BILL ANALYSIS Ó
SB 1039
Page 1
SENATE THIRD READING
SB
1039 (Hill)
As Amended August 19, 2016
Majority vote
SENATE VOTE: 25-12
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+-----------------------+---------------------|
|Business & |11-5 |Salas, Bloom, Campos, |Brough, Baker, |
|Professions | |Dodd, Eggman, Gatto, |Chávez, Dahle, Jones |
| | |Gomez, Holden, Mullin, | |
| | |Ting, Wood | |
| | | | |
|----------------+-----+-----------------------+---------------------|
|Appropriations |14-6 |Gonzalez, Bloom, |Bigelow, Chang, |
| | |Bonilla, Bonta, |Gallagher, Jones, |
| | |Calderon, Daly, |Obernolte, Wagner |
| | |Eggman, Eduardo | |
| | |Garcia, Holden, Quirk, | |
| | |Santiago, Weber, Wood, | |
| | |McCarty | |
| | | | |
| | | | |
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SB 1039
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SUMMARY: Makes several changes to the statutes governing
various boards and bureaus under the Department of Consumer
Affairs (DCA); includes specified fee increases for several
boards including the Dental Hygiene Committee of California
(DHCC), the California Board of Optometry (CBO), the Board of
Registered Nursing (BRN), the Board of Pharmacy (BOP), and the
Contractors State License Board (CSLB); and eliminates the
Telephone Medical Advice Services Bureau (TMAS). Specifically,
this bill:
1) Increases the statutory cap for the biennial renewal fee for
various types of registered dental hygienists from $160 to
$500.
2) Establishes a specified minimum and maximum application fee
amount for nonresident contact lens sellers, registered
dispensing opticians, and spectacle lens dispensers and
increases minimum and maximum amounts for already established
fees. Authorizes the CBO to periodically revise and fix the
fees, as specified.
3)Clarifies that the $50,000 cap on the administrative fine that
the CBO may issue for violations of the ownership prohibitions
applicable to optometrists, optical companies, and registered
dispensing opticians is "per investigation."
4)Authorizes the CBO to at any time inspect the premises in
which optometry is being practiced or in which spectacle or
contact lenses are fitted or dispensed, as specified.
5) Specifies that the CE standards established by the BRN 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
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required for the practice of nursing or be related to direct
or indirect patient or client care.
6) Requires the BRN to audit CE providers at least once every
five years to ensure adherence to regulatory requirements,
and requires the BRN to withhold or rescind approval from any
provider that is in violation of the regulatory requirements.
7) Prescribes various fee changes to be paid by licensees 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 raises specified fees, and provides for additional
fees to be paid by licensees and applicants for licensure as
well as by schools seeking approval by the BRN.
8) Modifies, on or after July 1, 2017, specified fees to be
paid by the licensees and applicants for licensure with the
BOP.
9) Specifies that a veterinarian from another state or country
does not have to be licensed in California if they are
holding a current, valid license in good standing in another
state or country and provide assistance to a California
licensed veterinarian. The California licensed veterinarian
shall maintain a valid veterinarian-client-patient
relationship and that the veterinarian providing the
assistance shall not establish a veterinarian-client-patient
relationship with the client, as specified. Clarifies that a
veterinarian in good standing from another state does not
have to be licensed in California if they are called into
this state by law enforcement agency or animal control
agency, as specified.
10)Eliminates the TMAS and repeals the requirement that certain
businesses that provide telephone medical advice services to
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a patient at a California address to be registered with the
TMAS.
11)Raises specified fees to be paid by the licensees and
applicants to the CSLB and requires the CSLB to establish
criteria for the approval of expedited processing
applications, as specified.
12)Requires the operator licensed and regulated by the
Structural Pest Control Board (SPCB) prior to conducting an
inspection as specified above to be employed by a registered
company. 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.
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 three years. 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. 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. Makes other clarifying and technical changes
regarding the SPCB.
13)Incorporates changes proposed in SB 1193 (Hill) of the
Current Legislative Session relating to outsourcing facility
licenses.
FISCAL EFFECT: According to the Assembly Appropriations
Committee:
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1)One-time costs of $260,000 and ongoing costs of $250,000 per
year for the BRN to audit providers of continuing education
(Board of Registered Nursing Fund).
2)Increased licensing fee revenues of about $23 million per year
to the BRN (Board of Registered Nursing Fund).
