BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    SB 1193


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          SENATE THIRD READING


          SB  
          1193 (Hill)


          As Amended  August 18, 2016


          Majority vote


          SENATE VOTE:  39-0


           -------------------------------------------------------------------- 
          |Committee       |Votes|Ayes                   |Noes                 |
          |                |     |                       |                     |
          |                |     |                       |                     |
          |                |     |                       |                     |
          |----------------+-----+-----------------------+---------------------|
          |Business &      |13-0 |Salas, Bloom, Campos,  |                     |
          |Professions     |     |Chávez, Dahle, Dodd,   |                     |
          |                |     |Eggman, Gatto, Gomez,  |                     |
          |                |     |Holden, Mullin, Ting,  |                     |
          |                |     |Wood                   |                     |
          |                |     |                       |                     |
          |----------------+-----+-----------------------+---------------------|
          |Appropriations  |15-0 |Gonzalez, Bloom,       |                     |
          |                |     |Bonilla, Bonta,        |                     |
          |                |     |Calderon, Daly,        |                     |
          |                |     |Eggman, Eduardo        |                     |
          |                |     |Garcia, Holden,        |                     |
          |                |     |Obernolte, Quirk,      |                     |
          |                |     |Santiago, Weber, Wood, |                     |
          |                |     |McCarty                |                     |
          |                |     |                       |                     |
          |                |     |                       |                     |








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          SUMMARY:  Extends the sunset date for the Board of Psychology  
          (BOPsych) by four years, until January 1, 2021; amends statutes  
          pertaining to psychological assistants (PA); revises continuing  
          education (CE) requirements; establishes policies for posting  
          licensee information on the BOPsych's Web site; authorizes the  
          BOPsych to issue a retired license; revises the requirements  
          related to approved schools; and makes other technical,  
          clarifying and conforming changes to the BOPsych and the  
          psychology practice act (act).  Extends the operation of the  
          Board of Pharmacy (BOPharm) and Pharmacy Law until January 1,  
          2021, and makes various changes to the Pharmacy Law intended to  
          improve BOPharm oversight of licensees involved in the  
          acquisition, storage, distribution and dispensing of dangerous  
          drugs and dangerous devices, including oversight by the BOPharm  
          for outsourcing facilities; registration with the BOPharm for  
          use of an automated delivery device by a pharmacy; timeline  
          requirements for the BOPharm to approve clinic licenses; and  
          various other technical changes.  This bill also makes various  
          changes that are intended to improve the effectiveness of the  
          Veterinary Medical Board (VMB) and extends the VMB's sunset  
          dates, until January 1, 2021. Specifically, this bill:


          1)Revises employment restrictions for PAs, as specified.


          2)Clarifies that PAs are required to register themselves with  
            the BOPsych, and the registration must be renewed annually in  
            accordance with BOPsych regulations, as specified.


          3)Deletes the provision allowing a licensed psychologist to  
            register, employ or supervise more than three psychological  
            assistants at a time with specific authorization from the  
            BOPsych.









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          4)Requires on or after January 1, 2020, that an applicant for  
            licensure as a psychologist possess an earned doctorate degree  
            in psychology, in educational psychology or in education with  
            the field of specialization in counseling psychology or  
            educational psychology from a college or institution of higher  
            education that is accredited by a regional accrediting agency  
            recognized by the United States Department of Education (USDE)  
            and authorizes the BOPsych to accept only until January 1,  
            2020, an applicant who possesses a doctorate degree in  
            psychology, educational psychology, or in education with the  
            field of specialization in counseling psychology or  
            educational psychology from an institution that is not  
            accredited by an accrediting agency recognized by the USDE but  
            is approved to operate by the Bureau of Private Postsecondary  
            Education (BPPE).


          5)Specifies that 4) above, does not apply to any student who has  
            enrolled in a doctoral program in psychology, educational  
            psychology, or in education with the field of specializing in  
            counseling psychology or educational psychology at a  
            nationally accredited or approved institution as of December  
            31, 2016.


          6)Changes references to CE to continuing professional  
            development (CPD).


          7)Requires applicants for licensure renewal to submit under  
            penalty of perjury that he or she is in compliance with  
            specified CPD requirements.


