BILL ANALYSIS                                                                                                                                                                                                    Ó







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        |Hearing Date: April 29, 2013       |Bill No:SB                         |
        |                                   |821                                |
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                      SENATE COMMITTEE ON BUSINESS, PROFESSIONS 
                               AND ECONOMIC DEVELOPMENT
                          Senator Curren D. Price, Jr., Chair
                                           

                Bill No:        SB 821Author:Business, Professions and
                                     Economic Development
                     As Amended:April 23, 2013          Fiscal:Yes

        
        SUBJECT:   Healing arts.
        
        SUMMARY:  Makes several non-controversial minor, non-substantive or  
        technical changes to various provisions pertaining to the  
        health-related regulatory Boards of the Department of Consumer Affairs  
        (DCA).

        Existing law:
        
        1) Provides for the licensing and regulation of various professions  
           and businesses by some 23 boards, 4 committees, 9 bureaus, and 1  
           commission within the DCA under various licensing acts within the  
           Business and Professions Code (BPC).

        2) Makes the following provisions relating to the California Board of  
           Behavioral Sciences (BBS):

           a)    Describes the qualifying degree program required to obtain  
             licensure as an Licensed Marriage and Family Therapist (LMFT) or  
             a Licensed Professional Clinical Counselor (LPCC), if the  
             applicant began graduate study after August 1, 2012.  
           (BPC §§ 4980.36(d)(2)(C)(i); 4999.33(d)(9))

           b)    Allows LMFT, Licensed Clinical Social Worker (LCSW) and LPCC  
             applicants to gain experience hours as a W-2 employee or a  
             volunteer.  (BPC §§ 4980.43(b); 4996.23; and 4999.47(a))

           c)    Specifies examination eligibility requirements for  
             out-of-state LMFT and LPCC licensees.  (BPC §§ 4980.72 and  





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             4999.60)

           d)    States that the delinquent renewal fee for a license is $75  
             for Licensed Educational Psychologists (LEPs) and LCSWs,  
             respectively.  (BPC §§ 4989.68 and 4996.3)

           e)    States that all applicants and interns must always be under  
             the supervision of a supervisor who is responsible to the BBS for  
             compliance with all laws and regulations.  
           (BPC § 4996.18)

           f)    Allows an LPCC applicant to count up to 250 hours of  
             experience providing crisis counseling over the telephone.  (BPC  
             § 4999.46)

           g)   Outlines the requirements for direct supervisor contact for  
             PCC interns.  
           (BPC § 4999.46(g)) 

           h)   Defines the practice of clinical social work.  (BPC § 4996.9)

           i)   Defines the practice of professional clinical counseling.   
             (BPC § 4999.20)

        3) Makes the following provisions relating to the Dental Board of  
           California (DBC):

           a)   The DBC shall have and use a seal bearing the name "Dental  
             Board of California Board of Dental Examiners of California."   
             (BPC § 1613)

        4) Makes the following provisions relating to the Dental Hygiene  
           Committee of California (DHCC):

           a)   Specifies that no person other than a registered dental  
             hygienist, registered dental hygienist in alternative functions  
             practice, 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.   (BPC § 1915)

           b)   Specifies that 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 DHCC.   
             (BPC § 1926.2(b))





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           c)   All dental hygiene services provided by a registered dental  
             hygienist in alternative practice may be covered as long as they  
             are within the scope of Denti-Cal benefits and they are necessary  
             services.  (Welfare and Institutions Code (WIC) § 14132(q)(2))

        1) Makes the following provisions relating to the California State  
           Board of Optometry (CBO):

           a)   Authorizes the CBO to grant or refuse to grant certificates of  
             registration or an optometrist license and may revoke or suspend  
             the certificate of registration license of any optometrist.  (BPC  
             § 3024)

           b)   Authorizes the CBO to make and promulgate rules and  
             regulations governing the procedures of the CBO, the admission of  
             applicants for examination for optometrists and the practice of  
             optometry.  (BPC § 3025)

           c)   Specifies that 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 a certificate of registration.   
             (BPC § 3040)

           d)   Establishes the educational and examination requirements for  
             licensure and use of pharmaceutical agents.  (BPC § 3041.2)

           e)   Outlines standards for evidence of education in the areas of  
             child abuse, alcoholism and substance dependency.  (BPC § 3051)

           f)   Specifies eligibility requirements for graduates from foreign  
             universities.  (BPC § 3057.5)

           g)   Defines "branch office licenses" and specifies provisions of  
             such licenses.  (BPC § 3077)

           h)   Specifies the procedure for reinstating a license after  
             revocation.  (BPC § 3093)

           i)   Provides guidelines for the use of "Dr." or "O.D."  (BPC §  
             3098)

           j)   Declares that it is unlawful to include in any advertisement  
             relating to the sale or disposition of goggles, sunglasses,  
             colored glasses or occupational eye-protective devices any words  





