BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 724
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          Date of Hearing:  July 10, 2001

                            ASSEMBLY COMMITTEE ON HEALTH
                                Helen Thomson, Chair
           SB 724 (Committee on Business and Professions) - As Introduced:  
                                  February 23, 2001

           SENATE VOTE  :  39-0
          
          POLICY QUESTION  :

          Should various changes be made to the laws regulating health  
          care professionals licensed under the Medical Board of  
          California, the Dental Board of California, the Speech-Language  
          Pathology and Audiology Board, the Board of Vocational Nursing  
          and Psychiatric Technicians, the Board of Pharmacy, and the  
          Board of Behavioral Sciences?
           
          SUBJECT  :  Healing arts.

           SUMMARY  :  Makes various changes to the laws regulating various  
          licensed health care professionals.  Specifically,  this bill  :   

          1)Makes the following changes pertaining to the  Medical Board  
            of California (MBC):

             a)   Requires that certain reports relating to settlements or  
               judgements against the licensee of more than $30,000  
               include the name and license number of the responsible  
               physician and surgeon.

             b)   Clarifies that an exemption from licensure as a  
               physician and surgeon during postgraduate training is  
               cancelled and participation in the program must cease if  
               MBC denies the individual's application for licensure.

             c)   Clarifies that MBC must approve an application for  
               exemption from licensure for out of state physicians and  
               surgeons who are recruited to practice in state and county  
               institutions.

             d)   Repeals a requirement relative to providing  
               documentation of specified coursework prior to entering  
               medical school.









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

             f)   Permits MBC to require licensure applicants to be  
               examined by a psychiatrist or psychologist or another  
               physician or health care practitioner, and also require an  
               oral clinical competency examination, in order to determine  
               whether it should issue a probationary license and whether  
               there should be any probationary conditions.

          2)Makes the following changes pertaining to the Dental Board of  
            California (DBC):

             a)   Repeals an obsolete provision allowing certification in  
               oral conscious sedation for minor patients by documentation  
               of 10 cases of oral conscious sedation satisfactorily  
               performed.

             b)   Requires DBC to utilize in the administration of its  
               licensure examinations only examiners whom it has appointed  
               and who meet specified criteria, including practicing in  
               their licensure category for at least five years.

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

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

          3)Extends the sunset date of the Speech-Language Pathology and  
            Audiology Board from July 1, 2002, to July 1, 2004.

          4)Requires persons whose license under the Board of Vocational  
            Nursing and Psychiatric Technicians has been revoked,  
            suspended, surrendered, or placed on probation, to wait for  
            specified time periods before petitioning for reinstatement.   
            The time periods vary from one to three years, depending on  
            the condition placed on the license.

          5)Makes the following changes pertaining to the  Board of  
            Pharmacy (BOP):









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             a)   Deletes an obsolete reference to medical device  
               retailers.

             b)   Specifies that "manufacturer" does not mean a pharmacy  
               that, at the patient's request, repackages a drug  
               previously dispensed to the patient or the patient's agent  
               pursuant to a prescription.

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

             d)   Modifies BOP's authority to issue a temporary permit to  
               a pharmacy by limiting the time of the temporary permit to  
               180 days, and specifying that the temporary permits may be  
               subject to conditions or restrictions as BOP deems  
               necessary.

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

             f)   Clarifies who is required to obtain an out-of-state  
               dangerous drug or dangerous device distributor's license.

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

          6)Makes the following changes pertaining to the Board of  
            Behavioral Sciences (BBS):


             a)   Revises the doctor's or master's degree requirements for  
               marriage and family therapist licensure applicants to  
               eliminate degrees in social work with an emphasis in  
               clinical social work from qualifying for licensure as a  
               marriage and family therapist.

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

             c)   Requires registered marriage and family therapist  
               interns and associate clinical social workers, applying for  
               renewal, to notify BBS if they have been convicted of a  








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               crime since their last renewal and to pay a renewal fee of  
               $75.  Prohibits renewal of registration if the application  
               is made more than six years after the registration was  
               initially issued.

             d)   Requires BBS to accept a passing score on the written  
               examination for marriage and family therapists, social  
               workers, and educational psychologists for a period of  
               seven years from the date on which the examination  
               occurred.