          8)Specifies that CPD means certain continuing education learning  
            activities approved in the following four categories:  a)  
            professional; b) academic; c) sponsored continuing education  
            coursework; and, d) Board certification from the American  








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            Board of Professional Psychology, and authorizes the BOPsych  
            to develop regulations further defining acceptable CPD. 


          9)Authorizes the BOPsych to develop regulations further defining  
            CPD activities. 


          10)Deletes the exemption from CE requirements for a licensed  
            psychologist whose practice does not include the direct  
            provision of mental health services.


          11)Deletes the requirement that CE instruction be completed in  
            California or be approved for credit by the American  
            Psychological Association or its equivalent and instead  
            specifies that courses must be approved for credit by  
            organizations approved by the BOPsych, and those organizations  
            previously approved by the BOPsych to provide CE is deemed  
            approved, as specified.


          12)Revises the BOPsych's authority to accept CE courses from  
            certain entities.  


          13)Deletes the requirement that a licensed psychologist must  
            choose CE instruction that is related to the assessment,  
            diagnosis, and intervention for the client population that is  
            being served or to the fields of psychology in which the  
            psychologist intends to provide services, as specified.


          14)Authorizes the BOPsych to grant an exemption or an extension  
            of the time for compliance with, from CPD, as specified. 


          15)Deletes the authorization for CE credit to be approved for  
            licensees who serve as commissioners on any examination.








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          16)Extends the sunset date for the BOPsych by four years, until  
            January 1, 2021.


          17)Authorizes the BOPsych to post on its Internet Web site the  
            following information on the current status of the license for  
            all current and former licensees:


             a)   Whether or not the license has a record of disciplinary  
               action; and,
             b)   Any of the following enforcement actions or proceedings:


               i)     Temporary restraining orders;
               ii)Interim suspension orders;


               iii)Revocations, suspensions, probations, or limitations on  
                 practice ordered by the BOP or by a court with  
                 jurisdiction in the state, including those made part of a  
                 probationary order, cease practice order or stipulated  
                 agreement;


               iv)Accusations filed by the BOPsych including those  
                 accusations that are on appeal, excluding ones that have  
                 been dismissed or withdrawn where the action is no longer  
                 pending; and,


               v)     Citations issued by the BOPsych, unless withdrawn,  
                 posted for five years from the date of issuance.


          18)Authorizes the BOPsych to post on its Internet Web site all  
            of the following historical information in its possession,  








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            custody, or control regarding all current and former  
            licensees:
             a)   Institutions that awarded the qualifying educational  
               degree and type of degree awarded; and, 
             b)   A link to the licensee's professional Web site, and  
               specifies that any link to a professional licensee's  
               professional Web site, once clicked, must be accompanied by  
               a notification that informs the Web site viewer that they  
               are no longer on the BOPsych's Internet Web site..  


          19)Permits the BOPsych to post other information as determined  
            through regulation. 
          20)Deletes the section on appointment of commissioners on  
            examinations, as specified.


          21)Permits the BOPsych to issue a retired license, as specified.  



          22)Authorizes the holder of a retired license to return to  
            active status if specified conditions are met including, the  
            retired license not being issued more than three years for the  
            date of return to active status; not committed acts or crimes  
            constituting grounds for denial; paying the renewal fee;  
            completing CPD, and complying with fingerprint submission  
            requirements.


          23)Authorizes the holder of a retired license to return to  
            active status if the retired license was issued three or more  
            years from the application date if specified conditions are  
            met including, completing an application packet, taking and  
            passing the California Psychology Law and Ethics Examination;  
            paying all fees; complying with fingerprint submission  
            requirements, having met educational and experience  
            requirements, as specified, and establishing that he or she  
            has not been subject to denial or discipline of a license. 








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          24)Extends the operation of the BOPharm and its Executive  
            Officer (EO) until January 1, 2021.


          25)Requires, beginning July 1, 2017, each pharmacist, intern  
            pharmacist, pharmacy technician, designated representative-3PL  
            licensed in this state to join the BOPharm's email  
            notification list within 60 days of obtaining a license or at  
            the time of license renewal; requires him or her to update his  
            or her email address with the BOPharm's email notification  
            list within 30 days of a change in the licensee's email  
            address; exempts this email address from being posted on the  
            board's online license verification system; and requires the  
            BOPharm, with each renewal application, to remind licensees of  
            this obligation.


