BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON
          BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
                              Senator Jerry Hill, Chair
                                2015 - 2016  Regular 

          Bill No:            SB 1194         Hearing Date:    April 18,  
          2016
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          |Author:   |Hill                                                  |
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          |Version:  |April 11, 2016                                        |
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          |Urgency:  |No                     |Fiscal:    |Yes              |
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          |Consultant|Sarah Huchel                                          |
          |:         |                                                      |
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               Subject:  Psychology:  Board of Psychology:  personnel


          SUMMARY:  Amends statutes related to psychological assistants (PAs),  
          psychologist academic requirements, and continuing education  
          (CE); establishes policies for posting licensee information on  
          the Board of Psychology's (BOP) Web site; extends the BOP's  
          sunset date to 2021; authorizes the issuance of a retired  
          license; and makes technical amends.  

          Existing law:
          
          1)Establishes the BOP to enforce and administer the Psychology  
            Licensing Law.  (Business and Professions Code (BPC) § 2900 et  
            seq.)  

          2)Requires a PA to be employed by a clinic, as specified; a  
            psychological corporation; a licensed psychology clinic, as  
            specified; or by a medical corporation. (BPC § 2913) 

          3)Prohibits a licensed psychologist from supervising more than  
            three PAs at a time unless otherwise authorized by the BOP.  
            (BPC § 2913)

          4)Prohibits a board certified psychiatrist from registering,  
            employing, or supervising more than one PA at a time. (BPC §  
            2913)

          5)Requires the licensed psychologist, board certified  







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            psychiatrist, contract clinic, psychological corporation, or  
            medical corporation, to register the PA with the BOP. (BPC §  
            2913)

          6)Prohibits a contract clinic, psychological corporation, or  
            medical corporation from employing more than ten PAs at any  
            time, and limits the number of PAs a contract clinic may  
            register, employ, or supervise to one PA for each designated  
            full-time staff psychiatrist.  (BPC § 2913)

          7)States that an applicant holding a doctoral degree in  
            psychology from an approved institution is deemed to meet  
            certain licensing requirements if both of the following are  
            true:

             a)   The approved institution offered a doctoral degree in  
               psychology designed to prepare students for a license to  
               practice psychology and was approved by the former Bureau  
               for Private Postsecondary and Vocational Education on or  
               before July 1, 1999; and,

             b)   The approved institution has not, since July 1, 1999,  
               had a new location, as described in § 94823.5 of the  
               Education Code. (BPC § 2914)

          8)Establishes requirements for CE. (BPC § 2915)

          9) Sunsets the BOP on January 1, 2017.  (BPC §§ 2920, 2933) 

          This bill:

          1)Deletes PA employment restrictions and related provisions. 

          2)Deletes the option for a licensed psychologist to supervise,  
            register, or employ more than three PAs with specific  
            authorization from the BOP. 

          3)Deletes provisions of law related to the employment,  
            supervision, and registration of a PA by a BOP certified  
            psychiatrist. 

          4)Deletes requirements related to an approved school and instead  
            requires that an applicant graduate from a college or  
            institution of higher education that is accredited by a  








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            regional accrediting agency recognized by the United States  
            Department of Education.  Authorizes BOP, until January 1,  
            2020, to accept an applicant who possesses a doctorate degree  
            from an institution that is not accredited by an accrediting  
            agency recognized by the United States Department of Education  
            but is approved to operate in this state by the Bureau for  
            Private Postsecondary Education (BPPE).  

          5)Changes references from CE to "continuing professional  
            development" (CPD) and instead of requiring licensees to  
            submit proof of compliance to BOP, requires licensees to  
            retain proof of compliance for submission to the BOP upon  
            request.  

          6)Deletes the requirement that CE instruction be completed in  
            California or be approved for CE credit by the American  
            Psychological Association or its equivalent; states instead  
            that courses shall be approved for credit by organizations  
            approved by the BOP. 

          7)Deletes BOP's authority to recognize CE courses that have been  
            approved by a nonprofit organization with at least 10 years  
            experience managing CE programs for psychologists.

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

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

          10)Allows CPD credit for individuals selected by the BOP for  
            enforcement-related functions.  

          11)Authorizes the BOP to post the following licensee  
            information:

             a)   Whether or not the licensee has any record of a  
               disciplinary action;

             b)   The following enforcement actions or proceedings against  








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               the licensee:

               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 BOP, 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 BOP. Unless withdrawn,  
                 citations shall be posted for five years from the date of  
                 issuance. 

             c)   Institutions that awarded the qualifying educational  
               degree and type of degree awarded;

             d)   A link to the licensee's professional website; and,

             e)   Other information designated by the BOP in regulation.