3)Increased licensing fee revenues of about $7 million per year
to the Board of Pharmacy (Pharmacy Board Contingent Fund).
4)Increased licensing fee revenues of about $12.5 million per
year to the Contractor's State Licensing Board (Contractors
Licensing Fund).
5)Unknown additional fee revenues due to increases in dental
hygienist license renewal fees (State Dental Hygiene Fund) and
for contact lens sellers, registered dispensing opticians, and
spectacle lens dispensers (State Optometry Fund).
6)Reduced expenditures (and license fee revenues) of about
$200,000 per year from the elimination of the Telephone
Medical Advice Services Bureau (Telephone Medical Advice
Services Fund).
7)Information technology costs to change fee amounts are
expected to be minor and absorbable.
COMMENTS:
Purpose. This bill is sponsored by the author. According to
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the author, "?this bill is intended to be an omnibus bill which
includes several changes to a number of boards under the [DCA]
and would also include 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 three 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 bill also makes other clarifying substantive changes for
the [SPCB] in regards to inspection conducted by structural pest
control operators and their companies and eliminates the [TMAS]
Bureau which is no longer necessary to provide oversight of
remote advice provided by healthcare practitioners."
Background. This bill contains several fee increases requested
by boards which have projected fund condition issues,
incorporates several of the recommendations from the DCA-wide
sunset paper published for this year's sunset review oversight
hearing in March, and other technical changes.
Fee Changes for the CBO. AB 684 (Alejo), Chapter 405, Statutes
of 2015, among other things, transferred the regulation of RDOs
from the MBC to the CBO, along with the authority to inspect
leases and premise locations for compliance with BPC section 655
(dealing with various kick-back arrangements). However, neither
the MBC nor the CBO collected data on how many locations are
co-located, so there is no concrete data on how many registrants
are subject to inspection. In the following years, the CBO will
collect the data and use it to further develop the inspection
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program.
Currently, the additional revenue brought in by a fee floor will
not support the inspection program. After more data is
collected, the CBO will reassess the cost of this new function
(as recommended by the fee audit) and potentially increase fees
through the regulation process.
Still, the fee audit shows that current RDO fee structure is not
sufficient to sustain the new RDO program. The fee audit shows
that the proposed fee floor is just enough to sustain the
program without factoring in the requirements specified in AB
684. Further, the CBO notes that there are a lot of "unknowns"
pertaining to the total impact on the program in regards to the
license population and enforcement workload. The fee auditor
recommended setting a fee floor, due to the immediate need, and
a fee ceiling high enough to allow the CBO to reassess total
impact after a few years of data collection.
The auditor recommended fees based on cost per item. However,
in an effort to even out the fees and make them more reasonable,
the DCA budgets used the auditor's projected program's
revenue/budget needs to determine the proposed fee structure.
BRN CE Audits. 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 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.
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During the comprehensive sunset review oversight of the BRN
in 2015 conducted by the Senate Committee on Business,
Professions and Economic Development and Assembly Business
and Professions Committee (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 provides more staffing to audit CE provided
pursuant to the fee increase.
Fee Changes for BRN. The BRN Fund is maintained by the BRN and
includes the revenues and expenditure related to licensing
nurses. According to the BRN, the cause of its projected
deficit is an ongoing problem.
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 fiscal year
(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 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.
Fee Changes for the BOP. The BOP's current statutory authority
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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.
Requirements for Veterinarians from Other States. This bill
makes changes to the exemption from California licensure for
out-of-state veterinarians who may consult or provide assistance
to a California licensed veterinarian to make it clear under
what circumstances veterinary practice in this state would be
permissible.
TMAS. Under current law, 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 TMAS. The registrant must 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
TMAS ensures that all registrants file quarterly reports and
checks to make sure that all the 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.
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TMAS 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 zero citations,
fines assessed, referrals for criminal or civil action, formal
disciplinary actions filed, or consumer restitution ordered by
the TMAS in the last five years. DCA licensing boards already
have concurrent authority with the practice of healthcare by
licensed and unlicensed individuals and can effectively police
this area without TMAS.
Fee Changes for the CSLB. The proposed fee increases for the
CSLB seek to provide the CSLB 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.
Inspection Requirements for Licensees of the SPCB. Currently,
the Structural Pest Control 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.
SB 1039
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Analysis Prepared by: Le Ondra Clark Harvey Ph.D. / B. & P. /
(916) 319-3301 FN: 0004694
Vincent
Chee