BILL ANALYSIS
SB 819
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SENATE THIRD READING
SB 819 (Yee)
As Amended September 10, 2009
2/3 vote. Urgency
SENATE VOTE :Vote not relevant
BUSINESS & PROFESSIONS (vote not relevant) APPROPRIATIONS
(vote not relevant)
BUSINESS & PROFESSIONS 10-0
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|Ayes:|Hayashi, Emmerson, | | |
| |Conway, Eng, Hernandez, | | |
| |Nava, Niello, | | |
| |John A. Perez, Ruskin, | | |
| |Smyth | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Expands the authorized functions that may be performed
by nurse practitioners (NP) practicing under standard
procedures, revises provisions of the Accountancy Act, and makes
several non-controversial, minor, non-substantive or technical
changes to various provisions pertaining to the regulatory
boards in the Department of Consumer Affairs (DCA).
Specifically, this bill :
1)Makes changes to the following general provisions in the
Business and Professions Code (BPC):
a) Adds the Professional Fiduciaries Bureau to the lists of
specified boards and bureaus which must disclose
information about licensees on the Internet (BPC Section
27);
b) Require applicants to furnish fingerprints for the
purpose of conducting criminal history record checks (BPC
Section 144);
c) Makes correcting and conforming changes (BPC Sections
101 and 146);
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d) Makes cleanup provisions relating to professional
fiduciaries to correct amendments that were made in SB 1047
of 2007 (BPC Sections 6534, 6536, 6561); and,
e) Corrects the name of the Cemetery and Funeral Bureau and
references to the Bureau's licensees (BPC Sections 27 and
144);
f) Clarifies provisions relating to the filing and
submission of disciplinary information for specified health
care practitioners (BPC Section 800); and,
g) Makes non-substantive clarifying and technical
amendments, and delete obsolete requirements.
2)Makes the following changes pertaining to the Board of
Behavioral Sciences (BBS):
a) Makes technical changes to maintain the clarity and
consistency of the BBS statutes (BPC Sections 128.5, 801,
803, 4980.04, 4980.30, 4980.43, 4996.17 and 4996.18);
b) Repeals several sections that are obsolete and outdated
(BPC Sections 4981, 4994.1, 4996.20 and 4996.21);
c) Specifies that engaging in conduct that subverts any
licensing examination or administration of an examination
is considered unprofessional conduct and therefore, subject
to disciplinary action (BPC Sections 4982, 4989.54 and
4992.3); and,
d) Specifies that the BBS would cease publishing a citation
and fine determination against a licensee on the Internet
after five years from the issuance of the citation (BPC
Section 4990.09). The five-year limit would not apply to
citations where the fine paid is in excess of $1,500.
3)Makes the following changes pertaining to the Board of
Pharmacy (BOP):
a) Corrects incorrect code section references (BPC Sections
733, 4027, 4040, 4051, 4060, 4076, 4111, and 4174; Health
and Safety Code (HSC) Section 11150);
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b) Clarifies the definition of "designated
representative-in-charge" as well as the responsibilities
of a licensee acting in that capacity (BPC Section 4022.5);
c) Defines the term "pharmacist-in-charge" as well as the
responsibilities of a pharmacist serving as such (BPC
Section 4036.5);
d) Clarifies that a designated representative must sign for
and receive delivery for drugs by a wholesaler (BPC Section
4059.5);
e) Permits the use of a mobile pharmacy in the event of a
declared natural disaster under specified criteria (BPC
Section 4062);
f) Corrects a drafting error in previous legislation (BPC
Section 4081). The correct term should be "designated
representative in charge;
g) Permits the use of a mobile pharmacy on a temporary
basis when a pharmacy is destroyed or damaged, and it is
necessary to protect the health and safety of the public,
as specified (BPC Section 4110) ;
h) Specifies who in the drug supply chain may receive
dangerous drugs furnished by a pharmacy (BPC Section
4126.5);
i) Corrects an oversight from a 2004 revision to the BPC
which left "sales" out of nonresident wholesaler language
causing issues with the Board's ability to cite and fine
violations of law (BPC Section 4161);
j) Grants the Board the authority to automatically
inactivate a pharmacist's license when a pharmacist who
certifies completion of required continuing education as a
part of licensure renewal fails to provide proof either as
part of an audit or investigation (BPC Section 4231);
aa) Clarifies the definition of long-term care facility (BPC
Section 4301);
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bb) Specifies that failure to meet pharmacist-in-charge
notification requirements can constitute grounds for
disciplinary action (BPC Section 4305);
cc) Prohibits a non-pharmacist from acting as supervisor or
pharmacist-in-charge (BPC Section 4329). California law
allows for anyone to own a pharmacy, but requires a
pharmacist must be in charge of and responsible for the
operations of a pharmacy;
dd) Clarifies that a pharmacy owner who subverts or tends to
subvert the efforts of a pharmacist-in-charge is guilty of
a misdemeanor (BPC Section 4330); and,
ee) Requires clinics that dispense schedule II, III and IV
controlled substances to report specified information to
CURES on a weekly basis (HSC Section 11165). This
requirement already applies to pharmacies.
