Amended in Senate April 23, 2013

Senate Bill No. 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, begin insert 4053, 4107, end insert 4980.36, 4980.43, 4980.72, 4989.68, 4996.3, 4996.9, 4996.18, 4996.23, begin insert 4999.20, end insert 4999.33, 4999.46, 4999.47, and 4999.60 of begin insert , and to add Section 4021.5 to, end insert 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 amended, 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.

begin insert

(3) Existing law, the Pharmacy Law, governs the business and practice of pharmacy in this state and establishes the California State Board of Pharmacy. Existing law prohibits the board from issuing more than one site license to a single premises except to issue a veterinary food-animal drug retailer license to a wholesaler or to issue a license for compound sterile injectable drugs to a pharmacy.

end insert begin insert

This bill would additionally authorize the board to issue more than one site license to a single premises to issue a centralized hospital packaging license. The bill would also establish a definition for the term “correctional pharmacy.”

end insert begin insert

Existing law authorizes the board to issue a license as a designated representative to provide supervision in a wholesaler or veterinary food-animal drug retailer. Existing law requires an individual to meet specified requirements to obtain and maintain a designated representative license, including a minimum of one year of paid work experience related to the distribution or dispensing of dangerous drugs or devices or meet certain prerequisites.

end insert begin insert

The bill would require the one year of paid work experience to obtain a designated representative license to be in a licensed pharmacy, or with a drug wholesaler, drug distributor, or drug manufacturer. The bill would also make related, technical changes.

end insert begin delete

(3)

end delete

begin insert (4) end insert  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 begin insert shall not be gained by interns or trainees end insert for work begin insert performed as an independent contractor or end insert reported on an IRS Form begin delete 1099 does not count towards the necessary experience. end delete begin insert 1099. end insert

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.

begin delete

(4)

end delete

begin insert (5) end insert  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:

SECTION 1.  

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

1613.  

The board shall have and use a seal bearing the name
“Dental Board of California.”

SEC. 2.  

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

1915.  

No person other than a registered dental hygienist,
registered dental hygienist in alternative practice, or registered
dental hygienist in extended functions or a licensed dentist may
engage in the practice of dental hygiene or perform dental hygiene
procedures on patients, including, but not limited to, supragingival
and subgingival scaling, dental hygiene assessment, and treatment
planning, except for the following persons:

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

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

(1) Applying nonaerosol and noncaustic topical agents.

(2) Applying topical fluoride.

(3) Taking impressions for bleaching trays.

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

(1) Polishing the coronal surfaces of teeth.

(2) Applying bleaching agents.

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

(4) Applying pit and fissure begin delete sealant end delete begin insert sealants end insert .

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

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

SEC. 3.  

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

1926.2.  

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

(b) A mobile service unit, as defined in subdivision (b) of
Section 1765.105 of the Health and Safety Code, and a mobile
unit operated by an entity that is exempt from licensure pursuant
to subdivision (b), (c), or (h) of Section 1206 of the Health and
Safety Code, are exempt from this article. Notwithstanding this
exemption, the owner or operator of the mobile unit shall notify
the committee within 60 days of the date on which dental hygiene
services are first delivered in the mobile unit, or the date on which
the mobile unit’s application pursuant to Section 1765.130 of the
Health and Safety Code is approved, whichever is earlier.

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

SEC. 4.  

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

3024.  

The board may grant or refuse to grant an optometrist
license as provided in this chapter and may revoke or suspend the
license of any optometrist for any of the causes specified in this
chapter.

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

SEC. 5.  

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

3025.  

The board may make and promulgate rules and
regulations governing procedure of the board, the admission of
applicants for examination for a license as an optometrist, and the
practice of optometry. All of those rules and regulations shall be
in accordance with and not inconsistent with the provisions of this
chapter. The rules and regulations shall be adopted, amended, or
repealed in accordance with the provisions of the Administrative
Procedure Act.

SEC. 6.  

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

3040.  

It is unlawful for a person to engage in the practice of
optometry or to display a sign or in any other way to advertise or
hold himself or herself out as an optometrist without having first
obtained an optometrist license from the board under the provisions
of this chapter or under the provisions of any former act relating
to the practice of optometry. The practice of optometry includes
the performing or controlling of any acts set forth in Section 3041.

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

SEC. 7.  

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

3041.2.  

