BILL ANALYSIS Ó SB 1478 Page 1 Date of Hearing: June 14, 2016 ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS Rudy Salas, Chair SB 1478(Committee on Business, Professions and Economic Development) - As Introduced March 10, 2016 SENATE VOTE: 38-0 SUBJECT: Healing arts SUMMARY: Makes numerous minor, technical, or non-substantive changes to various provisions pertaining to the health-related regulatory boards of the Department of Consumer Affairs (DCA). EXISTING LAW: 1)Establishes the Task Force on Culturally and Linguistically Competent Physicians and Dentists (task force), as specified. (BPC Section 852(a)) 2)States that the duties of the task force include developing recommendations for a continuing education program that includes language proficiency standards, identifying the key cultural elements necessary to meet cultural competency, and assessing the need for voluntary certification standards and examinations for cultural and linguistic competency. (BPC Section 852(c)) SB 1478 Page 2 3)Requires the Medical Board of California (MBC) to keep a copy of a complaint it receives regarding the poor quality of care rendered by a licensee for ten years from the date the MBC receives the complaint, as specified. (BPC Section 2029) 4)Establishes within the MBC a Bureau of Medical Statistics. Provides that the purpose of the bureau is to provide the MBC and its divisions with statistical information necessary to carry out their functions of licensing, medical education, medical quality, and enforcement. (BPC Section 2380) 5)Establishes the Dental Board of California (DBC) to license and regulate dentists, registered dental assistants and registered dental assistants in extended functions, as specified. (BPC Section 1601.1 et seq.) 6)Requires each applicant for a dental license to successfully complete the Part I and Part II written examination of the National Dental Examination of the Joint Commission on National Dental Examinations. (BPC Section 1632(a)) 7)Establishes the Podiatric Medical Board within the Jurisdiction of the MBC to license and regulate podiatrists. (BPC Section 2460 et seq.) 8)Establishes the Board of Behavioral Sciences (BBS), under the Department of Consumer Affairs (DCA), to license and regulate Licensed Clinical Social Workers (LCSWs), Licensed Marriage and Family Therapists (LMFTs), Licensed Educational Psychologists (LEPs), Licensed Professional Clinical Counselors (LPCCs), Associate Clinical Social Workers (ACSWs), Marriage and Family Therapist Interns (MFT Interns), and Professional Clinical Counselor Interns (PCC Interns). (BPC Sections 4990 et seq.) 9)Requires LMFT applicants to possess a specified doctoral or master's degree obtained from an educational institution SB 1478 Page 3 approved by the Bureau for Private Postsecondary Education (BPPE) or accredited by either the Commission on Accreditation for Marriage and Family Therapy Education, or a regional accrediting agency that is recognized by the United States Department of Education. (BPC Section 4980.36(b)) 10)Prohibits MFT and LPCC interns and trainees from completing supervised experience hours as an independent contractor. (BPC Section 4980.43(c), 4999.47(a)) 11)Refers to applicants for LCSW who are registered with the BBS as associate social workers (ASW). (BPC Section 4992.05) 12)Specifies that an applicant who possesses a master's degree from a school or department of social work that is a candidate for accreditation by the Commission on Accreditation of the Council on Social Work Education (Commission), is required to register as an ASW in order to gain experience toward licensure, but the applicant is not eligible to take an examination until the school or department of social work has received accreditation by the Commission. (BPC Section 4996.18 (c)) 13)Defines an "accredited" school for the purpose of licensure as an LPCC, as a school, college, or university accredited by the Western Association of Schools and Colleges, or its equivalent regional accrediting association. (BPC Section 4999.12(b)) THIS BILL: 14)Makes the following changes related to the DBC and the dental practice act: a) Reflects the integration of the National Board Dental SB 1478 Page 4 Examination of the Joint Commission on National Dental Examinations (Joint Commission) from two parts to one. 15)Makes the following changes related to the MBC and the practice act: a) Deletes obsolete language pertaining to an inoperative task force. b) Deletes an obsolete reference to complaint retention for licensees. c) Deletes obsolete language pertaining to the inoperative Bureau of Medical Statistics. 16)Requires the Board of Podiatric Medicine (BPM) to elect a secretary in addition to a president and vice president. 