BILL ANALYSIS
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|Hearing Date:April 27, 2009 |Bill No:SB |
| |821 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Gloria Negrete McLeod, Chair
Bill No: SB 821Author:Business, Professions and
Economic
Development
As Amended:April 16, 2009 Fiscal: Yes
SUBJECT: Healing arts: licensees.
SUMMARY: Makes several non-controversial, minor, non-substantive or
technical changes to various miscellaneous provisions pertaining to
the health-related regulatory boards of the Department of Consumer
Affairs (DCA).
Existing law:
1)Provides for licensing and regulating various professions and
businesses under separate licensing acts contained within the
California Business and Professions Code (BPC). The BPC establishes
the DCA within the State and Consumer Services Agency. The DCA is
comprised of some 26 boards, 8 bureaus, and 1 commission.
2)Provides for the professional review of specified healing arts
licentiates through a peer review process and requires the peer
review body to report to the relevant agency upon certain
circumstances, including circumstances related to the Medical Board
of California's diversion program, which no longer exists.
3)Creates the Speech-Language Pathology and Audiology Board to license
and regulate speech-language pathologists and audiologists;
establishes minimum requirements for audiologist aides and who works
under the supervision of an audiologist and sets specified
educational and curriculum standards for audiologist licensure.
4)The Occupational Therapy Practice Act provides for the licensure and
regulation of occupational therapists by the California Board of
Occupational Therapy (CBOT); prohibits occupational therapy
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assistants from supervising aides engaged in client-related tasks;
defines hand therapy as the art and science of hand, wrist and
forearm rehabilitation requiring comprehensive knowledge of the
upper extremity; and provides for the minimizing the transmission
risk of blood-borne infectious diseases.
5)Establishes the Board of Vocational Nursing and Psychiatric
Technicians to license and regulate vocational nurses and
psychiatric technicians and allows interim permits to be given to
vocational nursing and psychiatric technician licensure applicants,
whose licensing examination results are pending, to practice their
skills.
6)Provides for the licensure and regulation of hearing aid dispensers
by the Hearing Aid Dispensers Bureau; permits a temporary license,
valid for six months, to be issued to a licensure applicant who has
demonstrated that he or she will be supervised or trained by a
hearing aid dispenser; and specifies that the temporary license may
be renewed twice for an additional period of six months.
7)The Respiratory Care Practice Act provides for the licensure and
regulation of respiratory care practitioners by the Respiratory Care
Board (RCB) of California and authorizes the RCB to deny, suspend or
revoke a respiratory care license if the licensee obtains or
possesses, furnishes, administers or uses a controlled substance or
dangerous drug unless directed by an authorized health care
practitioner.
8)The Pharmacy Law provides for the licensure and regulation of
pharmacists and pharmacies by the California State Board of Pharmacy
(BOP)
9)Establishes the Acupuncture Board to license and regulate
acupuncturists and specifies five board members constitutes a
quorum.
10)Provides for the licensure and regulation of psychologists, social
workers and marriage and family therapists by the Board of
Behavioral Sciences (BBS); requires the BBS to regulate educational
psychologists; and specifies prohibited acts for all BBS licensees.
11)Appropriates specified sums from the Dental Auxiliary Fund to the
Committee on Dental Auxiliaries for operating expenses required to
manage the dental hygiene licensing examination.
This bill:
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1)Makes the following change pertaining to the Acupuncture Board:
a) Defines quorum as four (4) members of the board and specifies
that one of the four must be an acupuncturist (BPC 4933).
2)Makes the following changes pertaining to the Board of Behavioral
Sciences (BBS) :
a) Limits the total number of registrants under the supervision
of a board licensee in private practice to two associate clinical
social workers (ASWs) or marriage and family therapist interns at
any one time (BPC 4980.45 & 4996.24).
b) Requires the disclosure of a supervisor's name, license title
and license number on advertisements related to services provided
by trainees (BPC 4980.48).
c) Adds the subversion of the examination process to the
definition of unprofessional conduct (BPC 4982, 4989.54 &
4992.3).
d) Adds MFTs and ASWs to the list of licensees permitted to
petition the BBS for the reinstatement of a revoked or suspended
license or modification of any penalties imposed by the board
(BPC 4982.2).
e) Makes clarifying and conforming changes to the eligibility
requirements and examination retention schedule for BBS licensees
(BPC 4989.22 & 4992.1).
f) Exempts signs in religious buildings or notices in bulletins
from religious organizations from the advertising provisions (BPC
4989.49, 4992.2).
g) Permits group supervision of LCSW applicants to be provided in
one-hour increments, as long as both increments are provided in
the same week as the experience claimed (BPC 4996.23).
h) Prohibits ASW registrants from renewing their registration
more than five times to prevent them from providing intern
services indefinitely and upon the fifth registration, prohibits
the ASW registrant from volunteering or working in a private
practice setting (BPC 4996.28).
i) Deletes the "annual" reference to renewal fees as the fees are
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biennial (BPC 4996.5).
