination shall receive a minimum of one hour
6of supervision per week for each setting in which he or she is
7working.

8

SEC. 26.  

Section 4999.33 of the Business and Professions
9Code
is amended to read:

10

4999.33.  

(a) This section shall apply to the following:

11(1) Applicants for examination eligibility or registration who
12begin graduate study before August 1, 2012, and do not complete
13that study on or before December 31, 2018.

14(2) Applicants for examination eligibility or registration who
15begin graduate study before August 1, 2012, and who graduate
16from a degree program that meets the requirements of this section.

17(3) Applicants for examination eligibility or registration who
18begin graduate study on or after August 1, 2012.

19(b) To qualify for examination eligibility or registration,
20 applicants shall possess a master’s or doctoral degree that is
21counseling or psychotherapy in content and that meets the
22requirements of this section, obtained from an accredited or
23approved institution, as defined in Section 4999.12. For purposes
24of this subdivision, a degree is “counseling or psychotherapy in
25content” if it contains the supervised practicum or field study
26experience described in paragraph (3) of subdivision (c) and, except
27as provided in subdivision (f), the coursework in the core content
28areas listed in subparagraphs (A) to (M), inclusive, of paragraph
29(1) of subdivision (c).

30(c) The degree described in subdivision (b) shall contain not
31less than 60 graduate semester or 90 graduate quarter units of
32instruction, which shall, except as provided in subdivision (f),
33include all of the following:

34(1) The equivalent of at least three semester units or four and
35 one-half quarter units of graduate study in all of the following core
36content areas:

37(A) Counseling and psychotherapeutic theories and techniques,
38including the counseling process in a multicultural society, an
39orientation to wellness and prevention, counseling theories to assist
40in selection of appropriate counseling interventions, models of
P31   1counseling consistent with current professional research and
2practice, development of a personal model of counseling, and
3multidisciplinary responses to crises, emergencies, and disasters.

4(B) Human growth and development across the lifespan,
5including normal and abnormal behavior and an understanding of
6developmental crises, disability, psychopathology, and situational
7and environmental factors that affect both normal and abnormal
8behavior.

9(C) Career development theories and techniques, including
10career development decisionmaking models and interrelationships
11among and between work, family, and other life roles and factors,
12including the role of multicultural issues in career development.

13(D) Group counseling theories and techniques, including
14principles of group dynamics, group process components, group
15developmental stage theories, therapeutic factors of group work,
16group leadership styles and approaches, pertinent research and
17literature, group counseling methods, and evaluation of
18effectiveness.

19(E) Assessment, appraisal, and testing of individuals, including
20basic concepts of standardized and nonstandardized testing and
21other assessment techniques, norm-referenced and
22criterion-referenced assessment, statistical concepts, social and
23cultural factors related to assessment and evaluation of individuals
24and groups, and ethical strategies for selecting, administering, and
25interpreting assessment instruments and techniques in counseling.

26(F) Multicultural counseling theories and techniques, including
27counselors’ roles in developing cultural self-awareness, identity
28development, promoting cultural social justice, individual and
29community strategies for working with and advocating for diverse
30populations, and counselors’ roles in eliminating biases and
31prejudices, and processes of intentional and unintentional
32oppression and discrimination.

33(G) Principles of the diagnostic process, including differential
34diagnosis, and the use of current diagnostic tools, such as the
35current edition of the Diagnostic and Statistical Manual, the impact
36of co-occurring substance use disorders or medical psychological
37disorders, established diagnostic criteria for mental or emotional
38disorders, and the treatment modalities and placement criteria
39within the continuum of care.

P32   1(H) Research and evaluation, including studies that provide an
2understanding of research methods, statistical analysis, the use of
3research to inform evidence-based practice, the importance of
4research in advancing the profession of counseling, and statistical
5methods used in conducting research, needs assessment, and
6program evaluation.

7(I) Professional orientation, ethics, and law in counseling,
8including California law and professional ethics for professional
9clinical counselors, professional ethical standards and legal
10considerations, licensing law and process, regulatory laws that
11delineate the profession’s scope of practice, counselor-client
12privilege, confidentiality, the client dangerous to self or others,
13treatment of minors with or without parental consent, relationship
14between practitioner’s sense of self and human values, functions
15and relationships with other human service providers, strategies
16for collaboration, and advocacy processes needed to address
17institutional and social barriers that impede access, equity, and
18success for clients.

19(J) Psychopharmacology, including the biological bases of
20behavior, basic classifications, indications, and contraindications
21of commonly prescribed psychopharmacological medications so
22that appropriate referrals can be made for medication evaluations
23and so that the side effects of those medications can be identified.

24(K) Addictions counseling, including substance abuse,
25co-occurring disorders, and addiction, major approaches to
26identification, evaluation, treatment, and prevention of substance
27abuse and addiction, legal and medical aspects of substance abuse,
28populations at risk, the role of support persons, support systems,
29and community resources.

30(L) Crisis or trauma counseling, including crisis theory;
31multidisciplinary responses to crises, emergencies, or disasters;
32cognitive, affective, behavioral, and neurological effects associated
33with trauma; brief, intermediate, and long-term approaches; and
34assessment strategies for clients in crisis and principles of
35intervention for individuals with mental or emotional disorders
36during times of crisis, emergency, or disaster.

37(M) Advanced counseling and psychotherapeutic theories and
38techniques, including the application of counseling constructs,
39assessment and treatment planning, clinical interventions,
40therapeutic relationships, psychopathology, or other clinical topics.