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

             f)   Repeals a section of law regarding the rights of a blind  
               person in relation to education and licensure as a licensed  
               clinical social worker.

             g)   Clarifies BBS's authority to deny a license to  
               applicants who are subject to an order of registration as a  
               sexual offender.

             h)   Requires applicants for licensure as a clinical social  
               worker to provide evidence of completion of 10 contact  
               hours of training or coursework in human sexuality, as  
               specified in regulations, and a minimum of seven contact  
               hours of training or coursework in child abuse assessment  
               and reporting, as specified in regulations.

             i)   Deletes the requirement that a supervisor of a  
               registered associate clinical worker submit evidence of  
               satisfactory completion of supervised experience gained by  
               an associate clinical social worker.

             j)   Revises the criteria by which required experience must  
               be obtained for licensure as a clinical social worker by  
               specifying that a minimum of 750 hours of the required  
               experience must consist of face-to-face individual or group  
               psychotherapy provided to clients in the context of  
               clinical social work services.

           EXISTING LAW  :








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          1)Licenses and regulates various health care professionals  
            through various boards within the Department of Consumer  
            Affairs.

          2)Requires that specified information relating to claims against  
            a physician for acts of professional negligence or for the  
            unauthorized rendering of professional services be reported to  
            MBC.

          3)Sunsets certain provisions of law permitting the  
            administration of general anesthesia by a physician to  
            patients in the office of a dentist on January 1, 2002. 

           FISCAL EFFECT  :  Unknown

           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  According to the author, this is one of  
            the Senate Business and Professions Committee's omnibus bills  
            that makes changes to various provisions of licensing statutes  
            for health professionals.  The author states that at any time,  
            if provisions in this bill become controversial, they will be  
            removed.  According to the author, this bill is intended to  
            address "housekeeping" items for health care regulatory  
            programs, by:  1) updating statutes to reflect various changes  
            to programs over the past year; 2) attending to code  
            maintenance by doing technical clean-up and deleting obsolete  
            references; or, 3) improving the administration of the various  
            boards by clearing up ambiguity or enhancing enforcement  
            authority.

           2)SUPPORT  .  The Medical Board of California, Board of Pharmacy,  
            Board of Vocational Nursing and Psychiatric Technicians  
            (BVNPT), Dental Board of California, and Board of Behavioral  
            Sciences have all written letters in support of those  
            provisions of this bill pertaining to their practice acts.

          BVNPT states in support of the provision extending the minimum  
            time period a petitioner is required to wait before applying  
            for reinstatement of a license, that because existing law in  
            the Administrative Procedures Act permits application for  
            reinstatement after a one-year period, many petitioners are  
            applying for reinstatement without being sufficiently  
            rehabilitated.  This is especially true of petitioners who  








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            have been disciplined for sexual or substance abuse.  BBS  
            states that the provisions of this bill relating to BBS,  
            including requiring interns to notify BBS if they have been  
            convicted of a crime subsequent to their last renewal, would  
            clarify and strengthen existing law and provide for better  
            oversight of its licensing and enforcement programs.

          Both the California Speech-Language Hearing Association and the  
            California Academy of Audiology support this bill to extend  
            the Speech-Language Pathology and Audiology Board's sunset  
            date, and to make technical changes.

           3)SUPPORT IF AMENDED  .  The California Chapter of the National  
            Association of Social Workers (NASW) states that it would  
            support this bill if the provision that prohibits social  
            workers from engaging in sexual relations with a former client  
            within two years of the termination of therapy is amended to  
            prohibit sexual relations with a former client  regardless of  
            any time period following therapy  .  NASW argues that unless  
            extraordinary circumstances warrant it, social workers should  
            never engage in sexual activities or sexual contact with  
            former clients.

           4)OPPOSE UNLESS AMENDED  .  The California Medical Association  
            (CMA) opposes this bill unless the following amendments are  
            taken:

             a)   Removal of the provision of this bill that permits MBC  
               to request a psychological evaluation of any applicant for  
               licensure.  CMA states that this language presents a new  
               policy discussion that simply has not taken place and which  
               further raises several questions as to its purpose and  
               implementation; and,

             a)   With regard to the provision of this bill permitting the  
               Board of Pharmacy to establish a list of those dangerous  
               devises that may only be dispensed by a pharmacy, CMA  
               requests that physicians be exempted from any list adopted  
               pursuant to this provision.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          Board of Behavioral Sciences








                                                                  SB 724
                                                                  Page  7

          Board of Pharmacy, Board of Vocational Nursing and Psychiatric  
          Technicians
          California Academy of Audiology
          California Association of Marriage and Family Therapists
          California Speech-Language Hearing Association
          Dental Board of California
          Medical Board of California
           
            Opposition 
           
          None on file


           Analysis Prepared by  :  Vincent D. Marchand / HEALTH / (916)  
          319-2097