BILL ANALYSIS �
-----------------------------------------------------------------------
|Hearing Date:April 23, 2012 |Bill No:SB |
| |1238 |
-----------------------------------------------------------------------
SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: SB 1238Author:Price
As Introduced: February 23, 2012 Fiscal:Yes
SUBJECT: Professions: Board of Psychology: Board of Behavioral
Sciences.
SUMMARY: Extends until January 1, 2017, the provisions establishing
the California Board of Psychology (BOP), the Board of Behavioral
Sciences (BBS), and extends the term of the executive officers of the
BOP and BBS.
Existing law:
1)Licenses and regulates psychologists by the BOP within the Department
of Consumer Affairs (DCA), and makes the BOP inoperative and
repealed on January 1, 2013. (Business and Professions Code (BPC) �
2920)
2)Authorizes the BOP to employ an executive officer and makes that
authority inoperative and repealed on January 1, 2013. (BCP � 2933)
3)Provides that protection of the public shall be the highest priority
for the BOP in exercising its licensing, regulatory, and
disciplinary functions, and whenever the protection of the public is
inconsistent with other interests sought to be promoted, the
protection of the public shall be paramount. (BPC �2920.1)
4)Authorizes BBS, under the DCA, to license and regulate educational
psychologists, social workers, marriage and family therapists and
licensed professional clinical counselors, and makes the BBS
inoperative and repealed on January 1, 2013. (BPC � 4990).
5)Authorizes the BBS to employ an executive officer and makes that
SB 1238
Page 2
authority inoperative and repealed on January 1, 2013. (BPC �
4990.04)
6)Provides that protection of the public shall be the highest priority
for the BBS in exercising its licensing, regulatory, and
disciplinary functions, and whenever the protection of the public is
inconsistent with other interests sought to be promoted, the
protection of the public shall be paramount. (BPC � 4990.16)
This bill:
1)Extends until January 1, 2017, the provisions establishing the BOP.
2)Extends until January 1, 2017, the term of the executive officer of
the BOP.
3)Extends until January 1, 2017, the provisions establishing the BBS.
4)Extends until January 1, 2017, the term of the executive officer of
the BBS.
FISCAL EFFECT: Unknown. This bill has been keyed "fiscal" by
Legislative Counsel.
COMMENTS:
1.Purpose. The Author is the Sponsor of this measure. According to
the Author, in 2012, this Committee conducted oversight hearings to
review 7 regulatory boards within the DCA: the Acupuncture Board,
the Board of Podiatric Medicine, the Physician Assistant Committee,
the Board of Pharmacy, the Court Reporters Board, the Board of
Behavioral Sciences and the Board of Psychology. The Committee
began its review of these licensing agencies in March and conducted
two days of hearings. This bill, and the accompanying sunset bills,
is intended to implement legislative changes as recommended in the
Committee's Background/Issue Papers for all of the agencies reviewed
by the Committee this year.
This bill is one of the four "sunset bills" authored by the Chair
of this Committee. According to the Author, this bill is necessary
to extend the sunset date of the BOP and the BBS in order to
SB 1238
Page 3
continue the regulation of psychologists, educational
psychologists, social workers, marriage and family therapists and
licensed professional clinical counselors in California. The
continued regulation will help to ensure that the BOP and BBS's
mission of protecting the public is in place for an additional four
years.
2.Background of the BOP. The BOP in the DCA is responsible for
implementation and enforcement of the Psychology Licensing Law; the
laws and regulations related to the licensure, practice and
discipline of those who are engaged in the practice of psychology in
California in order to protect the public. Only licensed
psychologists can practice psychology independently in the private
sector in California.
The Board's mission statement is as follows:
"The Board of Psychology protects and advocates for Californians
by promoting the highest professional standards through its
licensing, regulation, legislation, enforcement, continuing
education, and outreach programs."