P33   1(2) In addition to the course requirements described in paragraph
2(1), 15 semester units or 22.5 quarter units of advanced coursework
3to develop knowledge of specific treatment issues or special
4populations.

5(3) Not less than six semester units or nine quarter units of
6supervised practicum or field study experience, or the equivalent,
7in a clinical setting that provides a range of professional clinical
8counseling experience, including the following:

9(A) Applied psychotherapeutic techniques.

10(B) Assessment.

11(C) Diagnosis.

12(D) Prognosis.

13(E) Treatment.

14(F) Issues of development, adjustment, and maladjustment.

15(G) Health and wellness promotion.

16(H) Professional writing including documentation of services,
17treatment plans, and progress notes.

18(I) How to find and use resources.

19(J) Other recognized counseling interventions.

20(K) A minimum of 280 hours of face-to-face supervised clinical
21experience counseling individuals, families, or groups.

22(d) The 60 graduate semester units or 90 graduate quarter units
23of instruction required pursuant to subdivision (c) shall, in addition
24to meeting the requirements of subdivision (c), include instruction
25in all of the following:

26(1) The understanding of human behavior within the social
27context of socioeconomic status and other contextual issues
28affecting social position.

29(2) The understanding of human behavior within the social
30context of a representative variety of the cultures found within
31California.

32(3) Cultural competency and sensitivity, including a familiarity
33with the racial, cultural, linguistic, and ethnic backgrounds of
34persons living in California.

35(4) An understanding of the effects of socioeconomic status on
36treatment and available resources.

37(5) Multicultural development and cross-cultural interaction,
38including experiences of race, ethnicity, class, spirituality, sexual
39orientation, gender, and disability and their incorporation into the
40psychotherapeutic process.

P34   1(6) Case management, systems of care for the severely mentally
2ill, public and private services for the severely mentally ill,
3community resources for victims of abuse, disaster and trauma
4response, advocacy for the severely mentally ill, and collaborative
5treatment. The instruction required in this paragraph may be
6provided either in credit level coursework or through extension
7programs offered by the degree-granting institution.

8(7) Human sexuality, including the study of the physiological,
9psychological, and social cultural variables associated with sexual
10behavior, gender identity, and the assessment and treatment of
11psychosexual dysfunction.

12(8) Spousal or partner abuse assessment, detection, intervention
13strategies, and same-gender abuse dynamics.

begin delete

14(9) Child abuse assessment and reporting.

end delete
begin insert

15(9) A minimum of seven contact hours of training or coursework
16in child abuse assessment and reporting, as specified in Section
1728, and any regulations promulgated thereunder.

end insert

18(10) Aging and long-term care, including biological, social,
19cognitive, and psychological aspects of aging. This coursework
20shall include instruction on the assessment and reporting of, as
21well as treatment related to, elder and dependent adult abuse and
22neglect.

23(e) A degree program that qualifies for licensure under this
24section shall do all of the following:

25(1) Integrate the principles of mental health recovery-oriented
26care and methods of service delivery in recovery-oriented practice
27environments.

28(2) Integrate an understanding of various cultures and the social
29and psychological implications of socioeconomic position.

30(3) Provide the opportunity for students to meet with various
31consumers and family members of consumers of mental health
32services to enhance understanding of their experience of mental
33illness, treatment, and recovery.

34(f) (1) An applicant whose degree is deficient in no more than
35three of the required areas of study listed in subparagraphs (A) to
36(M), inclusive, of paragraph (1) of subdivision (c) may satisfy
37those deficiencies by successfully completing post-master’s or
38postdoctoral degree coursework at an accredited or approved
39institution, as defined in Section 4999.12.

P35   1(2) Coursework taken to meet deficiencies in the required areas
2of study listed in subparagraphs (A) to (M), inclusive, of paragraph
3(1) of subdivision (c) shall be the equivalent of three semester units
4or four and one-half quarter units of study.

5(3) The board shall make the final determination as to whether
6a degree meets all requirements, including, but not limited to,
7course requirements, regardless of accreditation.

8

SEC. 27.  

Section 4999.46 of the Business and Professions
9Code
, as amended by Section 65 of Chapter 799 of the Statutes of
102012, is amended to read:

11

4999.46.  

(a) To qualify for the licensure examination specified
12by paragraph (2) of subdivision (a) of Section 4999.53, applicants
13shall complete clinical mental health experience under the general
14supervision of an approved supervisor as defined in Section
154999.12.

16(b) The experience shall include a minimum of 3,000 postdegree
17hours of supervised clinical mental health experience related to
18the practice of professional clinical counseling, performed over a
19period of not less than two years (104 weeks), which shall include:

20(1) Not more than 40 hours in any seven consecutive days.

21(2) Not less than 1,750 hours of direct counseling with
22 individuals or groups in a setting described in Section 4999.44
23using a variety of psychotherapeutic techniques and recognized
24counseling interventions within the scope of practice of licensed
25professional clinical counselors.

26(3) Not more than 500 hours of experience providing group
27therapy or group counseling.

begin delete

28(4) Not more than 250 hours of experience providing counseling
29or crisis counseling on the telephone.

end delete
begin insert

30(4) Not more than 375 hours of experience providing personal
31psychotherapy, crisis counseling, or other counseling services via
32telehealth in accordance with Section 2290.5.

end insert

33(5) Not less than 150 hours of clinical experience in a hospital
34or community mental health setting, as defined in Section 1820 of
35Title 16 of the California Code of Regulations.

