BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  SB 821
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          Date of Hearing:   June 25, 2013

              ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER  
                                     PROTECTION
                              Richard S. Gordon, Chair
             SB 821 (Business, Professions and Economic Development) - As  
                               Amended:  June 19, 2013

           SENATE VOTE  :   39-0
           
          SUBJECT  :   Healing arts.

           SUMMARY  :   Makes several technical and noncontroversial changes  
          to provisions within the Business and Professions Code (BPC)  
          related to the regulation of the Dental Board of California  
          (DBC), Board of Optometry (BO) Board of Behavioral Sciences  
          (BBS), as well as dental hygienists regulated under the Welfare  
          and Institutions Code (WIC), as specified.  Specifically,  this  
          bill  :   

          1)Revises the seal utilized by the DBC from "Board of Dental  
            Examiners of California" to the "Dental Board of California".

          2)Clarifies the in the context of optometry, preferred name for  
            a license is "optometrist license" and the preferred name for  
            certifications is "optometrist certification(s)."

          3)Defines the term "correctional pharmacy" to mean "a pharmacy,  
            licensed by the Board of Pharmacy (BOP), located within a  
            state correctional facility for the purpose of providing  
            pharmaceutical care to inmates of the state correctional  
            facility."

          4)Specifies that one year of paid work experience in a licensed  
            pharmacy or with a drug wholesaler, drug distributor, or drug  
            manufacturer as specified, meets a requirement for a  
            designated representative license in a wholesaler or  
            veterinary food-animal drug retailer.

          5)Revises the BOP's authority to not issue more than one site  
            license to a single premise except as follows:

             a)   To issue a veterinary food-animal drug retailer license  
               to a wholesaler, as specified;









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             b)   To issue a license to compound sterile injectable drugs  
               to a pharmacy, as specified; and

             c)   To issue a centralized hospital packaging license, as  
               specified.

          6)Specifies that the qualifying degree program required to  
            obtain licensure as a Licensed Marriage and Family Therapist  
            (LMFT) or a Licensed Professional Clinical Counselor (LPCC)  
            must include a minimum of seven contact hours of training or  
            coursework in child abuse assessment and reporting as  
            specified.

          7)Revises the operation date for specified requirements for  
            licensure as a LMFT from 2014 to 2016.

          8)Specifies that LMFT applicants may obtain supervised  
            experience only as an employee or volunteer, and further  
            specifies that experience may not be gained by interns or  
            trainees for work performed as an independent contractor or  
            reported on specified IRS Form 1099.

          9)Specifies that an LMFT applicant licensed outside of  
            California that has less than 3000 hours of qualifying  
            supervised experience, may count their supervised experience  
            as substantially equivalent with time actively licensed as a  
            LMFT, at a rate of 100 hours per month up to a maximum of 1200  
            hours. 

          10)Clarifies that the delinquent renewal fee for a Licensed  
            Educational Psychologist (LEP) shall be a maximum amount of  
            $75.

          11)Extends the operational date of specified requirements for  
            licensure as a Licensed Clinical Social Worker (LCSW) from  
            January 1, 2014 to January 1, 2016.

          12)Clarifies that the use, application and integration of  
            specified social work coursework and experience shall be  
            considered a part of the application of social work principals  
            and methods.

          13)Requires all applicants for licensure as LCSW to be at all  
            times under the supervision of a supervisor who shall be  
            responsible for ensuring that the extent, kind, and quality of  








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            counseling performed is consistent with the training and  
            experience of the person being supervised, and who shall be  
            responsible to the BBS for compliance with all laws, rules,  
            and regulations governing the practice of clinical social  
            work.

          14)Clarifies that the use, application and integration of  
            specified coursework and experience may be a part of the  
            definition of professional clinical counseling principals and  
            methods.

          15)Allows an applicant for LPCC licensure to obtain up to 375  
            hours of experience providing personal psychotherapy, crisis  
            counseling or other counseling services via telehealth as  
            specified.

          16)Specifies that Professional Clinical Counseling (PCC) interns  
            are not required to have direct supervision for attendance at  
            workshops, seminars, training sessions or conferences.  

          17)Specifies that PCCs trainees, interns, and applicants may  
            obtain supervised experience only as an employee or volunteer,  
            and further specifies that experience may not be gained by  
            interns or trainees for work performed as an independent  
            contractor or reported on an IRS Form 1099.

          18)Extends the operational and repeal dates for specified  
            requirements for licensure as a LPCC from January 1, 2014 to  
            January, 1 2016.

