BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 333


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          Date of Hearing:  April 28, 2015


                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS


                                Susan Bonilla, Chair


          AB 333  
          (Melendez) - As Amended March 26, 2015


          SUBJECT:  Healing arts:  continuing education.


          SUMMARY:  Authorizes healing arts licensees to earn one unit of  
          continuing education (CE) credit by attending a course that  
          results in the licensee becoming a certified instructor of  
          cardiopulmonary resuscitation (CPR) or the proper use of an  
          automated external defibrillator (AED) and up to two units of CE  
          credit for conducting CPR or AED training sessions for employees  
          of school districts and community college districts in the  
          state.


          EXISTING LAW:


          1)Provides for the licensure and regulation of various healing  
            arts licensees by various boards within the Department of  
            Consumer Affairs (DCA) and imposes various continuing  
            education (CE) requirements for license renewal. (Business and  
            Professions Code (BPC) §§ 500-4999.129)


          2)Requires the Director of the DCA to establish guidelines for  
            mandatory CE administered by the boards under the DCA,  
            including, among other things, the CE's relevancy to the  








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            occupation.  (BPC § 166)


          THIS BILL:


          3)Authorizes healing arts licensees, who are required to  
            complete CE units as a condition of renewing their license, to  
            earn one unit of CE credit by attending a course that results  
            in the licensee becoming a certified instructor of CPR or the  
            proper use of an AED.
          4)Authorizes healing arts licensees, who are required to  
            complete CE units as a condition of renewing their license, to  
            apply up to two units of CE credit towards the requirement for  
            conducting CPR or AED training sessions for employees of  
            school districts and community college districts in the state.


          5)Defines "unit" as a measurement for continuing education, such  
            as hours or course credits.


          FISCAL EFFECT:  Unknown. This bill is keyed fiscal by the  
          Legislative Counsel. 


          COMMENTS:


          6)Purpose.  This bill is sponsored by the author.  According to  
            the author, "As cardiac emergencies become more common on  
            school campuses, it is not only imperative that our schools  
            have lifesaving resources available to faculty and  
            administration, but the ability to provide the faculty and  
            administration with hands-on training with those resources. By  
            incentivizing licensed medical professionals to provide this  
            training in turn for continual education credit, we are  
            providing a no-cost solution that will allow school officials  
            to become familiar with the technology. This will ultimately  








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            lead to less hesitation in emergency environments and  
            increases in the success rate of cardiac emergency care."
          7)Background.  All 20 healing arts boards under the DCA develop  
            their own CE curriculum for licensees and approve the  
            providers that offer the CE courses.  However, they are  
            limited to CE that is relevant to the profession.  Current law  
            specifies that the purpose of CE is "?to create a more  
            competent licensing population, thereby enhancing public  
            protection" (BPC § 166).


          Further, the boards often have limiting language within their  
            practice acts.  For instance, the Dental Board is permitted to  
            establish its own CE curriculum within the general areas of  
            patient care, health and safety, and law and ethics (BPC §  
            1645).  The Medical Board's standards are aimed at  
            maintaining, developing, or increasing the knowledge, skills,  
            and professional performance that licensees use to provide  
            care (BPC § 2190.1).  


          Using the criteria set out in statute, the boards then determine  
            relevant CE courses and approve the providers that teach the  
            courses.  This bill would permit the licensees of healing arts  
            boards to use CPR and AED instructor certification courses and  
            teaching sessions to earn credit towards the CE requirements  
            established by the boards, regardless of the approved CE  
            courses. 


          ARGUMENTS IN SUPPORT: 


          The  American Red Cross  writes in support, "The American Red  
          Cross is pleased to support your AB 333, which would incentivize  
          the training of K-12 school faculty and administrators in the  
          use of [AEDs], by allowing individuals the ability to earn  
          continuing education units.









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          AEDs are used to treat the effects of sudden cardiac arrest,  
          which is triggered by an electrical malfunction in the  
          heart-with the heart unable to pump blood to the brain, lungs,  
          and other vital organs, death can happen in minutes. Each year  
          nearly 424,000 people experience sudden cardiac arrest outside  
          of a hospital.  Only 10% of these individuals survive.   
          Encouraging school employees to be prepared in time of  
          emergency, including the use of an AED, can save lives."


          ARGUMENTS IN OPPOSITION:


          None on file.


          IMPLEMENTATION ISSUES:


          This bill may conflict with the California Emergency Medical  
          Services Authority's (EMSA) regulations regarding "lay rescuers"  
          and AED training (California Code of Regulations Title 22, §  
          100031-100043).  The author may wish to work with EMSA to ensure  
          that the requirements for lay rescuers, as spelled out in the  
          EMSA regulations, is consistent with the requirements for  
          healing arts licensees that would be impacted by this bill.


          POLICY ISSUES:


          Some boards, such as the Board for Behavioral Sciences (BBS),  
          may wish to opt out of this bill. For instance, at the April 23,  
          2015 BBS Policy and Advocacy Committee meeting, a board analysis  
          noted that this bill may conflict with the board's continuing  
          education statutory and regulatory requirements. The analysis  
          stated that: 









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            "Current law specifies that continuing education must  
            incorporate either aspects of the discipline for which  
            licensed that are fundamental to the practice of the  
            profession, aspects of the discipline where significant recent  
            developments have occurred, or aspects of other disciplines  
            that enhance the understanding or practice of the profession.


            While CPR/AED training is important, it may be difficult to  
            argue that it is fundamental to, or enhances the understanding  
            of, the practice of psychotherapy."


          Therefore, the author should make the following amendments to  
          provide boards the authority to opt out and to exclude boards  
          with conflicting statutes. 


          AMENDMENTS:


          8)Ensure that licensees only apply the credits once per renewal  
            cycle:
          On page 2, line 5, strike:  may  and after "license" insert:


           may, once per renewal cycle, 


           On page 2, line 12, strike:  may  and after "license" insert:


           may, once per renewal cycle,   


           9)Specify which certification courses apply: 










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          On page 2, line 9, after "state" insert:


             The licensee may attend the following courses:


            (1) An instructional program developed by the American Heart  
            Association.


            (2) An instructional program developed by the American Red  
            Cross.


            (3) An instructional program that is nationally recognized and  
            based on the most current national evidence-based emergency  
            cardiovascular care guidelines for the performance of CPR and  
            the use of an AED.


           10)Ensure the training sessions are approved by the appropriate  
            board:


          On page 2, line 15, after "state" insert:


             The training session must be approved by the applicable  
            licensing entity. 


           11)and exclude boards that do not wish to participate or have  
            conflicting statutory or regulatory requirements:


          On page 2, after line 17, insert:


             (e) This section does not apply to a person licensed under  








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            this division if the applicable board's laws establishing  
            continuing education exclude the courses or activities  
            described in subdivisions (a) and (b). 


           REGISTERED SUPPORT:  


          The American Red Cross




          REGISTERED OPPOSITION:  


          None on file.


          Analysis Prepared by:Vincent Chee / B. & P. / (916) 319-3301