36(6) Not more than a combined total of 1,250 hours of experience
37in the following related activities:

38(A) Direct supervisor contact.

39(B) Client centered advocacy.

P36   1(C) Not more than 250 hours of experience administering tests
2and evaluating psychological tests of clients, writing clinical
3reports, writing progress notes, or writing process notes.

4(D) Not more than 250 hours of verified attendance at
5workshops,begin insert seminars,end insert training sessions, or conferences directly
6related to professional clinical counseling that are approved by the
7applicant’s supervisor.

8(c) No hours of clinical mental health experience may be gained
9more than six years prior to the date the application for examination
10eligibility was filed.

11(d) An applicant shall register with the board as an intern in
12order to be credited for postdegree hours of experience toward
13licensure. Postdegree hours of experience shall be credited toward
14licensure, provided that the applicant applies for intern registration
15within 90 days of the granting of the qualifying degree and is
16registered as an intern by the board.

17(e) All applicants and interns shall be at all times under the
18supervision of a supervisor who shall be responsible for ensuring
19that the extent, kind, and quality of counseling performed is
20consistent with the training and experience of the person being
21supervised, and who shall be responsible to the board for
22compliance with all laws, rules, and regulations governing the
23practice of professional clinical counseling.

24(f) Experience obtained under the supervision of a spouse or
25relative by blood or marriage shall not be credited toward the
26required hours of supervised experience. Experience obtained
27under the supervision of a supervisor with whom the applicant has
28had or currently has a personal, professional, or business
29relationship that undermines the authority or effectiveness of the
30supervision shall not be credited toward the required hours of
31supervised experience.

32(g) begin deleteSupervision end deletebegin insertExcept for experience gained pursuant to
33subparagraph (D) of paragraph (6) of subdivision (b), supervision end insert

34shall include at least one hour of direct supervisor contact in each
35week for which experience is credited in each work setting.

36(1) No more than five hours of supervision, whether individual
37or group, shall be credited during any single week.

38(2) An intern shall receive at least one additional hour of direct
39supervisor contact for every week in which more than 10 hours of
P37   1face-to-face psychotherapy is performed in each setting in which
2experience is gained.

3(3) For purposes of this section, “one hour of direct supervisor
4contact” means one hour of face-to-face contact on an individual
5basis or two hours of face-to-face contact in a group of not more
6than eight persons in segments lasting no less than one continuous
7hour.

8(4) Notwithstanding paragraph (3), an intern working in a
9governmental entity, a school, a college, or a university, or an
10institution that is both nonprofit and charitable, may obtain the
11required weekly direct supervisor contact via two-way, real-time
12videoconferencing. The supervisor shall be responsible for ensuring
13that client confidentiality is upheld.

14(h) This section shall become operative on January 1, 2014.

15

SEC. 28.  

Section 4999.47 of the Business and Professions
16Code
is amended to read:

17

4999.47.  

(a) Clinical counselor trainees, interns, and applicants
18shall perform servicesbegin insert onlyend insert as an employee or as a volunteer.

19The requirements of this chapter regarding gaining hours of
20clinical mental health experience and supervision are applicable
21equally to employees and volunteers.begin delete Experience shall not be
22gained by clinical counselor interns or trainees as an independent
23contractorend delete
begin insert Work performed as an independent contractor or
24reported on an IRS Form 1099 shall not satisfy the requiremeend insert
begin insertnts
25 of this chapter regarding gaining hours of supervised experienceend insert
.

26(1) If employed, a clinical counselor intern shall provide the
27board with copies of the corresponding W-2 tax forms for each
28year of experience claimed upon application for licensure as a
29professional clinical counselor.

30(2) If volunteering, a clinical counselor intern shall provide the
31board with a letter from his or her employer verifying the intern’s
32employment as a volunteer upon application for licensure as a
33professional clinical counselor.

34(b) Clinical counselor trainees, interns, and applicants shall not
35receive any remuneration from patients or clients, and shall only
36be paid by their employers.

37(c) While an intern may be either a paid employee or a volunteer,
38employers are encouraged to provide fair remuneration.

39(d) Clinical counselor trainees, interns, and applicants who
40provide voluntary services or other services, and who receive no
P38   1more than a total, from all work settings, of five hundred dollars
2($500) per month as reimbursement for expenses actually incurred
3by those clinical counselor trainees, interns, and applicants for
4services rendered in any lawful work setting other than a private
5practice shall be considered an employee and not an independent
6contractor.

7(e) The board may audit an intern or applicant who receives
8reimbursement for expenses and the intern or applicant shall have
9the burden of demonstrating that the payments received were for
10reimbursement of expenses actually incurred.

11(f) Clinical counselor trainees, interns, and applicants shall only
12perform services at the place where their employer regularly
13conducts business and services, which may include other locations,
14as long as the services are performed under the direction and
15control of the employer and supervisor in compliance with the
16laws and regulations pertaining to supervision. Clinical counselor
17trainees, interns, and applicants shall have no proprietary interest
18in the employer’s business.

19(g) Each educational institution preparing applicants for
20licensure pursuant to this chapter shall consider requiring, and
21shall encourage, its students to undergo individual, marital or
22conjoint, family, or group counseling or psychotherapy, as
23appropriate. Each supervisor shall consider, advise, and encourage
24his or her interns and clinical counselor trainees regarding the
25advisability of undertaking individual, marital or conjoint, family,
26or group counseling or psychotherapy, as appropriate. Insofar as
27it is deemed appropriate and is desired by the applicant, the
28educational institution and supervisors are encouraged to assist
29the applicant in locating that counseling or psychotherapy at a
30reasonable cost.

