BILL NUMBER: SB 747 INTRODUCED
BILL TEXT
INTRODUCED BY Senator Kehoe
FEBRUARY 18, 2011
An act to amend Sections 2190.1, 2811.5, 2892.5, 2915, 4517,
4980.54, and 4996.22 of the Business and Professions Code, relating
to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
SB 747, as introduced, Kehoe. Continuing education: lesbian, gay,
bisexual, and transgender patients.
Existing law provides for licensing and regulation of various
healing arts professions and generally requires licensees to complete
continuing education courses in order to remain eligible to renew
their licenses or certifications.
This bill would require physicians and surgeons, registered
nurses, certified vocational nurses, psychologists, marriage and
family therapists, licensed clinical social workers, and psychiatric
technicians to complete at least one course of 2 to 5 hours in
duration that provides instruction on cultural competency,
sensitivity, and best practices for providing adequate care to
lesbian, gay, bisexual, and transgender persons, as specified. The
bill would require the applicable licensing board to enforce these
requirements.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 2190.1 of the Business and Professions Code is
amended to read:
2190.1. (a) The continuing medical education standards of Section
2190 may be met by educational activities that meet the standards of
the Division of Licensing board and
serve to maintain, develop, or increase the knowledge, skills, and
professional performance that a physician and surgeon uses to provide
care, or improve the quality of care provided for patients,
including, but not limited to, educational activities that meet any
of the following criteria:
(1) Have a scientific or clinical content with a direct bearing on
the quality or cost-effective provision of patient care, community
or public health, or preventive medicine.
(2) Concern quality assurance or improvement, risk management,
health facility standards, or the legal aspects of clinical medicine.
(3) Concern bioethics or professional ethics.
(4) Are designed to improve the physician-patient relationship.
(b) (1) On and after July 1, 2006, all continuing medical
education courses shall contain curriculum that includes cultural and
linguistic competency in the practice of medicine.
(2) Notwithstanding the provisions of paragraph (1), a continuing
medical education course dedicated solely to research or other issues
that does not include a direct patient care component and a course
offered by a continuing medical education provider that is not
located in this state are not required to contain curriculum that
includes cultural and linguistic competency in the practice of
medicine.
(3) Associations that accredit continuing medical education
courses shall develop standards before July 1, 2006, for compliance
with the requirements of paragraph (1). The associations may develop
these standards in conjunction with an advisory group that has
expertise in cultural and linguistic competency issues.
(4) A physician and surgeon who completes a continuing education
course meeting the standards developed pursuant to paragraph (3)
satisfies the continuing education requirement for cultural and
linguistic competency.
(c) In order to satisfy the requirements of subdivision (b),
continuing medical education courses shall address at least one or a
combination of the following:
(1) Cultural competency. For the purposes of this section,
"cultural competency" means a set of integrated attitudes, knowledge,
and skills that enables a health care professional or organization
to care effectively for patients from diverse cultures, groups, and
communities. At a minimum, cultural competency is recommended to
include the following:
(A) Applying linguistic skills to communicate effectively with the
target population.
(B) Utilizing cultural information to establish therapeutic
relationships.
(C) Eliciting and incorporating pertinent cultural data in
diagnosis and treatment.
(D) Understanding and applying cultural and ethnic data to the
process of clinical care.
(2) Linguistic competency. For the purposes of this section,
"linguistic competency" means the ability of a physician and surgeon
to provide patients who do not speak English or who have limited
ability to speak English, direct communication in the patient's
primary language.
(3) A review and explanation of relevant federal and state laws
and regulations regarding linguistic access, including, but not
limited to, the federal Civil Rights Act (42 U.S.C. Sec. 1981, et
seq.), Executive Order 13166 of August 11, 2000, of the President of
the United States, and the Dymally-Alatorre Bilingual Services Act
(Chapter 17.5 (commencing with Section 7290) of Division 7 of Title 1
of the Government Code).
(d) On and after January 1, 2012, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2012, shall complete the course no later January 1, 2016. Persons who
are newly licensed by the board on and after January 1, 2012, shall
complete the course within four years of their initial license
issuance date or their second license renewal date, whichever occurs
first. The course shall be between two and five hours in duration and
shall contain content similar to the content described in the
publication of the Gay and Lesbian Medical Association entitled
"Guidelines for Care of Lesbian, Gay, Bisexual and Transgender
Patients." The board may specify the required contents of the course
by regulation consistent with this subdivision. The board shall
enforce this requirement in the same manner as it enforces other
required continuing education requirements.
