BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: SB 1039 Hearing Date: April 18,
2016
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|Author: |Hill |
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|Version: |April 12, 2016 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Bill Gage |
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Subject: Professions and vocations
SUMMARY: This is an omnibus bill which includes several changes to a
number of boards under the Department of Consumer Affairs and
also includes specified fee increases for several boards
including the Board of Registered Nursing, the Pharmacy Board,
the Contractors State License Board and the Court Reporters
Board. This measure would also eliminate the current Telephone
Medical Advice Services Bureau.
Existing law:
1)Requires the Office of Statewide Health Planning and
Development to establish the Health Professions Education
Foundation to, among other things, solicit and receive funds
for the purpose of providing scholarships, as specified.
(Health and Safety Code (HSC) § 128330 et seq.)
2)Contains the following provisions relating to the Dental Board
of California (DBC):
a) Provides for the licensure and regulation of persons
engaged in the practice of dentistry by the DBC which is
within the Department of Consumer Affairs (DCA). (Business
and Professions Code (BPC) § 1600 et seq.)
b) Provides that the DBC shall be responsible for the
approval of foreign dental schools, as specified, and that
the DBC may contract with outside consultants or a national
SB 1039 (Hill) Page 2
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professional organization to survey and evaluate foreign
dental schools and that the consultant or organization
shall report to the DBC regarding its findings in the
survey and evaluation. (BPC § 1636.4 (b))
c) Requires the DBC to establish a technical advisory group
to review and comment upon the survey and evaluation of a
foreign dental school by the outside consultant or
organization prior to any final action taken by the DBC
regarding certification of the foreign dental school and
that the technical advisory shall consist of members, as
specified. (BPC § 1636.4 (c))
d) Specifies that any foreign dental school that wishes to
be approved by the DBC shall make an application to the DBC
for its approval, which shall be based upon a finding by
the DBC that the educational program of the foreign dental
school is equivalent to that of similar accredited
institutions in the United States and adequately prepares
its students for the practice of dentistry; that
curriculum, faculty qualifications, student attendance,
plant and facilities, and other factors shall be reviewed
and evaluated by the DBC; and that the DBC shall identify
by rule the standards and review procedures and methodology
to be used in the approval process and that the DBC shall
not grant approval if deficiencies found are of such
magnitude as to prevent the students in the school from
receiving an educational base suitable for the practice of
dentistry. (BPC § 1636.4 (d))
e) Requires the DBC to make periodic surveys and
evaluations of all approved schools to ensure continued
compliance with those standards and qualifications, as
specified above, and that the DBC may provide for
provisional approval of foreign dental schools so that the
school has an opportunity to provide evidence that
deficiencies noted at the time of initial application have
been remedied and that permanent approval may be granted.
(BPC § 1634 (e))
f) States that a school shall pay a registration fee
established by rule of the DBC, not to exceed one thousand
dollars ($1,000), at the time of application of approval
and shall pay all reasonable costs and expenses the DBC
SB 1039 (Hill) Page 3
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incurs for the conduct of the approval survey. (BPC § 1634
(f))
3)Contains the following provisions relating to the California
Board of Podiatric Medicine (BPM):
a) Creates the BPM within the jurisdiction of the Medical
Board of California.
(BPC § 2460)
b) Provides that certificates to practice podiatric
medicine and registrations of spectacle lens dispensers and
contact lens dispensers, among others, expire on a certain
date during the second year of a 2-year term if not
renewed. (BPC § 2423)
4)Contains the following provisions relating to the Board of
Registered Nursing (BRN):
a) Provides for the licensure and regulation of nurse
practitioners by the BRN which is within the DCA. (BPC §
2700 et seq.)
b) Requires the BRN to adopt regulations establishing
standards for continuing education for licensees, as
specified, and that the standards shall take cognizance of
specialized areas of practice. (BPC § 2811.5)
c) Prescribes various fees to be paid by licensees and
applicants for licensure for the BRN and requires these
fees to be credited to the BRN Fund, which is a
continuously appropriated fund as it pertains to fees
collected by the BRN.
(BPC §§ 2786.5, 2815, 2815.5, 2830.7 and 2838.2.)
5)Contains the following provisions relating to the California
State Board of Pharmacy (BOP):
a) Provides for the licensure and regulation of pharmacists
by the BOP within the DCA. (BPC § 4000 et seq.)
b) Prescribes various fees to be paid by licensees and
applicants for licensure, and requires all fees collected
on behalf of the BOP to be credited to the BOP Contingent
SB 1039 (Hill) Page 4
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Fund, which is continuously appropriated as it pertains to
fees collected by the BOP. (BPC § 4400)
6)Requires the certain businesses that provide telephone medical
advice services to a patient at a California address to be
registered with the Telephone Medical Advice Services Bureau
and further requires telephone medical advice services to
comply with the requirements established by the DCA, among
other provisions, as specified. (BPC § 4999 et seq.)
7)Contains the following provisions relating to the Contractors
State License Board (CSLB):
a) Provides for the licensure and registration of
contractors by the CSLB within the DCA. (BPC § 7000 et
seq.)
b) Prescribes various fees to be paid by licensees and
applicants for licensure with the CSLB, and requires fees
and civil penalties received under the Contractors' State
License Law to be deposited in the Contractors' License
Fund, which is a continuously appropriated fund as it
pertains to fees collected by the CSLB.
(BPC §§ 7137 and 7153.3)
8)Contains the following provisions relating to the Court
Reporters Board (CRB):
a) Provides for the licensure and regulation of shorthand
reporters by the CRB within the DCA. (BPC § 8000 et seq.)
b) Authorizes the CRB by resolution to establish a fee for
renewal of a certificate issued by the CRB not to exceed
$125, as specified, and that all fees and revenues received
by the CRB are deposited into the Court Reporters' Fund,
which is a continuously appropriated fund as it pertains to
fees collected by the CRB. (BPC § 8031)
9)Contains the following provisions relating to the Structural
Pest Control Board (SPCB):
a) Provides for the licensure and regulation of structural
pest control operators and registered companies, as
defined, by the Structural Pest Control Board (SPCB), which
SB 1039 (Hill) Page 5
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is within the DCA and requires a licensee to pay a
specified fee.
(BPC § 8500 et seq.)
b) Places certain requirements on a registered company or
licensee with regards to wood destroying pests or
organisms, including that a registered company or licensee
is prohibited from commencing work on a contract until an
inspection has been made by a licensed Branch 3 field
representative, as defined, or operator, that the address
of each property inspected or upon which work was completed
is required to be reported to the SPCB, as specified, and
that a written inspection report be prepared and delivered
to the person requesting the inspection or his or her
agent. Also requires that the original inspection report
to be submitted to the SPCB upon demand; for the written
report to contain certain information, including a
foundation diagram or sketch of the structure or portions
of the structure inspected; and requires the report, and
any contract entered into, to expressly state if a
guarantee for the work is made, and if so, the terms and
time period of the guarantee. (BPC §§ 8516 and 8519)
c) Defines control service as the regular inspection of a
property after a report has been made in compliance with
the requirements of an inspection as specified above, and
any corrections as have been agreed upon and have been
completed. (BPC § 8516 (g)).