(a) The State Board of Optometry shall, by regulation,
establish educational and examination requirements for licensure
to begin delete insure end delete begin insert ensure end insert the competence of optometrists to practice
pursuant to subdivision (a) of Section 3041. Satisfactory
completion of the educational and examination requirements shall
be a condition for the issuance of an original optometrist license
under this chapter, on and after January 1, 1980. Only those
optometrists who have successfully completed educational and
examination requirements as determined by the State Board of
Optometry shall be permitted the use of pharmaceutical agents
specified by subdivision (a) of Section 3041.

(b) Nothing in this section shall authorize an optometrist issued
an original optometrist license under this chapter before January
1, 1996, to use or prescribe therapeutic pharmaceutical agents
specified in subdivision (d) of Section 3041 without otherwise
meeting the requirements of Section 3041.3.

SEC. 8.  

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

3051.  

All applicants for examination for an optometrist license
in accordance with the educational and examination requirements
adopted pursuant to Section 3023.1 shall show the board by
satisfactory evidence that he or she has received education in child
abuse detection and the detection of alcoholism and other chemical
substance dependency. This section shall apply only to applicants
who matriculate in a school of optometry on or after September
1, 1997.

SEC. 9.  

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

3057.5.  

Notwithstanding any other provision of this chapter,
the board shall permit a graduate of a foreign university who meets
all of the following requirements to take the examinations for an
optometrist license:

(a) Is over begin delete the age of end delete 18 years begin insert of age end insert .

(b) Is not subject to denial of a license under Section 480.

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

SEC. 10.  

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

3077.  

As used in this section, “office” means any office or
other place for the practice of optometry.

(a) No person, singly or in combination with others, may have
an office unless he or she is licensed to practice optometry under
this chapter.

(b) An optometrist, or two or more optometrists jointly, may
have one office without obtaining a branch office license from the
board.

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

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

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

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

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

(g) Any failure to comply with the provisions of this chapter
relating to branch offices or branch office licenses as to any branch
office shall work the suspension of the optometrist license of each
optometrist who, individually or with others, has a branch office.
An optometrist license so suspended shall not be restored except
upon compliance with those provisions and the payment of the fee
prescribed by this chapter for restoration of a license after
suspension for failure to comply with the provisions of this chapter
relating to branch offices.

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

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

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

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

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

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

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

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

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

SEC. 11.  

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

3093.  

Before setting aside the revocation or suspension of any
optometrist license, the board may require the applicant to pass
the regular examination given for applicants for an optometrist
license.

SEC. 12.  

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

3098.  

When the holder uses the title of “Doctor” or “Dr.” as a
prefix to his or her name, without using the word “optometrist” as
a suffix to his or her name or in connection with it, or, without
holding a diploma from an accredited school of optometry, the
letters “Opt. D.” or “O.D.” as a suffix to his or her name, it
constitutes a cause to revoke or suspend his or her optometrist
license.

SEC. 13.  

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

3103.  

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

This section does not prohibit the advertising of the practice of
optometry by a licensed optometrist in the manner permitted by
law.

SEC. 14.  

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

3106.  

Knowingly making or signing any license, certificate,
or other document directly or indirectly related to the practice of
optometry that falsely represents the existence or nonexistence of
a state of facts constitutes unprofessional conduct.

SEC. 15.  

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

3107.  

It is unlawful to use or attempt to use any license or
certificate issued by the board that has been purchased, fraudulently
issued, counterfeited, or issued by mistake, as a valid license or
certificate.

SEC. 16.  

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

3109.  

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

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

Notwithstanding the provisions of this section or the provisions
of any other law, a licensed optometrist may be employed to
practice optometry by a physician and surgeon who holds a license
under this division and who practices in the specialty of
ophthalmology or by a health care service plan pursuant to the
provisions of Chapter 2.2 (commencing with Section 1340) of
Division 2 of the Health and Safety Code.

SEC. 17.  

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

3163.  

Except as provided in Section 3078, the name of an
optometric corporation and any name or names under which it
may be rendering professional services shall contain and be
restricted to the name or the last name of one or more of the
present, prospective, or former shareholders and shall include the
words optometric corporation or wording or abbreviations denoting
corporate existence, provided that the articles of incorporation
shall be amended to delete the name of a former shareholder from
the name of the corporation within two years from the date the
former shareholder dies or otherwise ceases to be a shareholder.

begin insert

begin insert SEC. 18. end insert   

end insert

begin insert Section 4021.5 is added to the end insert begin insert Business and
Professions Code end insert begin insert , to read: end insert

begin insert

begin insert

begin insert 4021.5. end insert   

end insert

“Correctional pharmacy” means a pharmacy, licensed
by the board, located within a state correctional facility for the
purpose of providing pharmaceutical care to inmates of the state
correctional facility.

end insert

begin insert

begin insert SEC. 19. end insert   

end insert

begin insert Section 4053 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4053.  

