BILL ANALYSIS                                                                                                                                                                                                    







           ---------------------------------------------------------- 
          |Hearing Date:April 2, 2001     |Bill No:SB                |
          |                               |724                       |
           ---------------------------------------------------------- 


                    SENATE COMMITTEE ON BUSINESS AND PROFESSIONS
                             Senator Liz Figueroa, Chair

           Bill No:        SB 724Author:  Business & Professions Committee
                    As Introduced                      Fiscal:Yes

          
          SUBJECT:    Healing arts.
          
          SUMMARY:  Makes changes to the regulation of various health  
          care professionals, including licensed educational  
          psychologists, licensed clinical social workers, marriage  
          and family therapists, dentists, physicians and surgeons,  
          pharmacists, vocational nurses and psychiatric technicians.

          Existing law:
          
          1)Requires that specified information relating to claims  
            against a physician and surgeon for acts of professional  
            negligence or for the unauthorized rendering of  
            professional services be reported to the Medical Board of  
            California (Medical Board).

          2)The Dental Practice Act (DPA), establishes an examining  
            committee within the Dental Board of California (Dental  
            Board) and makes it responsible, among other matters, for  
            assisting the Dental Board in the examination of  
            applicants for licensure by the Dental Board.

          3)The DPA and the Medical Practice Act (MPA), includes  
            certain provisions operative until January 1, 2002,  
            relating to the administration of general anesthesia by a  
            physician and surgeon to patients in the office of a  
            dentist licensed by the Dental Board.

          4)The MPA, prohibits a physician and surgeon from  
            practicing without a certificate issued by the Medical  
            Board and establishes criteria for the issuance of this  
            certificate, including evidence of the completion of  





                                                                     SB 724
                                                                     Page 2



            specified preprofessional education courses.  Under  
            specified conditions, a graduate of an approved medical  
            school and a graduate of a foreign medical school from  
            this certificate requirement while participating in  
            postgraduate training.

          5)The Speech-Language Pathologists and Audiologists  
            Licensure Act, creates, until July 1, 2002, the  
            Speech-Language Pathology and Audiology Board.

          6)Provides for the licensing of vocational nurses and  
            psychiatric technicians by the Board of Vocational  
            Nursing and Psychiatric Technicians and authorizes the  
            board to reinstate a suspended or revoked license under  
            specified conditions.
          7)The Pharmacy Law, provides for the regulation and  
            licensing of pharmacists and various other persons and  
            entities by the Board of Pharmacy and makes it a  
            misdemeanor for a wholesaler or any other person to  
            permit the dispensing of prescriptions except by a  
            pharmacist or exemptee.

          8)Requires persons engaged in the practice of marriage and  
            family therapy to be licensed by the Board of Behavioral  
            Sciences (BBS).  An applicant for this license is  
            required to achieve a passing score on an examination and  
            to possess a doctoral or master's degree in one of  
            several designated subjects, including social work.   
            Interns, defined as a person who has earned a master's or  
            doctoral degree but is not yet licensed, are required to  
            register with the BBS and renew this registration  
            annually.  The BBS is authorized to assess various fees  
            in connection with its licensing activities that are  
            deposited into the Behavioral Sciences Fund, which is  
            continuously appropriated.

          9)Requires persons engaged in the practice of clinical  
            social work to be licensed by the BBS.  An applicant for  
            this license is required to meet specified professional  
            experience and educational requirements and to achieve a  
            passing score on a professional licensure examination.   
            The BBS is authorized to take disciplinary action against  
            a licensee for unprofessional conduct and makes the  
            violation of any provision regulating the licensure or  
            practice of a clinical social worker a crime.






                                                                     SB 724
                                                                     Page 3



          This bill:

          1)Makes the following changes pertaining to the  Board of  
            Behavioral Sciences  :

             a)   Adds a qualifying degree title that conforms to the  
               current marriage and family therapist license title.

             b)   Broadens the Board's authority to approve qualifying  
               degree programs.

             c)   Specifies that a degree program must be a single,  
               integrated program that is designed to train marriage and  
               family therapists.

             d)   Eliminates references to degrees that are no longer  
               granted.

             e)   Requires registered marriage and family therapist  
               interns and associate clinical social workers, applying for  
               renewal, to notify the Board if they have been convicted of  
               a crime since their last renewal.

             f)   Clarifies that the registration of unlicensed marriage  
               and family therapist interns shall not be renewed or  
               reinstated beyond the timeframe identified in law.

             g)   Clearly identifies a timeframe during which the Board  
               will accept a passing score on the California written  
               examination.

             h)   Deletes an inaccurate reference to registrant status for  
               licensed educational psychologists.

             i)   Clarifies the current prohibition against licensed  
               clinical social workers having sexual relations with  
               patients by specifying that such conduct is prohibited  
               within 2 years following the termination of therapy.

             j)   Corrects inaccurate code references.

             aa)Repeals an obsolete section of law regarding the rights of  
               a visually impaired person in relation to education and  
               licensure as a licensed clinical social worker.

             bb)Broadens the Board's authority to deny a license to  





                                                                     SB 724
                                                                     Page 4



               applicants who are subject to an order of registration  
               pursuant to Section 290 of the penal code. ["Megan's Law"]

             cc)Clearly identifies all the educational requirements for  
               licensure as a licensed clinical social worker.

             dd)Deletes obsolete language referencing experience gained  
               toward requirements for registration as an associate  
               clinical social worker.

             ee)Deletes language that could be misconstrued to mean that  
               an associate clinical social worker must be an employee of  
               their supervisor.

             ff)Deletes obsolete language regarding a report already  
               submitted to the Legislature.

             gg)Deletes the requirement that a supervisor submit evidence  
               of satisfactorily completing supervised experience gained  
               by an associate clinical social worker.

             hh)Clearly outlines the actual number of hours of experience  
               that must be accrued for face-to-face psychotherapy.

             ii)Clarifies that the supervisor of an associate clinical  
               social worker in a private practice setting must also  
               regularly conduct business in this setting.

             jj)Specifies that all associate clinical social workers,  
               regardless of whether they have accrued their experience  
               toward licensure, must continue to receive a minimum of one  
               hour of supervision each week until licensed.

