BILL ANALYSIS Ó
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|Hearing Date:April 28, 2014 |Bill No:SB |
| |1466 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Ted W. Lieu, Chair
Bill No: SB 1466 Author:Business, Professions and
Economic Development Committee
As Introduced: March 25, 2014Fiscal: Yes
SUBJECT: Health care professionals.
SUMMARY: Makes several non-controversial, minor, non-substantive or
technical changes to various provisions within the Business and
Professions Code (BPC) relating to the regulatory boards of the
Department of Consumer Affairs (DCA).
Existing law:
1) Provides for the licensing and regulation of various professions
and businesses by the
23 boards, 4 committees, 9 bureaus and 1 commission within the DCA
under various licensing acts within the Business and Professions
Code (BPC).
2) Contains the following provisions relating to the Medical Board of
California (MBC):
a) Requires any physician and surgeon, or a person acting under
the physician and surgeon's orders or supervision, who perform a
scheduled medical procedure, outside of a general acute care
hospital, that results in the death of any patient on whom that
medical treatment was performed on, to report that occurrence to
the MBC, in writing on a form prescribed by the MBC, within 15
days after the occurrence. (BPC § 2240 (a))
b) Requires institutions formally affiliated with a medical
school or a school of osteopathic medicine located outside of
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located outside of the United States or Canada to be accredited.
For medical schools in the United States, they are to be
accredited by the Joint Commission on Accreditation of Hospitals,
and for medical schools located in another country they are to be
accredited in accordance with the law of that country.
(BPC § 2089.5 (e) (3))
3) Contains the following provisions relating to the Speech-Language
Pathology and Audiology and Hearing Aid Dispensers Board
(SLPAHADB):
a) Requires that an applicant for licensure as a speech-language
pathologist or audiologist to submit transcripts from an
educational institution approved by the SLPAHADB evidencing
completion of specified coursework, and submit evidence of the
completion of supervised clinical practice. (BPC § 2532.2 et
seq.)
b) Requires the SLPAHADB to establish by regulation the required
number of clock hours of supervised clinical practice necessary
for the applicant. (BPC § 2532.2 et seq.)
4) Contains the following provisions relating to the California State
Board of Pharmacy (SBP):
a) Governs the regulation of the practice of pharmacy and
establishes the SBP to administer and enforce these provisions.
(BPC § 4001 et seq.)
b) Authorizes the SBP to issue a license to an individual to
serve as a designated representative to provide sufficient and
qualified supervision in a wholesaler or veterinary food-animal
drug retailer. (BPC § 4053 et seq.)
c) Requires the licensee to 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 et seq.)
d) Defines a correctional pharmacy to mean a pharmacy, licensed
by the SBP, located within a state correctional facility, as
specified. (BPC § 4021.5)
5) Contains the following provisions relating to the California Board
of Behavioral Sciences (BBS):
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a) Requires an applicant for a license as a marriage and family
therapists, social worker, or professional clinical counselor, to
participate in and obtain a passing score on a
BBS administered California law and ethics examination in order to
qualify for a license or renewal of a license. (BPC § 4980)
This bill:
1) Makes the following changes relating to the Medical Board of
California (MBC):
a) Requires a physician and surgeon, or a person acting under the
physician and surgeon's orders or supervision, who performs any
medical procedure, outside of a general acute care hospital, that
results in the death of any patient on whom that medical
treatment was performed, to report that occurrence to the MBC, in
writing on a form prescribed by the MBC, within 15 days after the
occurrence.
b) Requires institutions formally affiliated with a medical
school or a school of osteopathic medicine located outside of
located outside of the United States or Canada to be accredited.
For medical schools in the United States, they are to be
accredited by the Joint Commission on Accreditation of Hospitals
or the American Osteopathic Association's Healthcare Facilities
Accreditation Program, and for medical schools located in another
country, they are to be accredited in accordance with the law of
that country.
(BPC § 2089.5 (e) (3))
2) Makes the following changes relating to the Speech-Language
Pathology and Audiology and Hearing Aid Dispensers Board
(SLPAHADB):
a) Deletes the requirement that the applicant submit transcripts
from an educational institution approved by the SLPAHADB
evidencing completion of specified coursework and would increase
the maximum number of clock hours that the Board may establish by
regulation to 375.