17)Makes the following changes related to the BBS and LMFT, LCSW and LPCC practice acts. a) Replaces the titles "marriage and family therapist intern" or "marriage and family therapist registered intern" with the titles "associate marriage and family therapist" or "registered associate marriage and family therapist" beginning January 1, 2018. b) Deletes an obsolete reference pertaining to school approval. c) Clarifies that social worker, marriage and family, and professional clinical counselor interns, trainees, or associates may not gain supervised experience while employed as independent contractors, as specified. d) Replaces the term "associate social worker" with associate clinical social worker. SB 1478 Page 5 e) Prohibits LCSW applicants from taking only the clinical examination until the school has obtained accreditation, as specified. f) Expands the approved accreditation agencies, as specified. g) Replaces the titles "professional clinical counselor intern" or "professional clinical counselor registered intern" with the titles "associate professional clinical counselor" or registered associate professional clinical counselor" beginning January 1, 2018. h) Requires applicants for licensure or registration as a professional clinical counselor to submit to the BBS a certification from the applicant's educational institution that the institution's required curriculum for graduation and any associated coursework meet specified curriculum requirements. i) Deletes an obsolete reference to a grandfathering provision for licensure as an LPCC. 18)Makes numerous other technical and clarifying amendments. FISCAL EFFECT: According to the Senate Appropriations Committee, pursuant to Senate Rule 28.8, this bill will result in negligible state costs. COMMENTS: Purpose. This bill is sponsored by the author. According to SB 1478 Page 6 the author, "this bill is one of two "committee bills" authored by the [Senate Committee on Business, Professions and Economic Development] and is intended to consolidate a number of non-controversial provisions related to various regulatory programs and professions governed by the BPC. Consolidating the provisions in one bill is designed to relieve the various licensing boards, bureaus, professions, and other regulatory agencies from the necessity and burden of having separate measures for a number of non-controversial revisions. Many of the provisions of this bill are minor, technical, and updating changes, while other provisions are substantive changes intended to improve the ability of various licensing programs and other entities to efficiently and effectively administer their respective laws. However, as a Committee bill, if controversy or opposition should arise regarding any provision that cannot be resolved, then that provision will be removed from the bill. This will eliminate the chance of placing any of the other provisions in jeopardy." Background. Dental Board of California. The DBC is responsible for the licensure and regulation of licensed dental health professionals, which includes dentists, registered dental assistants, and registered dental assistants in extended functions. BPC 1632(a) specifies that applicants for licensure as a dentist must successfully complete the Part I and Part II written examinations of the National Board Dental Examination of the Joint Commission. As noted by the author, in 2017, the Joint Commission will be integrating the two-part examination into one singular examination. The changes in this bill reflect the integration of the examinations into one examination. Medical Board of California. AB 2394 (Firebuagh), Chapter 808, Statues of 2000, established a Task Force on Culturally and Linguistically Competent Physicians and Dentists, chaired by the Director of the DCA. The task force was required to report to the Legislature and the respective licensing boards within two years after its establishment. The task force released its SB 1478 Page 7 report to the Legislature as required by AB 2394 in 2003. According to the author, the task force has not been active since 2003. This bill deletes BPC section 852 pertaining to the establishment of the inactive task force. BPC Section 2029 requires the MBC to keep a copy of a complaint received regarding poor quality of care rendered by a licensee for 10 years from the date the MBC received the complaint. Currently, the MBC follows the provisions of BPC Sections of 2227.5 which requires the MBC to keep a copy of a complaint it receives concerning the unprofessional conduct of a licensee for seven years or until the statute of limitations for filing an accusation against a licensee has expired, whichever period is shorter, if the MBC finds after an investigation that there is insufficient evidence to proceed with disciplinary action. The author notes that this provision, along with the statute pertaining to the time limit for filing an accusation (BPC Section 2230.5), renders BPC Section 2029 inoperative; therefore, this bill deletes BPC Section 2029. The Bureau of Medical Statistics under the MBC was enacted in 1980. Currently, the MBC is responsible for collecting medical statistics and the bureau is no longer active. This bill deletes obsolete language pertaining to the Bureau of Medical Statistics. Board of Podiatric Medicine. BPC Section 2467 requires the BPM to annually elect a president and a vice president of its board; this bill will require the BPM to additionally elect a secretary. The author notes that the BPM requested the additional elected board position. Board of Behavioral Sciences. The BBS licenses and regulates LCSWs, LMFTs, LEPs, and LPCCs. Additionally, the BBS registers ACSWs, MFT Interns, PCC Interns, and until June 30, 2015, SB 1478 Page 8 registered continuing education (CE) providers. Each profession has its own scope of practice, entry-level requirements, and professional settings, with some overlap in certain areas. Below are a few examples of settings in which licensees may work; however, licensees may work in other settings that lawfully provide mental health services. Current law requires applicants for licensure as LMFT, LCSW, and