4)Makes the following changes pertaining to the Board of
Podiatric Medicine (BPM):
a) Specifies that in order to be issued a license to
practice podiatric medicine, an applicant must submit
directly to the Board verification from the credentialing
organizations, that he or she has met the licensing
requirements (BPC Sections 2486 and 2488); and,
b) Makes technical changes to maintain the clarity and
consistency of the BPM statutes (BPC Section 2307).
5)Makes the following changes pertaining to the Board for
Professional Engineers and Land Surveyors (BPELS):
Corrects an erroneous reference in law and repeals an outdated
provision which requires the board to meet in order to approve
a license to be issued. Requiring applicants who have met all
qualifications to be issued a license while waiting for the
board to meet delays in licensure for otherwise qualified
individuals (BPC Sections 6761, 8740, and 8746).
6)Makes the following changes pertaining to the Board of
Registered Nursing (BRN):
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a) Expands the authorized functions that may be performed
by an NP practicing under standardized procedures to
include:
i) Ordering durable medical equipment, subject to any
limitations set forth in the standardized procedures.
Specifies that this authority does not limit the ability
of a third-party payor to require prior approval;
ii) Certifying disability, as specified, after
performance of a physical examination by the NP and in
collaboration with a physician and surgeon; and,
iii) Approving, signing, modifying, or adding to a plan
of treatment or plan of care for individuals receiving
home health services or personal care services, after
consultation with the treating physician and surgeon.
b) Prohibits this bill from affecting the validity of any
standard procedures and protocols in effect prior to the
enactment of this bill or those adopted subsequent to the
enactment of this bill.
c) Clarifies the time period for which registered nurse
licensure applicants may petition BRN for a change in their
discipline status (BPC Section 2760.1). This conforms the
petitioning time period for both applicants and licensees.
7)Makes the following changes pertaining to the Bureau of
Electronic and Appliance Repair (BEAR):
Makes it an infraction for any person to act as a service
contractor unless that person first registers with the BEAR,
and authorizes issuing infraction citations to unregistered
service contractors (BPC Section 9855.1.5).
8)Makes the following changes pertaining to the Bureau of
Naturopathic Medicine:
a) Permits the bureau to reimburse the advisory council and
committee members for their travel expenses (BPC Section
3625). This amount is limited to no more than $100 per day
(BPC Section 103);
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b) Deletes an obsolete reference to the Medical Board of
California (MBC) as one of the entities responsible for
approving continuing education courses and replaces it with
language that states any course approved as continuing
education for physicians and surgeons is also deemed
approved for naturopathic doctors (BPC Section 3635);
c) Deletes a reference to a redundant reactivation fee for
licensees whose licenses have voluntarily been placed on
inactive status (BPC Section 3636); and,
d) Deletes an obsolete provision that provides start-up
funding for the Bureau (BPC Section 3685).