3) Makes the following changes relating to the California State Board
of Pharmacy (SBP):
a) Requires an individual who applies for a designated
representative license to be at least 18 years of age.
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b) Revises the definition of a correctional pharmacy to mean a
pharmacy licensed by the SBP located within a correctional
facility, without regard to whether the facility is a state or
local correctional facility.
4) Makes the following changes relating to the California Board of
Behavioral Sciences (BBS):
a) Permits an applicant who holds a registration eligible for
renewal, and who applies for renewal of that registration between
January 1, 2016 and June 30, 2016, if eligible, to renew the
registration without first participating in the California law
and ethics examination.
b) Requires the applicant to pass the California law and ethics
examination prior to licensure or issuance of a subsequent
registration number.
c) Permits an applicant who holds or has held a registration, and
who applies for a subsequent registration number between January
1, 2016 and January 1, 2017, if eligible, to obtain the
subsequent registration number without first passing the
California law and ethics examination, if he or she passes the
law and ethics examination at the next renewal period or prior to
licensure, whichever occurs first.
d) Requires courses on elder and dependent adult abuse and
neglect to be taken by Licensed Marriage and Family Therapists.
e) Allows a Licensed Marriage and Family Therapist or Licensed
Professional Clinical Counselor licensee, who already holds a
license in another state, to be exempt from re-taking the
clinical exam in order to obtain their California license if they
meet certain conditions.
f) Makes other technical, conforming and clarifying changes
relating to licensed marriage and family therapists and licensed
professional clinical counselors.
FISCAL EFFECT: Unknown. This bill has been keyed "fiscal" by
Legislative Counsel.
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COMMENTS:
1.Purpose. This bill is one of two "committee bills" authored by the
Business, Professions and Economic Development Committee (Committee)
and is intended to consolidate 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,
professions and other regulatory agencies 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 changes intended to
improve the ability of various licensing programs and other entities
to efficiently and effectively administer their respective laws.
However, as a Committee bill, if controversy or opposition should arise
regarding any provision 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 following is background and reasons for the more
significant and substantive provisions in this measure:
a) Medical Board of California (MBC). Existing law (Business and
Professions Code Section 2240 (a)) requires a physician who
performs a scheduled medical procedure outside of a general acute
care hospital, that results in a death, to report the occurrence
to the Board within 15 days. The MBC would like to ensure all
deaths in outpatient settings are reported to the MBC, not just
those that resulted from a scheduled medical procedure.
Currently, the MBC recognizes the Accreditation Council Graduate
for Medical Education (ACGME) accredited postgraduate training
for the purposes of allopathic medical school students' clinical
clerkship training and for the required postgraduate training for
licensure as a physician and surgeon. ACGME accredited
postgraduate training programs are at institutions that are
accredited by the Joint Commission on Accreditation of Hospitals.
Recently, ACGME has accredited postgraduate training programs in
hospitals that are accredited by the American Osteopathic
Association's Healthcare Facilities Accreditation Program
(AOA-HFAP). However, existing law (B&P Code Section 2089.5)
specifically references the "Joint Commission on Accreditation of
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Hospitals" as the hospital accreditation agency for ACGME
postgraduate training programs.
American Osteopathic Association (AOA) accredits postgraduate
training for licensure purposes for osteopathic medical school
graduates. AOA accredited postgraduate training programs are
usually obtained in hospitals that are accredited by the
AOA-HFAP. ACGME and AOA have reached an agreement for ACGME to
approve all postgraduate training programs for both allopathic
medical school (M.D. degrees awarded) and osteopathic medical
school (D.O. degrees awarded) graduates.
This change will require an amendment to B&P Code Section 2089.5
to include the AOA-HFAP as an approved accreditation agency for
hospitals offering ACGME accredited postgraduate training
programs.
b) Speech-Language Pathology and Audiology and Hearing Aid
Dispensers Board (SLPAHADB). Current provisions in the
SLPAHADB's laws and regulations do not specify that academic
equivalency is intended only for internationally trained
students. Terminology used in the laws and regulations is not
consistent with international institutions. Terms such as
"graduate courses" or "semester units" may not apply. The 300
clock hours of supervised clinical practice needs to increase to
375 clock hours to mirror the current requirements of all
national accredited training programs.
c) California State Board of Pharmacy (SPB). Section 4053 of the
Business and Professions Code specifies the minimum requirements
necessary to apply for a designated representative license. In
2013, this section was amended to require an applicant for
licensure as a designated representative to have a minimum one
year of paid work experience in a facility licensed by the SPB,
however, the section does not specify a minimum age requirement
for such an individual.