          19)Specifies that an LPCC applicant licensed outside of  
            California that has less than 3000 hours of qualifying  
            supervised experience, may count their supervised experience  
            as substantially equivalent with time actively licensed as an  
            LPCC, at a rate of 100 hours per month up to a maximum of 1200  
            hours.

          20)Specifies that all dental hygiene services provided by a  
            registered dental hygienist in extended functions, and a  
            registered dental hygienist in alternative practice as  
            specified, may be covered as long as they are within the scope  
            of the Denti-Cal benefits as specified, and the services are  
            provided by a registered dental hygienist in extended  
            functions or registered dental hygienist in alternative  
            practice. 








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          21)Makes other technical and clarifying changes. 

           EXISTING LAW  

          1)Describes the qualifying degree program required to obtain  
            licensure as a LMFT or a LPCC, if the applicant began graduate  
            study after August 1, 2012.  (BPC 4980.36; 4999.33)

          2)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; 4996.23; and 4999.47)

          3)Specifies examination eligibility requirements for  
            out-of-state LMFT and LPCC licensees. (BPC 4980.72 and  
            4999.60)

          4)Specifies that the delinquent renewal fee for a license is $75  
            for LEPs.  (BPC 4989.68 and 4996.3)

          5)Specifies that LCSW 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)

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

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

          8)Defines the practice of clinical social work and professional  
            clinical counseling.  (BPC 4996.9, 4999.20).

          9)Permits the DBC to have and use a seal bearing the name "Board  
            of Dental Examiners of California." (BPC 1613)

          10)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)









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          11)Specifies that a registered dental hygienist in alternative  
            practice may operate one mobile dental hygiene clinic  
            registered as a dental hygiene office or facility as  
            specified. (BPC 1926.2)

          12)Allows the OB to grant or refuse to grant a certificate of  
            registration as specified and may revoke or suspend the  
            certificate of registration of any optometrist for any cause  
            as specified. (BPC 3024)

          13)Allows the BO to make and promulgate rules and regulations  
            governing the procedures of the BO, the admission of  
            applicants for examination for optometrists and the practice  
            of optometry.  (BPC  3025)

          14)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)

          15)Defines a controlled substance, as specified, for purpose of  
            the Pharmacy law. (BPC 4021)

          16)Permits the BOP to issue a license to a designated  
            representative to provide sufficient and qualified supervision  
            in a wholesaler or veterinary food-animal drug retailer and  
            specifies that 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 of veterinary food-animal drug retailer. (BPC 4053)

          17)Specifies the minimum requirements necessary to apply for a  
            designated representative license, for purpose of the Pharmacy  
            law.  (BPC 4053)

          18)Specifies that the BOP may not issue more than one site  
            license to a single premise except to issue a veterinary  
            food-animal drug retailer license to a wholesaler or to issue  
            a license to compound sterile injectable drugs to a pharmacy  
            as specified. (BPC 4107)

           FISCAL EFFECT  :   Unknown

           COMMENTS  :   








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           1)Purpose of this bill  .  This is a "Committee bill" authored by  
            the Senate Business, Professions and Economic Development  
            Committee (BPED) for the purpose of consolidating multiple,  
            non-controversial revisions to existing law into a single  
            bill.  The provisions contained in this bill make minor,  
            technical, clarifying and other non-controversial substantive  
            changes to several health-related boards regulated under the  
            DCA.  
             
             Specifically, this bill makes various changes to the licensure  
            requirements for LMFTs, LEPs, LCSWs and LPCCs, and revises  
            their operational and repeal dates by two years; revises the  
            preferred title for optometrist licenses and certifications;  
            revises the current stamp utilized by the DBC; adds registered  
            dental hygienists and registered hygienists in extended  
            functions to statute in order to allow specified practitioners  
            to bill and be paid for the services provided; defines a  
            correctional pharmacy; and specifies the work experience  
            required to obtain a designated representative license.  This  
            bill is author sponsored.

           2)Author's statement  .  According to the author, "This bill is  
            the annual Omnibus Committee bill authored by the [BPED] which  
            consolidates a number of non-controversial provisions related  
            to various regulatory programs and professions governed by the  
            [BPC].  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."

           3)Dental Board of California  .  The DBC was created by the  
            Legislature and provides for the licensure and regulation of  
            dental health professionals in California.  The DBC regulates  
            approximately 100,000 licensed dental health professionals  
            including dentists, registered dental assistants and  
            registered dental assistants in extended functions.  
             
             This bill would update the seal used by the DBC to properly  
            reflect its formal name "Dental Board of California."   