9)Makes the following changes pertaining to the California Board
of Occupational Therapy (CBOT):
a) Requires the CBOT to report the name and license number
of licensees prohibited from practicing to the Department
of Health Services (DHS) with the intent to prevent
Medi-Cal reimbursement fraud (BPC Section 683);
b) Adds the CBOT to the list of Boards required to create a
central file of the names of all licensees for the purpose
of obtaining an historical record of each licensee (BPC
Section 800);
c) Requires Occupational Therapy Assistants (OTAs) to
document their services in patient records and requires
both OTAs and Occupational Therapists (OTs) to sign patient
records legibly (BPC Section 2570.18.5);
d) Deletes language pertaining to the "first available
examination" as the exam is now computer-based and offered
on demand and to clarify that the limited privilege ceases
to apply to people who fail to pass the exam during the
initial eligibility period (BPC Section 2570.5);
e) Authorizes the CBOT to allow "pre-ACOTE" qualified
applicants to be eligible for licensure (BPC Section
2570.6);
f) Requires occupational therapists unable to demonstrate
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completion of specified curriculum programs to demonstrate
passage of specified examinations to fulfill curriculum
requirements (BPC Section 2570.6); and,
g) Provides consistent nomenclature to ensure that
qualified practitioners are not denied licensure to
practice due to name changes of organization(s) over the
last 15-40 years (BPC Section 2570.7).
10)Makes the following changes pertaining to the Cemetery and
Funeral Bureau (CFB):
Technical cleanup to outdated provisions and other correcting
and clarifying changes (BPC Sections 7616 and 7629; HSC
Section 8778.5).
11)Makes the following change pertaining to the Certified
Interior Designers:
Clarifies that a person may qualify to become a certified
interior designer by either education or experience, or a
combination of both education and experience that totals eight
years (BPC Section 5801).
12)Makes the following change pertaining to Registered Dental
Hygienists:
a) Permits individuals holding a license as a registered
dental hygienist (RDH), RDH in alternative practice, or RDH
in extended functions, as of December 31, 2005, to perform
the duties of a registered dental assistant (RDA) in this
bill (BPC Section 1970); and,
b) Permits individuals holding a license as a RDH, RDH in
alternative practice, or RDH in extended functions, on or
after January 1, 2006, to qualify for and receive a RDA
license prior to performing the duties of a RDA in this
bill (BPC Section 1970).
13)Makes the following change pertaining to the Medi-Cal
Benefits Program:
Deletes a specific reference to osteopathic physicians and
replaces with language that refers to all physicians and
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surgeons (Welfare and Institutions Code Section 14132.100).
14)Makes the following change pertaining to the Certified
Interior Designers:
Requires all unencumbered funds remaining in the Transcript
Reimbursement Fund as of June 29, 2009, to be transferred to
the Court Reporters' Fund (BPC Section 8030.2).
15)Makes the following changes pertaining to the Medical Board
of California (MBC):
a) Explains and clarifies the types of residency programs
and post graduate training programs that are approved for
the clinical instruction requirement (BPC Sections 2089.5
and 2096);
b) Specifies the licensure requirements for applicants
whose training was received outside the country (BPC
Section 2102);
c) Makes technical corrections and conforming changes
regarding the duration of postgraduate training
requirements (BPC Section 2107);
d) Specifies that the professional instruction for resident
courses must be those which lead to a degree of Medical
Doctor (BPC Section 2135);
e) Includes a requirement for continuing medical education
for specialty faculty permits to make it consistent with
requirements for other licensees (BPC Sections 2168.4 and
2169);
f) Repeals obsolete language regarding licensing
examinations (BPC Sections 2172, 2173, 2174 and 2175). The
provisions are obsolete as the MBC no longer administers
examinations;
g) Creates a process by which an applicant's probationary
certificate can be modified or terminated in a way that is
consistent with the current process in which a probationary
certificate is modified through an enforcement action (BPC
Section 2221);
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h) Allows physicians licensed in other states to submit
letters of recommendation to the MBC on behalf of
physicians whose licenses are under investigation, on
probation or have been suspended (BPC Section2307);
i) Changes the MBC's timeframe acting on proposed decisions
from 90 days to 100 days (BPC Section 2335). The current
90-day requirement is not consistent with other sections
relating to this requirement; and,
j) Makes technical changes to maintain the clarity and
consistency of the MBC statutes (BPC Sections 2486 and
2488).