          26)Requires the BOPharm to take action against any holder of a  
            license who is guilty of unprofessional conduct, including  
            among others, actions that lead to the revocation, suspension,  
            or other discipline by another state of a license to practice  
            pharmacy, operate a pharmacy, or do any other act for which a  
            license is required, and specifies that the administrative  
            action taken in this state is coterminous with action taken by  
            another state, except as specified.


          27)Defines "outsourcing facility" as a facility that is located  
            within the United States at one address that is engaged in the  
            compounding of sterile and nonsterile drugs; has registered  
            with the Food and Drug Administration (FDA); is doing business  
            within or into California; and, is licensed with the BOPharm.


          28)Requires a pharmacy using an automated drug delivery system  
            (ADD) to register use of the ADD with the BOPharm within 30  
            days of installation of the device, and annually thereafter,  








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            including the address at which the ADD is being used; and,  
            requires a pharmacy to advise the BOPharm within 30 days if  
            the pharmacy discontinues the use of an ADD.


          29)Allows a pharmacy to use an ADD only if the pharmacy uses the  
            ADD consistent with legal requirements; the pharmacy's  
            policies and procedures related to the ADD include appropriate  
            security and monitoring measures; the pharmacy reports drug  
            losses as required by law; and, the pharmacy license is  
            unexpired and not subject to disciplinary action.  Exempts  
            from registration with the BOPharm an ADD operated by a  
            licensed hospital pharmacy for doses administered in a  
            facility operated under a consolidated license.


          30)Authorizes the BOPharm to prohibit a pharmacy from using an  
            ADD if specified conditions are not met; requires the BOPharm  
            to give the pharmacy written notice explaining the basis for  
            the determination; and allows the pharmacy to appeal the  
            decision within 30 days.


          31)Requires a pharmacy that issues a recall notice regarding a  
            nonsterile compounded drug product to contact the recipient  
            pharmacy, prescriber, or patient (as applicable) and the  
            BOPharm within 12 hours of the recall notice if both the use  
            or exposure to the recalled drug may cause serious adverse  
            health consequence or death, and if the recalled drug was  
            dispensed or intended for use in this state.


          32)Requires a pharmacy to report to MedWatch within 72 hours if  
            the pharmacy has been advised that a patient has been harmed  
            by using a nonsterile compounded product potentially  
            attributable to the pharmacy.


          33)Requires outsourcing facilities, as defined under federal  








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            law, to be licensed by the BOPharm; prohibits an outsourcing  
            facility to be simultaneously licensed with the BOPharm as a  
            sterile compounding pharmacy at the same location; prohibits a  
            licensed outsourcing facility from filling patient specific  
            prescriptions; requires an outsourcing facility to notify the  
            BOPharm of any disciplinary or other action taken by another  
            state or the FDA or of any recall notices or any adverse  
            events potentially attributable to an outsourcing facility's  
            products; requires the BOPharm to inspect the location of a  
            nonresident outsourcing facility to ensure that the facility  
            is in compliance with all laws and regulations before issuing  
            or renewing a nonresident outsourcing facility's license; and,  
            authorizes the BOPharm to issue a cease and desist order to an  
            outsourcing facility if the BOPharm has reasonable belief that  
            the products produced by the facility poses an immediate  
            threat to the public health or safety.


          34)Establishes a fee for the issuance of an in-state outsourcing  
            facility license fee of $2,270 that may be increased to up to  
            $3,180 by the BOPharm; establishes a renewal fee of $1,325  
            that may be increased to up to $1,855 by the BOPharm.


          35)Establishes a fee for the issuance of a nonresident  
            outsourcing facility license of $2,380 that may be increased  
            to up to $3,335 by the BOPharm; establishes the fee for the  
            renewal of a nonresident outsourcing facility license of  
            $2,270 that may be increased to up to $3,180 by the BOPharm,  
            as specified.


          36)Includes pharmacists in the list of licensed professionals  
            authorized to establish a professional corporation.


          37)Extends the sunset date for the VMB and its executive officer  
            until January 1, 2021. 