(d)
(e) Notwithstanding subdivision (a), educational
activities that are not directed toward the practice of medicine, or
are directed primarily toward the business aspects of medical
practice, including, but not limited to, medical office management,
billing and coding, and marketing shall not be deemed to meet the
continuing medical education standards for licensed physicians and
surgeons.
(e)
(f) Educational activities that meet the content
standards set forth in this section and are accredited by the
California Medical Association or the Accreditation Council for
Continuing Medical Education may be deemed by the Division of
Licensing to meet its continuing medical education standards.
SEC. 2. Section 2811.5 of the Business and Professions Code is
amended to read:
2811.5. (a) Each person renewing his or her license under Section
2811 shall submit proof satisfactory to the board that, during the
preceding two-year period, he or she has been informed of the
developments in the registered nurse field or in any special area of
practice engaged in by the licensee, occurring since the last renewal
thereof, either by pursuing a course or courses of continuing
education in the registered nurse field or relevant to the practice
of the licensee, and approved by the board, or by other means deemed
equivalent by the board.
(b) For purposes of this section, the board shall, by regulation,
establish standards for continuing education. The standards shall be
established in a manner to assure that a variety of alternative forms
of continuing education are available to licensees, including, but
not limited to, academic studies, in-service education, institutes,
seminars, lectures, conferences, workshops, extension studies, and
home study programs. The standards shall take cognizance of
specialized areas of practice. The continuing education standards
established by the board shall not exceed 30 hours of direct
participation in a course or courses approved by the board, or its
equivalent in the units of measure adopted by the board.
(c) The board shall encourage continuing education in spousal or
partner abuse detection and treatment. In the event the board
establishes a requirement for continuing education coursework in
spousal or partner abuse detection or treatment, that requirement
shall be met by each licensee within no more than four years from the
date the requirement is imposed.
(d) In establishing standards for continuing education, the board
shall consider including a course in the special care needs of
individuals and their families facing end-of-life issues, including,
but not limited to, all of the following:
(1) Pain and symptom management.
(2) The psycho-social dynamics of death.
(3) Dying and bereavement.
(4) Hospice care.
(e) In establishing standards for continuing education, the board
may include a course on pain management.
(f) This section shall not apply to licensees during the first two
years immediately following their initial licensure in California or
any other governmental jurisdiction.
(g) On and after January 1, 2012, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2012, shall complete the course no later January 1, 2016. Persons who
are newly licensed by the board on and after January 1, 2012, shall
complete the course within four years of their initial license
issuance date or their second license renewal date, whichever occurs
first. The course shall be between two and five hours in duration and
shall contain content similar to the content described in the
publication of the Gay and Lesbian Medical Association entitled
"Guidelines for Care of Lesbian, Gay, Bisexual and Transgender
Patients." The board may specify the required contents of the course
by regulation consistent with this subdivision. The board shall
enforce this requirement in the same manner as it enforces other
required continuing education requirements.
(g)
(h) The board may, in accordance with the intent of
this section, make exceptions from continuing education requirements
for licensees residing in another state or country, or for reasons of
health, military service, or other good cause.
SEC. 3. Section 2892.5 of the Business and Professions Code is
amended to read:
2892.5. (a) Each person renewing his or her license under the
provisions of this chapter shall submit proof satisfactory to the
board that, during the preceding two-year period, he or she has
informed himself or herself of developments in the vocational nurse
field or in any special area of vocational nurse practice, occurring
since the issuance of his or her certificate, or the last renewal
thereof, whichever last occurred, either by pursuing a course or
courses of continuing education approved by the board in the
vocational nurse field or relevant to the practice of such licensee,
and approved by the board; or by other means deemed equivalent by the
board.
(b) For purposes of this section, the board shall, by regulation,
establish standards for continuing education. The standards shall be
established in a manner to assure that a variety of alternative forms
of continuing education are available to licensees including, but
not limited to, academic studies, in-service education, institutes,
seminars, lectures, conferences, workshops, extension studies, and
home study programs. The standards shall take cognizance of
specialized areas of practice. The continuing education standards
established by the board shall not exceed 30 hours of direct
participation in a course or courses approved by the board, or its
equivalent in the units of measure adopted by the board.
(c) This section shall not apply to the first license renewal
following the initial issuance of a license.
(d) On and after January 1, 2012, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2012, shall complete the course no later January 1, 2016. Persons who
are newly licensed by the board on and after January 1, 2012, shall
complete the course within four years of their initial license
issuance date or their second license renewal date, whichever occurs
first. The course shall be between two and five hours in duration and
shall contain content similar to the content described in the
publication of the Gay and Lesbian Medical Association entitled
"Guidelines for Care of Lesbian, Gay, Bisexual and Transgender
Patients." The board may specify the required contents of the course
by regulation consistent with this subdivision. The board shall
enforce this requirement in the same manner as it enforces other
required continuing education requirements.