(a) Notwithstanding Section 4051, the board may issue
a license as a designated representative to provide sufficient and
qualified supervision in a wholesaler or veterinary food-animal
drug retailer. The designated representative shall protect the public
health and safety in the handling, storage, and shipment of
dangerous drugs and dangerous devices in the wholesaler or
veterinary food-animal drug retailer.

(b) An individual may apply for a designated representative
license. In order to obtain and maintain that license, the individual
shall meet all of the following requirements:

(1) He or she shall be a high school graduate or possess a general
education development begin insert certificate end insert equivalent.

(2) He or she shall have a minimum of one year of paid work
experience begin insert in a licensed pharmacy, or with a drug wholesaler,
drug distributor, or drug manufacturer end insert , in the past three years,
related to the distribution or dispensing of dangerous drugs or
dangerous devices or meet all of the prerequisites to take the
examination required for licensure as a pharmacist by the board.

(3) He or she shall complete a training program approved by
the board that, at a minimum, addresses each of the following
subjects:

(A) Knowledge and understanding of California law and federal
law relating to the distribution of dangerous drugs and dangerous
devices.

(B) Knowledge and understanding of California law and federal
law relating to the distribution of controlled substances.

(C) Knowledge and understanding of quality control systems.

(D) Knowledge and understanding of the United States
Pharmacopoeia standards relating to the safe storage and handling
of drugs.

(E) Knowledge and understanding of prescription terminology,
abbreviations, dosages and format.

(4) The board may, by regulation, require training programs to
include additional material.

(5) The board may not issue a license as a designated
representative until the applicant provides proof of completion of
the required training to the board.

(c) The veterinary food-animal drug retailer or wholesaler shall
not operate without a pharmacist or a designated representative
on its premises.

(d) Only a pharmacist or a designated representative shall
prepare and affix the label to veterinary food-animal drugs.

(e) Section 4051 shall not apply to any laboratory licensed under
Section 351 of Title III of the Public Health Service Act (Public
Law 78-410).

begin insert

begin insert SEC. 20. end insert   

end insert

begin insert Section 4107 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4107.  

begin insert (a) end insert begin insert   end insert The board may not issue more than one site license
to a single premises except begin delete to end delete begin insert as follows: end insert

begin insert (1) end insert begin insert   end insert begin insert To end insert issue a veterinary food-animal drug retailer license to a
wholesaler begin delete or to end delete begin insert pursuant to Section 4196. end insert

begin insert (2) end insert begin insert   end insert begin insert To end insert issue a license to compound sterile injectable drugs to a
pharmacy begin insert pursuant to Section 4127.1 end insert . begin delete For end delete

begin insert

(3) To issue a centralized hospital packaging license pursuant
to Section 4128.

end insert

begin insert (b) end insert begin insert   end insert begin insert For end insert the purposes of this subdivision, “premises” means a
location with its own address and an independent means of ingress
and egress.

begin delete SEC. 18. end delete
begin insert SEC. 21. end insert   

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

4980.36.  

(a) This section shall apply to the following:

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

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

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

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

(c) A begin delete doctor’s end delete begin insert doctoral end insert or master’s degree program that qualifies
for licensure or registration shall do the following:

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

(A) Marriage and family therapy principles.

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

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

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

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

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

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

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

(1) Both of the following:

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

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

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

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

(iii) A student must be enrolled in a practicum course while
counseling clients, except as specified in subdivision (c) of Section
4980.42.

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

(I) Applied use of theory and psychotherapeutic techniques.

(II) Assessment, diagnosis, and prognosis.

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

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

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

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

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

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

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

(2) Instruction in all of the following:

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

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

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

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

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

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

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

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

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

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

(i) A minimum of seven contact hours of training or coursework
in child abuse assessment and reporting as specified in Section 28,
and any regulations promulgated thereunder.

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

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

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

(v) Marriage, divorce, and blended families.

(vi) Long-term care.

(vii) End of life and grief.

(viii) Poverty and deprivation.

(ix) Financial and social stress.

(x) Effects of trauma.

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

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

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

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

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

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

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

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

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

(iii) The effects of psychoactive drug use.

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

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

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

(vii) Legal aspects of substance abuse.

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

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

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

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

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

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

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

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

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

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

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

(vii) Licensing law and licensing process.