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          38)Authorizes a veterinarian and Registered Veterinary  
            Technician (RVT), who is under the director supervision of a  
            veterinarian with a current and active license, to compound a  
            drug for anesthesia, the prevention, cure, or relief of a  
            wound, fracture, bodily injury, or disease of an animal in a  
            premises currently and actively registered with the VMB, as  
            specified, and would authorize the BOPharm and the VMB to  
            ensure compliance with these requirements.


          39)Requires veterinarians engaged in the practice of veterinary  
            medicine and employed by the University of California or by  
            Western University of Health Sciences, while engaged in the  
            performance of specific duties, to be licensed as a  
            veterinarians in the state or hold a university license issued  
            by the VMB, and that the applicant for a university license to  
            meet certain requirements, including that the applicant passes  
            a specified exam. 


          40)Provides that a veterinary premise registration may be  
            canceled after five years of delinquency, unless the VMB finds  
            circumstances or conditions that would justify a new premise  
            registration to be issued. 


          41)Makes technical changes to the BPC regarding the BOPsych,  
            BOPharm and the VMB.


          FISCAL EFFECT:  According to the Assembly Appropriations  
          Committee, the provisions of this bill related to the BOPsych  
          will result in: 


          1)Approximately $5 million (fee-supported Psychology Fund) per  
            year to continue operation of the BOPsych for an additional  
            four years. 








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          2)Minor and absorbable costs to issue regulations to implement a  
            retired license type, and to make necessary information  
            technology changes (Psychology Fund).


          3)Unknown, likely minor, ongoing revenue loss to the Psychology  
            Fund, as well as reduced administrative workload, to the  
            extent some individuals apply for a retired license ($75  
            one-time fee and application) instead of an inactive license  
            ($50 every two years). 


          According to the Assembly Appropriations Committee, the  
          provisions of this bill related to the BOPharm (All costs are  
          fee-supported - Pharmacy Board Contingent Fund) will result in:


          1)Ongoing costs of $20.1 million per year for the continued  
            operation of the BOPharm.  
          2)One-time costs of $335,000 and ongoing costs of $320,000 per  
            year, for licensing and inspection activities relating to  
            outsourcing facilities.  The BOPharm also estimates $288,000  
            in revenue from an outsourcing facilities fee authorized by  
            this bill in the first year, and $244,000 annually in the  
            second year.  Costs related to other provisions, including  
            information technology costs, are expected to be minor and  
            absorbable.


          According to the August 11, 2016, Assembly Appropriations  
          Committee, the provisions of this bill related to the VMB  
          provisions (All costs are fee-supported-Veterinary Medical Board  
          Contingent Fund), this bill will result in:


          1)Ongoing costs of about $5.0 million per year for the continued  
            operation of the VMB.  All costs to operate the VMB are funded  








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            with licensing fees.


          2)Costs related to VMB-related provisions are anticipated to be  
            minor and absorbable.


          COMMENTS:


          Purpose.  This bill is sponsored by the author, and is one of  
          five "sunset bills" the author is sponsoring this year.   
          According to the author, this bill is necessary to make changes  
          to the Pharmacy Law and Veterinary Practice Act in order to  
          strengthen the laws to improve [BOPharm] and VMB oversight of  
          licensees.


          Background.  Joint Oversight Hearings and Sunset Review of the  
          DCA Licensing Boards.  In March of 2016, the Assembly Committee  
          on Business and Professions and the Senate Committee on  
          Business, Professions and Economic Development (Committees)  
          conducted multiple joint oversight hearings to review 11  
          regulatory boards within the DCA and one regulatory entity  
          outside of the DCA.  The sunset bills are intended to implement  
          legislative changes recommended in the respective background  
          reports drafted by the Committee staff for the agencies reviewed  
          this year.