The Board regulates the field of psychology in three categories:
a) Psychologists . Practices psychology independently in any
private or public setting. The license must be renewed every two
years, and licensees must complete 36 hours of continuing
education for renewal. Requires a doctoral degree in psychology,
educational psychology, or in education with a field of
specialization in counseling psychology or educational
psychology; to complete 3,000 hours of qualifying supervised
professional experience, 1,500 of which must be accrued
post-doctorate; pass the Examination for Professional Practice in
Psychology (EPPP) and the California Psychology Supplemental
Examination (CPSE); complete coursework in human sexuality, child
abuse, substance abuse, spousal abuse, and aging and long-term
care.
b) Registered psychologist . A 30 month, non-renewable
registration to work and train under supervision in non-profit
agencies that receive government funding. Requires a doctoral
degree in psychology, and 1,500 hours of qualifying supervised
experience for registration.
c) Psychological assistant. An annually renewed registration
(for up to six years) to work and train while supervised by a
SB 1238
Page 4
qualified licensed psychologist in a private setting. Intended
to be a method by which an unlicensed person can perform limited
psychological functions to accrue hours of supervised
professional experience. Requires a qualifying master's degree
in psychology, with no experience required for registration.
3.Prior Review of the BOP. The Board was last reviewed by the former
Joint Committee on Boards, Commissions and Consumer Protection
(Joint Committee) seven years ago (2004-2005). During the previous
Review, the Joint Committee raised several issues and
recommendations regarding the Board. In November 2011, the Board
submitted its required Sunset Review Report to the Committee. In
this report, the Board described actions that have been taken since
the Board's prior review to address the recommendations of the Joint
Committee. The following are some of the more important
programmatic and operational changes and enhancements which the
Board has taken and other important policy decisions or regulatory
changes it has adopted, as well as some highlighted accomplishments:
Recommended Changes Enacted by SB 229 (Figueroa, Chapter 658,
Statutes of 2005). The 10 final recommendations made by the
Joint Committee in 2005 were embodied in SB 299 legislation
authored by the Joint Committee Chair, Senator Liz Figueroa. The
changes included: extend the Board's sunset date; establish the
title "registered psychologist" and increase the amount of time
one can work as a registered psychologist from 24 months to 30
months; add postdoctoral placements overseen by the American
Psychological Association (APA), the Association of Psychology
Postdoctoral and Internship Centers (APPIC) and the California
Psychology Internship Council (CAPIC) as acceptable post-doctoral
placement programs; delete the obsolete term "certified" with
regard to the regulation of psychology and include Canadian
licensed psychologists; provide that the Board makes the final
determination as to whether a degree from an accredited
university, college, or professional school meets the
requirements for licensure; make corrections to refer to "Ethical
Principles and Code of Conduct" rather than "code of ethics;"
refer to the "supplemental licensing examination" and reflect the
Board's use of computer-administered examinations; accurately
refers to the term of an initial license; add "retirement" to the
list of reasons to place a license on inactive status.
Posting Information About Non-Licensees Convicted of
Unlicensed Practice on the Board's Website. The Board believes
that the disclosure of a citation and fine, or conviction for
unlicensed practice, would be very relevant and important to the
SB 1238
Page 5
public. However, it is problematic for the Board's current IT
system to allow the posting of such information in a similar
place as the license verification function. According to the
Board, it has aggressively sought out those in unlicensed
practice through their advertising, websites and publications.
The Board states that it is currently involved with the
Department and IT regarding changes to its Website to disclose
actions taken regarding unlicensed practice.
Board Authority to Order Restitution to Consumers Who Have
Been Harmed by Licensees. During the 2004 sunset review, DCA
recommended that all Boards examine their authority to order
restitution to consumers and develop policies to execute our
authority. The Board now has the authority to order restitution,
as reflected in its disciplinary guidelines. Restitution is a
standard term in any case involving Medi-Cal or insurance fraud.
Failure to pay restitution when ordered is considered a violation
of probation. The Board also uses restitution as part of the
stipulation process.
New Executive Officer. Robert Kahane was appointed by the
Board in March of 2006.
Headquarter Relocation. In March 2008, the Board moved from
the Howe Avenue complex to its current location on Evergreen
Street in Sacramento.
Strategic Planning. The Board has conducted a number of
strategic planning sessions. In 2009, the Board began using a
two-year model for its Strategic Plan. The Board is currently
using a 2011-2013 plan.