3)Makes the following change pertaining to the Board of Vocational
Nursing and Psychiatric Technicians :
a) Establishes a four-month filing deadline and subsequent
expiration dates for interim permits and removes references to
"approved" programs (BPC 2872.2 & 4510.1).
4)Makes the following changes pertaining to the California Board of
Occupational Therapy (CBOT) :
a) Changes the status of occupational therapy assistants from
"certified" to "licensed" throughout the statue (BPC 2570.2 to
2570.10, 2570.13, 2570.16, 2570.18, 2570.20 & 2570.26).
b) Amends a number of outdated provisions and makes technical
changes (BPC 2570.2, 2570.3, 2570.28 & 2571).
c) Establishes the criteria, requirements and restrictions for
placing a license in "retired" status (BPC 2570.17).
d) Grants the CBOT the authority to inspect records or request
reports with respect to the care, treatment or patient services
and/or facilities in response to a complaint and specifies that a
failure to comply shall be considered unprofessional conduct (BPC
2570.186).
e) Includes occupational therapists (OTs) in the list of health
care provider authorized to provide in-state or out-of-state
telephone medical services (BPC 4999.2) and grants OTs access
to their patients' health records (Health and Safety Code
123105).
5)Makes the following changes pertaining to the Board of Pharmacy
(BOP) :
a) Requires all board licensed facilities to join the board's
e-mail notification list within 60 days of obtaining or renewing
a license (BPC 4013).
b) Clarifies when a pharmacist-in-charge or designated
representative-in-charge must notify the board that he or she is
no longer serving in such a capacity (BPC 4101).
c) Explicitly states that a person cannot act as a nonresident
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pharmacy unless he or she has obtained a license from the state
(BPC 4112).
d) Clarifies procedures to be followed by a pharmacy when
identifying a pharmacist-in-charge as well as the procedures to
notify the board when a change in pharmacist-in-charge has
occurred. In addition, this section allows for the use of an
interim pharmacist-in-charge, for a period not greater than 120
days, when a pharmacy is unable to identify a permanent new
pharmacist-in-charge within 30 days as required by board
regulation (BPC 4113).
e) Allows pharmacies to accept the return of needles and syringes
from the public, if contained in a sharps container, as defined
by law (BPC 4146).
f) Clarifies the procedures to be followed by a wholesaler when
identifying a designated representative-in-charge as well as the
procedures to notify the board when a change in the designated
representative-in-charge has occurred (BPC 4160).
g) Clarifies the procedures to be followed by a veterinary
food-animal drug retailer when identifying a designated
representative-in-charge as well as the procedures to notify the
board when a change in the designated representative-in-charge
has occurred (BPC 4196).
6)Makes the following change pertaining to the Dental Hygiene
Committee :
a) Corrects the name of a fund administered by the Dental Board
of California (changes Dental Auxiliary Fund to Dental Hygiene
Fund) and specifies money from the fund is to be transferred to
the Dental Hygiene Committee, which was previously called the
Committee on Dental Auxiliaries (Uncodified language in Section 3
of chapter 294, Statutes of 2004).
7)Makes the following change pertaining to the Hearing Aid Dispensers
Bureau :
a) Permits the Bureau to issue a new trainee license to a
previous trainee license holder (BPC 3357).
b) Requires licensees to notify the Bureau of address changes
within 30 days (BPC 3362).
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c) Allows the Bureau to inspect records relates to the sale and
fitting of hearing (BPC 3366) and deleted obsolete language
(BPC 3456).
8)Makes the following changes pertaining to the Medical Board of
California (MBC) :
a) Adds special faculty permit holders to the definition of
licentiates for the peer review process (BPC 805).
b) Deletes obsolete code sections regarding the MBC's diversion
program, which sunset last year (BPC 821.5 & 821.6).
9)Makes the following changes pertaining to the Speech-Language
Pathology and Audiology Board (SLPAB) :
a) Authorizes audiology aides to work under general supervision
of audiologists to allow audiologists to tend to more complex
diagnostic or clinical services. Requires the SLPAB to specify,
by regulation, the appropriate level of supervision for specified
duties (BPC 2530.2).
b) Changes the entry level licensing requirements for
audiologists from a master's degree model to the doctoral
training standard to reflect current industry and educational
standards for audiologists (BPC 2532.2, 2532.25 & 2532.7).