This bill:
1)Makes the following changes relating to the Dental Board of
California (DBC):
a) Declares that it is the intent of the Legislature to
enact future legislation that would establish a Dental
Corps Scholarship Program, as specified, to increase the
supply of dentists serving in medically underserved areas.
b) Authorizes the DBC, in lieu of conducting its own survey
and evaluation of a foreign dental school, to accept the
findings of any commission or accreditation agency approved
by the DBC, if the findings meet the DBC's specified
standards and allows the DBC to adopt those findings as
SB 1039 (Hill) Page 6
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their own.
c) Specifies that the new requirements for approval of
foreign dental schools as described above would not apply
to any foreign dental school currently seeking approval by
the DBC prior to January 1, 2017.
d) Deletes the requirement for the DBC to establish a
technical advisory group.
2)Makes the following changes relating to the Board of Podiatric
Medicine (BPM):
a) Creates the BPM within the DCA rather than having the
BPM within the jurisdiction of the Medical Board of
California (MBC).
b) Revises the requirement that certificates to practice
podiatric medicine expire at 12 midnight on the last day of
the birth month of the licensee during the second year of a
two-year term if not renewed and provides for requirements
for renewal of an unexpired certificate.
c) Makes other technical and conforming changes regarding
the BPM.
3)Makes the following changes relating to the Board of
Registered Nursing (BRN):
a) Specifies that the standards established for continuing
education for nurses shall take cognizance of specialized
areas of practice, as currently required, but in addition
the content shall be relevant to the practice of nursing
and shall be related to the scientific knowledge or
technical skills required for the practice of nursing or be
related to direct or indirect patient or client care.
b) Requires the BRN to audit continuing education providers
at least once every five years to ensure adherence to
regulatory requirements, and shall withhold or rescind
approval from any provider that is in violation of the
regulatory requirements.
c) Prescribes various fee changes to be paid by licensees
SB 1039 (Hill) Page 7
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and applicants for licensure and requires these fees to be
credited to the BRN Fund, which is a continuously
appropriated fund as it pertains to fees collected by the
BRN and also would raise specified fees, and would provide
for additional fees to be paid by licensees and applicants
for licensure as well as by schools seeking approval by the
BRN.
4)Makes the following change relating to the California State
Board of Pharmacy (BOP):
a) Modifies, on or after July 1, 2017, specified fees to be
paid by the licensees and applicants for licensure with the
BOP.
5)Makes the following change relating to the Telephone Medical
Advice Services Bureau (Bureau):
a) Eliminates the Bureau and repeals the requirement that
certain businesses that provide telephone medical advice
services to a patient at a California address to be
registered with the Bureau.
b) Eliminates other related provisions in the Health and
Safety Code and the Insurance Code regarding telephone
medical advice services.
6)Makes the following change relating to the Contractors State
License Board (CSLB):
a) Raises specified fees to be paid by the licensees and
applicants to the CSLB and would also require the CSLB to
establish criteria for the approval of expedited processing
applications, as specified.
7)Makes the following change relating to the Court Reporters
Board (CRB):
a) Raises the renewal fee limit to be assessed by the CRB
from $125 to $250.
8)Makes the following change relating to the Structural Pest
Control Board (SPCB):
SB 1039 (Hill) Page 8
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a) Requires the operator licensed and regulated by the SPCB
prior to conducting an inspection as specified in Item #
21, above, to be employed by a registered company, except
as specified.
b) Requires that the written inspection report be prepared
and delivered to the person requesting it, the property
owner, or the property owner's designated agent, as
specified, and would not require the address of an
inspection report prepared for use by an attorney for
litigation to be reported the SPCB or assessed a filing
fee.
c) Allows an inspection report to be a complete, limited,
supplemental or reinspection report, as defined.
d) Requires all inspection reports to be submitted to the
SPCB and maintained with field notes, activity forms, and
notices of completion until one year after the guarantee
expires if the guarantee extends beyond 3 years.
e) Requires the inspection report to clearly list the
infested or infected wood members or parts of the structure
identified in the required diagram or sketch.
f) Clarifies the definition of "control service agreement"
as an agreement, including extended warranties, to have a
licensee conduct over a period of time regular inspections
and other activities related to the control or eradication
of wood destroying pests and organisms.
g) Makes other clarifying and technical changes regarding
the SPCB.
FISCAL
EFFECT: Unknown. This bill has been keyed "fiscal" by
Legislative Counsel.
COMMENTS:
1.Purpose. This measure is sponsored by the Author. According
to the Author this bill is intended to be an omnibus bill
which includes several changes to a number of boards under the
Department of Consumer Affairs and would also include
SB 1039 (Hill) Page 9
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necessary fee increases for certain boards to ensure they
continue to operate without a major structural deficit and
maintain adequate reserves. With the advent of the BreEZe
project, which is an attempt to replace multiple antiquated
standalone information technology (IT) systems for most of the
boards under the DCA, some boards have anticipated what may be
significant costs and have also provided projections of future
fund conditions which show less than possibly 3 months in
reserve because of overall increased budgetary costs for these
individual boards. (Typically, boards consider seeking fee
increases when they project their funds in will be at, or dip
below, a three-month reserve.)
This measure also provides the Dental Board with the ability to
rely on a national accrediting agency in approving foreign
dental schools, makes other clarifying substantive changes for
the Structural Pest Control Board in regards to inspection
conducted by structural pest control operators and their
companies and eliminates the Telephone Advice Medical Services
Bureau which is no longer necessary to provide oversight of
remote advice provided by healthcare practitioners.
2.Background. The following is background and reasons for the
more significant and substantive provision in this measure:
a) DBC Approval of Foreign Dental Schools. In 1997, the
Legislature recognized the need to ensure that graduates of
foreign dental schools who have received an education that
is equivalent to that of accredited institutions in the
United States and that adequately prepares their students
for the practice of dentistry shall be subject to the same
licensure requirements as graduates of approved dental
schools or colleges.
AB 1116 (Keeley) was introduced and supported by a
coalition of various professional dental organizations,
because the process at the time for evaluating foreign
dental school graduates was observed to be inadequate
primarily because there was no effective way for the DBC to
evaluate the quality of dental education received by
foreign dental school graduates. Additionally, the
analysis indicated that California's licensing standards
for foreign dental graduates were unusually lenient and out
of sync with the requirements in the rest of the United
SB 1039 (Hill) Page 10
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States. The sponsor and supporters of this bill advocated
for the passage of AB 1116 in order for California to move
to a stricter and more uniform educational standard to
assure that all licensed dentists are equally qualified.