31

SEC. 29.  

Section 4999.60 of the Business and Professions
32Code
is amended to read:

33

4999.60.  

(a) This section applies to persons who are licensed
34outside of California and apply for examination eligibility on or
35after January 1, 2014.

36(b) The board may issue a license to a person who, at the time
37of submitting an application for a license pursuant to this chapter,
38holds a valid license as a professional clinical counselor, or other
39counseling license that allows the applicant to independently
P39   1provide clinical mental health services, in another jurisdiction of
2the United States if all of the following conditions are satisfied:

3(1) The applicant’s education is substantially equivalent, as
4defined in Section 4999.62.

5(2) The applicant complies with subdivision (b) of Section
64999.40, if applicable.

7(3) The applicant’s supervised experience is substantially
8equivalent to that required for a license under this chapter.begin delete The
9board shall consider hours of experience obtained outside of
10California during the six-year period immediately preceding the
11date the applicant initially obtained the license described above.end delete

12begin insert If the applicant has less than 3,000 hours of qualifying supervised
13experience, time actively licensed as a professional clinical
14counselor shall be accepted at a rate of 100 hours per month up
15to a maximum of 1,200 hoursend insert
begin insert.end insert

16(4) The applicant passes the examinations required to obtain a
17license under this chapter. An applicant who obtained his or her
18license or registration under another jurisdiction may apply for
19licensure with the board without taking the clinical examination
20if both of the following conditions are met:

21(A) The applicant obtained a passing score on the licensing
22examination set forth in regulation as accepted by the board.

23(B) The applicant’s license or registration in that jurisdiction is
24in good standing at the time of his or her application and has not
25been revoked, suspended, surrendered, denied, or otherwise
26restricted or encumbered as a result of any disciplinary proceeding
27brought by the licensing authority of that jurisdiction.

28

SEC. 30.  

Section 14132 of the Welfare and Institutions Code
29 is amended to read:

30

14132.  

The following is the schedule of benefits under this
31chapter:

32(a) Outpatient services are covered as follows:

33Physician, hospital or clinic outpatient, surgical center,
34respiratory care, optometric, chiropractic, psychology, podiatric,
35occupational therapy, physical therapy, speech therapy, audiology,
36acupuncture to the extent federal matching funds are provided for
37acupuncture, and services of persons rendering treatment by prayer
38or healing by spiritual means in the practice of any church or
39religious denomination insofar as these can be encompassed by
P40   1federal participation under an approved plan, subject to utilization
2controls.

3(b) (1) Inpatient hospital services, including, but not limited
4to, physician and podiatric services, physical therapy and
5occupational therapy, are covered subject to utilization controls.

6(2) For Medi-Cal fee-for-service beneficiaries, emergency
7services and care that are necessary for the treatment of an
8emergency medical condition and medical care directly related to
9the emergency medical condition. This paragraph shall not be
10construed to change the obligation of Medi-Cal managed care
11plans to provide emergency services and care. For the purposes of
12this paragraph, “emergency services and care” and “emergency
13medical condition” shall have the same meanings as those terms
14are defined in Section 1317.1 of the Health and Safety Code.

15(c) Nursing facility services, subacute care services, and services
16provided by any category of intermediate care facility for the
17developmentally disabled, including podiatry, physician, nurse
18practitioner services, and prescribed drugs, as described in
19subdivision (d), are covered subject to utilization controls.
20Respiratory care, physical therapy, occupational therapy, speech
21therapy, and audiology services for patients in nursing facilities
22and any category of intermediate care facility for the
23developmentally disabled are covered subject to utilization controls.

24(d) (1) Purchase of prescribed drugs is covered subject to the
25Medi-Cal List of Contract Drugs and utilization controls.

26(2) Purchase of drugs used to treat erectile dysfunction or any
27off-label uses of those drugs are covered only to the extent that
28federal financial participation is available.

29(3) (A) To the extent required by federal law, the purchase of
30outpatient prescribed drugs, for which the prescription is executed
31by a prescriber in written, nonelectronic form on or after April 1,
322008, is covered only when executed on a tamper resistant
33prescription form. The implementation of this paragraph shall
34conform to the guidance issued by the federal Centers of Medicare
35and Medicaid Services but shall not conflict with state statutes on
36the characteristics of tamper resistant prescriptions for controlled
37substances, including Section 11162.1 of the Health and Safety
38Code. The department shall provide providers and beneficiaries
39with as much flexibility in implementing these rules as allowed
40by the federal government. The department shall notify and consult
P41   1with appropriate stakeholders in implementing, interpreting, or
2making specific this paragraph.

3(B) Notwithstanding Chapter 3.5 (commencing with Section
411340) of Part 1 of Division 3 of Title 2 of the Government Code,
5the department may take the actions specified in subparagraph (A)
6by means of a provider bulletin or notice, policy letter, or other
7similar instructions without taking regulatory action.

8(4) (A) (i) For the purposes of this paragraph, nonlegend has
9the same meaning as defined in subdivision (a) of Section
1014105.45.

11(ii) Nonlegend acetaminophen-containing products, with the
12exception of children’s acetaminophen-containing products,
13selected by the department are not covered benefits.

14(iii) Nonlegend cough and cold products selected by the
15department are not covered benefits. This clause shall be
16implemented on the first day of the first calendar month following
1790 days after the effective date of the act that added this clause,
18or on the first day of the first calendar month following 60 days
19after the date the department secures all necessary federal approvals
20to implement this section, whichever is later.

