BILL ANALYSIS
SB 821
Page 1
Date of Hearing: June 30, 2009
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
SB 821 (Business, Professions and Economic Development) - As
Amended: June 15, 2009
SENATE VOTE : 39-0
SUBJECT : Healing arts: licensees.
SUMMARY : Makes non-controversial, minor, non-substantive or
technical changes to various provisions pertaining to the
health-related regulatory boards of the Department of Consumer
Affairs (DCA). Specifically, this bill :
1)Defines a quorum as four members of the Acupuncture 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) Clarifies that registered interns under the supervision
of a marriage and family therapy corporation must be
registered as either associate clinical social workers
(ASW) or marriage and family therapist (MFT) interns (BPC
4980.45);
b) Permits a licensed clinical social workers (LCSW)
corporation to employ no more than two individuals
registered as either ASWs or MFT interns for each qualified
supervisor, and no more than a total of 10 individuals
registered as either ASWs or MFT interns (BPC 4996.24);
c) Requires the disclosure of a supervisor's name, license
title, and license number on advertisements for services
performed by trainees (BPC 4980.48);
d) Adds the subversion of the examination process and
fraudulent advertising to the definition of unprofessional
conduct (BPC 4982, 4989.54 & 4992.3);
e) Adds MFTs and ASWs to the list of licensees permitted to
petition the BBS for the reinstatement of a revoked or
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suspended license or modification of any penalties imposed
by BBS (BPC 4982.2);
f) Clarifies the rights of an educational psychologist
applicant or LCSW applicant to gain admission to and
receive the results of his or her respective examination if
the applicant is the subject of a complaint or is under BBS
investigation (BPC 4989.22 & 4992.1);
g) Adds to the definition of unprofessional conduct for an
educational psychologist licensee or applicant:
impersonation, allowing any other person to use the
licensee's license, or permitting a person under the
licensee's control to perform professional services beyond
his or her qualifications (BPC 4989.54);
h) Defines "advertising" as used in this bill and exempts
signs in religious buildings or notices in bulletins from
religious organizations from advertising provisions (BPC
4989.49, 4992.2);
i) Adds to the definition of unprofessional conduct for
LCSWs a requirement to limit access to psychological tests
to persons with professional interest who will safeguard
the tests' use and clarifies the definition of gross
negligence (BPC 4992.3);
j) Deletes the "annual" reference to renewal fees as the
fees are biennial (BPC 4996.5);
aa) Permits group supervision of LCSW applicants to be
provided in two one-hour increments, as long as both
increments are provided in the same week as the hours
claimed (BPC 4996.23);
bb) Permits ASWs working for governmental, educational, or
charitable organizations to fulfill the supervised
experience requirement with supervision by
videoconferencing and to obtain weekly direct supervisor
contact by videoconferencing (BPC 4996.23);
cc) Prohibits ASWs from leasing or renting space, paying for
furnishings, equipment, or supplies, or paying for the
obligations of his or her employer in any other way (BPC
4996.23); and,
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dd) Prohibits ASW registrants from renewing their
registration more than five times, and upon the fifth
registration, prohibits the ASW registrant from
volunteering or working in a private practice setting (BPC
4996.28).
3)Establishes a four-month deadline to apply for licensure by
examination after completion of an accredited nursing or
psychiatric technician program, and subsequent expiration
dates for interim permits, and removes references to
"approved" programs within the Board of Vocational Nursing and
Psychiatric Technicians (BVNPT) (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 (OT)
assistants from "certified" to "licensed" throughout the
statute (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, including permitting an OT assistant to
supervise an aide in client-related tasks (BPC 2570.2,
2570.3, 2570.28 & 2571);
c) Establishes the criteria, requirements and restrictions
for placing a licensee in "retired" status (BPC 2570.17);
and,
d) Includes OTs in the list of health care providers
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 every BOP licensed facility to join the BOP's
e-mail notification list within 60 days of obtaining or
renewing a license and to update its e-mail address within
30 days of a change, effective July 1, 2010 (BPC 4013);
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b) Clarifies when a pharmacist-in-charge or designated
representative-in-charge must notify the BOP that he or she
is no longer serving in such a capacity (BPC 4101);
c) Prohibits a person from acting as a nonresident
pharmacist unless he or she has obtained a license from the
state (BPC 4112);
d) Clarifies the procedures to be followed by a pharmacy
when identifying a pharmacist-in-charge, notifying the BOP
of a change in the pharmacist-in-charge, and identifying an
interim pharmacist-in-charge (BPC 4113);
e) Allows pharmacies to accept the return of needles and
syringes from the public, if contained in a sharps
container, as defined (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 BOP when a change in
the designated representative-in-charge has occurred (BPC
4160); and,
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 BOP when a change in the designated
representative-in-charge has occurred (BPC 4196).
6)Within the Dental Hygiene Committee (DHC), corrects the name
of the Dental Auxiliary Fund to Dental Hygiene Fund and
specifies that money from the fund is to be transferred to the
DHC.