Probation. Approximately 51% of the Board's disciplinary
actions result in probation. The average term of probation is
three to five years. The Board monitors approximately 60
licensees on probation per year. Since the last sunset review,
there has been a 400% increase in the number of probationers that
the Board must monitor. Probationers must be adequately
monitored to ensure compliance with the terms and conditions of
the disciplinary order. The Board has taken a proactive approach
in implementing new procedures to reduce the strain on staffing
resources and improve consumer protection. In July 2010, the
Board entered into the DCA master contract with Phamatech, Inc.
for drug testing services. Phamatech services give the Board
drug test results within 24 hours, and access to experts in the
interpretation of test results. The Board has further
SB 1238
Page 6
implemented a requirement for an annual face to face meeting with
all probationers, resulting in fewer probation violations which
represents a cost savings for the Board.
1.Background of the BBS. The BBS licenses and regulates licensed
clinical social workers (LCSW), licensed marriage and family
therapists (LMFT), licensed educational psychologists (LEP), and
licensed professional clinical counselors (LPCC). Additionally,
the Board registers associate social workers (ASW), marriage and
family therapist interns (MFT Interns), professional clinical
counselor interns (PCC Interns), and continuing education providers.
The BBS's mission is to protect Californians by promoting consumer
awareness, advocating for improved mental health services, and
setting, communicating, and enforcing standards. In order to
accomplish its mission, the BBS develops and administers licensure
examinations, investigates consumer complaints and criminal
convictions, responds to emerging changes and trends in the mental
health profession legislatively or through regulations, and creates
publications for consumers, students, and licensees.
The BBS's statutes and regulations require a license before an
individual may engage in the practice of licensed clinical social
work, licensed marriage and family therapy, licensed educational
psychology, and licensed professional clinical counseling. These
statutes and regulations set forth the requirements for
registration and licensure and provide the BBS the authority to
discipline a registrant or licensee.
Effective January 1, 2010, a fourth mental health profession, LPCC,
was added to the Board's jurisdiction. Today, the BBS is
responsible for the regulatory oversight of nearly 77,000
licensees. Current law provides for thirteen board members; six
licensees and seven public members. Eleven members are appointed
by the Governor, one public member is appointed by the Speaker of
the Assembly, and one public member is appointed by the Senate
Rules Committee. In 2010, a public member was added to the BBS and
in 2012, a LPCC member was added to the BBS increasing the board
composition to thirteen members, however, it is still a public
majority board.
2.Prior Review of the BBS. The BBS was last reviewed by the Joint
Committee seven years ago (2004-2005). During the previous Sunset
Review, the Joint Committee raised several issues regarding the BBS.
The following are actions which the BBS took since the last Sunset
Review to address these issues.
SB 1238
Page 7
Continuing Education Through Self-Study. The Joint Committee
questioned whether the Board should allow licensees to fulfill
all 36 hours of Continuing Education (CE) through only
self-study. The Joint Committee pointed out that licensees may
obtain all 36 hours of CE by visiting internet sites, accessed
remotely from their home or other location, and that the licensee
need only certify to the BBS that they have done this, without
any further proof, and the BBS does not audit the licensee
certifications. The Joint Committee raised two potential
problems:
a) There may exist a potential for licensees to abuse this
method of fulfilling CE.
b) In a profession so heavily dependent on human interaction,
is it entirely appropriate
that licensees be permitted to fulfill all of their CE
requirements without interaction with others?
The BBS conducted a random survey of licensees who renewed their
licenses between October 1, 2004, and April 1, 2005, and found
that of the 554 responses, only two percent (2%) completed the
entire required CE through online courses. The BBS concluded
that the survey indicated that the Board's licensees favor
traditional, classroom style courses, but that online courses
remain a useful alternative. According to BBS, the Board is
currently in the process of reviewing its continuing education
program.
Restitution. The Joint Committee questioned whether the Board
should have the authority to order restitution to consumers who
have been seriously harmed by licensees. The Joint Committee
raised the issue of whether the Board's authority should include
the ability to request restitution in appropriate cases or in
cases where there is reason to believe restitution would be
substantial, or when such an award would serve the interest of
justice in a particular case.