16)Makes the following change pertaining to the Physician
Assistant Committee (PAC):
Deletes obsolete references to interim approval to practice
(BPC Sections 3503, 3517 and 3518). Interim approval is no
longer needed as the licensing examination is now offered on a
monthly basis.
17)Makes the following change pertaining to the Physical Therapy
Board of California (PTBC):
Authorizes the PTBC to disconnect telephone service furnished
to an unlicensed person advertising in a telephone directory
(BPC Section 149).
18)Makes the following changes pertaining to the Respiratory
Care Board of California (RCB):
a) Allows the Board to take disciplinary action against a
licensee practicing respiratory care while under the
influence of drugs or alcohol (BPC Section 3750.5). Limits
the Board's action to the timeframe in which the individual
applies for licensure or is licensed by the Board;
b) Clarifies the Board's authority to recover costs for
disciplinary matters involving probation violations (BPC
Section 3753.5);
c) Permits the Board to inactivate the license of any
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licensee who fails to provide requested information
pertaining to his or her conviction record within 30 days
(BPC Section 3773); and,
d) Adds respiratory care practitioners (RCPs) to a list a
health care providers who have liability protection in
states of emergency (Government Code Section 8659).
19)Makes the following change pertaining to the Veterinary
Medical Board (VMB):
Specifies that veterinary records regarding euthanasia are
subject to the Public Records Act (BPC Section 4857).
20)Makes the following changes to the laws relating to
accountancy:
a) Revises the educational standards to require an
applicant for admission to the certified public accountant
(CPA) examination to present satisfactory evidence that the
applicant has completed a baccalaureate or higher degree
conferred by a degree-granting university, college, or
other institution of learning accredited by a regional or
national accrediting agency included in a list of these
agencies published by the United States Secretary of
Education, as specified, or meeting at a minimum the
standards established for education received outside the
United States, as specified;
b) Requires an applicant for a CPA license to present
evidence that he or she has completed a minimum of 24
semester units in accounting subjects and 24 semester units
in business-related subjects;
c) States that CPA applicants completing education at a
college or university located outside of California who
meet, at a minimum, the standards as specified, be deemed
to meet the educational requirements of this bill if the
California Board of Accountancy (CBA) determines that the
education is substantially equivalent to the standards of
education as specified;
d) Defines the following:
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i) The "Advisory Committee Accounting Ethics," or
"Advisory Committee" (AC), means an eleven person
committee whose terms will be at the pleasure of the
appointing authority. The AC shall comply with the
Bagley-Keene Open Meeting Act, and will expire on January
1, 2014 or after it has issued the final report, as
specified, whichever is later. The AC will be appointed
as follows:
(1) One appointee of the California Public
Employees Retirement System;
(2) Two appointees of the Regents of the
University of California, who must be professors of
business ethics or accounting who have published works
on the desirability and potential contents of
accounting ethics education;
(3) Two appointees of the California State
University Board of Trustees, who must be professors
of business ethics or accounting who have published
works on the desirability and potential contents of
accounting ethics education;
(4) Two appointees representing the California
Community Colleges appointed by the Chancellor, who
must be instructors of business ethics or accounting;
(5) Two appointees of the Senate Rules Committee
and the Speaker of the Assembly, who shall be from
organized labor or consumer advocacy organizations
(6) One appointee by the CBA, respectively; and,
(7) One appointee of the Governor, who shall be a
California CPA in public practice, selected from a
list provided by the California Society of Certified
Public Accountants.
ii) "Ethics study" means the guidelines for the study of
ethics adopted by the AC and the CBA consisting of a
program of learning that provides students with a
framework of ethical reasoning, professional values and
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attitudes for exercising professional skepticism and
other behavior that is in the best interest of the
investing and consuming public and the profession. At a
minimum, it shall require academic work or independent
study and include a foundation for ethical reasoning and
the core values of integrity, objectivity, and
independence consistent with the International Education
Standards-4 of the International Accountants Education
Standards Board, the International Federation of
Accountants Code of Ethics, and the American Institute of
CPA Code of Professional Conduct;
iii) "Accounting study" means independent study or other
academic work in accounting, business, ethics, business
law, or other academic work relevant to accounting and
business so as to enhance the competency of students as
practitioners;
e) Requires the AC to recommend to CBA by June 1, 2012
ethics study guidelines consisting of no less than 10
semester units to be included as educational requirements.
