BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: SB 800 Hearing Date: April 27,
2015
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|Author: |Committee on Business, Professions and Economic |
| |Development |
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|Version: |April 20, 2015 Amended |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Janelle Miyashiro |
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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.
Existing law:
1) Provides for the licensing and regulation of various
professions and businesses by the 26 boards, 9 bureaus, 3
committees, 2 programs, and 1 commission within the
Department of Consumer Affairs (DCA) under various licensing
acts within the Business and Professions Code (BPC).
2) Contains the following provisions relating to the Dental
Board of California (DBC):
a) The Dental Practice Act (Act) provides for the
licensure and regulation of dentists by the DBC. The Act
refers to the Board as the "Board of Dental Examiners".
(Business & Professions Code (BPC) §§ 500, 650.2(f),
6650.2(g), 650.2(i), 1603(a), 1618.5(a), 1640.1(c),
1648.10(b), 1648.10(c), 1650, 1695, and 1695.1(a))
3) Contains the following provisions relating to the California
State Board of Optometry:
SB 800 (Committee on Business, Professions and Economic
Development) Page 2 of ?
a) Requires out of state applicants to submit proof that
he or she has been in active practice in a state in which
he or she is licensed for a total of at least 5,000 hours
in five of the seven consecutive years immediately
preceding the date of his or her application and has never
had his or her license to practice optometry revoked or
suspended. The applicant must not be found mentally
incompetent by a physician. (BPC § 3057)
4) Contains the following provisions relating to the Physical
Therapy Board of California (PTBC):
a) Requires physical therapist assistants (PTA) to
fulfill the educational requirements prescribed by the
Commission on Accreditation in Physical Therapy Education
(CAPTE) of the American Physical Therapy Associations or
Physiotherapy Education Accreditation Canada. These
requirements include a combination of didactic and
clinical experiences, which consist of at least 18 weeks
of full-time experience with a variety of patients. (BPC
§ 2650)
5) Contains the following provisions relating to the Physician
Assistant Board (PAB):
a) Requires the Physician Assistant Board to elect a
chairperson and vice chairperson annually from among its
members. (BPC § 3509.5)
6) Contains the following provisions relating to the Medical
Board of California (MBC):
a) Lists specified provisions that require registration,
licensure, certification, or other authorization to engage
in certain businesses or professions regulated by the DCA
and make a violation of a listed provision a punishable
infraction.
(BPC § 146)
b) Prohibits an individual from renewing a license after
he or she has failed to renew the license within 5 years
after its expiration and prohibits the license from being
reissued, reinstated, or restored. (BPC § 2428)
SB 800 (Committee on Business, Professions and Economic
Development) Page 3 of ?
c) States an individual issued a license to practice
medicine cannot have had that license revoked or
suspended. (BPC § 2054)
d) References a pilot program that allows hospitals owned
by health care districts to employ physicians. (BPC §
2401)
e) Allows students and graduates in psychoanalysis to
engage in psychoanalysis if stated individuals register
with the Board and states that the Board may suspend or
revoke the exemption of these students based on violations
in professional conduct. (BPC § 2529)
f) Allows the Board to suspend or revoke the licenses of
its various allied health care licensees and registrants.
(BPC §§ 2519, 2520, 2546.7, 2546.9, 2559.3, 2563, 2565,
2566, 2566.1, and 3576)
g) Authorizes the Board to deny a physician's and
surgeon's certificate to an applicant guilty of
unprofessional conduct or of any cause that would subject
a licensee to revocation or suspension of his or her
license. (BPC § 2221)
7) Contains the following provisions relating to the California
Board of Behavioral Sciences (BBS):
a) Requires individuals applying for a new license or for
renewal of a license to practice as a psychologist,
clinical social worker, professional clinical counselor,
or marriage and family therapist to have completed
coursework or training in child, elder, and dependent
adult abuse assessment and reporting. Requires that this
training must be obtained from an accredited or approved
educational institution, a continued education provider
approved by the responsible board, or a course sponsored
or offered by a professional association or a local,
county, or state department of health or mental health for
continued education that has been approved by the
responsible board. (BPC § 28)
b) Requires licensure to practice as a licensed marriage
SB 800 (Committee on Business, Professions and Economic
Development) Page 4 of ?
and family therapist (LMFT) or licensed clinical social
worker (LCSW). (BPC § 146)
c) Requires the Board to approve continuing education
providers for specified educational courses relating to
licensure for marriage and family therapists, educational
psychologists, clinical social workers, and professional
clinical counselors. (BPC §§ 4980.3999, 4980.54, 4989.34,
4992.09, 4996.22, and 4999.55)
d) Requires all post degree hours of experience to be
credited toward licensure except when employed in a
private practice setting for interns training for
licensure as a professional clinical counselor (PCC).