Last year, as part of the provisions of SB 821(Chapter 473,
Statutes of 2013), The California Department of Corrections and
Rehabilitation (CDCR) requested and obtained approval to create a
new definition for "correctional pharmacy" defined as a pharmacy
located within a state correctional facility. This change was
important to CDCR because they have licensed hospitals that
distribute medication to inmates. This new definition however
excludes a local correctional facility that meets the same
guidelines as state correctional pharmacies.
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d) California Board of Behavioral Sciences (BBS). Current law
for Licensed Marriage and Family Therapists (LMFT) and Licensed
Professional Clinical Counselor (LPCC) degrees initiated prior to
August 1, 2012, requires an applicant to complete coursework in
aging and long term care, which must include instruction on the
assessment and reporting of, as well as treatment related to,
elder and dependent adult abuse and neglect. BPC Section
4980.36(d)(2), which applies to LMFT applicants who began their
degree program after August 1, 2012, requires instruction in
aging, and also in long term care. However, it does not mention
any coursework requirement for elder and dependent adult abuse
and neglect.
Current law allows an applicant for LMFT or LPCC licensure who
already holds a license in another state, to be exempt from
re-taking the clinical exam in order to obtain their California
license if they meet certain conditions. The conditions are as
follows:
a) They must have already taken and passed the
national licensing exam the BBS is accepting as the
clinical exam; and
b) Their license or registration in the other
jurisdiction is in good standing, 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.
There is a concern that the term "as a result of any disciplinary
proceeding brought by the licensing authority of that
jurisdiction" is unnecessarily restrictive to only discipline
brought by the licensing authority; in reality, another entity
could have brought forth discipline affecting the license status.
The BBS is in the process of implementing the examination
restructure, which will change the examination process for
applicants who are seeking licensure as a LMFT, clinical social
worker (LCSW), or LPCC. Recently, SB 821 (Chapter 473, Statutes
of 2013) changed the implementation date of the examination
restructure from January 1, 2014 to January 1, 2016. The need
for additional legislative amendments is based on questions the
BBS has received regarding renewal of intern and associate
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registrations in the months after January 1, 2016, when the
examination restructure becomes effective. Currently, the law
related to the exam restructure states that a registrant shall
take the California law and ethics examination prior to
registration renewal. In addition, the law also states that the
BBS shall not issue a subsequent registration number to someone
whose registration is expiring, until they have passed the
California law and ethics exam.
This raises two potential problems:
1. An intern or associate renewing a registration
in the months after January 1, 2016, will not have had
much time to attempt the California law and ethics exam as
the exam will not begin to be offered until January 1,
2016.
2. As of January 1, 2016, an intern or associate
who has an expiring registration number (because they have
held it six years) will be required to pass the California
law and ethics exam prior to being issued their second
registration number. However, this is a new requirement,
leaving those with a registration that expires after
January 1, 2016 with little time to prepare.
In order to address these potential problems in an equitable
manner, the BBS proposes two amendments:
1. Allow an applicant who holds an active
registration, who applies for renewal of that registration
between January 1, 2016 and June 30, 2016 to be allowed,
if eligible, to renew his or her registration without
first participating in the California law and ethics
examination. Under this scenario, these registrants will
be required to participate in the California law and
ethics examination when they apply for their next renewal.
This will ensure they have adequate advance notice to
sign up for and prepare for the exam.
2. Allow an applicant who holds an active
registration, who applies for a subsequent registration
number between January 1, 2016 and January 1, 2017, to be
allowed, if eligible, to obtain the subsequent
registration number without first passing the California
law and ethics examination.
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1. Arguments in Support. The Medical Board of California (MBC)
supports this measure and writes, "The Board is supportive of the
provisions in SB 1466 that pertain to the MBC. The MBC feels that
these provisions will help to ensure consumer protection and allow
the Board to operate in a more efficient manner."
SUPPORT AND OPPOSITION:
Support:
Medical Board of California
Opposition:
None received as of April 23, 2014
Consultant:Le Ondra Clark, Ph.D.