(d)
(e) The board may, in accordance with the intent of
this section, make exceptions from continuing education for licensees
residing in another state or country, or for reasons of health,
military service, or other good cause.
This section shall become operative on July 1, 1980.
SEC. 4. Section 2915 of the Business and Professions Code is
amended to read:
2915. (a) Except as provided in this section, on or after January
1, 1996, the board shall not issue any renewal license unless the
applicant submits proof that he or she has completed no less than 18
hours of approved continuing education in the preceding year. On or
after January 1, 1997, except as provided in this section, the board
shall issue renewal licenses only to those applicants who have
completed 36 hours of approved continuing education in the preceding
two years.
(b) Each person renewing his or her license issued pursuant to
this chapter shall submit proof of compliance with this section to
the board. False statements submitted pursuant to this section shall
be a violation of Section 2970.
(c) A person applying for relicensure or for reinstatement to an
active license status shall certify under penalty of perjury that he
or she is in compliance with this section.
(d) (1) The continuing education requirement shall include, but
shall not be limited to, courses required pursuant to Sections 25 and
28. The requirement may include courses pursuant to Sections 32 and
2914.1.
(2) (A) The board shall require a licensed psychologist who began
graduate study prior to January 1, 2004, to take a continuing
education course during his or her first renewal period after the
operative date of this section in spousal or partner abuse
assessment, detection, and intervention strategies, including
community resources, cultural factors, and same gender abuse
dynamics. Equivalent courses in spousal or partner abuse assessment,
detection, and intervention strategies taken prior to the operative
date of this section or proof of equivalent teaching or practice
experience may be submitted to the board and at its discretion, may
be accepted in satisfaction of this requirement.
(B) Continuing education courses taken pursuant to this paragraph
shall be applied to the 36 hours of approved continuing education
required under subdivision (a).
(C) A licensed psychologist whose practice does not include the
direct provision of mental health services may apply to the board for
an exemption from the requirements of this paragraph.
(3) Continuing education instruction approved to meet the
requirements of this section shall be completed within the State of
California, or shall be approved for continuing education credit by
the American Psychological Association or its equivalent as approved
by the board.
(e) The board may establish a policy for exceptions from the
continuing education requirement of this section.
(f) The board may recognize continuing education courses that have
been approved by one or more private nonprofit organizations that
have at least 10 years' experience managing continuing education
programs for psychologists on a statewide basis, including, but not
limited to:
(1) Maintaining and managing related records and data.
(2) Monitoring and approving courses.
(g) The board shall adopt regulations as necessary for
implementation of this section.
(h) A licensed psychologist shall choose continuing education
instruction that is related to the assessment, diagnosis, and
intervention for the client population being served or to the fields
of psychology in which the psychologist intends to provide services,
that may include new theoretical approaches, research, and applied
techniques. Continuing education instruction shall include required
courses specified in subdivision (d).
(i) A psychologist shall not practice outside his or her
particular field or fields of competence as established by his or her
education, training, continuing education, and experience.
(j) On and after January 1, 2012, the board shall require every
person licensed under this chapter to take at least one continuing
education course that provides instruction on cultural competency,
sensitivity, and best practices for providing adequate care to
lesbian, gay, bisexual, and transgender persons. Persons licensed by
the board before January 1, 2012, shall complete the course no later
January 1, 2016. Persons who are newly licensed by the board under
this chapter on and after January 1, 2012, shall complete the course
within four years of their initial license issuance date or their
second license renewal date, whichever occurs first. The course shall
be between two and five hours in duration and shall contain content
similar to the content described in the publication of the Gay and
Lesbian Medical Association entitled "Guidelines for Care of Lesbian,
Gay, Bisexual and Transgender Patients." The board may specify the
required contents of the course by regulation consistent with this
subdivision. The board shall enforce this requirement in the same
manner as it enforces other required continuing education
requirements.
(j)
(k) The administration of this section may be funded
through professional license fees and continuing education provider
and course approval fees, or both. The fees related to the
administration of this section shall not exceed the costs of
administering the corresponding provisions of this section.
(k)
(l) Continuing education credit may be approved for
those licensees who serve as commissioners on any examination
pursuant to Section 2947, subject to limitations established by the
board.
( l ) This section shall become operative on
January 1, 2004.