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

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

begin delete SEC. 19. end delete
begin insert SEC. 22. end insert   

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

4980.43.  

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

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

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

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

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

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

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

(6) No hours of experience may be gained more than six years
prior to the date the application for examination eligibility was
filed, except that up to 500 hours of clinical experience gained in
the supervised practicum required by subdivision (c) of Section
4980.37 and subparagraph (B) of paragraph (1) of subdivision (d)
of Section 4980.36 shall be exempt from this six-year requirement.

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

(A) Direct supervisor contact.

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

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

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

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

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

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

(B) Client centered advocacy.

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

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

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

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

(b) All applicants, trainees, and registrants shall be at all times
under the supervision of a supervisor who shall be 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 shall be responsible to the board for
compliance with all laws, rules, and regulations governing the
practice of marriage and family therapy. Supervised experience
shall be gained by interns and trainees only as an employee or as
a volunteer. The requirements of this chapter regarding gaining
hours of experience and supervision are applicable equally to
employees and volunteers. begin delete Work performed by an intern or trainee
as an independent contractor or reported on an IRS Form 1099
shall not satisfy the requirements of this chapter regarding gaining
hours of supervised experience. end delete begin insert Experience shall not be gained
by interns or trainees for work performed as an independent
contractor or reported on an IRS Form 1099. end insert

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

begin delete SEC. 20. end delete
begin insert SEC. 23. end insert   

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

4980.72.  

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

(b) The board may 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 all of the
following conditions are satisfied:

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

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

(3) The applicant’s supervised experience is substantially
equivalent to that required for a license under this chapter. If the
applicant has less than 3,000 hours of qualifying supervised
experience, time actively licensed as a marriage and family
therapist shall be accepted at a rate of 100 hours per month up to
a maximum of 1,200 hours.

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

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

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

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

begin delete SEC. 21. end delete
begin insert SEC. 24. end insert   

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

4989.68.  

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

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

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

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

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

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

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

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

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

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

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

begin delete SEC. 22. end delete
begin insert SEC. 25. end insert   

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

4996.3.  

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

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

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

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

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

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

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

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

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

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

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

(9) The renewal delinquency fee shall be a maximum of
seventy-five dollars ($75). A person who permits his or her license
to expire is subject to the delinquency fee.

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

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

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

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

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

begin delete SEC. 23. end delete
begin insert SEC. 26. end insert   

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

4996.9.  

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

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

begin delete SEC. 24. end delete
begin insert SEC. 27. end insert   

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

4996.18.  

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

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

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

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

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

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

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

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

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

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

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

(G) Licensing law and process.

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

(d) All applicants and registrants shall be at all times under the
supervision of a supervisor who shall be 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 shall be responsible to the board for
compliance with all laws, rules, and regulations governing the
practice of clinical social work.

(e) Any experience obtained under the supervision of a spouse
or relative by blood or marriage shall not be credited toward the
required hours of supervised experience. Any experience obtained
under the supervision of a supervisor with whom the applicant has
a personal relationship that undermines the authority or
effectiveness of the supervision shall not be credited toward the
required hours of supervised experience.

(f) An applicant who possesses a master’s degree from an
accredited school or department of social work shall be able to
apply experience the applicant obtained during the time the
accredited school or department was in candidacy status by the
Commission on Accreditation of the Council on Social Work
Education toward the licensure requirements, if the experience
meets the requirements of Section 4996.23. This subdivision shall
apply retroactively to persons who possess a master’s degree from
an accredited school or department of social work and who
obtained experience during the time the accredited school or
department was in candidacy status by the Commission on
Accreditation of the Council on Social Work Education.

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

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

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

begin delete SEC. 25. end delete
begin insert SEC. 28. end insert   

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

4996.23.  

The experience required by subdivision (c) of Section
4996.2 shall meet the following criteria:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(i)  begin delete Work performed by an associate as an independent contractor
or reported on an IRS Form 1099 shall not satisfy the requirements
of this chapter regarding gaining hours of supervised experience. end delete
begin insert Experience shall not be gained by interns or trainees for work
performed as an independent contractor or reported on an IRS
Form 1099.00. end insert

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

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

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

(m) An associate shall not do the following:

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

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

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

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

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

begin insert

begin insert SEC. 29. end insert   

end insert

begin insert Section 4999.20 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4999.20.  