Permits ethics study to consist of academic courses or
portions of courses or independent study offered by
degree-granting universities, colleges, or other
institutions of learning accredited by a regional or
national accrediting agency;
f) Requires CBA to adopt the AC's ethics study
recommendations without substantive changes by January 31,
2013. Requires the AC to issue a report during the public
comment period and no later than 30 days after the
regulations are final, offering an opinion as to whether
the regulations will implement their recommendations;
g) Requires CBA to adopt, by regulation, guidelines for the
accounting study, as specified, by January 1, 2012.
Requires CBA to consider the views of an Accounting
Education AC comprised of its own appointees where the
appointees are experts on accounting education. Requires
the Accounting Education AC to comply with the Bagley-Keene
Open Meetings Act, and expire by January 1, 2012;
h) Requires CBA to hold a hearing on the California
Research Bureau's accounting report on the Uniform
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Accountancy Act's 150-hour rule by September 1, 2010.
Requires CBA to make recommendations to the National
Association of State Boards of Accountancy and the American
Institute of Certified Public Accountants based on the
report for ensuring the relevancy of accountancy education
to the modern practice of accounting, and approve a plan
for CBA to seek the adoption of those recommendations and
any others CBA may recommend related to enforcement and
Internet disclosure;
i) Deletes certain standards for qualifying education;
j) States that the qualifying education from a
degree-granting university, college, or other institution
of learning accredited, as specified, shall include after
January 1, 2014 a minimum of 10 units of ethics study
consistent with regulations promulgated by CBA and 20 units
of accounting study, as specified. The Accounting
Education AC may determine that a course or a portion of a
course satisfies the ethics study requirement;
aa) Sunsets the pathway for licensure that requires two
years of qualifying experience on January 1, 2014 unless
either:
i) The educational requirements in ethics study and
accounting study are reduced or eliminated; or
ii) The practice privilege requirements, as specified,
are amended or repealed; and,
bb) Deletes provisions of law relating to the sunset of
practice privileges.
21)Takes effect immediately as an urgency measure.
22)Makes legislative findings and declarations.
FISCAL EFFECT : Unknown
COMMENTS : Current regulations define a NP as a registered nurse
who possesses additional preparation and skills in physical
diagnosis, psychosocial assessment, and management of
health-illness needs in primary health care, and who has been
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prepared by a program that conforms to BRN standards, as
specified. The Nursing Practice Act delineates nurse's scope of
practice, which includes: direct and indirect patient care
services that ensure the safety, comfort, personal hygiene, and
protection of a patient; the performance of disease prevention
and restorative measures; direct and indirect patient care
services, including, the administration of medications and
therapeutic agents necessary to implement treatment, disease
prevention, or rehabilitation regimen ordered by a physician,
dentist, podiatrist and clinical psychologist; the performance
of skin tests, immunization techniques, and the withdrawal of
blood from veins and arteries; observation of signs and symptoms
of illness, reactions to treatment, general behavior, or general
physical condition, and determining whether the signs, symptoms,
reaction, behaviors, or general appearance exhibit abnormal
characteristics; and implementation, based on observed
abnormalities, of appropriate reporting, referral, standardized
procedure, changes in treatment regimen in accordance with
standardized procedures, or the initiation of emergency
procedures.
Standardized procedures are the legal mechanism for RNs and NPs
to perform functions which otherwise would be considered the
practice of medicine and which would be within the scope of
practice of a physician and surgeon. Standardized procedures
and protocols are policies and protocols developed by a health
facility or organized health care system, and developed through
collaboration with the administration, physicians and nurses.
They must include a written description of the method used in
developing and approving them.
This bill also makes technical changes to the BPC. 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.
The amendments related to the practice of accountancy will
establish the California CPA license as substantially equivalent
to nationwide standards, enabling California CPAs to practice
outside of California.
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Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301
FN: 0003133