AB 1116 was signed by the Governor on October 7, 1997 and
required, in pertinent part, the following:
a) Revision of the requirements for licensure of
applicants who are graduates of foreign dental
schools;
b) The Board to be responsible for the approval
of foreign dental schools based on prescribed
standards (California Code of Regulations § 1024.1);
and
c) Establishment of procedures regarding this
approval process.
In addition, the Legislature urged all California dental
schools to provide in their curriculum a two year course of
study that may be used by graduates of foreign dental
schools to attain the prerequisites for licensure in
California.
Since the implementation of AB 1116 in 2003, there have
been a limited number for foreign dental schools seeking
DBC approval. One school in Mexico has been approved and
one school in Moldova is in the application process. It is
important to specify that the DBC does not "accredit"
dental schools, but rather evaluates foreign dental schools
in order to determine that the education is equivalent with
the accredited institutions in the United States.
Accreditation of dental education programs in the United
State has been vested in the Commission on Dental
Accreditation (CODA) by the United States Department of
Education. Educational standards are established by the
CODA and revised as knowledge, techniques, and technology
affects the educational needs and goals of dental education
and thus, the practice of dentistry in the United States.
The DBC accepts dental education programs that are
accredited by the CODA as meeting the educational
requirements for dental licensure in California. The CODA
was established in 1975 and recognized by the United States
Department of Education as the sole agency to accredit
SB 1039 (Hill) Page 11
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dental and dental-related education programs conducted at
the post-secondary level in the United States.
Prior to 2003, the CODA did not have in place processes for
the review and approval of foreign dental schools.
Therefore, the only alternative at that time, to be
compliant with statutory requirement, was to establish a
process by which the DBC would be responsible for the
approval of foreign dental schools.
Since 2003, the CODA has established processes for review
and accreditation of foreign dental schools' education
programs. International consultation and accreditation
fee-based services are available to international
pre-doctoral dental education programs, upon request. Once
an international dental education program meets the
established criteria, consultation and accreditation
services will be provided in accordance with the CODA
policies and procedures.
This measure will allow the DBC to accept the findings of a
CODA approved foreign dental school in lieu of conducting
its own evaluation. This would also alleviate the
necessity of forming a technical advisory group, which adds
an extra layer of review that is unnecessary.
a) Clarify Jurisdiction of the BPM. Technical changes
striking references to the Medical Board of California
(MBC) in the podiatry practice act are intended to reflect
the independent status of each board. While the BPM was
once housed within the MBC, it has been an independent
entity since the late 1980's and relies on the MBC only for
contractually specified duties, which the MBC provides for
other boards, as well. The BPM is independently
responsible for determining the eligibility of its
licensees and making final disciplinary decisions.
b) Clarify Continuing Education (CE) Requirements for the
BRN and Provide for Various Fee Increases. CE Changes .
All BRN licensees are required by statute to complete 30
hours of CE during each two year renewal cycle to ensure
continued competence. Licensees are required to submit
proof of their compliance by signing a statement under
penalty of perjury and agreeing to produce documentation
upon request. The BRN relies on adherence to CE standards
SB 1039 (Hill) Page 12
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as the primary method of assuring the continued competence
of its licensees, but it has not institutionalized regular
audits of licensees' CEs or CE providers (CEPs) since 2002.
This issue was raised in the 2011 Sunset Review Report.
Prior to 2002, the BRN conducted random audits of CEs and
CEPs, averaging 2,700 RN CEs and 282 CEPs per year. The
BRN completed only 200 RN CE audits from 2011 to 2014 and
no CEP audits since 2001, citing lack of staff. This is
particularly concerning because the BRN acknowledges that
CE compliance is "essential to ensure public safety and
protection." While BRN reports having made multiple
requests in the past 14 years to obtain additional staffing
for audits, it only very recently redirected existing staff
towards this work.
A 2009 article titled, "State-Sponsored Quackery: Feng
Shui and Snake Oil for California Nurses" detailed the
BRN's lax CEP approval process. Reporters uncovered a
nursing CEP called Clearsight, which offered credits for a
class in "energetic medicine." "Energetic medicine" is
Clearsight's name for therapeutic touch, the manipulation
of alleged energy fields such as chakras and auras over the
body. (The practitioner's hands make no actual contact with
the patient.) ?. Clearsight introduces you to the skills of
Free Will, the art of energy diagnosis, how to make
Separations from your Healee so you do not take another
person's energy or disease home and how to release old
patterns and stuck energy in your body and auric field.
When you use Clearsight healing skills you clear and clean
the entire energy field (chakras, channels and aura) and
grow and evolve evenly at the rate of growth you are ready
to access."
After some prodding to remind BRN that Clearsight's
provider application was public record, the reporter
received a copy of the application and discovered that
it was blank in some places and that the instructor's
educational credentials consisted of a BA in
comparative religion and a ministerial certificate
from the Church of Divine Man, a psychic institute
that offers healings, psychic readings, and other such
SB 1039 (Hill) Page 13
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activities. Clearsight is no longer an approved CEP,
but only because its license lapsed in 2014; no
disciplinary actions were ever taken against it. This
is understandable because, as the article notes, the
BRN supported the approval of CEPs that promote
education with little to no scientific merit.
Refinement of CEP regulations have not since occurred.
There was an additional article in 2016 titled, "The
Miseducation of California Nurses: Legal Loophole
Enables Spread of Anti-Choice Medical Myths," which
highlighted a BRN CE Provider, Heartbeat
International, offering credits to nurses who take a
class about undoing a pill-induced abortion; a
procedure unsupported by sufficient evidence. When
confronted with the information, the BRN was basically
nonresponsive to the reporter and cited code sections
that restate that the BRN approves the provider and
the provider accepts full responsibility for course
content and instructor qualifications. According to
the acting EO, the BRN began looking further into the
CE provider when the reporter started looking into
them for this story. BRN indicated they do not audit
CE providers regularly, but do look into them when an
issue with one is raised.
During the comprehensive sunset review oversight of
the BRN in 2015 conducted by the Senate Committee on
Business, Professions and Economic Development and
Assembly Committee on Business and Professions
(Committees), staff recommended the following: "The
BRN should review its criteria for CEPs and require
content to be science-based and directly related to
professionally appropriate practice. The BRN should
continue to pursue additional staffing for CE
auditors, but should simultaneously rebalance its
existing workload and prioritize ongoing CE and CEP
audits."
This measure reflects the recommendation made in 2015
during sunset review and would provide more staffing to
audit CE provided pursuant to the fee increase.
Fee Changes . The BRN Fund is maintained by the BRN and
SB 1039 (Hill) Page 14
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includes the revenues and expenditure related to licensing
nurses. According to the BRN, the cause of its projected
deficit is an ongoing problem. Annual increases in
enforcement expenditures (Attorney General, Office of
Administrative Hearings, and Evidence/Witness fees) since
approximately FY 2010/11 were able to be absorbed as a
result of budget bill language in FY 2010/11. However, the
following have been annual increases from FY 2010/11 to FY
2014/15 and projected for FY 2015/16: $2,278,000 million
in FY 2010/11, along with an additional $2,872,338 through
budget bill language in FY 2010/11, $2,284,607 million in
FY 11/12, $4,074,512 million in FY 13/14, a BCP
augmentation of $2,700,000 million along with an additional
$3,330,833 in FY 14/15, and $1,820 million projected in FY
15/16. Also, increasing costs to the BRN as a result of
unanticipated BreEZe cost increases (which increased from
$2,444,396 million in FY 2014/15 to $5,182,708 million in
FY 2015/16 and $4,997,301 in FY 2016/17). As of March 31,
2016, the BRN has expended approximately $10,596,070 on
BreEZe.