21(iv) Beneficiaries under the Early and Periodic Screening,
22Diagnosis, and Treatment Program shall be exempt from clauses
23(ii) and (iii).

24(B) Notwithstanding Chapter 3.5 (commencing with Section
2511340) of Part 1 of Division 3 of Title 2 of the Government Code,
26the department may take the actions specified in subparagraph (A)
27by means of a provider bulletin or notice, policy letter, or other
28similar instruction without taking regulatory action.

29(e) Outpatient dialysis services and home hemodialysis services,
30including physician services, medical supplies, drugs and
31equipment required for dialysis, are covered, subject to utilization
32controls.

33(f) Anesthesiologist services when provided as part of an
34outpatient medical procedure, nurse anesthetist services when
35rendered in an inpatient or outpatient setting under conditions set
36forth by the director, outpatient laboratory services, and X-ray
37services are covered, subject to utilization controls. Nothing in
38this subdivision shall be construed to require prior authorization
39for anesthesiologist services provided as part of an outpatient
40medical procedure or for portable X-ray services in a nursing
P42   1facility or any category of intermediate care facility for the
2developmentally disabled.

3(g) Blood and blood derivatives are covered.

4(h) (1) Emergency and essential diagnostic and restorative
5dental services, except for orthodontic, fixed bridgework, and
6partial dentures that are not necessary for balance of a complete
7artificial denture, are covered, subject to utilization controls. The
8utilization controls shall allow emergency and essential diagnostic
9and restorative dental services and prostheses that are necessary
10to prevent a significant disability or to replace previously furnished
11prostheses which are lost or destroyed due to circumstances beyond
12the beneficiary’s control. Notwithstanding the foregoing, the
13director may by regulation provide for certain fixed artificial
14dentures necessary for obtaining employment or for medical
15conditions that preclude the use of removable dental prostheses,
16and for orthodontic services in cleft palate deformities administered
17by the department’s California Children Services Program.

18(2) For persons 21 years of age or older, the services specified
19in paragraph (1) shall be provided subject to the following
20conditions:

21(A) Periodontal treatment is not a benefit.

22(B) Endodontic therapy is not a benefit except for vital
23pulpotomy.

24(C) Laboratory processed crowns are not a benefit.

25(D) Removable prosthetics shall be a benefit only for patients
26as a requirement for employment.

27(E) The director may, by regulation, provide for the provision
28of fixed artificial dentures that are necessary for medical conditions
29that preclude the use of removable dental prostheses.

30(F) Notwithstanding the conditions specified in subparagraphs
31(A) to (E), inclusive, the department may approve services for
32persons with special medical disorders subject to utilization review.

33(3) Paragraph (2) shall become inoperative July 1, 1995.

34(i) Medical transportation is covered, subject to utilization
35controls.

36(j) Home health care services are covered, subject to utilization
37controls.

38(k) Prosthetic and orthotic devices and eyeglasses are covered,
39subject to utilization controls. Utilization controls shall allow
40replacement of prosthetic and orthotic devices and eyeglasses
P43   1necessary because of loss or destruction due to circumstances
2beyond the beneficiary’s control. Frame styles for eyeglasses
3replaced pursuant to this subdivision shall not change more than
4once every two years, unless the department so directs.

5Orthopedic and conventional shoes are covered when provided
6by a prosthetic and orthotic supplier on the prescription of a
7physician and when at least one of the shoes will be attached to a
8prosthesis or brace, subject to utilization controls. Modification
9of stock conventional or orthopedic shoes when medically
10indicated, is covered subject to utilization controls. When there is
11a clearly established medical need that cannot be satisfied by the
12modification of stock conventional or orthopedic shoes,
13custom-made orthopedic shoes are covered, subject to utilization
14controls.

15Therapeutic shoes and inserts are covered when provided to
16beneficiaries with a diagnosis of diabetes, subject to utilization
17controls, to the extent that federal financial participation is
18available.

19(l) Hearing aids are covered, subject to utilization controls.
20Utilization controls shall allow replacement of hearing aids
21necessary because of loss or destruction due to circumstances
22beyond the beneficiary’s control.

23(m) Durable medical equipment and medical supplies are
24covered, subject to utilization controls. The utilization controls
25shall allow the replacement of durable medical equipment and
26medical supplies when necessary because of loss or destruction
27due to circumstances beyond the beneficiary’s control. The
28utilization controls shall allow authorization of durable medical
29equipment needed to assist a disabled beneficiary in caring for a
30child for whom the disabled beneficiary is a parent, stepparent,
31foster parent, or legal guardian, subject to the availability of federal
32financial participation. The department shall adopt emergency
33regulations to define and establish criteria for assistive durable
34medical equipment in accordance with the rulemaking provisions
35of the Administrative Procedure Act (Chapter 3.5 (commencing
36with Section 11340) of Part 1 of Division 3 of Title 2 of the
37Government Code).

38(n) Family planning services are covered, subject to utilization
39 controls.

P44   1(o) Inpatient intensive rehabilitation hospital services, including
2respiratory rehabilitation services, in a general acute care hospital
3are covered, subject to utilization controls, when either of the
4following criteria are met:

5(1) A patient with a permanent disability or severe impairment
6requires an inpatient intensive rehabilitation hospital program as
7described in Section 14064 to develop function beyond the limited
8amount that would occur in the normal course of recovery.

9(2) A patient with a chronic or progressive disease requires an
10inpatient intensive rehabilitation hospital program as described in
11Section 14064 to maintain the patient’s present functional level as
12long as possible.