BBS stated that it did not have specific legislative authority to
require restitution for consumers. However, it may consider
seeking restitution when negotiating a stipulated agreement.
Historically, BBS indicates that it has placed more importance on
consumer safety and protection, and on imposing discipline that
either helps correct the problem through probation monitoring and
remedial education, supervised practice, or in cases involving
SB 1238
Page 8
the most serious misconduct, removes the individual from the
profession by revoking their license or registration.
According to BBS, the intangible nature of the services provided by
Board licensees and registrants makes it difficult if not
impossible to determine the monetary value of those services.
The BBS recognizes there are other avenues, such as civil or
malpractice actions, available to consumers who seek financial
compensation from licensees who have provided services that are
inappropriate or harmful.
Non-licensee Notices on Website. The Joint Committee
questioned whether the public would benefit by being able to
learn from the Board's website of non-licensees who have been
convicted of the unlicensed practice of psychology. The Joint
Committee recommended the BBS should work with the DCA to
determine an appropriate and efficient way to post information
about non-licensees who engage in unlicensed practice.
According to BBS, the current online license verification feature
was programmed by the DCA's Office of Information Services, and
extracts public data from the BBS's licensing records and
enforcement actions from its enforcement tracking system,
allowing the information to be accessed on the BBS website. The
BBS states the program requires a license or registration number
to be present, and does not have the ability to extract
unlicensed records from the enforcement tracking system.
According to BBS, since 2004, the DCA and the Board have initiated
educational campaigns urging consumers to verify a practitioner's
license prior to engaging in services. These efforts focus on
the requirement of licensure for the service offered. The BBS
believes the addition of information to the BBS's website about
individuals not licensed with the BBS would cause confusion.
Reorganization. Since the last Sunset Review in 2004, the BBS
restructured its organization to meet its operational needs more
efficiently. Following an evaluation of the BBS's operational
needs and desire to improve efficiency, the BBS added a manager
position in 2005 to provide oversight of the daily activities of
all the BBS's programs. This allowed the EO and AEO to primarily
focus on policy decisions, changes in mental health affecting the
BBS's licensees and registrants, and implementing the direction
of the board members.
A steady growth in licensees and registrants and the addition of
SB 1238
Page 9
the Licensed Professional Clinical Counselor program in 2011,
resulted in a 38% increase in total staffing since 2005. Three
separate units were created grouping similar or related
activities together. The Licensing and Examination, Enforcement,
and Administration units each are under the direction and
supervision of a Staff Services Manager.
Relocation. In 2005 the BBS relocated from R Street in
Sacramento to its current location at North Market Boulevard.
Change in Leadership. Prior to 2010, the BBS consisted of
eleven board members. The addition of the LPCC program increased
the composition of the Board to twelve members in 2010 (by adding
a public member), and to its current makeup of thirteen members
by adding a LPCC to the Board. Since November 2004, the BBS has
had two executive officers. The previous incumbent served from
November 2004 to November 2009. The current Executive Officer,
Kim Madsen, was appointed in January 2010.
Strategic Plan. The BBS revised its Strategic Plan in 2007,
adopting its current mission statement to protect Californians by
promoting consumer awareness, advocating for improved mental
health services, and setting, communicating, and enforcing
standards. The Strategic Plan was updated in 2009 to further
define the BBS's goals with the inclusion of performance
measures. In 2010, the Strategic Plan was revised to reflect the
core functions of the BBS with the primary goal to become a model
state agency and enhance consumer protection.
6.Current Issues and Problems Identified for BBS. The following are
some of the major unresolved issues pertaining to the BBS, or areas
of concern presented to the Committee for consideration, along with
background information concerning the particular issue.
Recommendations were made by Committee staff regarding the
particular issues or problem areas which needed to be addressed.
The BBS has 30 days to submit a response to the issues raised at the
Sunset Review informational hearings on April 19, 2012.
a) Issue : New license category.
