BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 1039|
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UNFINISHED BUSINESS
Bill No: SB 1039
Author: Hill (D)
Amended: 8/25/16
Vote: 21
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 6-2, 4/18/16
AYES: Hill, Block, Galgiani, Hernandez, Mendoza, Wieckowski
NOES: Bates, Berryhill
NO VOTE RECORDED: Jackson
SENATE APPROPRIATIONS COMMITTEE: 5-2, 5/27/16
AYES: Lara, Beall, Hill, McGuire, Mendoza
NOES: Bates, Nielsen
SENATE FLOOR: 25-12, 6/1/16
AYES: Allen, Beall, Block, De León, Galgiani, Glazer, Hall,
Hancock, Hernandez, Hill, Hueso, Jackson, Lara, Leno, Leyva,
Liu, McGuire, Mendoza, Mitchell, Monning, Pan, Pavley, Roth,
Wieckowski, Wolk
NOES: Anderson, Bates, Berryhill, Fuller, Gaines, Huff,
Moorlach, Morrell, Nguyen, Nielsen, Stone, Vidak
NO VOTE RECORDED: Cannella, Hertzberg, Runner
ASSEMBLY FLOOR: 51-29, 8/29/16 - See last page for vote
SUBJECT: Professions and vocations
SOURCE: Author
DIGEST: This bill 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
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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).
Assembly Amendments prohibit the biennial renewal fee for the
DHCC from exceeding $500; establish a specified minimum and
maximum fee amounts for the CBO and made other conforming fee
revisions; remove the fee increase for the Court Reporters Board
of California; remove the BOP from the statutory jurisdiction of
the Medical Board of California (MBC) and establish it
independently within the DCA; delete provisions removing the BOP
from the statutory jurisdiction of the MBC and establish it
independently within the DCA; delete BOP fee increases;
establish fees parameters for resident and nonresident
outsourcing facility licenses; authorize the CBO to inspect
premises in which optometry is being practiced or in which
spectacle or contact lenses are fitted or dispensed; clarify
that specified CBO fines shall not exceed $50,000 per
investigation; eliminate certain exemptions for veterinarians;
and add chaptering amendments.
ANALYSIS:
Existing law:
1)Requires the DHCC to establish by resolution the amount of the
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. Prohibits the biennial renewal fee from exceeding
$160. (BPC § 1944)
2)Establishes the CBO to regulate nonresident contact lens
sellers, registered dispensing opticians (RDO), spectacle lens
dispensers, and contact lens dispensers. Establishes the
CBO's regulatory fees, including an initial registration fee,
a renewal fee, and a delinquency fee. (BPC §§ 2546.9, 2565,
2566, 2566.1)
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3) Requires the BRN to adopt regulations establishing standards
for continuing education for licensees, as specified, and
requires that the standards take cognizance of specialized
areas of practice. (BPC § 2811.5)
4) 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 Fund,
which is continuously appropriated as it pertains to fees
collected by the BOP. (BPC § 4400)
5) Requires the certain businesses that provide telephone
medical advice services to a patient at a California address
to be registered with the TMAS 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.)
6) 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)
7) Provides for the licensure and regulation of structural pest
control operators and registered companies, as defined, by
the Structural Pest Control Board (SPCB) within the DCA.
(BPC §§ 8500-8697.4)
This bill:
1) Increases the statutory cap for the biennial renewal fee for
various types of registered dental hygienists from $160 to
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$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 continuing education (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 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
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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
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.
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12)Requires the operator licensed and regulated by the SPCB
prior to conducting an inspection as specified 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.
Makes other clarifying and technical changes regarding the
SPCB.
Background
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
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"
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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.
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
establishes both a minimum and maximum level for all fees. The
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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. 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
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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.
FISCAL EFFECT: Appropriation: Yes Fiscal
Com.:YesLocal: Yes
According to the Assembly Appropriations Committee:
1)One-time costs of $260,000 and ongoing costs of $250,000 per
year for the BRN to audit providers of continuing education
(BRN Fund).
2)Increased licensing fee revenues of about $23 million per year
to the BRN (BRN Fund).
3)Increased licensing fee revenues of about $7 million per year
to the BOP (Pharmacy Board Contingent Fund).
4)Increased licensing fee revenues of about $12.5 million per
year to the CSLB (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
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$200,000 per year from the elimination of the TMAS Bureau
(TMAS Fund).
7)Information technology costs to change fee amounts are
expected to be minor and absorbable.
SUPPORT: (Verified8/26/16)
Board of Pharmacy
Board of Podiatric Medicine
Board of Registered Nursing
California State Council of Laborers
OPPOSITION: (Verified8/26/16)
American Nurses Association/California
ARGUMENTS IN SUPPORT: The BRN is in support of this measure
and indicate that they will continue to work with the Committees
relating to CE to ensure the BRN safeguards the public by
confirming continued competence of its licensees. The BPM is in
support of this measure as it was amended to eliminate the
provisions which would have removed it from the jurisdiction of
the Medical Board of California. The California State Council of
Laborers is in support of this bill as it pertains to the fee
schedule changes to the CSLB.
ARGUMENTS IN OPPOSITION:The American Nurses Association\
California (ANA\C) writes in opposition, "The ANAC supports
without question evidence-based nursing education, nursing
practice and evidence-based continuing nursing education.
Furthermore, we do not question the need for regular audits
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every 5 years. We do however question the BRN's current
capacity of its already stretched-to-the-max staff to
effectively work on all the courses curriculums and approvals,
to efficiently process all CEPs applications and to provide
timely audits of all offered courses?."
ASSEMBLY FLOOR: 51-29, 8/29/16
AYES: Alejo, Arambula, Atkins, Bloom, Bonilla, Bonta, Brown,
Burke, Calderon, Campos, Chau, Chiu, Chu, Cooley, Cooper,
Dababneh, Daly, Dodd, Eggman, Frazier, Cristina Garcia,
Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray,
Roger Hernández, Holden, Jones-Sawyer, Levine, Lopez, Low,
McCarty, Medina, Mullin, Nazarian, O'Donnell, Quirk,
Ridley-Thomas, Rodriguez, Salas, Santiago, Mark Stone,
Thurmond, Ting, Weber, Williams, Wood, Rendon
NOES: Achadjian, Travis Allen, Baker, Bigelow, Brough, Chang,
Chávez, Dahle, Beth Gaines, Gallagher, Grove, Hadley, Harper,
Irwin, Jones, Kim, Lackey, Linder, Maienschein, Mathis, Mayes,
Melendez, Obernolte, Olsen, Patterson, Steinorth, Wagner,
Waldron, Wilk
Prepared by:Bill Gage / B., P. & E.D. / (916) 651-4104
8/30/16 14:05:08
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