13(p) (1) Adult day health care is covered in accordance with
14Chapter 8.7 (commencing with Section 14520).

15(2) Commencing 30 days after the effective date of the act that
16added this paragraph, and notwithstanding the number of days
17previously approved through a treatment authorization request,
18adult day health care is covered for a maximum of three days per
19week.

20(3) As provided in accordance with paragraph (4), adult day
21health care is covered for a maximum of five days per week.

22(4) As of the date that the director makes the declaration
23described in subdivision (g) of Section 14525.1, paragraph (2)
24shall become inoperative and paragraph (3) shall become operative.

25(q) (1) Application of fluoride, or other appropriate fluoride
26treatment as defined by the department,begin insert andend insert other prophylaxis
27treatment for children 17 years of age andbegin delete under,end deletebegin insert underend insert are covered.

28(2) All dental hygiene services provided by abegin insert registered dental
29hygienist, registered dental hygienist in extended function, andend insert

30 registered dental hygienist in alternative practicebegin insert licensedend insert pursuant
31to Sectionsbegin delete 1768 and 1770end deletebegin insert 1753, 1917, 1918, and 1922end insert of the
32Business and Professions Code may be covered as long as they
33are within the scope of Denti-Cal benefits and they are necessary
34services provided by abegin insert registered dental hygienist, registered dental
35hygienist in extended functions, orend insert
registered dental hygienist in
36alternative practice.

37(r) (1) Paramedic services performed by a city, county, or
38special district, or pursuant to a contract with a city, county, or
39special district, and pursuant to a program established under Article
403 (commencing with Section 1480) of Chapter 2.5 of Division 2
P45   1of the Health and Safety Code by a paramedic certified pursuant
2to that article, and consisting of defibrillation and those services
3specified in subdivision (3) of Section 1482 of the article.

4(2) All providers enrolled under this subdivision shall satisfy
5all applicable statutory and regulatory requirements for becoming
6a Medi-Cal provider.

7(3) This subdivision shall be implemented only to the extent
8funding is available under Section 14106.6.

9(s) In-home medical care services are covered when medically
10appropriate and subject to utilization controls, for beneficiaries
11who would otherwise require care for an extended period of time
12in an acute care hospital at a cost higher than in-home medical
13care services. The director shall have the authority under this
14section to contract with organizations qualified to provide in-home
15medical care services to those persons. These services may be
16provided to patients placed in shared or congregate living
17arrangements, if a home setting is not medically appropriate or
18 available to the beneficiary. As used in this section, “in-home
19medical care service” includes utility bills directly attributable to
20continuous, 24-hour operation of life-sustaining medical equipment,
21to the extent that federal financial participation is available.

22As used in this subdivision, in-home medical care services,
23include, but are not limited to:

24(1) Level of care and cost of care evaluations.

25(2) Expenses, directly attributable to home care activities, for
26materials.

27(3) Physician fees for home visits.

28(4) Expenses directly attributable to home care activities for
29shelter and modification to shelter.

30(5) Expenses directly attributable to additional costs of special
31diets, including tube feeding.

32(6) Medically related personal services.

33(7) Home nursing education.

34(8) Emergency maintenance repair.

35(9) Home health agency personnel benefits which permit
36coverage of care during periods when regular personnel are on
37vacation or using sick leave.

38(10) All services needed to maintain antiseptic conditions at
39stoma or shunt sites on the body.

40(11) Emergency and nonemergency medical transportation.

P46   1(12) Medical supplies.

2(13) Medical equipment, including, but not limited to, scales,
3gurneys, and equipment racks suitable for paralyzed patients.

4(14) Utility use directly attributable to the requirements of home
5care activities which are in addition to normal utility use.

6(15) Special drugs and medications.

7(16) Home health agency supervision of visiting staff which is
8medically necessary, but not included in the home health agency
9rate.

10(17) Therapy services.

11(18) Household appliances and household utensil costs directly
12attributable to home care activities.

13(19) Modification of medical equipment for home use.

14(20) Training and orientation for use of life-support systems,
15including, but not limited to, support of respiratory functions.

16(21) Respiratory care practitioner services as defined in Sections
173702 and 3703 of the Business and Professions Code, subject to
18prescription by a physician and surgeon.

19Beneficiaries receiving in-home medical care services are entitled
20to the full range of services within the Medi-Cal scope of benefits
21as defined by this section, subject to medical necessity and
22applicable utilization control. Services provided pursuant to this
23subdivision, which are not otherwise included in the Medi-Cal
24schedule of benefits, shall be available only to the extent that
25federal financial participation for these services is available in
26accordance with a home- and community-based services waiver.

27(t) Home- and community-based services approved by the
28United States Department of Health and Human Services may be
29covered to the extent that federal financial participation is available
30for those services under waivers granted in accordance with Section
311396n of Title 42 of the United States Code. The director may
32seek waivers for any or all home- and community-based services
33approvable under Section 1396n of Title 42 of the United States
34Code. Coverage for those services shall be limited by the terms,
35conditions, and duration of the federal waivers.

36(u) Comprehensive perinatal services, as provided through an
37agreement with a health care provider designated in Section
3814134.5 and meeting the standards developed by the department
39pursuant to Section 14134.5, subject to utilization controls.