Background : Effective January 1, 2010, a fourth mental health
profession, Licensed Professional Clinical Counselor, was added
to the Board's jurisdiction. Today, the Board is responsible
for the regulatory oversight of nearly 77,000 licensees. Current
law provides for twelve board members; five licensees and seven
public members. Ten members are appointed by the Governor, one
SB 1238
Page 10
public member is appointed by the Speaker of the Assembly, and
one public member is appointed by the Senate Rules Committee. In
2012, a LPCC member appointed by the Governor will be added,
increasing the board composition to thirteen members.
Considering that the LPCC is the newest license category, the
Committee desires to know if the Board has fully implemented this
new licensing category. What is the current status of training
programs for LPCC candidates? What is the current status of
newly licensed Professional Clinical Counselors? Have there been
any challenges in this process? Is any legislation needed to
assist the Board in overseeing the training and/or licensing
process for LPCCs?
Recommendation. The BBS should provide an update to the Committee
on the current status of the LPCC category including information
about training programs, licensed LPCCs and any challenges to
implementing this new license category. The BBS should also
indicate if any legislation needs to be proposed in order to help
the BBS more effectively oversee this facet of the profession and
serve the professional interests of licensees.
b) Issue : Does the BBS have adequate authority to oversee the
course content of continuing education providers?
Background : The BBS requires each licensee to complete 36 hours of
continuing education (CE) every two years, in or relevant to, the
licensee's field of practice in order renew the license. CE
courses must be obtained from either:
i. An accredited or state-approved school.
ii. A professional association, licensed health
facility, governmental entity, educational institution,
individual, or other organization approved by the BBS.
CE course content must be applicable to the practice of the
particular profession, must be related to direct or indirect
patient care and must incorporate one or more of the following
elements related to the licensed discipline:
i. Elements fundamental to the understanding and
practice of the profession.
ii. Elements in which significant recent developments
have occurred.
SB 1238
Page 11
iii. Elements of other disciplines that enhance the
understanding or the practice of the discipline of the
licensee.
BBS regulations outline the requirements for CE Provider
(Provider) approval by the Board. In order to be approved by the
Board, a Provider must meet the Board's course content and
instructor qualification. Provider approval must be renewed
every two years. A Provider must apply for renewal by submitting
the appropriate form and paying the required $200 fee. A
Provider with an expired approval is prohibited from presenting
courses for credit to BBS licensees, and licensees are unable to
use CE courses from a Provider whose approval has expired in
order to meet the CE requirement. Provider approvals that are
not renewed within one year after expiration may not be renewed
and will be cancelled. Cancelled providers will need to apply
for a new provider number by submitting the Continuing Education
Provider Application and application fee. For FY 2010/2011, the
BBS indicates there were 2,528 approved providers and 185
delinquent approvals.
Current law outlines broad course content requirements for CE
courses, and requires the Provider to ensure that course content
and instructor qualifications criteria are met. The BBS may
revoke or deny a provider application for good cause, including:
a criminal conviction, failure to comply with the licensing law,
or making a misrepresentation of fact in information submitted to
the BBS.
Though the BBS does not have explicit authority to review course
content, the Board may audit provider records to ensure
compliance with the CE requirements, including the requirement
that a Provider ensure that the course content and instructors
teaching courses meet the specified criteria. The law gives the
Board authority to revoke or deny a Provider based on not
ensuring quality of content, however, it does not allow the Board
to approve or deny specific courses offered by a Provider.
Language expressly permitting the review of course content and
instructor qualification relates only to an initial Provider
approval application. This review of coursework content and
instructor qualification does not extend to renewal or
maintenance of a Provider's approval.
A recent case illustrates need for the BBS to review its process
for approving CE Providers, and make appropriate changes to its
SB 1238
Page 12
procedures, or recommend legislative changes to its CE
requirements. In July of 2011, the BBS began receiving
complaints from the public regarding the BBS approved CE
Provider, the National Association of Research and Therapy of
Homosexuality (NARTH). The BBS received hundreds of emails from
individuals protesting the approval of an organization that
offers "reparative" or "conversion" therapy for individuals that
have unwanted homosexual tendencies. NARTH was approved by the
Board as a CE Provider in 1998. As of November 1, 2010 NARTH had
not renewed its Provider Approval and is currently unable to
provide CE courses to the BBS licensees for credit. Since that
time NARTH's approval remained expired for more than one year and
can no longer be renewed, and has been cancelled by the BBS. In
order to become a CE Provider, NARTH would have to apply for a
new Provider authorization from the BBS.