(a) (1) “Professional clinical counseling” means the
application of counseling interventions and psychotherapeutic
techniques to identify and remediate cognitive, mental, and
emotional issues, including personal growth, adjustment to
disability, crisis intervention, and psychosocial and environmental
problems begin insert , and the use, application, and integration of the
coursework and training required by Sections 4999.32 and
4999.33 end insert . “Professional clinical counseling” includes conducting
assessments for the purpose of establishing counseling goals and
objectives to empower individuals to deal adequately with life
situations, reduce stress, experience growth, change behavior, and
make well-informed, rational decisions.

(2) “Professional clinical counseling” is focused exclusively on
the application of counseling interventions and psychotherapeutic
techniques for the purposes of improving mental health, and is not
intended to capture other, nonclinical forms of counseling for the
purposes of licensure. For purposes of this paragraph, “nonclinical”
means nonmental health.

(3) “Professional clinical counseling” does not include the
assessment or treatment of couples or families unless the
professional clinical counselor has completed all of the following
additional training and education, beyond the minimum training
and education required for licensure:

(A) One of the following:

(i) Six semester units or nine quarter units specifically focused
on the theory and application of marriage and family therapy.

(ii) A named specialization or emphasis area on the qualifying
degree in marriage and family therapy; marital and family therapy;
marriage, family, and child counseling; or couple and family
therapy.

(B) No less than 500 hours of documented supervised experience
working directly with couples, families, or children.

(C) A minimum of six hours of continuing education specific
to marriage and family therapy, completed in each license renewal
cycle.

(4) “Professional clinical counseling” does not include the
provision of clinical social work services.

(b) “Counseling interventions and psychotherapeutic techniques”
means the application of cognitive, affective, verbal or nonverbal,
systemic or holistic counseling strategies that include principles
of development, wellness, and maladjustment that reflect a
pluralistic society. These interventions and techniques are
specifically implemented in the context of a professional clinical
counseling relationship and use a variety of counseling theories
and approaches.

(c) “Assessment” means selecting, administering, scoring, and
interpreting tests, instruments, and other tools and methods
designed to measure an individual’s attitudes, abilities, aptitudes,
achievements, interests, personal characteristics, disabilities, and
mental, emotional, and behavioral concerns and development and
the use of methods and techniques for understanding human
behavior in relation to coping with, adapting to, or ameliorating
changing life situations, as part of the counseling process.
“Assessment” shall not include the use of projective techniques
in the assessment of personality, individually administered
intelligence tests, neuropsychological testing, or utilization of a
battery of three or more tests to determine the presence of
psychosis, dementia, amnesia, cognitive impairment, or criminal
behavior.

(d) Professional clinical counselors shall refer clients to other
licensed health care professionals when they identify issues beyond
their own scope of education, training, and experience.

begin delete SEC. 26. end delete
begin insert SEC. 30. end insert   

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

4999.33.  

(a) This section shall apply to the following:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(A) Applied psychotherapeutic techniques.

(B) Assessment.

(C) Diagnosis.

(D) Prognosis.

(E) Treatment.

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

(G) Health and wellness promotion.

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

(I) How to find and use resources.

(J) Other recognized counseling interventions.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

begin delete SEC. 27. end delete
begin insert SEC. 31. end insert   

Section 4999.46 of the Business and Professions
Code, as amended by Section 65 of Chapter 799 of the Statutes of
2012, is amended to read:

4999.46.  

(a) To qualify for the licensure examination specified
by paragraph (2) of subdivision (a) of Section 4999.53, applicants
shall complete clinical mental health experience under the general
supervision of an approved supervisor as defined in Section
4999.12.

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

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

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

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

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

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

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

(A) Direct supervisor contact.

(B) Client centered advocacy.

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

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

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

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

(e) All applicants and interns shall be at all times under the
supervision of a supervisor who shall be 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 shall be responsible to the board for
compliance with all laws, rules, and regulations governing the
practice of professional clinical counseling.

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

(g) Except for experience gained pursuant to subparagraph (D)
of paragraph (6) of subdivision (b), supervision shall include at
least one hour of direct supervisor contact in each week for which
experience is credited in each work setting.

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

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

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

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

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

begin delete SEC. 28. end delete
begin insert SEC. 32. end insert   

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

4999.47.  

(a) Clinical counselor trainees, interns, and applicants
shall perform services only as an employee or as a volunteer.

The requirements of this chapter regarding gaining hours of
clinical mental health experience and supervision are applicable
equally to employees and volunteers. begin delete Work performed as an
independent contractor or reported on an IRS Form 1099 shall not
satisfy the requirements of this chapter regarding gaining hours of
supervised experience. end delete begin insert Experience shall not be gained by interns
or trainees for work performed as an independent contractor or
reported on an IRS Form 1099. end insert

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

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

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

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

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

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

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

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

begin delete SEC. 29. end delete
begin insert SEC. 33. end insert   

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

4999.60.  