          Board of Psychology.  The BOPsych regulates licensed  
          psychologists, registered PAs, and registered psychologists.   
          Only licensed psychologists can practice psychology  
          independently in the private sector in California.  In order to  
          be a licensed psychologist, an individual must obtain a  
          doctorate degree in psychology, educational psychology, or  
          education within the field of specialization in counseling  
          psychology or educational psychology from an accredited or  
          approved institution, and have completed two years (3,000) hours  








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          of supervised professional experience, where at least 1,500 of  
          those hours be completed post-doctoral.  PAs are registered to a  
          licensed psychologist or to a board-certified psychiatrist as  
          employees who provide limited psychological services.  Those  
          registered psychologists are registered with the BOPsych and  
          work and train under supervision in non-profit agencies that  
          receive government funding.  PAs are employed and supervised by  
          a qualified licensed psychologist as employees who may provide  
          limited services.  PAs are required to have a master's degree,  
          but no specified experience requirements.  


          Joint Oversight Hearings and Sunset Review of DCA Licensing  
          Boards.  In March of 2016, the Assembly Business and Professions  
          Committee and the Senate Business, Professions and Economic  
          Development Committee (Committees) conducted multiple joint  
          oversight hearings to review 11 regulatory boards within the DCA  
          and one regulatory entity outside of the DCA.  The sunset bills  
          are intended to implement legislative changes recommended in the  
          respective background reports drafted by the Committee staff for  
          the agencies reviewed this year.


          The Sunset Review Process.  The sunset review process provides a  
          formal mechanism for the DCA, the Legislature, the regulatory  
          boards, bureaus and committees, interested parties, and  
                                      stakeholders to make recommendations for improvements to the  
          authority of consumer protection boards and bureaus.  This is  
          performed on a standard four-year cycle and was mandated by SB  
          2036 (McCorquodale), Chapter 908, Statutes of 1994.  Each  
          eligible agency is required to submit to the Committees a report  
          covering the entire period since last reviewed that includes,  
          among other things, the purpose and necessity of the agency and  
          any recommendations of the agency for changes or reorganization  
          in order to better fulfill its purpose.  During the sunset  
          review hearings, the Committees take public testimony and  
          evaluate the eligible agency prior to the date the agency is  
          scheduled to be repealed.  An eligible agency is allowed to  
          sunset unless the Legislature enacts a law to extend,  








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          consolidate, or reorganize the eligible agency.


            The BOPsych was last reviewed in 2011 and received a four-year  
            sunset extension at that time  The legislation pertaining to  
            this bill is based on specific issues raised and addressed in  
            the report released by the Senate Committee on Business and  
            Professions along with the sunset review hearing on March 14,  
            2016.  


          Approved Schools and National Accreditation.  California is the  
          only state that allows students from unaccredited schools to sit  
          for psychology licensing examinations.  Current law requires the  
          BOPsych to accept doctoral degrees in psychology from either  
          accredited or approved institutions.  An institution is deemed  
          approved if it is not a franchise, was approved by the former  
          Bureau of Private Postsecondary Vocational Education on or  
          before 1999, and has not moved to a new location since 1999.   
          There are six schools meeting these criteria, with approvals and  
          oversight conducted solely by the BPPE.  This issue was raised  
          during the previous review of the BOPsych.  At that time, the  
          BOPsych noted that it was concerned that there is little quality  
          control over the schools' operations or curriculum and students  
          have a low pass rate on the national exam, among other issues.   
          At that time, the BOPsych stated that the students from these  
          schools should not be eligible for licensure and expressed their  
          preference for a change in law to prohibit applicants from  
          approved schools.  The law was not changed during the previous  
          sunset review. 


          In an effort to increase the quality of educational programs in  
          California, the California Private Postsecondary Education Act  
          of 2009 was amended in 2014.  SB 1247 (Lieu), Chapter 840,  
          Statutes of 2014, required degree granting institutions to be  
          accredited by an agency recognized by the USDE by July 1, 2020,  
          in order to receive BPPE approval.  Further, AB 2099 (Frazier),  
          Chapter 676, Statutes of 2014 also established requirements for  








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          unaccredited degree granting programs participating in Title 38,  
          the program that provides educational awards for eligible active  
          duty military members and veterans.  While the BOPsych  
          recognizes recent Legislative actions as significant progress,  
          there remains a concern that these changes may be insufficient  
          to raise California's psychologists to the national standard.   
          As a result, in the 2016 Committee Staff Background Paper, it  
          was recommended that current language authorizing graduates with  
          degrees from unaccredited institutions to sit for licensure by  
          the BOPsych be removed, and ensure that timeframes for this  
          change accommodate current students.  Additionally, it was  
          requested for the BOPsych to provide information to the  
          Committees as to whether regional accreditation may be  
          preferable to other types of accreditation, and the Committees  
          should specify the type of accreditation that should be required  
          of institutions offering degrees intended to lead to licensure.