One of the primary factors in this issue is that NARTH has
advocated the use of "reparative" or "conversion" therapy.
Conversion therapy (also called reparative therapy or
reorientation therapy) is a type of sexual orientation change
effort that attempts to change the sexual orientation of a person
from homosexual or bisexual to heterosexual. The American
Psychological Association defines conversion therapy as "therapy
aimed at changing sexual orientation." The American Psychiatric
Association states that conversion therapy is a type of
psychiatric treatment "based upon the assumption that
homosexuality per se is a mental disorder or based upon the a
priori assumption that a patient should change his/her sexual
homosexual orientation." Both the American Psychiatric
Association and the American Psychological Association have
rejected the concept of conversion therapy for therapists.
However, the approval of an organization advocating conversion
therapy, such as NARTH, by the BBS drew the attention of the
public and a number of Legislators. Since that time, BBS staff
has met with Legislative staff to discuss the provider approval
process and deficiencies in the process. Concern has been
expressed over the approval of NARTH and the provider approval
process.
The BBS states in its November Sunset Report that at its October
13, 2011, Policy and Advocacy Committee (BBS-PAC) meeting,
committee members discussed needed changes to the regulations
that set forth requirements for Providers. Additionally, BBS-PAC
members discussed the possible need to transition to a continuing
competency model for licensure renewal. The BBS-PAC recommended
SB 1238
Page 13
that the BBS create a Continuing Education sub-committee to
conduct meetings with stakeholders, professional associations,
and experts in continuing competence programs to determine the
best possible solutions in moving forward with a restructure of
the continuing education program.
Recommendation : The BBS should report to the Committee its
current assessment of changes that may need to be made to the
requirements for CE Providers, and advise the Committee on any
legislative changes that should be made. The BBS should further
work with the stakeholders in the profession and in the
Legislature to make the appropriate procedural, regulatory or
legislative changes to its CE program.
a) Issue : Why is staff turnover rate so high?
Background : Historically, the BBS has had very little staff
turnover. Currently, the BBS has authorization for 43.3 staff
positions and 3.3 blanket positions. The Governor's Hiring
Freeze (Executive Order B-3-11) and the past Executive Orders for
the Furlough Programs were adversely impacted the Board's
recruitment efforts and operations. The BBS currently has eight
vacancies and has initiated recruitment efforts to fill the
following positions: 1 Staff Services Manager I, 1 Special
Investigator, 1 Associate Governmental Program Analyst, and 5
Office Technicians. Recruitment efforts were not successful
under the recent hiring freeze constraints. The majority of the
vacancies are in the BBS's licensing and cashiering unit. The
time of the year when the BBS sees an increase in the application
volume has recently passed. Consequently, as a result of the
ongoing vacancies, the BBS's processing times increased.
The BBS was legislatively mandated to license and regulate a new
mental health profession, Licensed Professional Clinical
Counselor, established by Senate Bill 788 (Wyland, Chapter 619,
Statues of 2009), starting January 1, 2010. The Board staff
faced challenges implementing this new licensing program with the
existing vacancies and significant delays in filling positions
specifically created for the LPCC licensing program.
The Committee understands the impact that the recent hiring
freeze has had on the BBS. However, it would be helpful to
explain why so many vacancies exist. Has a survey of departing
staff been conducted to ascertain why they left? What are the
efforts to fix the problems that led to the vacancies? What are
the plans to hire new staff and what are the impediments to
SB 1238
Page 14
accomplishing this task?
Recommendation : The BBS should report the current status of
vacancies and newly hired staff to the Committee. The BBS should
review the nature of the remaining vacancies and report to the
Committee its plan to fill the vacancies.
b) Issue : Webcasting meetings.