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             or figures that advertise or have a tendency to advertise the  
             practice of optometry.  (BPC § 3103)

           aa)  Clarifies that the false representation of facts is  
             unprofessional conduct.  (BPC § 3106)

           bb)  States that it is unlawful to use or attempt to use any  
             license issued by the CBO that has been purchased, fraudulently  
             issued, counterfeited or issued by mistake as a valid license.   
             (BPC § 3107)

           cc)  Specifies that a licensed optometrist may be employed to  
             practice optometry by a physician and surgeon who holds a  
             certificate under this division and who practices in the  
             specialty of ophthalmology or by a health care service plan.   
             (BPC § 3109)

           dd)  Includes various specifications regarding the name of an  
             optometric corporation.  
           (BPC § 3163)

        1) Makes the following provisions relating to the California Board of  
           Pharmacy (BOP): 

           a)   Permits the BOP to issue licenses to hospital pharmacies  
             within any licensed hospital, institution or establishment that  
             maintains and operates organized facilities for the diagnosis,  
             care and treatment of human illnesses to which persons may be  
             admitted for overnight stay according to the rules and  
             regulations of the CBO.   (BPC § 4029) 

           b)   Specifies that a hospital pharmacy also includes a pharmacy  
             that may be located outside of the hospital, in another physical  
             plant that is regulated under a hospital's consolidated license  
             issued.  (Health and Safety Code § 1250.8)  

           c)   Defines "pharmacy" as an area, place or premises licensed by  
             the BOP and specifies that a pharmacy shall not include any areas  
             in a facility licensed by the State Department of Public Health  
             where certain supplies, drugs and devices are stored.   (BPC §  
             4037)

           d)   Specifies the minimum requirements necessary to apply for a  
             designated representative license.  (BPC § 4053)

        





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        This bill:

        1)  Makes the following changes relating to the BBS: 

           a)   Adds language specifying that a LMFT or LPCC applicant for  
             licensure must have a minimum of seven contact hours of training  
             or coursework in child abuse assessment and reporting.  (BPC §§  
             4980.36(d)(2)(C)(i); 4999.33(d)(9))

           b)   Clarifies that experience gained as an independent contractor  
             and/or reported on an IRS Form 1099 does not count toward  
             licensure as an LMFT, LPCC or LCSW.  (BPC §§ 4980.43(b); 4996.23;  
             and 4999.47(a))

           c)   Amends the out-of-state licensee experience requirements for  
             LMFT and LPCC applicants to a rate of 100 hours to 1,200 hours  
             per month.  (BPC §§ 4980.72 and 4999.60)

           d)   Amends the delinquency fee requirements for LEPs and LCSWs to  
             not exceed $75.00.  (BPC §§ 4989.68 and 4996.3)

           e)    Clarifies that Associate Clinical Social Workers (ACSW) must  
             at all times be under the supervision of a supervisor who is  
             responsible to the BBS.  
           (BPC § 4996.18)

           f)   Allows up to 375 experience hours to be gained providing  
             telehealth counseling for LPCC applicants consistent with what is  
             allowed for LMFT applicants.  (BPC § 4999.46)

           g)   Amends BPC § 4999.46(g) to specify that Professional Clinical  
             Counselor (PCC) interns are not required to have direct  
             supervision for attendance at workshops, seminars, training  
             sessions, or conferences.

           h)   Amends BPC § 4996.9 to specify that the practice of clinical  
             social work includes the use, application and integration of the  
             coursework and experience required by BPC § 4996.2 (which  
             describes required training and education) and 4996.23 (which  
             describes required supervised experience).

           i)   Amends BPC § 4999.20 to make the law regarding scope of  
             practice for LPCCs more consistent with the scope of practice law  
             for the BBSs other license types.





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           j)   Amends §§ 4996.23, 4999.47 and 4980.43 to specify that work  
             performed as an independent contractor or reported on IRS 1099  
             form cannot count towards clinical training experience for PCC  
             interns or trainees. 

        1) Makes the following changes relating to the CBO: 

           a)    Clarifies the preferred name for a license is "optometrist  
             license" and the preferred name for certifications is  
             "optometrist certification(s)" and makes conforming changes (BPC  
             §§ 3024, 3025, 3040, 3041.2(a)(b), 3051, 3057.5, 3077(a)(b)(g),  
             3093, 3098, 3103, 3106, 3107, 3109, 3163).