LPCC to obtain supervised hours of experience in order to qualify for licensure. LMFT, LCSW, and LPCC applicants are permitted to obtain experience hours as a volunteer or an employee, but BPC Sections 4980.43 and 4999.47 specifically prohibit applicants for LMFT and LPCC from gaining experience while employed as an independent contractor. This bill further clarifies that associates, trainees or interns employed as independent contractors may not gain experience for work performed as an independent contractor or employed as an independent contractor. SB 704 (Negrete McLeod) Chapter 387, Statutes of 2011, restructured the examination process for Licensed Marriage and Family Therapists (LMFTs), LCSWs, and Licensed Professional Clinical Counselors (LPCCs). That bill established new requirements for licensure and registration which included a provision that applicants must take and pass both a California law and ethics examination and a clinical examination as prescribed by the BBS. Those changes also required that beginning January 1, 2016, in order to renew registration as an ACSW, an individual must take and pass the California law and ethics examination. However, under current law, BPC Section 4996.18 specifies that a LCSW applicant is not eligible to take any examination until his or her school or department of social work has received accreditation by the Commission. Without the changes proposed by this bill, an individual may not be able to take the California and law and ethics examination rendering the applicant ineligible for renewal. SB 1478 Page 9 According to information from the BBS, the purpose of BPC Section 4996.18 was to prohibit an LCSW applicant from obtaining licensure until the applicant's school or department of social work obtained accreditation from the Commission. However, as a result of SB 704, the new examination requirements will be implemented January 1, 2016. After this date, in order to renew an ACSW registration, an applicant must take and pass the law and ethics examination. Previously, both required examinations were taken at the end of acquiring hours and upon meeting educational accreditation standards. Since accrediting a school can takes several years, the current law could cause a first year associate to be unable to take the California law and ethics examination, and consequently, be unable to renew his or her registration. This bill makes conforming changes to allow applicants for LCSW to take the law and ethics examination while their school or department of social work is waiting for accreditation, in order to meet new examination requirements for registered as ACSWs. SB 788 (Wyland), Chapter 619, Statutes of 2009, established the LPCC Act. BPC Section 4999.54 was enacted to establish a grandfathering provision at the beginning of the LPCC licensure program. At that time the BBS accepted specified applications for licensure under the grandfathering provisions between January 1, 2011 and December 31, 2011. Although the application period ended five years ago, the provision remained to allow those applicants to remediate missing coursework requirements. The remediation period has since ended and this bill will delete now obsolete references to the grandfathering provisions. Persons seeking licensure as an LMFT, LCSW, and LPCC must first register with the BBS and obtain hours of supervised experience. According to the author, Registrants gaining supervised experience hours toward an LMFT or LPCC license are referred to as "interns" throughout applicable code. Stakeholders and registrants have voiced concerns that the "intern" title for SB 1478 Page 10 LMFT and LPCC registrants may not be an accurate representation of their post-master's degree graduate status. Registrants gaining experience hours toward an LCSW license are referred to as "associates." This bill would change reference from "intern" to "associate" for LMFT and LPCC applicants to create consistency in the titles used by the BBS and remedy a common misconception that LMFT and LPCC interns have not yet graduated. Current Related Legislation. SB 1479 (Senate Committee on Business, Professions and Economic Development), of the current legislative session, makes several non-controversial, minor, non-substantive or technical changes to various provisions within the Business and Professions Code relating to the non-health regulatory boards or bureaus of the DCA. Status: This bill is currently pending in the Assembly Committee on Business and Professions. Prior Related Legislation. SB 800 (Senate Committee on Business, Professions and Economic Development), Chapter 426, Statutes of 2015, made numerous substantive, technical, and minor non-controversial changes to various provisions of the healing arts boards regulated by the DCA. SB 1466 (Senate Committee on Business, Professions and Economic Development), Chapter 316, Statues of 2014, made several non-controversial, minor, non-substantive or technical changes to various provisions pertaining to the health regulatory programs under the BPC. SB 1575 (Senate Committee on Business, Professions and Economic Development), Chapter 799, Statutes of 2012, made numerous minor and technical changes to various provisions pertaining to the health-related regulatory boards within the DCA. SB 1478 Page 11 REGISTERED SUPPORT: None on file. REGISTERED OPPOSITION: None on file. Analysis Prepared by:Elissa Silva / B. & P. / (916) 319-3301