Background : In 2010 two BBS committee meetings were available
via webcast. The Committee is concerned about the BBS's lack of
use of technology in order to make the content of the BBS
meetings more available to the public. Webcasting is an
important tool that can allow for remote members of the public
and/or those who are disabled to stay apprised of the activities
of the Board as well as well as trends in the professions.
Recommendation : The BBS should utilize webcasting at future
Board meetings in order to allow the public the best access to
meeting content and to stay apprised of the activities of the BBS
and trends in the professions.
7. Current Issues and Problems Identified for BOP. The following are
some of the major unresolved issues pertaining to the BOP, or areas
of concern presented to the Committee for consideration, along with
background information concerning the particular issue.
Recommendations were made by Committee staff regarding the
particular issues or problem areas which needed to be addressed.
The BOP has 30 days to submit a response to the issues raised at the
Sunset Review informational hearings on April 19, 2012.
a) Issue . Will the BOP be able to fill vacant positions?
Background : As with other regulatory boards, the Board of
Psychology has been working within the limitations of the current
fiscal emergency and the resulting Executive Orders. As a
result, the BOP has experienced a number of vacancies and
encountered considerable difficulty in filling the vacancies due
to the hiring limitations. As a small board without any
redundant positions, all vacancies directly affect the
productivity and timeliness of the BOP's processes as the
workload resulting from these vacancies must be absorbed by
remaining staff.
Effective January 2011, the BOP received additional budget approval
through the DCA's Consumer Protection Enforcement Initiative
SB 1238
Page 15
(CPEI) to hire 2 investigators, 2 medical consultants, and one
limited term analyst, bringing its staffing level to 19.5
authorized positions. The BOP has worked with DCA Office of
Human Resources (OHR) to fill these CPEI positions. Although
these positions were funded in January 2011, the BOP had been
unable to fill them due to the hiring freeze implemented in
August 2010.
Though the BOP continues to improve its timeliness, vacancies
reduce the amount of progress that can be made. At the time of
its November 2011 Report, 41% of the BOP's allotted positions (or
8 positions), including the positions that were granted as a
result of the CPEI, were vacant. Also, because of the
classification level of some of these positions, the BOP
indicated that it has received disappointingly low interest from
potential candidates to fill those positions.
Recommendation : The BOP should inform the Committee of its current
staffing levels. Are there current staff vacancies? What are
the current challenges to fill vacant positions? What has been
the effect of the staff vacancies on the BOP's operations?
b) Issue . Are regulatory or legislative changes needed regarding
telehealth or the online practice of psychology?
Background : The BOP states in its Report that the issue of the
practice of psychology by alternative methods such as telephone
and online psychotherapy has recently moved to the forefront of
issues facing the profession of psychology. The BOP states that
California, along with many other states and provinces, are
beginning to look seriously into this topic and how it affects
consumers.
The BOP acknowledges that there are many issues regarding providing
psychological services electronically across state lines, such as
the location of the recipient of the services and the location of
the provider; however, there are many other issues regarding the
provision of psychological services electronically within
California that the BOP needs to address first. These issues
include, but are not limited to, safety, security, informed
consent, and ethical practice.
The BOP has considered conducting a symposium and inviting various
individuals and organizations knowledgeable about telehealth,
including the Association of State and Provincial Psychology
Boards (ASPPB) which is currently developing guidelines that
SB 1238
Page 16
could be useful for all psychology licensing jurisdictions. The
California Psychological Association (CPA) has offered to partner
with the BOP in this endeavor. The BOP is aware of the urgency
of this issue, as there are licensees who are currently
practicing telehealth, and the BOP will be determining if
regulations regarding this issue are necessary to protect
consumers of psychological services in California.
According to the BOP, whether legislation or some basic regulations
are needed is yet to be determined. There are many similar
discussions in other jurisdictions regarding telehealth. Since
this delivery of mental health services will encompass much more
than our state, the BOP states that efforts must be made to
ensure that consumers are not harmed if receiving services from
another jurisdiction. Working with the other jurisdictions
(boards) in assessing what is needed for the best practice in
teleheath will also benefit the California consumer when they
leave the state. Telehealth would allow the continuation of
therapy without interruption due to proximity to the
practitioner.