10)Makes the following changes pertaining to the Respiratory Care
Board of California (RCB) :
a) Amends BPC 3740 reference the "Committee on Accreditation
for Respiratory Care or its successor" as the recognized
accreditation agency for approved respiratory care education
programs.
b) Permits the RCB to take disciplinary action against a licensee
practicing respiratory care while under the influence of drugs or
alcohol and limits the RCB's action to the timeframe in which the
individual applies for licensure or is licensed by the Board (BPC
3750.5).
c) Authorizes the Board to inactivate the license of any licensee
who fails to provide requested information pertaining to his or
her conviction record within 30 days (BPC 3773).
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FISCAL EFFECT: Unknown. The measure is keyed "fiscal" by Legislative
Counsel.
COMMENTS:
1.Purpose. This bill is one of three Committee bills authored by the
Business, Professions and Economic Development Committee that are
intended to consolidate a number of non-controversial provisions
related to various regulatory programs governed by the Business and
Professions Code, and generally located within the DCA.
Consolidating the provisions in one bill is designed to relieve the
various licensing boards from the necessity and burden of having
separate measures for a number of non-controversial revisions.
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.
2.Background. The following is background and reasons given by the
affected boards and professions for the provisions in this measure.
Acupuncture Board. Existing law requires that five (5) of the seven
board members present in order for the board to conduct business.
If there are vacancies on the board and one member is unable to make
a meeting, there is definitely the potential for less than five
members being present at a meeting. This occurred at least twice
last year and as a result, no business was conducted.
Board of Behavorial Science (BBS). Many of the changes proposed by
the BBS seek to bring conformity and consistency to the
unprofessional conduct statues and the statutes governing their
licensees. The BBS is seeking to make changes to the Associate
Social Worker (ASW) supervision requirements of to address practice
realities that do not permit many ASWs to receive the amount of
supervision required for Licensed Clinical Social Worker (LCSW)
licensure. The BBS is also seeking to delete an obsolete reference
to renewal fees.
Board of Vocational Nursing and Psychiatric Technicians (BVNPT).
Existing law allows a recent graduate taking the examination to
practice as an interim permittee while he/she waits for the results
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of the first BVNPT licensure examination. However, if the applicant
fails his/her "first" licensure examination he/she can no longer
practice as an interim permittee. The language presumes that a
recent graduate taking the examination has the minimum
qualifications to practice and provides the opportunity to do so
unless proven otherwise by unsuccessful examination results. This
proposal would add filing deadlines and expiration dates to clarify
existing statutes regarding the IP requirements and remove
references to approved programs.
California Board of Occupational Therapy (CBOT): The CBOT is
seeking to change the reference of occupational therapy assistants
(OTAs) from "certified" to "licensed: to bring parity between those
individuals and physical therapy assistants (PTAs) and delete
outdated or redundant sections of law that need to be updated.
Additionally, occupational therapists are not authorized to provide
as a telephone medical advice services' registrant and this measure
seeks to grant them that authority,
Current law does not allow the CBOT to require health care providers
provide them patient records. This is problematic when the CBOT is
assisting patients who are trying to recover those records and when
the CBOT is investigating complaints against its licensees over the
quality of care, treatment or patient services. Provisions included
in this measure will grant them access to patient records to all
CBOT to fulfill its public protection mandate.
Board of Pharmacy (BOP). Current pharmacy law requires the
designation of a pharmacist-in-charge for a pharmacy and the
designation of a designated representative-in-charge for a
wholesaler or veterinary food-animal drug retailer. This proposal
clarifies the reporting requirements of how and when the board must
be notified of any change in pharmacist in charge (PIC) or
designated representative in charge (DRC). The BOP states several
non-substantive changes are necessary to update pharmacy law,
correct a drafting error, make consistent the board's ability to
inactivate a pharmacist license when continuing education
requirements are not satisfied and set into statute the
administrative co-payment for participants in the Pharmacists
Recovery Program (PRP).
Dental Hygiene Committee of California. SB 853 (Perata, Chapter 31,
Statutes of 2008) dissolved Committee on Dental Auxiliaries (COMDA)
and the Dental Auxiliary Fund and in their place established the
Hygiene Committee and the State Dental Hygiene Fund effective July
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1, 2009. This proposal would update specified names within existing
law to reflect the dissolving of the State Dental Auxiliary fund and
Committee on Dental Auxiliaries (COMDA) and the establishment of the
State Dental Hygiene Fund and the Dental Hygiene Committee of
California (Hygiene Committee).
Hearing Aid Dispensers Bureau. The Bureau has received many
requests for trainees' licenses from applicants who have previously
held a hearing aid dispenser trainee's license for the full amount
of time allowed under the law (18 months), left the profession for
an extended period of time and are now interested in returning to
the profession. Current law does not allow for the issuance of a
new trainee's license to a previous trainee's license holder under
these circumstances.