SEC. 5. Section 4517 of the Business and Professions Code is
amended to read:
4517. (a) The board may, in its discretion,
provide for a continuing education program in connection with the
professional functions and courses described in this chapter. The
number of course hours that the board may require in a continuing
education program shall not exceed the number of course hours
prescribed for licensed vocational nurses pursuant to Section 2892.5.
(b) On and after January 1, 2012, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2012, shall complete the course no later January 1, 2016. Persons who
are newly licensed by the board on and after January 1, 2012, shall
complete the course within four years of their initial license
issuance date or their second license renewal date, whichever occurs
first. The course shall be between two and five hours in duration and
shall contain content similar to the content described in the
publication of the Gay and Lesbian Medical Association entitled
"Guidelines for Care of Lesbian, Gay, Bisexual and Transgender
Patients." The board may specify the required contents of the course
by regulation consistent with this subdivision. The board shall
enforce this requirement in the same manner as it enforces other
required continuing education requirements.
SEC. 6. Section 4980.54 of the Business and Professions Code is
amended to read:
4980.54. (a) The Legislature recognizes that the education and
experience requirements in this chapter constitute only minimal
requirements to assure that an applicant is prepared and qualified to
take the licensure examinations as specified in subdivision (d) of
Section 4980.40 and, if he or she passes those examinations, to begin
practice.
(b) In order to continuously improve the competence of licensed
marriage and family therapists and as a model for all
psychotherapeutic professions, the Legislature encourages all
licensees to regularly engage in continuing education related to the
profession or scope of practice as defined in this chapter.
(c) Except as provided in subdivision (e), the board shall not
renew any license pursuant to this chapter unless the applicant
certifies to the board, on a form prescribed by the board, that he or
she has completed not less than 36 hours of approved continuing
education in or relevant to the field of marriage and family therapy
in the preceding two years, as determined by the board.
(d) The board shall have the right to audit the records of any
applicant to verify the completion of the continuing education
requirement. Applicants shall maintain records of completion of
required continuing education coursework for a minimum of two years
and shall make these records available to the board for auditing
purposes upon request.
(e) The board may establish exceptions from the continuing
education requirements of this section for good cause, as defined by
the board.
(f) The continuing education shall be obtained from one of the
following sources:
(1) An accredited school or state-approved school that meets the
requirements set forth in Section 4980.36 or 4980.37. Nothing in this
paragraph shall be construed as requiring coursework to be offered
as part of a regular degree program.
(2) Other continuing education providers, including, but not
limited to, a professional marriage and family therapist association,
a licensed health facility, a governmental entity, a continuing
education unit of an accredited four-year institution of higher
learning, or a mental health professional association, approved by
the board.
(g) The board shall establish, by regulation, a procedure for
approving providers of continuing education courses, and all
providers of continuing education, as described in paragraphs (1) and
(2) of subdivision (f), shall adhere to procedures established by
the board. The board may revoke or deny the right of a provider to
offer continuing education coursework pursuant to this section for
failure to comply with the requirements of this section or any
regulation adopted pursuant to this section.
(h) Training, education, and coursework by approved providers
shall incorporate one or more of the following:
(1) Aspects of the discipline that are fundamental to the
understanding or the practice of marriage and family therapy.
(2) Aspects of the discipline of marriage and family therapy in
which significant recent developments have occurred.
(3) Aspects of other disciplines that enhance the understanding or
the practice of marriage and family therapy.
(i) A system of continuing education for licensed marriage and
family therapists shall include courses directly related to the
diagnosis, assessment, and treatment of the client population being
served.
(j) On and after January 1, 2012, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2012, shall complete the course no later January 1, 2016. Persons who
are newly licensed by the board on and after January 1, 2012, shall
complete the course within four years of their initial license
issuance date or their second license renewal date, whichever occurs
first. The course shall be between two and five hours in duration and
shall contain content similar to the content described in the
publication of the Gay and Lesbian Medical Association entitled
"Guidelines for Care of Lesbian, Gay, Bisexual and Transgender
Patients." The board may specify the required contents of the course
by regulation consistent with this subdivision. The board shall
enforce this requirement in the same manner as it enforces other
required continuing education requirements.
(j)
(k) The board shall, by regulation, fund the
administration of this section through continuing education provider
fees to be deposited in the Behavioral Sciences Fund. The fees
related to the administration of this section shall be sufficient to
meet, but shall not exceed, the costs of administering the
corresponding provisions of this section. For purposes of this
subdivision, a provider of continuing education as described in
paragraph (1) of subdivision (f) shall be deemed to be an approved
provider.