The BRN further indicates that as a result of the high
volume of work regularly referred to the Office of the
Attorney General, they have requested additional deputies
beginning in FY 2016/17 and 10 senior legal analysts to
comply with the data reporting requirements contained in SB
467 (Hill, Chapter 656, Statutes of 2015). The BRN will
have to help pay for these augmentations if approved by the
Legislature and the Governor.
The BRN notes that fees were increased for the first time
in 19 years in 2011 when enforcement was authorized
additional staff of 34 and then 27 more staff in 2014/15.
Fees were increased to the current statutory limit
beginning in October 2015, as approved by the Office of
Administrative Law.
Due to the addition of the approximately 61 enforcement
positions as indicated above, the BRN has been without
comparable administrative support in the area of
information technology, human resources, supply
coordination and delivery, mail delivery, etc. The BRN
also transitioned from its legacy systems into BreEZe in
October 2013 and did not fully understand or appreciate the
SB 1039 (Hill) Page 15
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length of time it would take until well after the initial
go-live date to use the system to cashier money, approve
applicants to take the registered nurse licensure exam,
issue licenses, complete license renewals, issue license
verifications, etc. As a result, the BRN is in need of
additional funding to support and improve the call center,
cashiering, license renewals, licensee support, initial
licensing, administrative support, legislation,
contracting, social media and public records act requests.
The BRN also underwent a fee audit of all fees to determine
whether the BRN was charging appropriate fees in order to
conduct its business at an adequate service level to
provide public protection. It was found that the BRN has
not been charging enough fees for many areas and has not
been collecting enough fees to support the increased
enforcement efforts. The proposed fee increases for the
BRN are as follows:
----------------------------------------------------
|Fee Names |Current| Board | Board |
| | Fees |Proposed|Proposed|
| | | | Fee |
| | |Minimum | Caps |
| | | Fees | |
|--------------------------+-------+--------+--------|
|INITIAL APPLICATIONS | | | |
|--------------------------+-------+--------+--------|
|Interim permit - | $50 | $100 | $250|
|registered nurse | | | |
|--------------------------+-------+--------+--------|
|Temporary certificate - | $50 | $100 | $250|
|registered nurse | | | |
|--------------------------+-------+--------+--------|
|Temporary certificate - | $50 | $100 | $250|
|public health nurse | | | |
|--------------------------+-------+--------+--------|
|Temporary certificate - | $50 | $150 | $500|
|nurse anesthetist | | | |
|--------------------------+-------+--------+--------|
|Temporary certificate - | $50 | $150 | $500|
|nurse midwife | | | |
|--------------------------+-------+--------+--------|
|Temporary certificate - | $50 | $150 | $500|
SB 1039 (Hill) Page 16
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|nurse practitioner | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Initial exam app - | $150 | $300 | $1,000|
|registered nurse (CA | | | |
|grad) | | | |
|--------------------------+-------+--------+--------|
|Initial exam app - | None| $350 | $1,000|
|registered nurse | | | |
|(Out-of-state) | | | |
|--------------------------+-------+--------+--------|
|Initial exam app - | None| $750 | $1,500|
|registered nurse | | | |
|(International) | | | |
|--------------------------+-------+--------+--------|
|Repeat exam app - | $150 | $250 | $1,000|
|registered nurse | | | |
|--------------------------+-------+--------+--------|
|Endorsement app - | $100 | $350 | $1,000|
|registered nurse | | | |
|(Out-of-state) | | | |
|--------------------------+-------+--------+--------|
|Endorsement app - | None| $750 | $1,500|
|registered nurse | | | |
|(International) | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Initial app - public | $150 | $300 | $1,000|
|health nurse | | | |
|--------------------------+-------+--------+--------|
|Initial app - clinical | $150 | $500 | $1,500|
|nurse specialist | | | |
|--------------------------+-------+--------+--------|
|Initial app - nurse | $150 | $500 | $1,500|
|anesthetist | | | |
|--------------------------+-------+--------+--------|
|Initial app - nurse | $150 | $500 | $1,500|
|midwife | | | |
|--------------------------+-------+--------+--------|
|Initial app - nurse | $150 | $400 | $1,500|
|midwife furnishing | | | |
|--------------------------+-------+--------+--------|
SB 1039 (Hill) Page 17
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|Initial app - nurse | $150 | $500 | $1,500|
|practitioner | | | |
|--------------------------+-------+--------+--------|
|Initial app - nurse | $150 | $400 | $1,500|
|practitioner furnishing | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Psychiatric mental health | None| $350 | $750|
|nurse listing app | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Initial app - continuing | $300 | $500 | $1,000|
|education provider | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Initial app - new school |$5,000 |$40,000 | $80,000|
|of nursing | | | |
|--------------------------+-------+--------+--------|
|RENEWAL APPLICATIONS | | | |
|--------------------------+-------+--------+--------|
|Renewal app - registered | $150 | $180 | $750|
|nurse | | | |
|--------------------------+-------+--------+--------|
|Renewal app - registered | None| $350 | $1,000|
|nurse 8-year, no exam | | | |
|--------------------------+-------+--------+--------|
|Renewal app - public | None| $125 | $500|
|health nurse | | | |
|--------------------------+-------+--------+--------|
|Renewal app - clinical | $100 | $150 | $1,000|
|nurse specialist | | | |
|--------------------------+-------+--------+--------|
|Renewal app - nurse | $100 | $150 | $1,000|
|anesthetist | | | |
|--------------------------+-------+--------+--------|
|Renewal app - nurse | $100 | $150 | $1,000|
|midwife | | | |
|--------------------------+-------+--------+--------|
|Renewal app - nurse | $30 | $150 | $1,000|
|midwife furnishing | | | |
|--------------------------+-------+--------+--------|
SB 1039 (Hill) Page 18
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|Renewal app - nurse | None| $150 | $1,000|
|practitioner | | | |
|--------------------------+-------+--------+--------|
|Renewal app - nurse | $30 | $150 | $1,000|
|practitioner furnishing | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Renewal app - continuing | $200 | $250 | $1,000|
|education provider | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Continuing approval - |$3,500 |$15,000 | $30,000|
|school of nursing | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Delinquent renewal - | $65 | $90 | $375|
|registered nurse | | | |
|--------------------------+-------+--------+--------|
|Delinquent renewal - | None| $63 | $250|
|public health nurse | | | |
|--------------------------+-------+--------+--------|
|Delinquent renewal - | $37 | $75 | $500|
|clinical nurse specialist | | | |
|--------------------------+-------+--------+--------|
|Delinquent renewal - | $37 | $75 | $500|
|nurse anesthetist | | | |
