BILL ANALYSIS �
AB 774
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Date of Hearing: April 5, 2011
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 774 (Campos) - As Introduced: February 17, 2011
SUBJECT : Health facilities: licensure.
SUMMARY : Expands authority, already provided to the Department
of Public Health (DPH) and the California Department of
Corrections and Rehabilitation (CDCR) under existing law, to all
other state departments to grant a request for an extension of a
professional waiver of licensure based on extenuating
circumstances to marriage and family therapists (MFTs) and
clinical social workers (CSWs), who are gaining qualifying
experience in those professions in this state. Specifically,
this bill :
1)Expands authority, already provided to DPH and CDCR under
existing law, to all state departments that employ a MFT or a
CSW, including a MFT or CSW recruited from outside this state,
to grant a request for an extension of a waiver of licensure
based on extenuating circumstances, if any of the following
circumstances exist:
a) The person requesting the extension has experienced a
recent catastrophic event which may impair the person's
ability to qualify for and pass the license examination.
Those events may include, but are not limited to,
significant hardship caused by a natural disaster, serious
and prolonged illness of the person, serious and prolonged
illness or death of a child, spouse, or parent, or other
stressful circumstances;
b) The person requesting the extension has difficulty
speaking or writing the English language, or other cultural
and ethnic factors exist which substantially impair the
person's ability to qualify for and pass the license
examination; and,
c) The person requesting the extension has experienced
other personal hardship which the department, in its
discretion, determines to warrant the extension.
EXISTING LAW :
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1) Provides for the licensure of health facilities by DPH.
2)Establishes within the Department of Consumer Affairs, the
Board of Behavioral Sciences (BBS) which is responsible for
consumer protection through the licensing and regulation of
MFTs and CSWs in the state of California.
3)Establishes within the Department of Consumer Affairs, the
Board of Psychology which is responsible for consumer
protections through the licensing and regulation of
psychologists.
4)Prohibits the licensure requirements for professionals in
state and other governmental health facilities, licensed by
DPH and CDCR, from being less than those for professionals in
health facilities under private ownership. Allows this
requirement to be waived by DPH and CDCR for psychologists,
MFTs, and CSWs who are gaining qualifying experience for
licensure in this state. Specifically, a waiver of
professional licensure can be granted under the following
circumstances:
a) For persons employed in publicly operated health
facilities who are gaining qualifying experience for
licensure, permits the waiver cannot exceed three years
from the commencement of employment in the state in the
case of psychologists or four years for MFTs or CSWs;
b) For psychologists, MFTs, and CSWs employed less than
full time, permits a waiver for additional years
proportional to the extent of part-time employment, but not
to exceed six years in the case of MFTs and CSWs or five
years in the case of psychologists;
c) For MFTs and CSWs recruited for employment from outside
this state and whose experience is sufficient to gain
admission to a licensing examination, permits a one-year
waiver from the date of their employment in California to
become licensed or the employment is required to be
terminated. Requires that the employee takes the licensure
examination at the earliest possible date after the date of
his or her employment, and if the employee does not pass
the examination at that time, he or she is required to have
a second opportunity to pass the examination, subject to
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the one year limit;
5)Requires DPH and CDCR, for MFTs and/or CSWs employed in a DPH
or CDCR licensed facility, or recruited for employment from
outside this state, to grant a request for an extension of the
professional waiver referenced in 4) above, for one additional
year, based upon the following extenuating circumstances.
This exemption does not apply to psychologists:
a) The person requesting the extension has experienced a
recent catastrophic event which may impair the person's
ability to qualify for and pass the license examination.
Those events may include, but are not limited to,
significant hardship caused by a natural disaster, serious
and prolonged illness of the person, serious and prolonged
illness or death of a child, spouse, or parent, or other
stressful circumstances;
b) The person requesting the extension has difficulty
speaking or writing the English language, or other cultural
and ethnic factors exist which substantially impair the
person's ability to qualify for and pass the license
examination; and,
c) The person requesting the extension has experienced
other personal hardship which the department, in its
discretion, determines to warrant the extension.
FISCAL EFFECT : This bill has not yet been heard by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, existing law
limits the authority to DPH and CDCR to allow MFTs and CSWs to
work on a provisional basis for up to five-years in their
licensed facilities by granting a request for an initial
four-year professional waiver and an additional one-year
waiver extension based on extenuating circumstances. The
author maintains that the exclusion of health facilities
licensed by other state departments from being eligible to
grant the professional waiver of licensure and the additional
extension has proved problematic for some CSWs. The sponsor,
the American Federation of State, County and Municipal
Employees (AFSCME) cites two programs, the outpatient units of
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the Vacaville Psychiatric Program and the Salinas Valley
Psychiatric Program as examples. The Department of Mental
Health (DMH) and CDCR initiated the joint planning of a mental
health treatment hospital within CDCR's existing prisons. The
outpatient portion of these programs is licensed by DMH.
According to the sponsor, CSWs that work in the outpatient
portion of the programs licensed by DMH, even though they meet
the requirements for the professional waiver of licensure and
its extension, are ineligible to receive them because statute
does not provide expressed authority to DMH to grant these
waivers. The author maintains that this bill would ensure
equitable treatment of CSWs employed by various state
departments.
2)BACKGROUND . According to BBS, there are a total of 31,046
MFTs and 18,283 CSWs currently licensed to practice in
California. BBS also states that within the last year, BBS
has issued 1,274 licenses for MFTs and 861 licenses for CSWs.
According to DPH, in response to requests for one-year
extensions of professional waivers based on extenuating
circumstances for MFTs and CSWs, DPH has responded in the
following ways to requests: granted 11 in 2009; granted 30 and
denied one in 2010; and, granted two so far in 2011.