(BPC §§ 4980.43; 499.46)
e) Allows a maximum number of possible renewals after
initial registration for an intern, after which a new
registration number is required. An applicant who is
issued a subsequent number is barred from employment or
volunteering in a private practice. (BPC §§ 4984.01,
4996.28, 4999.45, and 4999.100)
f) Lists the requirements for a LCSW applicant, including
being at least 21 years old, having earned a master's
degree from an accredited school of social work, and
having 2 years of supervised post-master's degree
experience.
(BPC § 4996.2)
8) Contains the following provisions relating to the California
Board of Psychology (BOP):
a) States an applicant holding a doctoral degree in
psychology from an approved institution is deemed to meet
the requirements of specified section in the Business and
Professions Code. (BPC § 2914(g))
9) Contains the following provisions relating to the California
Board of Registered Nursing (BRN):
a) Requires a registered nurse to submit educational,
experience, and other credentials and information as the
board requires in order to the use the title "nurse
SB 800 (Committee on Business, Professions and Economic
Development) Page 5 of ?
practitioner" prior to his or her next license renewal.
(BPC § 2835.5)
b) Provides for a diversion program to identify and
rehabilitate registered nurses whose competency may be
impaired due to abuse of alcohol, drugs, or mental
illness. (BPC § 2770)
10)Contains the following provisions relating to the State of
California Acupuncture Board:
a) Requires applicants who have completed education and
training requirements outside of the United States and
Canada to document stated education and training for
approval by the Board. (BPC § 4938; 4939)
11)Contains the following provisions relating to the Dental
Hygiene Committee of California (DHCC):
a) Requires that the Medical Board of California, the
Board of Psychology, the Dental Board of California, the
Osteopathic Medical Board of California, the State Board
of Chiropractic Examiners, the Board of Registered
Nursing, the Board of Vocational Nursing and Psychiatric
Technicians, the State Board of Optometry, the Veterinary
Medical Board, the Board of Behavioral Sciences, the
Physical Therapy Board of California, the California State
Board of Pharmacy, the Speech-Language Pathology and
Audiology and Hearing Aid Dispensers Board, the California
Board of Occupational Therapy, the Acupuncture Board, and
the Physician Assistant Board each separately create and
maintain a central file of the names of all persons who
hold a license, certificate, or similar authority from
that board. (BPC § 800)
b) States deadline date of January 1, 2010 for the DHCC
to contract with the Dental Board to perform
investigations of applicants and licensees as well as
carry out other provisions. (BPC § 1905.1)
SB 800 (Committee on Business, Professions and Economic
Development) Page 6 of ?
c) States that the DHCC may license a third or fourth
year dental student as a registered dental hygienist as
long as he or she satisfies specified requirements. (BPC
§ 1917.2)
d) States that the DHCC shall establish a resolution to
the amount of fees that relate to the licensing of a
registered dental hygienist, a registered dental hygienist
in alternative practice and a registered dental hygienist
in extended functions. (BPC § 1944(a))
12)Contains the following provisions relating to the California
Veterinary Medical Board (VMB):
a) States that the Board may revoke or suspend a
veterinary assistant controlled substance permit for
specified reasons. (BPC § 4836.2)
b) States that a person whose license or registration has
been revoked or who has been placed on probation may
petition the Board for reinstatement or modification of
penalty. (BPC § 4887)
13)Contains the following provisions relating to the Telephone
Medical Advice Services Bureau (TMAS):
a) States that any business entity that employs,
contracts, or subcontracts directly or indirectly with the
full-time equivalent of five or more persons functioning
as health care professionals, whose primary function is to
provide telephone medical advice, and that provides
telephone medical advice service to a patient at a
California address shall be registered with the Telephone
Medical Advice Services Bureau. (BPC § 4999)
This bill:
1) Makes the following changes relating to the Dental Board of
California (DBC):
a) Updates language to replace the "Board of Dental
Examiners" with the "Dental Board of California" for
consistency on how the Board is referenced.
