BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          SB 747 (Kehoe)
          
          Hearing Date: 5/9/2011          Amended: 4/25/2011
          Consultant: Bob Franzoia        Policy Vote: B,P&ED 6-2
          
















































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          BILL SUMMARY: SB 747 would require physicians and surgeons, 
          physician assistants, registered nurses, licensed vocational 
          nurses, nurse practitioners, psychologists, marriage and family 
          therapists, licensed clinical social workers, psychiatric 
          technicians, and certified nurse assistants to complete at least 
          one course of two to five hours in duration that provides 
          continuing education (CE) instruction on cultural competency, 
          sensitivity, and best practices for providing adequate care to 
          lesbian, gay, bisexual and transgender persons.  This bill would 
          require the applicable licensing or certifying entity to enforce 
          these requirements.  These new requirements would become 
          effective on January 1, 2013.
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                            Fiscal Impact (in thousands)

           Major Provisions         2011-12      2012-13       2013-14     Fund
           Continuing education
          requirement            
            - BRN*               $35        $71         $71       
          Special**
            - BVNPT***           $35        $61         $61       
          Special****                      
            - Other              Minor, absorbable costs, ongoing 
          Special*****                                                

          * Board of Registered Nursing
          ** Board of Registered Nursing Fund
          *** Board of Vocational Nursing and Psychiatric Technicians
          **** Vocational Nursing and Psychiatric Technicians Fund
          ***** Psychology Fund, Contingent Fund of the Medical Board of 
          California, Behavioral Science Examiners' Fund
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          STAFF COMMENTS: As noted by the policy committee, physicians and 
          surgeons, physician assistants, registered nurses, licensed 
          vocational nurses, psychologists, psychiatric technicians, MFTs 
          and clinical social workers must complete continuing education 
          courses to renew their license.  Healing arts boards generally 
          do not mandate the courses that must be taken but they must be 
          relevant to the licensee's area of practice.  However, there are 
          certain courses that are required to be taken by specific 
          licensees.  








          SB 747 (Kehoe)
          Page 3



          The fiscal impact of a CE requirement on a licensing board is 
          the cost to audit each licensee for compliance.  CE audits may 
          be performed in different ways.  For example, the Medical Board 
          of California continuing medical education (CME) audit was 
          performed in one batch for the entire year. A random sample of 
          one percent of licensed physicians and surgeons was selected and 
          approximately 1,200 letters were sent by certified mail.  In 
          order to complete the audit, a large conference room was used 
          exclusively by board licensing staff for several months to 
          complete audit tasks. The large increase in workload of 
          performing the CME audit once each year in one batch proved to 
          be unmanageable.  In response, the board shifted to performing 
          the audit on a monthly basis which resulted in a more effective 
          and manageable workload.

          While it appears that most boards, which are funded generally by 
          licensing fees, can absorb the additional workload, the Board of 
          Registered Nursing and the Board of Vocational Nursing and 
          Psychiatric Technicians may lack sufficient resources to conduct 
          CE audits of licensees and CE providers. 
          .