|--------------------------+-------+--------+--------|
|Delinquent renewal - | $37 | $75 | $500|
|nurse midwife | | | |
|--------------------------+-------+--------+--------|
|Delinquent renewal - | $15 | $75 | $500|
|nurse midwife furnishing | | | |
|--------------------------+-------+--------+--------|
|Delinquent renewal - | None| $75 | $500|
|nurse practitioner | | | |
|--------------------------+-------+--------+--------|
|Delinquent renewal - | $15 | $75 | $500|
|nurse practitioner | | | |
|furnishing | | | |
|--------------------------+-------+--------+--------|
| | | | |
SB 1039 (Hill) Page 19
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|--------------------------+-------+--------+--------|
|Delinquent renewal - | $100 | $125 | $500|
|continuing education | | | |
|provider | | | |
|--------------------------+-------+--------+--------|
|MISCELLANEOUS FEES | | | |
|--------------------------+-------+--------+--------|
|Duplicate - pocket | $50 | $50 | $75|
|license | | | |
|--------------------------+-------+--------+--------|
|Duplicate - wall | $30 | $60 | $100|
|certificate | | | |
|--------------------------+-------+--------+--------|
|License certification - | $2 | $20 | $30|
|simple letter | | | |
|--------------------------+-------+--------+--------|
|License verification - | $60 | $100 | $200|
|endorsement out-of-state | | | |
|--------------------------+-------+--------+--------|
|License verification - | $60 | $100 | $200|
|international credentials | | | |
|--------------------------+-------+--------+--------|
|Duplicate - NCLEX-RN exam | None| $60 | $100|
|results | | | |
|--------------------------+-------+--------+--------|
|Copy - transcripts | $30 | $50 | $100|
|out-of-state | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Major curriculum change - | $500 | $2,500| $5,000|
|school of nursing | | | |
|--------------------------+-------+--------+--------|
| | | | |
|--------------------------+-------+--------+--------|
|Modification of penalty - | None| $50| $50|
|probation | | | |
|--------------------------+-------+--------+--------|
|Petition for | None| $50|$50 |
|reinstatement | | | |
----------------------------------------------------
d) Provide for Various Fee Increases for the Board of
Pharmacy (BOP). The BOP current statutory authority
SB 1039 (Hill) Page 20
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establishes both a minimum and maximum level for all fees.
The BOP uses its regulatory authority to establish each fee
within this range. As a result of a regulatory change that
took effect July 1, 2014, with few exceptions, all of the
BOP's fees are at their statutory maximums. The BOP
indicates that it is seeking to realign its current fee
structure to address a structural imbalance in its current
budget resulting from an increase in annual authorized
expenditures that is not offset by a corresponding increase
in revenue. As a precursor to establishing the new fee
schedules, the DCA's Budget Office completed a fee analysis
of the BOP's fund condition and fee structure in late 2015.
As part of its assessment, the DCA noted that the board is
currently required to maintain a reserve level of one year.
As of July 1, 2015, the board fund reserve was 4.9 months
and is projected to drop to 3.0 months in reserve on July
1, 2016. The BOP considered the findings of the DCA when
considering establishment of new fees. The assessment by
the DCA concluded that the board's current fee levels are
not sufficient to keep the board's fund solvent in the long
term, and will lead to a deficit early in FY 2018/19.
Specifically, the BOP's fund is expected to drop to about
three months in reserve in FY 2016/17 and will go into
deficit thereafter.
Currently, the BOP's authorized and actual expenditures
exceed actual revenue. Based on projections provided by
the DCA, in FY 2014/15 this deficit was about $1.14 million
or 6 percent shortfall. Based on projections for FY
2015/16 the deficit will grow to $3.5 million or 20 percent
shortfall. By FY 2017/18, the deficit is projected to be
$4.2 million or 26 percent shortfall and the BOP's budget
will become all but insolvent with only 0.1 months in
reserve on July 1, 2018.
The reason for the deficit according to the BOP is that over
the last five fiscal years its authorized expenditures
increased by approximately 50 percent. The growth is
primarily in the BOP's enforcement expenditures and
reflects continued focus on its mandate as well as its
focus on responding to change that impact the BOP's
jurisdiction (e.g., Consumer Protection Enforcement
Initiative from FY 2010-11, prescription drug abuse
epidemic, sterile compounding).
SB 1039 (Hill) Page 21
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The proposed fee increases for the BOP are as follows:
---------------------------------------------------------------
| Current Fee, Proposed Statutory Minimum Fee, |
| Proposed Statutory Maximum Fee, and Percentage Change |
| |
---------------------------------------------------------------
|------------------------+---------+--------+--------+----------|
| | Current |Proposed|Proposed|Percentage|
|Fee Type | Fee | | | |
| | |Statutor|Statutor| Change |
| | | y | y | from |
| | |Minimum |Maximum | Current |
| | | | | to |
| | | | | Proposed |
| | | | |Statutory |
| | | | | Minimum |
|------------------------+---------+--------+--------+----------|
|Centralized Hospital | $800 | $820 | $1,150 | 3% |
|Packaging | | | | |
|------------------------+---------+--------+--------+----------|
|Clinic Permit | $520 | $520 | $570 | 0% |
|------------------------+---------+--------+--------+----------|
|Designated | $330 | $150 | $210 | -55% |
|Representative | | | | |
|Certificate - Third | | | | |
|Party Logistics | | | | |
|Provider | | | | |
|------------------------+---------+--------+--------+----------|
|Designated | $330 | $150 | $210 | -55% |
|Representative | | | | |
|Certificate - | | | | |
|Veterinary Food-Animal | | | | |
|Drug Retailers | | | | |
|------------------------+---------+--------+--------+----------|
|Designated | $330 | $150 | $210 | -55% |
|Representative | | | | |
|Certificate - | | | | |
|Wholesalers | | | | |
|------------------------+---------+--------+--------+----------|
|Hypodermic Needle and | $165 | $170 | $240 | 3% |
|Syringe | | | | |
SB 1039 (Hill) Page 22
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|------------------------+---------+--------+--------+----------|
|Intern Pharmacist | $115 | $165 | $230 | 43% |
|------------------------+---------+--------+--------+----------|
|Non-Resident Pharmacy | $520 | $520 | $570 | 0% |
|------------------------+---------+--------+--------+----------|
|Non-Resident Sterile | $780 | $2,380 | $3,335 | 205% |
|Compounding | | | | |
|------------------------+---------+--------+--------+----------|
|Non-Resident Third | $780 | $780 | $820 | 0% |
|Party Logistics | | | | |
|Provider | | | | |
|------------------------+---------+--------+--------+----------|
|Non-Resident Wholesaler | $780 | $780 | $820 | 0% |
|------------------------+---------+--------+--------+----------|
|Pharmacist Initial | $195 | $195 | $215 | 0% |
|License Fee | | | | |
|------------------------+---------+--------+--------+----------|
|Pharmacist Licensure | $260 | $260 | $285 | 0% |
|Exam | | | | |