SB 800 (Committee on Business, Professions and Economic
Development) Page 7 of ?
2) Makes the following changes relating to the California State
Board of Optometry:
a) Removes the requirement for out of state applicants to
submit proof of active practice.
b) Requires that the license of an out of state applicant
has never been revoked or suspended in any state where the
applicant holds a license.
c) Requires that an applicant has not been found mentally
incompetent by a licensed psychologist or licensed
psychiatrist.
3) Makes the following changes relating to the Physical Therapy
Board of California (PTBC):
a) Deletes the requirement for PTAs to complete the
18-week full-time clinical experience.
4) Makes the following changes relating to the Physician
Assistant Board (PAB):
a) Will replace the titles "chairperson" and "vice
chairperson" with "president" and "vice president".
5) Makes the following changes relating to the Medical Board of
California (MBC):
a) Clarifies that registration is required to practice as
a polysomnographic technologist, technician, or trainee in
California.
b) Requires that an individual who voluntarily cancels
his or her license must apply again if it has been over
five years since the cancellation.
c) Clarifies change that regulates when individuals can
use the words "doctor", "physician", "Dr.", or the
initials "M.D." when an individual has been issued a
license to practice medicine in another jurisdiction and
has had that license suspended or revoked.
SB 800 (Committee on Business, Professions and Economic
Development) Page 8 of ?
d) Removes a Code section referring to a repealed pilot
program that no longer exists.
e) Lists the commission of any act of sexual abuse,
misconduct, or relations with a patient, client, or
customer as grounds for suspension or revocation.
f) Authorizes the MBC to place its various allied health
care licensees and registrants on probation.
g) Reinstates language authorizing licensed midwives,
non-resident contact lens sellers, spectacle lens
dispensers, contact lens dispensers, registered dispensing
opticians, and polysomnographic technologists to petition
the MBC for reinstatement of their license or registration
after their license has been revoked, suspended,
surrendered, or placed on probation.
h) Authorizes the MBC to deny a post graduate training
authorization letter (PTAL) for international graduates.
6) Makes the following changes relating to the California Board
of Behavioral Sciences (BBS):
a) Requires the responsible board (either the BBS or the
BOP) in regulation to specify a CE provider and accept and
approve a sponsored course to provide the training in
child, elder, and dependent adult abuse assessment and
reporting.
b) Includes licensed educational psychologists (LEPs) and
licensed professional clinical counselors (LPCCs) to the
list of license types the BBS has authority to regulate.
c) Changes the reference to the current authority
regarding acceptable CE providers.
d) Requires interns to register with the BBS in order to
volunteer or work in a private practice.
e) States registrants may apply for and obtain a
subsequent registration number to work in a private
practice if the applicant meets all requirements for
registration.
SB 800 (Committee on Business, Professions and Economic
Development) Page 9 of ?
f) States the listed requirements are intended for
applicants of a license as a LCSW license.
7) Makes the following changes relating to the California Board
of Psychology (BOP):
a) Deletes section that refers to institutions that are
no longer in existence.
8) Makes the following changes relating to the California Board
of Registered Nursing (BRN):
a) Deletes title act and adds other clarifying changes.
b) Changes the name of the "Diversion Program" to
"Intervention Program for Registered Nurses".
9) Makes the following changes relating to the State of
California Acupuncture Board:
a) Removes Canada as the domestic equivalent to the
United States in regards to training and clinical
experience.
10)Makes the following changes relating to the Dental Hygiene
Committee of California (DHCC):
a) States that the DHCC is a separate entity from the
Dental Board of California and must separately create and
maintain a central file of the names of persons who hold a
license, certificate, or similar authority.
b) Removes a deadline date of January 1, 2010.
c) Repeals fee for examination for licensure as a
registered dental hygienist for third and fourth year
dental students.
11)Makes the following changes relating to the California
Veterinary Medical Board (VMB):
a) Allows the Board to deny a veterinary assistant
controlled substance permit for specified reasons.
SB 800 (Committee on Business, Professions and Economic
Development) Page 10 of ?
b) Removes ability of a person who is under sentence for
any criminal offense to petition the VMB for reinstatement
or modification of penalty.