(k)
(l) The continuing education requirements of this
section shall comply fully with the guidelines for mandatory
continuing education established by the Department of Consumer
Affairs pursuant to Section 166.
SEC. 7. Section 4996.22 of the Business and Professions Code is
amended to read:
4996.22. (a) (1) Except as provided in subdivision (c), the board
shall not renew any license pursuant to this chapter unless the
applicant certifies to the board, on a form prescribed by the board,
that he or she has completed not less than 36 hours of approved
continuing education in or relevant to the field of social work in
the preceding two years, as determined by the board.
(2) The board shall not renew any license of an applicant who
began graduate study prior to January 1, 2004, pursuant to this
chapter unless the applicant certifies to the board that during the
applicant's first renewal period after the operative date of this
section, he or she completed a continuing education course in spousal
or partner abuse assessment, detection, and intervention strategies,
including community resources, cultural factors, and same gender
abuse dynamics. On and after January 1, 2005, the course shall
consist of not less than seven hours of training. Equivalent courses
in spousal or partner abuse assessment, detection, and intervention
strategies taken prior to the operative
date of this section or proof of equivalent teaching
or practice experience may be submitted to the board and at its
discretion, may be accepted in satisfaction of this requirement.
Continuing education courses taken pursuant to this paragraph shall
be applied to the 36 hours of approved continuing education required
under paragraph (1).
(b) The board shall have the right to audit the records of any
applicant to verify the completion of the continuing education
requirement. Applicants shall maintain records of completion of
required continuing education coursework for a minimum of two years
and shall make these records available to the board for auditing
purposes upon request.
(c) The board may establish exceptions from the continuing
education requirement of this section for good cause as defined by
the board.
(d) The continuing education shall be obtained from one of the
following sources:
(1) An accredited school of social work, as defined in Section
4991.2, or a school or department of social work that is a candidate
for accreditation by the Commission on Accreditation of the Council
on Social Work Education. Nothing in this paragraph shall be
construed as requiring coursework to be offered as part of a regular
degree program.
(2) Other continuing education providers, including, but not
limited to, a professional social work association, a licensed health
facility, a governmental entity, a continuing education unit of an
accredited four-year institution of higher learning, and a mental
health professional association, approved by the board.
(e) The board shall establish, by regulation, a procedure for
approving providers of continuing education courses, and all
providers of continuing education, as described in paragraphs (1) and
(2) of subdivision (d), shall adhere to the procedures established
by the board. The board may revoke or deny the right of a provider to
offer continuing education coursework pursuant to this section for
failure to comply with the requirements of this section or any
regulation adopted pursuant to this section.
(f) Training, education, and coursework by approved providers
shall incorporate one or more of the following:
(1) Aspects of the discipline that are fundamental to the
understanding, or the practice, of social work.
(2) Aspects of the social work discipline in which significant
recent developments have occurred.
(3) Aspects of other related disciplines that enhance the
understanding, or the practice, of social work.
(g) A system of continuing education for licensed clinical social
workers shall include courses directly related to the diagnosis,
assessment, and treatment of the client population being served.
(h) The continuing education requirements of this section shall
comply fully with the guidelines for mandatory continuing education
established by the Department of Consumer Affairs pursuant to Section
166.
(i) On and after January 1, 2012, the board shall require all of
its licensees to take at least one continuing education course that
provides instruction on cultural competency, sensitivity, and best
practices for providing adequate care to lesbian, gay, bisexual, and
transgender persons. Persons licensed by the board before January 1,
2012, shall complete the course no later January 1, 2016. Persons who
are newly licensed by the board on and after January 1, 2012, shall
complete the course within four years of their initial license
issuance date or their second license renewal date, whichever occurs
first. The course shall be between two and five hours in duration and
shall contain content similar to the content described in the
publication of the Gay and Lesbian Medical Association entitled
"Guidelines for Care of Lesbian, Gay, Bisexual and Transgender
Patients." The board may specify the required contents of the course
by regulation consistent with this subdivision. The board shall
enforce this requirement in the same manner as it enforces other
required continuing education requirements.
(i)
(j) The board may adopt regulations as necessary to
implement this section.
(j)
(k) The board shall, by regulation, fund the
administration of this section through continuing education provider
fees to be deposited in the Behavioral Science Examiners Fund. The
fees related to the administration of this section shall be
sufficient to meet, but shall not exceed, the costs of administering
the corresponding provisions of this section. For purposes of this
subdivision, a provider of continuing education as described in
paragraph (1) of subdivision (d) shall be deemed to be an approved
provider.