        1) Makes the following changes relating to the DBC: 

           a)    Amends BPC § 1613 to replace the phrase "Board of Dental  
             Examiners of California" with "Dental Board of California."

        1) Makes the following changes relating to the DHCC: 

           a)    Amends BPC § 1915 to replace the phrase "registered dental  
             hygienist in alternative functions" to "registered dental  
             hygienist in alternative practice."

           b)    Amends the Sections of statutory law referenced in BPC §  
             1926.2(b) from "Article 3.5" to "Article 9" and BPC § "1658" to  
             Section "1925."

           c)    Adds "registered dental hygienist" and "registered dental  
             hygienist in extended functions" to WIC § 14132(q)(2) in order to  
             conform statute to allow these practitioners to bill and be paid  
             for the services that they provide to patients.  Corrects  
             references for dental hygiene services by striking references to  
             WIC § 1768 and 1770 and replacing with current WIC §§ 1917, 1918,  
             1753.7 and 1922.

        1) Makes the following changes relating to the BOP: 
           
           a)    BPC § 4107 provides the BOP with the express authority to  
             issue a second license to a (board licensed) hospital pharmacy  
             for the purpose of conducting centralized hospital packaging.

           b)   Defines the term "Correctional Pharmacy" and provides the  
             express authority for the BOP to issue the license.  (BPC § 4046)





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           c)    Specifies the setting in which the one year of paid work  
             experience must be earned.  (BPC § 4053)

        FISCAL EFFECT:  Unknown.  This bill has been keyed "fiscal" by  
        Legislative Counsel. 

        COMMENTS:
        
        1. Purpose.  This bill is one of the annual Omnibus Committee bills  
           authored by the Business, Professions and Economic Development  
           Committee which consolidates a number of non-controversial  
           provisions related to various regulatory programs and professions  
           governed by the Business and Professions Code.  Consolidating the  
           provisions in one bill is designed to relieve the various licensing  
           boards, bureaus and professions from the necessity and burden of  
           having separate measures for a number of non-controversial  
           revisions.

           Many of the provisions of this bill are minor, technical and  
           updating changes, while other provisions are substantive consensus  
           changes intended to improve the ability of various licensing  
           programs and other entities to efficiently and effectively  
           administer their respective laws.

           As a Committee bill, this measure is jointly Authored by each of  
           the members of the Committee.  As such, by its very nature, it is a  
           consensus bill.  If controversy or opposition should arise  
           regarding any provision in this bill that cannot be resolved, then  
           that provision will be removed from the bill.  This will eliminate  
           the chance of placing any of the other provisions in jeopardy.

        2. Background.  The BBS is the only board which appears to have the  
           more significant and substantive provisions in this measure:

           a)   Board of Behavioral Sciences (BBS).   Child Abuse Assessment  
             and Reporting.   Business and Professions Code  
             §4980.36(d)(2)(C)(i) and §4999.33(d)(9) describe the qualifying  
             degree program required to obtain licensure as an LMFT or an  
             LPCC, if the applicant began graduate study after August 1, 2012.  
              Unlike the requirements for graduate study prior to August 1,  
             2012, these sections do not specify that the instruction in child  
             abuse assessment and reporting must be at least seven hours in  
             length, and must meet the requirements of BPC § 28 (which  
             outlines required course content and acceptable course  
             providers).  Because the requirements of BPC § 28 are still in  





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             effect, the BBS recommends an amendment to BPC §§ 4980.36 and  
             4999.33 that will clarify that the course must be seven hours in  
             length and meet certain other requirements specified in BPC § 28.  
              This will make it clearer to both applicants for licensure and  
             BBS staff that the child abuse assessment and reporting  
             instruction must still meet certain requirements.

            b)   Hours Gained as an Independent Contractor  .  The law allows  
             LMFT, LCSW and LPCC applicants to gain experience hours as a W-2  
             employee or a volunteer, but not as an independent contractor.   
             However, the BBS sometimes receives applications for exam  
             eligibility from individuals who are contracting and receiving a  
             1099 tax form.  Some applicants think that because the statute  
             says "employed," they can be 1099 employees, which is incorrect.   
             The BBS desires to amend the law to clarify that experience  
             gained as an independent contractor and/or reported on an IRS  
             Form 1099 does not count toward licensure.

        
        SUPPORT AND OPPOSITION:
        
         Support:  

        None received as of April 22, 2013

         Opposition:  

        None received as of April 22, 2013



        Consultant: Le Ondra Clark, Ph.D.