12)Makes the following changes relating to the Telephone Medical
Advice Services Bureau (TMAS):
a) Removes references to in-state and out-of-state
registrants.
b) Adds professional clinical counselor and naturopathic
doctor licensure categories to the list of qualified
medical advice licensed health care professionals.
c) Adds additional technical, clarifying amendments.
FISCAL
EFFECT: Unknown. This bill was keyed "fiscal" by Legislative
Counsel.
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
SB 800 (Committee on Business, Professions and Economic
Development) Page 11 of ?
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) California State Board of Optometry. The requirements
for licensure as an optometrist in California for an
out-of-state licensee include submission of proof that he
or she has been in active practice in a state in which he
or she is licensed for a total of at least 5,000 hours in
five of the seven consecutive years immediately preceding
the date of his or her application (SB 579, Chapter 302,
Statutes of 2006). The applicant must submit a completed
"Certification of 5,000 Practice Hours" form with the
application. The Certification includes information
pertaining to each worksite where the hours were earned,
such as worksite addresses, dates, and number of hours
worked at each location. The applicant signs this
certification under penalty of perjury that the
information is true and correct. However, no supporting
information is required to substantiate that the
information provided is true.
When this law was first enacted in 2006, the Board wanted
to ensure that out-of-state practicing optometrists were
proficient in treating patients with therapeutic
pharmaceutical agents (TPAs) and determined that the 5,000
practice hours of experience would be sufficient to do so.
However, this requirement is now considered obsolete by
the Board and inconsistent with the licensing requirements
for new graduates.
Under current law, a recent graduate from any U.S. school
or college can apply for and obtain licensure in
California. However, if the graduate were to become
licensed in another state after graduation and then apply
for licensure in California within a two year period after
graduation, his or her application would be denied because
the applicant would not meet the 5,000 practice hour
requirement.
This bill would make a technical, clarifying amendment to
remove the requirement for out of state licensees to
SB 800 (Committee on Business, Professions and Economic
Development) Page 12 of ?
submit the 5,000 practice hour proof of practice
certification which is not required by other optometrist
licensees in California.
b) Medical Board of California (MBC). In 2009, SB 132
(Denham, Chapter 635, Statutes of 2009) created licensure
for polysomnographic technologists, technicians, and
trainees under the Medical Board of California (Board).
Polysomnography is defined as the treatment, management,
diagnostic testing, control, education, and care of
patients with sleep and wake disorders. SB 132 required
the Board to adopt regulations related to the employment
of polysomnographic technologists, technicians, and
trainees. Regulations were adopted by the Board, which
became effective on February 8, 2012.
Although SB 132 gave authority to the Board for licensure
of polysomnographic technologists, technicians, and
trainees according to specified training and education
standards, existing statute does not specifically state
that registration is required to practice as a
polysomnographic technologist, technician, or trainee in
California. Current Business and Professions Code does
not specifically list the practice of polysomnography as
one of the provisions that require registration,
licensure, certification, or other authorization by the
DCA and therefore does not make unlicensed practice of
polysomnography a punishable infraction.
Due to this ambiguity, the Board states that it has
encountered issues with pursuing action against
individuals with unlicensed practice who are practicing
polysomnography without being registered with the Board.
This bill would make a clarifying change to ensure that
individuals practicing as polysomnographic technologists,
technicians, or trainees in California are registered and
are subject to regulation by the Board.
c) California Board of Behavioral Sciences (BBS). The
California Board of Behavioral Sciences (Board) first
established a licensure program for licensed professional
clinical counselors (LPCCs) in 1967 and then for licensed
educational psychologists (LEPs) in 1970. LPCCs diagnose
SB 800 (Committee on Business, Professions and Economic
Development) Page 13 of ?
and treat mental health and emotional disorders as well as
substance abuse through counseling and other therapeutic
treatments. LEPs focus on youth and adult education as
well as the conditions, both biological and environmental,
that contribute to individual learning.
Although the Board currently licenses and regulates LPCCs
and LEPs according to specified training and education
standards, existing statute does not specifically state
that registration is required to practice as a LPCC or LEP
in California. Current Business and Professions Code does
not specifically list the practice of LPCCs or LEPs as
provisions that require registration, licensure,
certification, or other authorization by the DCA and
therefore does not make unlicensed practice as a LPCC or
LEP a punishable infraction.