P47   1The department shall seek any federal waivers necessary to
2implement the provisions of this subdivision. The provisions for
3which appropriate federal waivers cannot be obtained shall not be
4implemented. Provisions for which waivers are obtained or for
5which waivers are not required shall be implemented
6notwithstanding any inability to obtain federal waivers for the
7other provisions. No provision of this subdivision shall be
8implemented unless matching funds from Subchapter XIX
9(commencing with Section 1396) of Chapter 7 of Title 42 of the
10United States Code are available.

11(v) Early and periodic screening, diagnosis, and treatment for
12any individual under 21 years of age is covered, consistent with
13the requirements of Subchapter XIX (commencing with Section
141396) of Chapter 7 of Title 42 of the United States Code.

15(w) Hospice service which is Medicare-certified hospice service
16is covered, subject to utilization controls. Coverage shall be
17available only to the extent that no additional net program costs
18are incurred.

19(x) When a claim for treatment provided to a beneficiary
20includes both services which are authorized and reimbursable
21under this chapter, and services which are not reimbursable under
22this chapter, that portion of the claim for the treatment and services
23authorized and reimbursable under this chapter shall be payable.

24(y) Home- and community-based services approved by the
25United States Department of Health and Human Services for
26beneficiaries with a diagnosis of AIDS or ARC, who require
27intermediate care or a higher level of care.

28Services provided pursuant to a waiver obtained from the
29Secretary of the United States Department of Health and Human
30Services pursuant to this subdivision, and which are not otherwise
31included in the Medi-Cal schedule of benefits, shall be available
32only to the extent that federal financial participation for these
33services is available in accordance with the waiver, and subject to
34the terms, conditions, and duration of the waiver. These services
35shall be provided to individual beneficiaries in accordance with
36the client’s needs as identified in the plan of care, and subject to
37medical necessity and applicable utilization control.

38The director may under this section contract with organizations
39qualified to provide, directly or by subcontract, services provided
40for in this subdivision to eligible beneficiaries. Contracts or
P48   1agreements entered into pursuant to this division shall not be
2subject to the Public Contract Code.

3(z) Respiratory care when provided in organized health care
4systems as defined in Section 3701 of the Business and Professions
5Code, and as an in-home medical service as outlined in subdivision
6(s).

7(aa) (1) There is hereby established in the department, a
8program to provide comprehensive clinical family planning
9services to any person who has a family income at or below 200
10percent of the federal poverty level, as revised annually, and who
11is eligible to receive these services pursuant to the waiver identified
12in paragraph (2). This program shall be known as the Family
13Planning, Access, Care, and Treatment (Family PACT) Program.

14(2) The department shall seek a waiver in accordance with
15Section 1315 of Title 42 of the United States Code, or a state plan
16amendment adopted in accordance with Section
171396a(a)(10)(A)(ii)(XXI)(ii)(2) of Title 42 of the United States
18Code, which was added to Section 1396a of Title 42 of the United
19States Code by Section 2303(a)(2) of the federal Patient Protection
20and Affordable Care Act (PPACA) (Public Law 111-148), for a
21program to provide comprehensive clinical family planning
22services as described in paragraph (8). Under the waiver, the
23program shall be operated only in accordance with the waiver and
24the statutes and regulations in paragraph (4) and subject to the
25terms, conditions, and duration of the waiver. Under the state plan
26amendment, which shall replace the waiver and shall be known as
27the Family PACT successor state plan amendment, the program
28shall be operated only in accordance with this subdivision and the
29statutes and regulations in paragraph (4). The state shall use the
30standards and processes imposed by the state on January 1, 2007,
31including the application of an eligibility discount factor to the
32extent required by the federal Centers for Medicare and Medicaid
33Services, for purposes of determining eligibility as permitted under
34Section 1396a(a)(10)(A)(ii)(XXI)(ii)(2) of Title 42 of the United
35States Code. To the extent that federal financial participation is
36available, the program shall continue to conduct education,
37outreach, enrollment, service delivery, and evaluation services as
38specified under the waiver. The services shall be provided under
39the program only if the waiver and, when applicable, the successor
40state plan amendment are approved by the federal Centers for
P49   1Medicare and Medicaid Services and only to the extent that federal
2financial participation is available for the services. Nothing in this
3section shall prohibit the department from seeking the Family
4PACT successor state plan amendment during the operation of the
5waiver.

6(3) Solely for the purposes of the waiver or Family PACT
7successor state plan amendment and notwithstanding any other
8provision of law, the collection and use of an individual’s social
9security number shall be necessary only to the extent required by
10federal law.

11(4) Sections 14105.3 to 14105.39, inclusive, 14107.11, 24005,
12and 24013, and any regulations adopted under these statutes shall
13apply to the program provided for under this subdivision. No other
14provision of law under the Medi-Cal program or the State-Only
15Family Planning Program shall apply to the program provided for
16under this subdivision.

17(5) Notwithstanding Chapter 3.5 (commencing with Section
1811340) of Part 1 of Division 3 of Title 2 of the Government Code,
19the department may implement, without taking regulatory action,
20the provisions of the waiver after its approval by the federal Health
21Care Financing Administration and the provisions of this section
22by means of an all-county letter or similar instruction to providers.
23Thereafter, the department shall adopt regulations to implement
24this section and the approved waiver in accordance with the
25requirements of Chapter 3.5 (commencing with Section 11340) of
26Part 1 of Division 3 of Title 2 of the Government Code. Beginning
27six months after the effective date of the act adding this
28subdivision, the department shall provide a status report to the
29Legislature on a semiannual basis until regulations have been
30adopted.