          1)Makes the following changes pertaining to the  Dental  
            Board  :

             a)   Repeals the provision allowing certification in oral  
               conscious sedation for minor patients by documentation.

             b)   Modifies the provisions governing the Board's examining  
               committee.

             c)   Provides for a disabled inactive status and reduced  
               license fee for any licensee who can demonstrate, to the  
               satisfaction of the Board, that they are unable to practice  
               dentistry due to a disability.





                                                                     SB 724
                                                                     Page 5




             d)   Repeals the sunset dates of various general  
               anesthesia provisions.

          1)Makes the following changes pertaining to the  Medical  
            Board  :

             a)   Clarifies that the 2 year exemption from licensure as a  
               physician and surgeon during postgraduate training is  
               cancelled and participation in the program must cease if  
               the Board's Division of Licensing denies the individual's  
               application for licensure.

             b)   Clarifies that the 2 year exemption from licensure for  
               physicians and surgeons who are recruited to practice in  
               state and county institutions is not allowed without the  
               approval of the Board's Division of Licensing.

             c)   Repeals an unnecessary requirement relative to providing  
               documentation of specified coursework prior to entering  
               medical school.

             d)   Repeals an obsolete reference to verification of  
               citizenship in relation to applicants for a physician and  
               surgeon's certificate.

             e)   Codifies a current practice of referring applicants for  
               a psychiatric evaluation or an oral clinical competency  
               examination when there is clear and convincing evidence in  
               the applicant's background that a condition has affected  
               the individual's ability to practice safely or has resulted  
               in disciplinary action.

             f)   Clarifies and specifies that certain reports shall  
               include the name and license number of the responsible  
               physician and surgeon.

          1)Makes the following changes pertaining to the  Board of  
            Pharmacy  :
          
             a)   Deletes an obsolete reference to medical device  
               retailers.

             b)   Provides that "manufacturer" shall not mean a pharmacy  
               that, at the patient's request, repackages a drug  
               previously dispensed to the patient or the patient's agent  





                                                                     SB 724
                                                                     Page 6



               pursuant to a prescription.

             c)   Reinstates an inadvertently repealed provision that  
               authorizes the Board to specify in regulation that certain  
               dangerous devices may only be dispensed in a pharmacy.

             d)   Authorizes the Board to issue a temporary permit to a  
               pharmacy in certain limited instances.

             e)   Deletes obsolete language providing an exception to the  
               registration requirements for pharmacy technicians.

             f)   Corrects a reference to an erroneous type of license.

             g)   Deletes an incorrect reference to dispensing of  
               prescriptions.

             h)   Simplifies existing law, which requires out of state  
               entities distributing dangerous drugs or dangerous devices  
               on a wholesale basis in California to be licensed by the  
               Board as a wholesaler.

             i)   Eliminates an obsolete provision regarding the  
               processing fee for remodeling plans and inspecting a  
               remodeled pharmacy.

          1)Makes the following change pertaining to the  
             Speech-Language Pathology and Audiology Board  :

             a)   Extends the sunset date for the Board.

          1)Makes the following change pertaining to the  Board of  
            Vocational Nursing and Psychiatric Technicians  :

             a)   Extends the period of time required for petitioners  
               to wait prior to applying for reinstatement of a  
               license, modification of probation, or termination of  
               probation.


          FISCAL EFFECT:  Unknown.

          COMMENTS:
          
          Measure Intended to Make Various Improvements to Regulatory  
          Programs Within the Department of Consumer Affairs.  The  





                                                                     SB 724
                                                                     Page 7



          measure, one of three annual omnibus bills, is intended to  
          attend to various housekeeping items for health care  
          regulatory programs and licensees.  The bill attempts to do  
          this by either, i) updating statutes to reflect various  
          changes to programs within the Department of Consumer  
          Affairs over the past year, ii) attending to code  
          maintenance by doing technical clean-up and deleting  
          obsolete references, or 
          iii) improving the administration of the various boards by  
          clearing up ambiguity or enhancing enforcement authority.

          Many of the provisions make minor, technical and updating  
          changes, while other provisions are substantive changes  
          which are intended to improve the ability of the various  
          licensing programs to efficiently and effectively  
          administer their respective licensing 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.
          



          SUPPORT AND OPPOSITION:
          
          Support:
          Board of Behavioral Sciences 
          Board of Pharmacy
          Board of Vocational Nursing and Psychiatric Technicians
          California Academy of Audiology
          California Association of Marriage and Family Therapists
          Dental Board of California


           Opposition:  None reported to the Committee as of March  
                     27, 2001


          Consultant:Kristin J. Triepke