          12)Authorizes the BOP to issue a retired psychologist license,  
            as specified.   

          13)Extends the BOP sunset to January 1, 2021.  

          14)Makes technical amendments.

          
          FISCAL EFFECT:  Unknown.  This bill is keyed "fiscal" by  
          Legislative Counsel.  

          
          COMMENTS:
          
          1. Purpose.  This bill is sponsored by the  Author  , and is one of  
             five sunset bills the Author is sponsoring this session.   








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             According to the Author's office, this bill is necessary to  
             update provisions of the Psychology Licensing Law to reflect  
             current practices and improve information available to  
             consumers.     

          2. Oversight Hearings and Sunset Review of Licensing Boards and  
             Programs.  Beginning in 2015, the Senate Business,  
             Professions and Economic Development Committee and the  
             Assembly Business and Professions Committee (Committees)  
             conducted joint oversight hearings to review 12 regulatory  
             entities:  DCA, Acupuncture Board, Board of Behavioral  
             Sciences, California Massage Therapy Association, Court  
             Reporters Board, Board of Pharmacy, Physician Assistant  
             Board, Board of Podiatric Medicine, BPPE, BOP, Bureau of Real  
             Estate, Bureau of Real Estate Appraisers and Veterinary  
             Medical Board.

             This and other accompanying sunset bills are intended to  
             implement legislative changes as recommended by Committee  
             staff in the Background Papers prepared for each agency and  
             program reviewed.

          3. Background on BOP.  The BOP regulates licensed psychologists,  
             registered PAs, and registered psychologists.  BOP is one of  
             30 regulatory entities that falls under the organizational  
             structure of the Department of Consumer Affairs.  It is  
             funded by license, application, and examination fees, and  
             receives no revenue from California's General Fund.   

             Psychology as a profession was recognized with the  
             Certification Act of 1958, which provided only title  
             protection.  In 1967, the Legislature statutorily defined the  
             practice of psychology and required licensure to practice.   
             During these early days, the Board was an examining committee  
             under the jurisdiction of the Division of Allied Health  
             Professions of The Board of Medical Quality Assurance (BMQA).  
              The Psychology Examining Committee gradually became more  
             independent in the 1970s, taking responsibility for its own  
             operations, including the authority to adopt regulations and  
             administrative disciplinary actions without the endorsement  
             of BMQA.  The Psychology Examining Committee officially  
             became the BOP in 1990.
               









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             The BOP consists of nine members, five licensed  
             psychologists, and four public members.  The BOP is vested  
             with the authority to implement and enforce the Psychology  
             Licensing Law and appoints an Executive Officer (EO) to carry  
             out its will administratively.  The EO is responsible for  
             managing 23 staff and a budget of $4.8 million.  

          4. Review of the BOP - Issues Identified and Recommended Changes  
             

              a)   Issue  :  Approved schools and national accreditation. 
                
               Background  :  California is the only state that allows  
               students from unaccredited schools to sit for psychology  
               licensing examinations.  Current law requires the BOP 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 Bureau for Private Postsecondary and Vocational  
               Education on or before 1999, and has not moved to a new  
               location since 1999.  There are six schools meeting these  
               criteria, and approvals and oversight are conducted solely  
               by the BPPE.  

               This issue was raised during the previous review of the BOP  
               in 2011.  At that time, the BOP was concerned about the  
               lack of quality control over the schools' operations and  
               curriculum and that students attending approved schools  
               have a low pass rate on the national exam, among other  
               issues.  The BOP 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.  This law was not changed.

               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) to require  
               degree granting institutions to be accredited by an agency  
               recognized by the U.S. Department of Education (which  
               includes national accreditation) by July 1, 2020 in order  
               to receive BPPE approval.  

               However, these changes are insufficient to raise  








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               California's psychologists to the national standard.  The  
               main barrier is that the Association of State and  
               Provincial Psychology Boards (ASPPB) requires member states  
               to have regionally accredited schools to participate in  
               their Agreement of Reciprocity for licensure.  Current law  
               will only require national accreditation.  Further,  
               California psychologists cannot join the American  
               Psychological Association as full members; participate in  
               certain pre-doctoral or post-doctoral programs necessary  
               for some types of employment, including the U.S. Department  
               of Veterans' Affairs Health and Medical Centers -- the  
               largest employer of psychologists in the U.S; or be  
               eligible for licensure in some states.  

                Recommendation and Proposed Statutory Change  :  The  
               Committees should remove current language authorizing  
               graduates with degrees from unaccredited institutions to  
               sit for licensure by the BOP and ensure that timeframes for  
               this change accommodate current students.  The BOP should  
               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.
               