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            Currently, mobile units are licensed by the Department of  
            Health Care Services and regulated by the DBC.  This bill  
            would update those provisions allowing a registered dental  
            hygienist in alternative practice to operate one mobile dental  
            hygiene clinic registered as a dental hygiene office or  
            facility.  Lastly, this bill updates the Welfare and  
            Institutions Code (WIC) to provide that 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.   
             
           4)Board of Optometry  .  The BO is responsible for the regulatory  
            oversight of approximately 9,000 optometrists, the largest  
            population of optometrists in the United States.  In 1913, a  
            new Optometry Practice Act was enacted creating the BO,  
            defining its duties and powers, and prescribing a penalty for  
            a violation of the Act.  This bill simply updates current law  
            regarding the preferred name of an optometrist's authorization  
            to practice from "certificate of registration" to an  
            "optometrist license".  

          5)California Board of Pharmacy  .  The BOP was established in 1891  
            to protect consumers by licensing and regulating those  
            responsible for dispensing medications to the public.  The BOP  
            oversees all aspects of the practice of pharmacy, including  
            the practitioner, practice site, and drugs and devices.  The  
            BOP also regulates drug manufactures.  This bill updates the  
            provisions of law relating to who may apply for a designated  
            representative license and also adds the definition of a  
            correctional pharmacy. 

           6)Board of Behavioral Sciences  .  The BBS regulates professionals  
            who generally perform counseling services, but are not  
            registered psychologists or psychiatrists.  The BBS regulates  
            four different licensing categories: LMFTs, LCSWs, LPCCs, and  
            LEPs.  The BBS oversees a population of approximately 80,000  
            licensees.  
             
             Current law describes 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 other specified requirements.  Because  








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            the current requirements are still in effect, the BBS seeks a  
            clarifying provision specifying the course must be seven hours  
            in length and meet other requirements in current law.  This  
            bill will provide clarity to both applicants for licensure and  
            BBS staff that the child abuse assessment and reporting  
            instruction must still meet certain requirements.  

            Additionally, current 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.  This bill  
            specifically states that those applicants who obtain  
            experience as a contractor will not be counted for licensure  
            requirements. This bill makes other technical and clarifying  
            provisions to the BBS.

           7)Technical amendments  .  The Committee recommends the following  
            technical amendments to address any potential concerns with  
            this bill relating to supervised experience for applicants for  
            licensure as LPCC and LMFT:    
             
                On page 23, line 12, after the word "trainees" strike "for  
               work performed" and strike line 13. 

               On page 51, strike lines 14-16.  

               On page 64, line 33, after the word "trainees" strike "for  
               work performed" and on line 34, after "contractor" strike  
               "or reported on an IRS Form 1099."  

           8)Related legislation  .  SB 822 (Senate Committee on Business,  
            Professions and Economic Development) makes several technical  
            changes to provisions within the BPC related to the regulation  
            of various professions, including those overseen by the  
            California Board of Accountancy, the Contractors' State  
            License Board, the Board of Guide Dogs for the Blind, and the  
            Board for Professional Engineers, Land Surveyors and  
            Geologists.  This bill is pending in the Assembly  
            Appropriations Committee.  








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             SB 823 (Senate Committee on Business, Professions and Economic  
            Development) revises the qualifications for certified public  
            accountant licensure in order to smooth the transition to the  
            new requirements for some applicants, and reestablishes  
            certain provisions regarding the administration of the  
            Transcript Reimbursement Fund operated by the Court Reporters  
            Board of California.  This bill is pending in the Assembly  
            Appropriations Committee. 

           9)Potential chaptering out conflict  .  This bill amends the same  
            code section (BPC 4999.20) as SB 243 (Wyland) of 2013, which  
            revises the current training and education requirements for  
            LPCCs in order for them to complete the training needed for  
            treatment of couples or families during a degree program,  
            rather than after the program.  SB 243 is currently pending on  
            the Assembly Floor.  If both measures continue to move,  
            chaptering out language will need to be added to the bill and  
            SB 243 to prevent a conflict. 

            This bill also amends the same code section (WIC 14132) as SB  
            X1 (Ed Hernandez and Steinberg), which establishes the  
            existing Medi-Cal benefit package as the benefit package for  
            the expansion population eligible under the Affordable Care  
            Act (ACA).  SB X1 recently passed both the Assembly and Senate  
            and is pending in enrolling.  If this bill continues to move  
            forward, chaptering out language will need to be added to this  
            bill to prevent a conflict. 

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          Board of Behavioral Sciences
           
            Opposition 
           
          None on file. 

           Analysis Prepared by  :    Elissa Silva / B.,P. & C.P. / (916)  
          319-3301 












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