Medical Board of California (MBC). BPC 821.5 & 821.6 were added
to law in 1996 to require reporting to the MBC's diversion program
of physicians under investigation by health entities with mental and
physical illnesses. The diversion program sunsetted on June 30,
2008 and the reporting requirements are no longer necessary as those
physicians must be reported to the Board under section 805 if the
investigation leads to that level of action by the health entity.
Speech-Language Pathology and Audiology Board (SLPAB). The
existing restrictions on the use of audiology aides, that require
that they must function under direct in-line of sight supervision,
drastically reduce the benefits of using audiology support
personnel. Current supervision requirements do not allow the
independent practitioner to tend to other more complex or clinical
activities while the aide is performing routine functions, such as
hearing aide repair, checking audiological equipment, setting up
exam rooms, etc. Furthermore, the state is experiencing a shortage
crisis of audiologists and the required direct supervision of
audiology aides significantly impacts the amount of time that an
audiologist can serve the audiological needs of consumers. This
bill would authorize audiology aides to work under general
supervision with more specified terms established by regulation that
would define the appropriate levels of supervision for audiology
aides.
Additionally, the education requirements for the practice of
audiology have changed from master's degree training for entry-level
practitioners to a clinical doctorate model. As of December 2007,
the national accrediting body, the Council on Academic
Accreditation, which accredits all audiology training programs in
the country, amended its program accreditation standards to require
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that all audiology professional training programs offer academic and
clinical education at the doctoral degree level. Currently, there
are no master's degree audiology training programs in the country.
This bill reflects the statutes to conform the requirements for
entry level practitioners to national education and practice
standards.
Respiratory Care Board of California (RCB): The RCB was notified
November 20, 2008, that the Committee on Accreditation for
Respiratory Care (CoARC) is leaving the Commission on Accreditation
of Allied Health Education Programs (CAAHEP) to become a
freestanding accreditor of respiratory care educational programs.
The target date for this separation is January 15, 2010. Currently,
section 3740 only makes reference to programs accredited by CAAHEP
as qualified education programs for new applicants, when in fact it
is CoARC that provides the actual oversight of respiratory care
educational programs. This measure would state "CoARC or its
successor" as the recognized accreditation agency for approved
respiratory care education programs.
Current law requires RCB applicants to report on either their
initial or renewal licensure application if they have been convicted
of a crime. Licensees who mark the "Yes" box are referred to RCB's
enforcement unit where an initial letter (and if necessary,
subsequent follow up letters) is issued requesting details of the
conviction. Some licensees who do not respond to the RCB's requests
and short of full disciplinary action, the Respiratory Care Practice
Act does not provide a mechanism to require compliance. To remedy
this problem, the RCB is seeking authority to inactivate the license
of any licensee who fails to provide requested information within 30
days.
The RCB does not have explicit authority to take action against
individuals who are found to be under the influence of drugs or
alcohol. So far this year, the RCB has received approximately 7
cases in which its licensees were under the influence of
alcohol/drugs while at work. The RCB reports the licensees'
behaviour was so bad; it raised immediate concern with the employers
who then reported the incidents to the RCB. The RCB was able to
secure interim suspension orders (ISOs) in one case (3 others are
pending) using a statute from the Medical Practice Act (B&P 2239).
The RCB is concerned because it is intended for the practice of
medicine and fears its authority on the ISO may be challenged. This
proposal seeks to ensure that it can take disciplinary action
against a licensee practicing "respiratory care" while under the
influence of drugs and/or alcohol.
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3.Support if Amended. The Occupational Therapy Association of
California (OTAC) has taken a support if amended position on SB 821.
They are supportive of the CBOT provisions except for the
provisions that would redefine "hand therapy" (BPC 2570.3) and
authorize the CBOT to inspect patient records or request records
when responding to complaints (BPC 2570.186). If those provisions
are removed from the bill, they will support this bill.
4.Author's Amendments. In response to concerns raised by the
Occupational Therapy Association of California in the previous
section, the Author is willing to delete Sections 9 and 20, BPC
2570.3 and 2570.186, respectively, from the bill.
SUPPORT AND OPPOSITION:
Support:
Board of Behavioral Sciences
Board of Vocational Nursing and Psychiatric Technicians
California Academy of Audiology
California Acupuncture Board
Medical Board of California
Respiratory Care Board of California
Speech-Language Pathology and Audiology Board
Support if Amended :
Occupational Therapy Association of California
Opposition :None on file as of April 20th.
Consultant: Sieglinde Johnson