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

(b) The board may 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 as a professional clinical counselor, or other
counseling license that allows the applicant to independently
provide clinical mental health services, in another jurisdiction of
the United States if all of the following conditions are satisfied:

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

(2) The applicant complies with subdivision (b) of Section
4999.40, if applicable.

(3) The applicant’s supervised experience is substantially
equivalent to that required for a license under this chapter. If the
applicant has less than 3,000 hours of qualifying supervised
experience, time actively licensed as a professional clinical
counselor shall be accepted at a rate of 100 hours per month up to
a maximum of 1,200 hours.

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

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

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

begin delete SEC. 30. end delete
begin insert SEC. 34. end insert   

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

14132.  

The following is the schedule of benefits under this
chapter:

(a) Outpatient services are covered as follows:

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

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

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

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

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

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

(3) (A) To the extent required by federal law, the purchase of
outpatient prescribed drugs, for which the prescription is executed
by a prescriber in written, nonelectronic form on or after April 1,
2008, is covered only when executed on a tamper resistant
prescription form. The implementation of this paragraph shall
conform to the guidance issued by the federal Centers begin delete of end delete begin insert for end insert
Medicare and Medicaid Services but shall not conflict with state
statutes on the characteristics of tamper resistant prescriptions for
controlled substances, including Section 11162.1 of the Health
and Safety Code. The department shall provide providers and
beneficiaries with as much flexibility in implementing these rules
as allowed by the federal government. The department shall notify
and consult with appropriate stakeholders in implementing,
interpreting, or making specific this paragraph.

(B) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
the department may take the actions specified in subparagraph (A)
by means of a provider bulletin or notice, policy letter, or other
similar instructions without taking regulatory action.

(4) (A) (i) For the purposes of this paragraph, nonlegend has
the same meaning as defined in subdivision (a) of Section
14105.45.

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

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

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

(B) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
the department may take the actions specified in subparagraph (A)
by means of a provider bulletin or notice, policy letter, or other
similar instruction without taking regulatory action.

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

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

(g) Blood and blood derivatives are covered.

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

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

(A) Periodontal treatment is not a benefit.

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

(C) Laboratory processed crowns are not a benefit.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(q) (1) Application of fluoride, or other appropriate fluoride
treatment as defined by the department, and other prophylaxis
treatment for children 17 years of age and under are covered.

(2) All dental hygiene services provided by a registered dental
hygienist, registered dental hygienist in extended begin delete function end delete
begin insert functions end insert , and registered dental hygienist in alternative practice
licensed pursuant to Sections 1753, 1917, 1918, and 1922 of the
Business and Professions Code may be covered as long as they
are within the scope of Denti-Cal benefits and they are necessary
services provided by a registered dental hygienist, registered dental
hygienist in extended functions, or registered dental hygienist in
alternative practice.

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

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

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

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

As used in this subdivision, in-home medical care services begin delete , end delete
include, but are not limited to:

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

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

(3) Physician fees for home visits.

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

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

(6) Medically related personal services.

(7) Home nursing education.

(8) Emergency maintenance repair.

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

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

(11) Emergency and nonemergency medical transportation.

(12) Medical supplies.

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

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

(15) Special drugs and medications.

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

(17) Therapy services.

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

(19) Modification of medical equipment for home use.

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

(21) Respiratory care practitioner services as defined in Sections
3702 and 3703 of the Business and Professions Code, subject to
prescription by a physician and surgeon.

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

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

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

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

(v) Early and periodic screening, diagnosis, and treatment for
any individual under 21 years of age is covered, consistent with
the requirements of Subchapter XIX (commencing with Section
1396) of Chapter 7 of Title 42 of the United States Code.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

(i) Psychosocial and medical aspects of contraception.

(ii) Sexuality.

(iii) Fertility.

(iv) Pregnancy.

(v) Parenthood.

(vi) Infertility.

(vii) Reproductive health care.

(viii) Preconception and nutrition counseling.

(ix) Prevention and treatment of sexually transmitted infection.

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

(xi) Possible contraceptive consequences and followup.

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

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

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

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

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

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

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

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

(4) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
the department may implement the amendments to this subdivision
made by the act that added this paragraph by means of all-county
letters, provider bulletins, or similar instructions, without taking
regulatory action.

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

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