31(6) In the event that the Department of Finance determines that
32the program operated under the authority of the waiver described
33in paragraph (2) or the Family PACT successor state plan
34amendment is no longer cost effective, this subdivision shall
35become inoperative on the first day of the first month following
36the issuance of a 30-day notification of that determination in
37writing by the Department of Finance to the chairperson in each
38house that considers appropriations, the chairpersons of the
39committees, and the appropriate subcommittees in each house that
P50   1considers the State Budget, and the Chairperson of the Joint
2Legislative Budget Committee.

3(7) If this subdivision ceases to be operative, all persons who
4have received or are eligible to receive comprehensive clinical
5family planning services pursuant to the waiver described in
6paragraph (2) shall receive family planning services under the
7Medi-Cal program pursuant to subdivision (n) if they are otherwise
8eligible for Medi-Cal with no share of cost, or shall receive
9comprehensive clinical family planning services under the program
10established in Division 24 (commencing with Section 24000) either
11if they are eligible for Medi-Cal with a share of cost or if they are
12otherwise eligible under Section 24003.

13(8) For purposes of this subdivision, “comprehensive clinical
14family planning services” means the process of establishing
15objectives for the number and spacing of children, and selecting
16the means by which those objectives may be achieved. These
17means include a broad range of acceptable and effective methods
18and services to limit or enhance fertility, including contraceptive
19methods, federal Food and Drug Administration approved
20contraceptive drugs, devices, and supplies, natural family planning,
21abstinence methods, and basic, limited fertility management.
22Comprehensive clinical family planning services include, but are
23not limited to, preconception counseling, maternal and fetal health
24counseling, general reproductive health care, including diagnosis
25and treatment of infections and conditions, including cancer, that
26threaten reproductive capability, medical family planning treatment
27and procedures, including supplies and followup, and
28informational, counseling, and educational services.
29Comprehensive clinical family planning services shall not include
30abortion, pregnancy testing solely for the purposes of referral for
31abortion or services ancillary to abortions, or pregnancy care that
32is not incident to the diagnosis of pregnancy. Comprehensive
33clinical family planning services shall be subject to utilization
34control and include all of the following:

35(A) Family planning related services and male and female
36sterilization. Family planning services for men and women shall
37include emergency services and services for complications directly
38related to the contraceptive method, federal Food and Drug
39Administration approved contraceptive drugs, devices, and
P51   1supplies, and followup, consultation, and referral services, as
2indicated, which may require treatment authorization requests.

3(B) All United States Department of Agriculture, federal Food
4and Drug Administration approved contraceptive drugs, devices,
5and supplies that are in keeping with current standards of practice
6and from which the individual may choose.

7(C) Culturally and linguistically appropriate health education
8and counseling services, including informed consent, that include
9all of the following:

10(i) Psychosocial and medical aspects of contraception.

11(ii) Sexuality.

12(iii) Fertility.

13(iv) Pregnancy.

14(v) Parenthood.

15(vi) Infertility.

16(vii) Reproductive health care.

17(viii) Preconception and nutrition counseling.

18(ix) Prevention and treatment of sexually transmitted infection.

19(x) Use of contraceptive methods, federal Food and Drug
20Administration approved contraceptive drugs, devices, and
21supplies.

22(xi) Possible contraceptive consequences and followup.

23(xii) Interpersonal communication and negotiation of
24relationships to assist individuals and couples in effective
25contraceptive method use and planning families.

26(D) A comprehensive health history, updated at the next periodic
27visit (between 11 and 24 months after initial examination) that
28includes a complete obstetrical history, gynecological history,
29contraceptive history, personal medical history, health risk factors,
30and family health history, including genetic or hereditary
31conditions.

32(E) A complete physical examination on initial and subsequent
33periodic visits.

34(F) Services, drugs, devices, and supplies deemed by the federal
35 Centers for Medicare and Medicaid Services to be appropriate for
36inclusion in the program.

37(9) In order to maximize the availability of federal financial
38participation under this subdivision, the director shall have the
39discretion to implement the Family PACT successor state plan
40amendment retroactively to July 1, 2010.

P52   1(ab) (1) Purchase of prescribed enteral nutrition products is
2covered, subject to the Medi-Cal list of enteral nutrition products
3and utilization controls.

4(2) Purchase of enteral nutrition products is limited to those
5products to be administered through a feeding tube, including, but
6not limited to, a gastric, nasogastric, or jejunostomy tube.
7Beneficiaries under the Early and Periodic Screening, Diagnosis,
8and Treatment Program shall be exempt from this paragraph.

9(3) Notwithstanding paragraph (2), the department may deem
10an enteral nutrition product, not administered through a feeding
11tube, including, but not limited to, a gastric, nasogastric, or
12jejunostomy tube, a benefit for patients with diagnoses, including,
13but not limited to, malabsorption and inborn errors of metabolism,
14if the product has been shown to be neither investigational nor
15experimental when used as part of a therapeutic regimen to prevent
16serious disability or death.

17(4) Notwithstanding Chapter 3.5 (commencing with Section
1811340) of Part 1 of Division 3 of Title 2 of the Government Code,
19the department may implement the amendments to this subdivision
20made by the act that added this paragraph by means of all-county
21letters, provider bulletins, or similar instructions, without taking
22regulatory action.

23(5) The amendments made to this subdivision by the act that
24added this paragraph shall be implemented June 1, 2011, or on the
25first day of the first calendar month following 60 days after the
26date the department secures all necessary federal approvals to
27implement this section, whichever is later.

28(ac) Diabetic testing supplies are covered when provided by a
29pharmacy, subject to utilization controls.



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