               This bill deletes current requirements related to an  
               approved school and instead requires that an applicant for  
               psychologist licensure graduate from a college or  
               institution of higher education that is accredited by a  
               regional accrediting agency recognized by the United States  
               Department of Education. This bill also authorizes the BOP,  
               until January 1, 2020, to accept an applicant who possesses  
               a doctorate degree from an institution that is not  
               accredited by an accrediting agency recognized by the U.S.  
               Department of Education but is approved to operate in this  
               state by the BPPE.  

              b)   Issue  :  Continuing education. 
           
          Background  :  Traditional models of CE entail formal learning  
          activities conducted in classroom or workshop settings.  The BOP  
          is seeking changes to its CE program to accommodate a broader  
          competency model called CPD.  The model was developed by the  
          ASPPB and provides additional avenues for maintaining  








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          professional competence. These options are meant to expand the  
          ways licensees can increase their learning and to include  
          performance-based assessments. 

          Changes should include:

             1.   Redefining CE requirements as CPD requirements;

             2.   Removing specific course requirements found in the BPC;  
               and,

             3.   Enabling the BOP to approve specific organizations that  
               provide CPD 
                    activities.

                Recommendation and Proposed Statutory Change  :  The BOP  
               should provide recommendations to the Committee for  
               updating CE statutes.

               This bill changes references from "continuing education" to  
               "continuing professional development," requires licensees  
               to retain proof of CPD compliance for submission to the BOP  
               upon request; requires CPD courses to be approved for  
               credit by organizations approved by the BOP; allows CPD  
               credit for individuals selected by the BOP for  
               enforcement-related functions; and requires the BOP to  
               promulgate regulations relating to CPD.  

             a)      Issue  :  Expansion of PA practice areas. 

           Background  :  Applicants must accrue 3,000 hours of supervised  
          professional experience in order to qualify for psychologist  
          licensure. Individuals who have a Master's degree and are  
          admitted into a doctoral program may obtain these hours by  
          registering with the BOP 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 BOP recognizes that these statutes are outdated and do not  








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          reflect the employment, contract, or volunteer opportunities  
          available in settings beyond current limitations, such as  
          hospitals, nursing homes, and rehabilitation centers.

           Recommendation and Proposed Statutory Change  :  The BOP should  
          provide recommendations to the Committee for updating PA  
          statutes to focus on appropriate supervision, rather than  
          physical setting.   
          
          This bill deletes PA employment restrictions and related  
          provisions and deletes the option for a licensed psychologist to  
          supervise, register, or employ more than three PAs with specific  
          authorization from the BOP. 
          
              b)   Issue  :  Retired license.
           
          Background  :  The Psychology Licensing Law 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 BOP is seeking to establish a "retired" licensure category,  
          similar to many other healing arts programs such as the Medical  
          Board of California, Professional Fiduciaries Bureau, Board of  
          Behavioral Sciences, and Board of Optometry. The creation of  
          this license would require a one-time fee and would provide a  
          means for a retired licensee to return to active status under  
          certain circumstances.

          Adding this license designation is a consistent request from  
          licensees and is included in the BOP's 2014-2018 Strategic Plan.

           Recommendation and Proposed Statutory Change  :  The BOP should  
          provide recommendations to the Committee for establishing a  
          retired license.  
          
          This bill authorizes the BOP to issue a retired license.  
          
              c)   Issue  :  Web site information. 
           
          Background:   The BOP has been very active in providing  
          information to consumers and seeks legislative authority to post  
          historical information on existing and past licensees' approved  
          graduate and post-graduate education on its Web site.  This will  








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          enable consumers to make informed decisions when selecting a  
          psychology provider.   
           
          Recommendation and Proposed Statutory Change  :  The BOP should  
          provide recommendations to the Committee for updating its public  
          information policies.   

          This bill authorizes the BOP to post the information on the  
          status of its licensees relating to disciplinary and enforcement  
          actions, academic credentials, a licensee's website, and other  
          information designated by the BOP in regulations.  
          
          1. Prior Related Legislation.  AB 773  (Baker, Chapter 336,  
             Statutes of 2015) recast the expiration dates for certain  
             licenses, certificates, and registrations issued by the BOP  
             based on the date of issuance instead of a licensee's  
             birthdate.   
             
              AB 705  (Eggman, Chapter 218, Statutes of 2015) updated the  
             Psychology Licensing Law to require employees in exempt  
             settings be supervised by a licensed psychologist and become  
             licensed within five years of practice, and made technical  
             and clarifying changes.

