BILL ANALYSIS                                                                                                                                                                                                    Ó



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          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))









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          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  








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            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  








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               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.








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             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  








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          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  








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          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,  








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          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.  









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          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  








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          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.










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          REGISTERED SUPPORT:


          None on file.


          REGISTERED OPPOSITION:


          None on file. 


          Analysis Prepared by:Elissa Silva / B. & P. / (916) 319-3301