|------------------------+---------+--------+--------+----------|
|Pharmacy | $520 | $520 | $570 | 0% |
|------------------------+---------+--------+--------+----------|
|Pharmacy Technician | $105 | $140 | $195 | 33% |
|------------------------+---------+--------+--------+----------|
|Sterile Compounding | $780 | $1,645 | $2,305 | 111% |
|------------------------+---------+--------+--------+----------|
|Third Party Logistics | $780 | $780 | $820 | 0% |
|Provider | | | | |
|------------------------+---------+--------+--------+----------|
|Veterinary Food-Animal | $425 | $435 | $610 | 2% |
|Drug Retailer | | | | |
|------------------------+---------+--------+--------+----------|
|Wholesale Drug | $780 | $780 | $820 | 0% |
|------------------------+---------+--------+--------+----------|
| | | | | |
---------------------------------------------------------------
----------------------------------------------------------------
| Current Fee, Proposed Statutory Minimum Fee, |
| Proposed Statutory Maximum Fee, and Percentage Change |
| |
----------------------------------------------------------------
---------------------------------------------------------------
| | Current |Proposed|Proposed|Percentage|
|Fee Type | Fee | | | |
SB 1039 (Hill) Page 23
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| | |Statutor|Statutor| Change |
| | | y | y | from |
| | |Minimum |Maximum | Current |
| | | | | Fee to |
| | | | | Proposed |
| | | | |Statutory |
| | | | | Minimum |
| | | | | Fee |
---------------------------------------------------------------
|Centralized Hospital | $800 | $805 | $1,125 | 1% |
|Packaging Renewal | | | | |
---------------------------------------------------------------
|Clinic Renewal | $325 | $325 | $360 | 0% |
---------------------------------------------------------------
|Designated | $195 | $215 | $300 | 10% |
|Representative | | | | |
|Certificate - Third | | | | |
|Party Logistics | | | | |
|Provider Renewal | | | | |
---------------------------------------------------------------
|Designated | $195 | $215 | $300 | 10% |
|Representative - | | | | |
|Veterinary Food-Animal | | | | |
|Drug Retailers Renewal | | | | |
---------------------------------------------------------------
|Designated | $195 | $215 | $300 | 10% |
|Representative - | | | | |
|Wholesalers Renewal | | | | |
---------------------------------------------------------------
|Hypodermic Needle and | $165 | $200 | $280 | 21% |
|Syringe Renewal | | | | |
---------------------------------------------------------------
|Non-Resident Pharmacy | $325 | $325 | $360 | 0% |
|Renewal | | | | |
---------------------------------------------------------------
|Non-Resident Sterile | $780 | $2,270 | $3,180 | 191% |
|Compounding Renewal | | | | |
---------------------------------------------------------------
|Non-Resident Third | $780 | $780 | $820 | 0% |
|Party Logistics | | | | |
|Provider Renewal | | | | |
---------------------------------------------------------------
|Non-Resident Wholesaler | $780 | $780 | $820 | 0% |
|Renewal | | | | |
SB 1039 (Hill) Page 24
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---------------------------------------------------------------
|Pharmacist Renewal | $195 | $360 | $505 | 85% |
---------------------------------------------------------------
|Pharmacy Renewal | $325 | $665 | $930 | 105% |
---------------------------------------------------------------
|Pharmacy Technician | $130 | $140 | $195 | 8% |
|Renewal | | | | |
---------------------------------------------------------------
|Sterile Compounding | $780 | $1,325 | $1,855 | 70% |
|Renewal | | | | |
---------------------------------------------------------------
|Third Party Logistics | $780 | $780 | $820 | 0% |
|Provider Renewal | | | | |
---------------------------------------------------------------
|Veterinary Food-Animal | $325 | $330 | $460 | 2% |
|Drug Retailer | | | | |
|Renewal | | | | |
|------------------------+---------+--------+--------+----------|
|Wholesale Drug Renewal | $780 | $780 | $820 |0% |
| | | | | |
---------------------------------------------------------------
e) Eliminate the Telephone Medical Advice Services Bureau
(Bureau). The Bureau was created in 1999 (AB 285, Corbett,
Chapter 535, Statutes of 1999) in response to a situation
in which a Senator's constituent was unable to contact her
physician over the phone, received inadequate service at a
clinic, and then died after surgery at a hospital.
Telephone medical advice was not at issue.
Current law now requires any business that provides
telephone medical advice services to a patient in
California and who employs or contracts with five or more
health care professionals to register with the Bureau. A
business fills out a registration form provided by the
Bureau and pays a fee. The registrant must then renew
every two years and file quarterly reports which, among
other requirements, list all California and out-of-state
employees who provide medical advice services to California
patients. The Bureau verifies those licensees. There are
61 registrants as of 2015.
Enforcement. The Bureau ensures that all registrants file
quarterly reports and checks to make sure that all the
SB 1039 (Hill) Page 25
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licensees provided on the list by the registrant are
properly licensed. However, there is no effort to
independently confirm the accuracy of the lists provided -
for example, whether the registrant has provided a
comprehensive list of their licensed providers or whether
any non-California licensed providers offered advice to
Californians. Despite this honor system, some
discrepancies have been found. In these cases, according
to the Bureau, it works with the registrants to correct
errors and does not pursue discipline.
Registrants are also required to provide complaint data to
the Bureau on a quarterly basis, consisting of numbers of
complaints. The Bureau is not made aware of the nature or
resolution of the issues from the registrant, but rather
the registrant sends the complainant a form to fill out and
mail to the Bureau. The Bureau also solicits consumer
complaints on its Web site, though the consumer must
download the complaint form and mail it to the Bureau.
Even with these obstacles, the Bureau receives, on average,
21 consumer complaints per year. In the past five years,
105 complaints were received, and all but two were closed
without referral for investigation. According to the most
recent DCA reports, there have been no citations or fines
assessed, referrals for criminal or civil action, formal
disciplinary actions filed, or consumer restitution ordered
by the Bureau in the last five years.
Budget . The Bureau's enabling legislation required DCA to
set fees for registration and renewal "sufficient to pay
the costs of administration." Fees were set for the
initial registration and renewal at $7,500. Under BPC §
128.5, DCA entities are required to reduce license fees to
the amount that will reduce any surplus funds equal to the
entity's operating budget for the next two years. The
Bureau is in violation of this statute. The Bureau has had
over five years' reserve since at least 2009, when numbers
were available, and is presently on track to have nearly a
six-year reserve by the end of 2016 ($1,144,000). Fees
have not been adjusted since 2001.