7)Makes the following changes pertaining to the Hearing Aid
Dispensers Bureau (Bureau):
a) Permits the Bureau to issue a new temporary license to a
previous temporary license holder (BPC 3357);
b) Requires licensees to notify the Bureau of address
changes within 30 days (BPC 3362); and,
c) Allows the Bureau to inspect records related to the sale
and fitting of hearing aids (BPC 3366) and deletes
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obsolete fee 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); and,
b) Deletes obsolete code sections regarding the MBC's
diversion program (BPC 821.5 & 821.6).
9)Makes the following changes pertaining to the Speech-Language
Pathology and Audiology Board (SLPAB):
a) Authorizes the SLPAB to exempt by regulation certain
functions performed by an audiology aide from the
requirement that any function that constitutes the practice
of audiology be performed under the supervision of an
audiologist. (BPC 2530.2).
b) Changes the entry level licensing requirements for
audiologists from a master's degree to the doctoral
training standard, beginning with applicants who graduate
on or after January 1, 2008 (BPC 2532.2);
c) Makes conforming changes to the requirements for issuing
a required professional experience temporary license in
accord with the doctoral training program requirement (BPC
2532.7); and,
d) Requires applicants seeking licensure as an audiologist
who graduate on or after January 1, 2008 to complete
supervised clinical practice, submit evidence of no less
than 12 months of supervised professional experience, and
pass an examination or examinations approved by the SLPAB
(BPC 2532.25).
10)Makes the following changes pertaining to the Respiratory
Care Board of California (RCB):
a) Changes the reference to the "Committee on Accreditation
for Respiratory Care or its successor" as the recognized
accreditation agency for approved respiratory care
education programs (BPC 3740);
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b) Permits the RCB to take disciplinary action, including
probation, 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 RCB (BPC
3750.5); and,
c) Authorizes the RCB 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).
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 MBC's
diversion program, which no longer exists.
3)Creates the SLPAB 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 OTs by CBOT; prohibits OT
assistants from supervising aides engaged in client-related
tasks; and provides for the minimizing the transmission risk
of blood-borne infectious diseases.
5)Establishes the BVNPT 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.
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6)Provides for the licensure and regulation of hearing aid
dispensers by the 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 RCB
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 BOP.
9)Establishes the Acupuncture Board to license and regulate
acupuncturists and specifies that five board members
constitutes a quorum.
10)Provides for the licensure and regulation of psychologists,
social workers and marriage and family therapists by 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.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office, "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
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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."
Background . The following is background was submitted by the
affected boards and bureaus for the provisions in this measure.
Acupuncture Board. Existing law requires that five of the seven
board members be 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 Behavioral Science (BBS). Currently, there are six
different sections of law that outline licensee and registrant
unprofessional conduct, three in statute and three in
regulation. Though most of the provisions in the unprofessional
conduct regulations also appear in the unprofessional conduct
statutes, some do not. In order to create consistency and
lessen confusion, the BBS proposes to include in the statute
several unprofessional conduct provisions that currently appear
in the regulations. Once all unprofessional conduct provisions
are included in the statute, the BBS plans to repeal the
regulations related to unprofessional conduct, leaving all
activities considered unprofessional conduct only in the
respective licensing statute for each profession.
The BBS is also seeking to make changes to the ASW supervision
requirements to address practice realities that do not permit
many ASWs to receive the amount of supervision required for LCSW
licensure. Allowing certain ASWs to complete their supervision
by video conference rather than in person would make supervision
more available in underserved areas of the state, where there
are not enough licensed therapists available to provide
supervision.
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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 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
interim permit requirements and remove references to approved
programs.
California Board of Occupational Therapy (CBOT). The CBOT is
seeking to change the reference of OT assistants from
"certified" to "licensed" to bring parity between those
individuals and physical therapy assistants and delete outdated
or redundant sections of law.
Additionally, OTs are not authorized to provide services 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 it with 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 BOP must be notified of any change in pharmacist in charge
(PIC) or designated representative in charge. The BOP states
several non-substantive changes are necessary to update pharmacy
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law, correct a drafting error, make consistent BOP'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.
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 DHC and the State Dental Hygiene Fund effective
July 1, 2009. This proposal would update specified names within
existing law to reflect the dissolving of the State Dental
Auxiliary fund and COMDA and the establishment of the State
Dental Hygiene Fund and the DHC.
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
sunset on June 30, 2008 and the reporting requirements are no
longer necessary as those physicians must be reported to the MBC
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, which
require the aides to 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
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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 educational 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 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 conforms the
statutory requirements for entry level practitioners to national
educational 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. Current law 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
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alcohol. So far this year, the RCB has received approximately
seven cases in which its licensees were under the influence of
alcohol/drugs while at work. The RCB reports that the
licensees' behavior 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. 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.
REGISTERED SUPPORT / OPPOSITION :
Support
Board of Behavioral Sciences
Board of Vocational Nursing and Psychiatric Technicians
California Academy of Audiology
California Acupuncture Board
Medical Board of California
Occupational Therapy Association of California
Respiratory Care Board of California
Speech-Language Pathology and Audiology Board
Opposition
None on file.
Analysis Prepared by : Trinh Phan / B. & P. / (916) 319-3301