          As a result of that recommendation, this bill will delete the  
          current requirements pertaining to school approval and instead  
          require that an applicant for a psychologists' license graduate  
          from an institution that is accredited by a regional accrediting  
          agency recognized by the USDE.  This bill will allow the BOPsych  
          to continue to accept applicant who possesses a doctorate degree  
          from an institution that is not accredited by an agency  
          accredited by an accrediting agency recognized by the USDE, but  
          is approved to operate in this state by the BPPE until January  
          1, 2020; thereby giving persons who may be in a current program  
          time to complete a program.  


          Continuing Professional Development.  Traditional models of CE  
          entail formal learning activities conducted in classroom or  
          workshop settings.  As referenced earlier in the report, the  
          BOPsych seeks changes to their CE program to accommodate a  
          broader competency model called CPD.  The CPD model provides  
          additional avenues for maintaining competence.  These options  
          are meant to expand the ways licensees can increase their  
          learning and to include performance-based assessments of  








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          licensees' competence.  


          In the 2016 Committee Staff Background Paper, it was recommended  
          that the BOPsych provide recommendations to the Committee with  
          respect to establishing changes in CE requirements.  To address  
          the issues raised by the BOP, this bill will change current  
          references to CE and replace it with CPD.  This bill will define  
          CPD to include activities in four different categories including  
          professional, academic, sponsoring CE coursework, and board  
          certification from the American Board of Professional  
          Psychology.  This bill will allow the BOPsych to grant an  
          extension in addition to an exemption from CPD requirements.   
          This bill requires licensees to certify under penalty of perjury  
          that he or she has completed the required CPD instead of  
          submitting all documentation.  This bill will require CPD  
          courses to be approved by organizations that are approved by the  
          BOPsych.  


          Psychological Assistants. In order to become a licensed  
          psychologist, applicants must accrue 3,000 hours of supervised  
          professional experience. Individuals who have a Master's degree  
          and are admitted into a doctoral program may obtain these hours  
          by registering with the BOPsych as a PA.  A PA provides  
          psychological services to individuals or groups while under the  
          supervision of a licensed psychologist or a board certified  
          psychiatrist.  Current law requires that a PA be employed only  
          by a psychological or medical corporation, a California licensed  
          psychology clinic, a Bronzan-McCorquodale contract clinic, a  
          licensed psychologist, or a board certified psychiatrist.  The  
          BOPsych recognizes that these statutes are outdated and do not  
          reflect the employment, contract, or volunteer opportunities  
          available in settings beyond current limitations, such as  
          hospitals, nursing homes, and rehabilitation centers.  In the  
          2016 Committee Staff Background Paper, it was recommended that  
          the BOPsych should provide recommendations to the Committees for  
          updating PA statutes to focus on appropriate supervision, rather  
          than the physical setting.  This bill makes changes related to  








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          PAs by deleting outdated employment restrictions and deletes the  
          option for a licensed psychologist to supervise, register, or  
          employ more than three PAs.  In addition, this bill makes it  
          clear that a PA registers with the BOPsych and not the PAs  
          supervisor.  


          Retired License.  The Psychology Act does not authorize a  
          retired license. Under existing law, a retired licensee may  
          choose only between "inactive" status, which costs $25 per year,  
          or "delinquent" status.  These have negative connotations and  
          may not respect a long and honorable career.  The BOPsych is  
          seeking to establish a "retired" licensure category, similar to  
          many other healing arts programs such as the Medical Board,  
          Professional Fiduciaries Bureau, Board of Behavioral Sciences,  
          and Board of Optometry.  Adding this license designation is a  
          consistent request from licensees and is included in the  
          BOPsych's 2014-2018 Strategic Plan.


          This bill authorizes the BOPsych to establish a retired license  
          and sets up the criteria for such a license.  This bill provides  
          two pathways to return a retired license to active status; 1)  
          for those retired licensees whose retired license is less than  
          three years old, and 2) for those retired licensees who retired  
          license is more than three years old.  