Concurrent Authority and Emerging Technologies . It may be
argued that consumers are already protected from unlicensed
SB 1039 (Hill) Page 26
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providers by the other DCA regulatory health boards because
telehealth statutes have evolved to authorize and regulate
the provision of healthcare remotely via the telephone and
other technologies.
Although the Bureau insists that "telephone medical advice"
differs from "telemedicine," the law does not make such a
clear distinction. Under BPC § 4999.7, "telephone medical
advice" means a telephonic communication between a patient
and a health care professional in which the health care
professional's primary function is to provide to the
patient a telephonic response to the patient's questions
regarding his or her or a family member's medical care or
treatment. "Telephone medical advice" includes assessment,
evaluation, or advice provided to patients or their family
members. Under BPC § 2290.5 "Telehealth" means the mode of
delivering health care services and public health via
information and communication technologies to facilitate
the diagnosis, consultation, treatment, education, care
management, and self-management of a patient's health care
while the patient is at the originating site and the health
care provider is at a distant site. Telehealth facilitates
patient self-management and caregiver support for patients
and includes synchronous interactions and asynchronous
store and forward transfers. Telehealth includes telephone
medical advice, and all licensing laws and practice
restrictions apply to individuals caring for patients in
California whether face to face or remotely.
While telephone medical advice services may have been
critical to the provision of remote care in 1999, the
Internet and mobile device apps have accelerated and
encouraged the provision of remote advice by healthcare
professionals. Doctors on Demand, Teladoc, and even
Planned Parenthood are some of many current businesses that
bypass the telephone to connect patients and healthcare
licensees. These emerging platforms are outside of the
Bureau's jurisdiction and the healthcare licensees are
subject to regulation by the DCA's regulatory boards.
There have been no widespread issues of unlicensed activity
in these areas.
Recommendation During Sunset Review . During the
Committees' comprehensive sunset review oversight of the
SB 1039 (Hill) Page 27
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DCA and regulatory entities in 2015-16, staff indicated,
"It does not appear that the Bureau is providing consumer
protection by confirming self-reported registrant data.
The Bureau has not managed its budget within statutory
mandates, and has failed to keep pace with technological
innovations. Because the provision of remote healthcare is
already regulated by the DCA health care boards, the Bureau
is not necessary."
f) Provide for Various Fee Increases for the Contractors
State License Board.
The proposed fee increases for the CSLB seeks to provide the
Board with sufficient funding to support its existing
budget and provide for reasonable inflationary cost
increases. While costs have increased in every area in the
last few years, the most significant areas are in Personal
Services, DCA Pro Rata and Enforcement. The CSLB
anticipates that it will have, by FY 2018/19, a deficit of
approximately $6 million.
CSLB needs a fee increase in order to continue to provide its
existing level of service to both licensees and consumers.
In FY 2012/13, CSLB spent approximately $54 million, and in
the current budget year we expect to spend approximately
$61 million, an increase of approximately 16% and close to
$8.5 million. Of that $8.5 million in increased spending
$4.4 million went to Personal Services, which includes
salary, benefits, and retirements. During that time
period, CLSB added 4 positions, which were approved through
the annual budget process. The amount CSLB pays to DCA in
pro rata charges increased by $2 million. A significant
portion of that $2 million increase is due to DCA's new
BreEZe IT system. While CSLB was previously scheduled to
be included in the BreEZe system, it is now not currently
scheduled to be included. CSLB also had increased
enforcement costs of about $2 million, which is primarily
costs for the use of services by the Attorney's General's
Office and the Office of Administrative Hearings. If CSLB
is not able implement a fee increase, we will have to
reduce costs in Enforcement, beginning with cuts to our
proactive enforcement (stings and sweeps).
The proposed fee increases for the CSLB are as follows:
SB 1039 (Hill) Page 28
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----------------------------------
| | | | | |
| | Cur | Prop| Prop| |
| | re | osed| osed|% |
| DESCRIPT| nt | | |Increase|
| ION | | New | Incr| |
| | Fe | Fee | ease| |
| | e | | | |
----------------------------------
|----------+-+---+-+---+-+---+-----|
|License | | | | | | | |
|Pocket/Wal| $| 11| $| 13| $| 2| 1|
|l | | .0| | .0| | .| 8|
|Replcment | | 0 | | 0 | | 0| %|
| | | | | | | 0| |
| | | | | | | | |
|----------+-+---+-+---+-+---+-----|
| | | | | | | | |
|Hazard | | | | | | | |
|Cert | $| 75| $| 90| $| 15| 2|
| | | .0| | .0| | .0| 0|
| | | 0 | | 0 | | 0 | %|
| | | | | | | | |
----------------------------------
----------------------------------
| | | | | |
----------------------------------
----------------------------------
|Additi | | | | | | | |
|onal | $| 75| $| 75| $| -| 0%|
|Class | | .0| | .0| | | |
|Origin | | 0 | | 0 | | | |
|al | | | | | | | |
|Apps | | | | | | | |
|----------+-+---+-+---+-+---+-----|
|Sup & | | | | | | | |
|RME/RMO | | | | | | | |
|Apps | $| 75| $|300| $|225| 30|
| | | .0| |.00| |.00| 0%|
| | | 0 | | | | | |
----------------------------------
-----------------------------------------------------------------------------------------------------------
|Personne | | | | | | | | |
SB 1039 (Hill) Page 29
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|l/Office | | | | | | | | |
|r | $ | - | $ |150.00 | $ |150.00 | $ | - |
|Change | | | | | | | | |
-----------------------------------------------------------------------------------------------------------
----------------------------------
| | | | | | | | |
|Re-Exam | | | | | | | |
|Applicatio| $| 60| $| 60| $| -| 0%|
|ns | | .0| | .0| | | |
| | | 0 | | 0 | | | |
----------------------------------
|Initial | | | | | | | |
|License - | | | | | | | |
|Active | $|180| $|220| $| 40| 2|
| | |.00| |.00| | .0| 2|
|& | | | | | | 0 | %|
|Inactive | | | | | | | |
----------------------------------
|Reg. | | | | | | | |
|Fee-Home | | | | | | | |
|Improvemen| | | | | | | |
|t | $| 75| $| 90| $| 15| 2|
|Salesperso| | .0| | .0| | .0| 0|
|n (HIS) | | 0 | | 0 | | 0 | %|
| | | | | | | | |
----------------------------------
| | | | | | | | |
|Asbestos | $| 75| $| 90| $| 15| 2|
|Cert | | .0| | .0| | .0| 0|
| | | 0 | | 0 | | 0 | %|
| | | | | | | | |
----------------------------------
|Origina | | | | | | | |
|l App | $|300| $|360| $| 60| 2|
|Fee - | |.00| |.00| | .0| 0|
|Contrac | | | | | | 0 | %|
|tors | | | | | | | |
|----------+-+---+-+---+-+---+-----|
|Reactiva | | | | | | | |
|te | $|360| $|430| $| 70| 1|
|License | |.00| |.00| | .0| 9|
|- | | | | | | 0 | %|
|Contract | | | | | | | |
|ors | | | | | | | |
SB 1039 (Hill) Page 30
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----------------------------------
----------------------------------
| | | | | |
----------------------------------