This bill would make a clarifying change to ensure that
individuals practicing as a LPCC or LEP in California are
registered and are subject to regulation by the Board.
d) Dental Hygiene Committee of California (DHCC). The
Dental Hygiene Committee of California was established by
SB 853 (Perata, Chapter 31, Statutes of 2008) and came
into existence on July 1, 2009. SB 853 abolished the
Committee on Dental Auxiliaries and established the DHCC
in its place to regulate dental hygienists without the
oversight of the Dental Board of California, thus making
the DHCC a separate entity from the Dental Board.
The DHCC has the authority to review and evaluate all
registered dental hygienists, registered dental hygienists
in alternative practice, and registered dental hygienists
in extended functions, as well as applicants for licensure
and education programs. The DHCC determines the
appropriate fees and exam requirements for licensure in
the three licensure categories and issues licenses for
those who successfully complete the requirements. The
DHCC collects biennial renewal fees and forms.
Currently, the Business and Professions Code does not
include the DHCC in the list of entities required to
create and maintain an individual historical record for
SB 800 (Committee on Business, Professions and Economic
Development) Page 14 of ?
each licensee, even though the DHCC currently maintains
these records since its split from the Dental Board.
This bill would make a clarifying change to include the
DHCC in the list of entities required to create and
maintain an individual historical record for each
licensee.
e) Telephone Medical Advice Services Bureau (TMAS). The
Telephone Medical Advice Services Bureau (Bureau) was
created in 1999 by AB 285 (Corbett, Chapter 535, Statutes
of 1999). AB 285 required businesses providing telephone
medical advice to Californians, from either an in-state or
out-of-state location, to register with the Bureau.
Businesses with the equivalent of five full-time health
care practitioners whose primary function is to provide
telephone medical advice are subject to registration.
Registration involves the submission of details regarding
the company's health care professionals, quarterly reports
on the number of complaints received, and a $7,500
biennial registration fee. Bureau staff processes
applications, responds to questions from registrants and
the public, reviews complaint data, shares information
with licensing boards and the Department of Managed Health
Care, and researches as well as communicates with
companies that may require registration.
The majority of Bureau registrants are health
insurance-related companies or large health care provider
networks, including Kaiser Permanente, OptumHealth,
Accordant Health Services, and McKeeson Health Solutions.
Typically, the Bureau registrants' customers are employers
and other health care payers with whom they contract to
provide a medical advice line to covered patients. Some
of the registrants may also market directly to patients.
Most registrants utilize only registered nurses (RNs), but
some also employ licensed behavioral health professionals,
including professional clinical counselors, clinical
social workers, marriage and family therapists, and
psychologists.
Registration with the Bureau is a requirement for any
medical advice service used by health insurance companies.
The Bureau serves as a link between the Department and
SB 800 (Committee on Business, Professions and Economic
Development) Page 15 of ?
the Department of Managed Health Care. Registration has
allowed the Bureau to keep track of all of the providers
and ensures that those providing medical advice via
technology are properly licensed. Patients do not often
know the identity or location of the health care
professional from whom they receive advice, therefore
having a traceable registration system allows the state to
easily identify where medical advice is coming from and
who is providing it.
Currently, naturopathic doctors and licensed professional
clinical counselors are not included in the statutory list
of licensees that may provide medical advice through a
Bureau-registered company. Naturopathic doctors and
licensed professional clinical counselors are licensure
categories that have been created in California law since
the inception of the Bureau. The Bureau has stated that
it is aware that there is at least one naturopathic doctor
working for a Bureau-registered company and that other
registrants use the services of various categories of
licensed counselors.
This bill will make an amendment to include naturopathic
doctors and licensed professional clinical counselors in
the list of licensees that may provide medical advice
through a Bureau-registered company. This bill will also
delete language referring to either in-state or
out-of-state licensed telephone medical advice entities
since the Bureau does not currently make this distinction
for its registrants.
3. Arguments in Support. The Medical Board of California (MBC)
supports this measure and writes, "The Board is supportive of
the provisions in SB 800 that pertain to the Board?The Board
feels that these clarifying changes 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 (MBC)
SB 800 (Committee on Business, Professions and Economic
Development) Page 16 of ?
Opposition:
None on file as of April 21, 2015.
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