              AB 1374  (Levine, Chapter 529, Statutes of 2015) eliminated  
             the requirement for a fee in the practice of psychology so  
             that psychological services may be provided for free, revised  
             terms related to the practice of psychology, amended the  
             process by which an applicant submits a verification of  
             experience to the BOP, and made technical and clarifying  
             changes.  

          2. Arguments in Support.  The California Psychological  
             Association writes, "The Board of Psychology is a licensing  
             Board within the Department of Consumer Affairs responsible  
             for overseeing the laws and regulations related to the  
             licensure, practice and discipline of the diverse profession  
             of Psychology. The Board regulates over 20,000 psychologists,  
             registered psychologists, and psychological assistants.  
             Psychologists are doctoral-level mental health providers with  
             a variety of specialties.

          3. The profession is very diverse and necessitates its own  
             separate licensing board. The Board is fully funded by  








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             licensing and application fees.  As a result, there is  
             absolutely no General Fund cost to the state to run the Board  
             of Psychology. Without the sunset extension, the licensure,  
             regulation and discipline of psychologists and pre-licensed  
             psychologists would cease to exist in the state, cutting off  
             access to services for millions of Californians. We are fully  
             supportive of the four year extension in the bill, as well as  
             the pending amendments to ensure that all eligible licensees  
             will have graduated from an accredited institution and the  
             establishment of a 'retired licensee' status."

          4. Author's Amendments.  

                  a)        On page 3, line 14, after "person," strike "is  
                    registered" and insert  "shall register him or herself  "

             This amendment clarifies that the PA is responsible for  
             registering him or herself. 

                  b)        On page 4, line 26, insert "  or board certified  
                    psychiatrist  " after "psychologist.

             This bill does not include the number of PAs a board  
             certified psychiatrist can supervise; this amendment sets it  
             at the same number as a licensed psychologist. 
             
                  c)        On page 5, between lines 13 and 14, insert:

           (b) Possess an earned doctorate degree (A) in psychology, (B) in  
          educational psychology, or (C) in education with the field of  
          specialization in counseling psychology or educational  
                                                                psychology. Except as provided in subdivision (g), this degree  
          or training shall be obtained from an accredited university,  
          college, or professional school. The board shall make the final  
          determination as to whether a degree meets the requirements of  
          this section.                                           

                  d)        On page 7, between lines 14 and 15, insert:

           (g) Until January 1, 2020, an applicant holding a doctoral  
          degree in psychology from an approved institution is deemed to  
          meet the requirements of this section if both of the following  
          are true: 
          (1) The approved institution offered a doctoral degree in  








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          psychology designed to prepare students for a license to  
          practice psychology and was approved by the former Bureau for  
          Private Postsecondary and Vocational Education on or before July  
          1, 1999. 
            (2) The approved institution has not, since July 1, 1999, had a  
          new location, as described in Section 94823.5 of the Education  
          Code.
                     
          c) and d) are necessary to ensure that current license  
          requirements remain in place until January 1, 2020. 

                  e)        On page 8, at line 22, insert: 

                 "  c) Continuing professional development means certain  
                 continuing education learning activities approved in four  
                 different categories: (1) Professional (2) Academic (3)  
                 Sponsored Continuing Education Coursework and (4) Board  
                 Certification from the American Board of Professional  
                 Psychology (ABPP).  The Board may develop regulations  
                 further defining acceptable continuing professional  
                 development activities  ."

             It is unclear presently in the bill what constitutes  
             acceptable continuing professional development, and this  
             amendment will help clarify what may be applied towards  
             licensure requirements. 

                  f)        On page 9, line 8, delete "credit"

             This is a technical correction.

                  g)        On page 9, line 9, after "board." insert: "  An  
                    organization previously approved by the Board to  
                    provide or approve CE is deemed approved under this  
                    section  ."

                    "f)  The board may accept sponsored CE courses that  
                    have been approved by a private, non-profit  
                    organization that has demonstrated to the Board in  
                    writing, that it has, at a minimum, a 10-year history  
                    of providing educational programming for psychologists  
                    and has documented procedures for maintaining a  
                    continuing education approval program.  The Board  
                    shall adopt regulations as necessary for implementing  








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                    this section  ."

          This amendment gives the Board general legislative directions  
          for approving CE courses. 

                  h)        On page 10, delete lines 1-5.

               This is unnecessary because this opportunity will be  
               covered under professional CPD activities.  

           
          SUPPORT AND OPPOSITION:
          
           Support:  

          California Psychological Association

           Opposition:  None on file as of April 12, 2016.


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