----------------------------------
| | | | | | | | |
| | | | | | | | |
|Biennial | $| 75| $| 90| $| 15| 2|
|Renewal - | | .0| | .0| | .0| 0|
|HIS | | 0 | | 0 | | 0 | %|
| | | | | | | | |
----------------------------------
| | | | | | | | |
| | | | | | | | |
|Biennia | $|360| $|430| $| 70| 1|
|l | |.00| |.00| | .0| 9|
|Renewal | | | | | | 0 | %|
| | | | | | | | |
|Contrac | | | | | | | |
|tor | | | | | | | |
|----------+-+---+-+---+-+---+-----|
| | | | | | | | |
| | | | | | | | |
| | | | | | | | |
|4-Yr | $|180| $|220| $| 40| 2|
|Timely | |.00| |.00| | .0| 2|
|Inactive | | | | | | 0 | %|
| | | | | | | | |
----------------------------------
----------------------------------
| | | | | |
----------------------------------
----------------------------------
|Delinqu | | | | | | | |
|ent - | $| 37| $| 45| $| 7| 2|
|HIS | | .5| | .0| | .| 0|
|Renewal | | 0 | | 0 | | 5| %|
| | | | | | | 0| |
| | | | | | | | |
----------------------------------
|Delinquen | | | | | | | |
|t | $|180| $|215| $| 35| 1|
|Renewal | |.00| |.00| | .0| 9|
|- | | | | | | 0 | %|
SB 1039 (Hill) Page 31
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|Contactor | | | | | | | |
| | | | | | | | |
|----------+-+---+-+---+-+---+-----|
|Delinq | | | | | | | |
|uent | | | | | | | |
|4-Yr | $| 90| $|110| $| 20| 2|
|Inacti | | .0| |.00| | .0| 2|
|ve | | 0 | | | | 0 | %|
| | | | | | | | |
----------------------------------
----------------------------------
| | | | | |
----------------------------------
g) Provide for Renewal Fee Increase for Court Reporters
Board. As part of its fiduciary oversight, the CRB closely
monitors the budget, and it projected that the CRB would
need to address a projected deficit for $489,000 occurring
in fiscal year 2017-18. The deficit is caused by a steady
increase in expenditures over the years and a slow decline
in the number of licensees. Having already implemented all
cost-savings measures, including reduction of onsite school
reviews and reduction of exam development workshops, the
CRB looked at the various options for increasing revenue.
The CRB contends that they looked at increasing the license
examination fees, but with a relatively small number of
candidates annually, even a substantial hike in the exam
fee would not significantly improve the CRB long-term
solvency. The CRB also evaluated the possibility of
providing continuing education to increase revenue,
ultimately finding the required increase in staff would not
make it cost-effective, nor would it be a mission-critical
activity.
The existing cap of $125.00 was set in 1951. The CRB
reached that cap in 2010. The CRB states that it has
worked diligently to cut expenses wherever possible and to
operate as efficiently as possible. However, all costs
continue to rise, including the pro rata amount the CRB
pays to the DCA. While costs rise, the CRB indicates that
revenue has slowly decreased as court reporters of the Baby
Boom era begin to retire.
The CRB also administers the Transcript Reimbursement Fund
SB 1039 (Hill) Page 32
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(TRF) which is funded at $300,000 per year and which was
set up in 1981 to increase access to justice by providing
low or no-cost transcripts to qualified indigent litigants.
Since its inception, the TRF has provided over $8.5
million in transcript costs to claimants. It is critical
that the CRB be able to raise the license fees in order to
maintain a healthy fund balance. Business & Professions
Code 8030.2(a) prohibits a transfer being made from the
Court Reporters Fund to the Transcript Reimbursement Fund
if the transfer will result in reduction of the balance of
the Court Reporters Fund to an amount less than six months'
operating budget.
An increase of the fee cap to $250 would allow the CRB to
make incremental increases to the license fee as required
to maintain a foundation strong enough to fund the
activities necessary to fulfill the CRB's legislative
mandate, specifically, licensing, enforcement, school
oversight and administration of the TRF.
h) Clarify Inspection Requirements for Licensees of the
Structural Pest Control Board. Currently, the SPCB Act
(Act) outlines the procedures to be followed during the
performance of wood destroying organism pest inspections
and in the preparation of the accompanying inspection
reports and also provides guidelines for the preparation of
a notice of work completed and not completed after a
company completes work under a contract. In 2010, the SPCB
created an Act Review Committee and tasked it with
reviewing the Act for the purpose of making recommendations
to modernize and improve the language for the benefit of
consumers and the pest control industry. The proposed
changes in this measure related to SPCP are the result of
that review and are intended to clarify its provisions.
2.Related Legislation. AB 1116 (Keeley, Chapter 792, Statutes
of 1997) established procedures for accreditation of foreign
dental schools by the Board, as specified. Stated legislative
intent that this provision is to provide for evaluation of
foreign dental schools that provide an education equivalent to
similar, accredited institutions in the United States.
3.Arguments in Opposition. Former Senator Richard Polanco is
SB 1039 (Hill) Page 33
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opposed to the proposed language in the bill pertaining to
"Foreign Dental Schools" and believes it is contrary to the
Legislature's intent pertaining to approval of foreign dental
schools provided for in AB 1116 (Kelley ) that was intended to
address the dentistry issues of foreign dental school
graduates. "The board is attempting to remove itself from
some key provisions that are the legislative intent which
placed the responsibility of conducting the survey and
evaluation of a foreign dental school squarely with the board
and not to accept the finding of any other commission or
accreditation agency." The Senator believes that the process
pursuant to AB 1116 is working and it should not be changed or
amended
Both the Latin American Dental Association and the Southern
California Filipino Dental Society, Inc. are also opposed to
the provisions in this measure that would allow the Dental
Board to accept the findings of any commission or
accreditation agency approved by the DBC for purposes of
accrediting foreign dental schools, if the findings meet the
DBC's specified standards and allows the DBC to adopt those
findings as their own. They believe that such a change will
have a negative effect on the dental access to care for people
of California by decreasing the number of minority dentists in
California and believe that it will be impossible for another
dental school to be approved and for the existing one to be
re-approved.
4.Author's amendments. The Author is accepting amendments to
reinstate BPC §§ 4999.2, 4999.7, Insurance Code § 10279, and
Health and Safety Code § 1348.8 but without reference to the
Telephone Medical Advice Services Bureau or registration, and
clarifies that responsibility for enforcing California license
requirements of healthcare professionals who provide medical
advice services resides with the respective healing arts
boards.
SUPPORT AND OPPOSITION:
Support:
Mega Termite & Pest Control
Newport Exterminating
Western Exterminator Company
SB 1039 (Hill) Page 34
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Opposition:
Former Senator Richard Polanco
Latin American Dental Association
Southern California Filipino Dental Society
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