          Web site Information for Consumers.  The BOPsych's Web site  
          contains information for the benefit of consumers.  As such, the  
          BOPsych has requested additional legislative authority to post  
          historical information on existing and past licensees' approved  
          graduate and post-graduate education on its Web site.  This bill  
          will authorize the BOPsych to post specified information about  
          licensees on its Web site including information about  
          disciplinary licenses, enforcement actions or proceedings,  
          information about revocations, probations, or limitations on  
          practice ordered by the BOPsych, accusations filed by the  
          BOPsych, citations issued by the BOPsych, and specified  








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          information about licensee education, professional information  
          or other information as established by the BOPsych through  
          regulations.  


          Background on the BOP.  The BOPharm is responsible for enforcing  
          federal and state laws pertaining to the acquisition, storage,  
          distribution and dispensing of dangerous drugs (including  
          controlled substances) and dangerous devices.  The BOPharm has  
          over 140,000 licensees in 23 license categories that include  
          both personal and business licenses.  As an agency that  
          regulates the individuals and businesses that dispense,  
          compound, provide, store and distribute prescription drugs and  
          devices and pharmaceutical services to the public, or to other  
          health care practitioners in compliance with state and federal  
          law, the licensing of pharmacists, pharmacies, and pharmacy  
          technicians is the primary focus of BOPharm activity, with  
          consumer protection at the core of the BOPharm's operations.   
          The BOPharm's regulatory authority, as described in the Pharmacy  
          Law, extends over individuals and firms located both within and  
          outside California, if they provide services in California.  The  
          BOPharm notes that it also ensures the safety of drug products  
          dispensed to patients and regulates those who handle, store, and  
          ship products from the manufacturer through the supply chain to  
          the pharmacy and ultimately to the patient.


          Pharmacists also convey information related to drug therapy  
          management and are the health care provider most educated on  
          pharmaceutical care and management.  The BOPharm has a highly  
          diverse and detailed licensing program for the individuals and  
          facilities the BOPharm regulates, reflecting the careful and  
          deliberative manner in which the U.S. regulates the  
          manufacturing, distributing, and dispensing of prescription  
          drugs and devices.


          The BOPharm's enforcement activities are the core of its  
          program, with the majority of its staff and resources dedicated  








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          to enforcement functions.  The BOPharm employs investigators who  
          work from home offices throughout the state and perform random,  
          unannounced inspections to detect violations, investigate  
          complaints, monitor licensees on probation, educate licensees  
          about Pharmacy Law requirements, serve as expert witnesses in  
          disciplinary hearings and identify violations and issues that  
          non-pharmacists may not be able to identify.


          Background on the VMB.  The mission of the VMB is to protect  
          consumers and animals through development and maintenance of  
          professional standards, licensing of veterinarians, Registered  
          Veterinary Technicians (RVTs), and premises, and diligent  
          enforcement of the California Veterinary Medicine Practice Act.   
          The VMB is composed of eight members:  four veterinarians, one  
          RVT, and three public members.  The VMB licenses 12,086  
          Veterinarians and 6,424 RVTs.  The licensee population has  
          increased steadily over the past five years.  The VMB also  
          requires registration of all premises where veterinary medicine,  
          veterinary dentistry, veterinary surgery, and the various  
          branches thereof, is being practiced.  The VMB currently  
          registers 3,636 veterinary premises.


          The VMB conducts regular practice analyses to validate the  
          licensing examinations for both veterinarians and RVTs.   
          Additional eligibility pathways have also been approved for  
          licensure of internationally trained veterinary graduates and  
          certification of RVTs to allow qualified applicants from other  
          states in the U.S. and countries around the world to come to  
          California and to improve the provision of veterinary health  
          care for consumers and their animals.  The VMB's goals, as  
          stated in its Strategic Plan, include decreased enforcement  
          cycle times, enhanced quality and training of hospital  
          inspectors, inspecting existing hospitals within one year of  
          registration, and working with DCA to reduce the amount of  
          unlicensed activity occurring in the marketplace.










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          Analysis Prepared by:                                             
                          Gabby Nepomuceno, Elissa Silva / B. & P. / (916)  
                          319-3301                                    FN:  
          0004548