3)SUPPORT . AFSCME writes in support that, unfortunately,
existing law does not allow other state agencies or health
facilities that employ CSWs to grant a request for an
extension of a professional waiver of licensure based on
extenuating circumstances, even if they meet the criteria for
extenuating circumstances. This bill requires a uniform
application of existing law and would ensure equitable
treatment of CSWs.
4)PREVIOUS LEGISLATION . AB 1628, Chapter 729, Statutes of 2010,
authorizes the Secretary of CDCR to grant, under specified
circumstances, a three-year waiver for psychologists and a
four-year waiver for CSWs who work for CDCR. AB 1628 also
authorizes the CDCR Secretary to grant a CSW a waiver for one
additional year under certain extenuating circumstances.
5)SUGGESTED AMENDMENTS . The Committee suggests narrowing this
bill language to extend authority to only DMH, as opposed to
all state departments, to satisfy the problem cited by the
sponsor. The Committee also notes that, in order to grant a
request for a one-year extension to the initial waiver of
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professional licensure based on extenuating circumstances, DMH
must first be provided the authority to grant the initial
waiver. The following amendment language is significantly
similar to the language already in existing law that provides
authority to DPH and CDCR. The suggested amendments authorize
DMH to grant the initial three -year professional waiver of
licensure to psychologists and four-year professional waiver
of licensure to MFTs and CSWs. The language also provides DMH
with the authority to grant CSWs and MFTs an additional
one-year extension to that waiver based on extenuating
circumstances. The Committee suggests this amendment language
be placed in the Welfare and Institutions Code where staffing
requirements are expressed for DMH:
(a) Notwithstanding any other law, except as provided in
subdivisions (b) and (c), any person employed or under
contract to provide diagnostic, treatment, or other mental
health services in the state or to supervise or provide
consultation on these services in the Department of Mental
Health shall be a physician and surgeon, a psychologist, or
other health professional, licensed to practice in this
state.
(b) The following persons are exempt from the requirements
of subdivision (a), so long as they continue in employment
in the same class and in the same department:
(1) Persons employed on January 1, 1985, as psychologists
to provide diagnostic or treatment services including those
persons on authorized leave but not including intermittent
personnel.
(2)Persons employed on January 1, 1989, to supervise or
provide consultation on the diagnostic or treatment
services including persons on authorized leave but not
including intermittent personnel.
(c) (1) The requirements of subdivision (a) may be waived
by the state department solely for persons in the
professions of psychology, marriage and family therapy or
clinical social work who are gaining qualifying experience
for licensure in those professions in this state.
Providers working in a licensed health care facility
operated by the department must receive a waiver in
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accordance with Section 1277 of the Health and Safety Code.
(2) A waiver granted pursuant to this subdivision shall not
exceed three years from the date the employment commences
in this state in the case of psychologists, or four years
from commencement of the employment in this state in the
case of marriage and family therapists and clinical social
workers, at which time licensure shall have been obtained
or the employment shall be terminated, except that an
extension of a waiver of licensure for marriage and family
therapists and clinical social workers may be granted for
one additional year, based on extenuating circumstances
determined by the department pursuant to subdivision (d).
For persons employed as psychologists, clinical social
workers or marriage and family therapists less than full
time, an extension of a waiver of licensure may be granted
for additional years proportional to the extent of
part-time employment, as long as the person is employed
without interruption in service, but in no case shall the
waiver of licensure exceed six years in the case of
clinical social workers and marriage and family therapists
or five years in the case of psychologists. However, this
durational limitation upon waivers shall not apply to
active candidates for a doctoral degree in social work,
social welfare, or social science, who are enrolled at an
accredited university, college, or professional school, but
these limitations shall apply following completion of that
training.
(3) Additionally, this durational limitation upon waivers
shall not apply to active candidates for a doctoral degree
in marriage and family therapy who are enrolled at a
school, college, or university, specified in subdivision
(b) of Section 4980.36 of, or subdivision (b) of Section
4980.37 of, the Business and Professions Code, but the
limitations shall apply following completion of training.
(4) A waiver pursuant to this subdivision shall be granted
only to the extent necessary to qualify for licensure,
except that personnel recruited for employment from outside
this state and whose experience is sufficient to gain
admission to a licensure examination shall nevertheless
have one year from the date of their employment in
California to become licensed, at which time licensure
shall have been obtained or the employment shall be
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terminated, provided that the employee shall take the
licensure examination at the earliest possible date after
the date of his or her employment, and if the employee does
not pass the examination at that time, he or she shall have
a second opportunity to pass the next possible examination,
subject to the one-year limit for marriage and family
therapists and clinical social workers, and subject to a
two-year limit for psychologists.
(d) The department shall grant a request for an extension
of a waiver of licensure for a clinical social worker or
marriage and family therapist pursuant to subdivision (c)
based on extenuating circumstances if any of the following
circumstances exist:
(1) The person requesting the extension has experienced a
recent catastrophic event that may impair the person's
ability to qualify for and pass the licensure examination.
Those events may include, but are not limited to,
significant hardship caused by a natural disaster; serious
and prolonged illness of the person; serious and prolonged
illness or death of a child, spouse, or parent; or other
stressful circumstances.
(2) The person requesting the extension has difficulty
speaking or writing the English language, or other cultural
and ethnic factors exist which substantially impair the
person's ability to qualify for and pass the license
examination.
(3)The person requesting the extension has experienced
other personal hardship that the department, in its
discretion, determines to warrant the extension.
REGISTERED SUPPORT / OPPOSITION :
Support
American Federation of State, County and Municipal Employees,
AFL-CIO
Opposition
None on file.
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Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097