Recommendation : The BOP should update the Committee on its
evaluation of whether regulations or legislation are needed
regarding telehealth or the online practice of psychology.
c) Issue . Are there regulatory or legislative changes which
should be made regarding unaccredited schools?
Background : The BOP states that California is the only state which
allows students from unaccredited schools to sit for psychology
licensing examinations. All other states require students to be
from accredited institutions, accredited by either a regional or
national accrediting body. This leaves California as an outlier
in the profession, and stands as an impediment to the BOP
entering into any reciprocity agreements with other states.
The BOP indicates that the lack of reciprocity with other states is
a barrier to full participation by California-licensed
psychologists in national issues. The BOP also would like all
psychologists and students in California to be included in
national organizations, able to be accepted into internship
placement programs and have the ability to become licensed in
other states. These limitations are among many which those
practitioners from California, who attended an unaccredited
school, will be subject to.
SB 1238
Page 17
According to the BOP, it is currently monitoring statistics and
passing rates. The BOP has recently sent out letters to all
national organizations questioning their reasoning regarding the
limitations they have set for those who have not attended
accredited institutions. With the re-establishment of the Bureau
for Private Postsecondary Education (BPPE), the BOP is hopeful
that these unaccredited institutions, while having their students
continue to apply for licensure, will be held accountable within
the new regulations, to the minimum standard of notifying those
students, prior to attending, of the limitations of their
graduation and degree from a non-accredited program.
BPC � 2914 of the requires each applicant for licensure to possess
a doctoral degree in psychology, educational psychology, or in
education with a field of specialization in counseling psychology
or educational psychology from a regionally accredited
educational institution in the United States or Canada, or from
an educational institution in California that is approved by the
BPPE. It provides that applicants for licensure trained in an
educational institution outside the United States or Canada shall
demonstrate to the satisfaction of the BOP that he or she
possesses a doctorate degree in psychology that is equivalent to
a degree earned from a regionally accredited university in the
United States or Canada.
There are currently 6 schools approved by the BPPE that meet the
educational criteria to qualify for licensure. The BOP has no
authority over school approvals or their operation and
curriculum. The BOP feels very strongly about full disclosure in
regards to the restrictions an unaccredited degree program in
psychology has on California students in regards to mobility and
membership in various professional organizations and programs
within the profession. AB 611 (Gordon, Chapter 103, Statutes of
2011) set forth certain disclosure requirements pertaining to
accreditation status, licensure, and related limitations for
unaccredited doctoral programs.
Recommendation : The BOP should inform the Committee of its current
efforts regarding the issue of unaccredited schools. To what
extent are California students being harmed by this issue? Is
there a way for the BOP to better inform potential students of
the differences between attending an accredited versus an
unaccredited school and to keep a list of both? Are there
regulatory or legislative changes that need to be made regarding
unaccredited schools? What can be done to enhance the ability of
California's licensed psychologists to have reciprocity with
SB 1238
Page 18
other states?
d) Issue . What is the status of the BOP's efforts to ensure the
continued competency of its licensees?
Background : The BOP requires each licensee to complete 36 hours of
continuing education for each two-year license renewal. The BOP
reports that it averages a 92% compliance rate of licensee
compliance with the continuing education requirements, and that
most noncompliance issues deal deficiencies in submitting the
proper documentation of the completed continuing education
courses.
The BOP additionally states that it has also discussed continued
professional development/competency for licensed psychologists.
The BOP states that continued competency has been an issue on the
agenda for the BOP's Committee on Contemporary and Emerging
Issues for the past several board meetings. The Committee has
been looking at how licensees can demonstrate competency beyond
continuing education. In 2011, the Committee on Contemporary and
Emerging Issues recommended referring this topic to the BOP's
Continuing Education Committee. The BOP stated that the
Committee would review models regarding continued professional
development/competency created by the Association of State and
Provincial Psychology Boards and the American Psychological
Association at the November 2011 board meeting. The BOP states
that it is also planning to partner with the California
Psychological Association to address this developing issue.
Recommendation : The BOP should discuss with the Committee its
efforts to date to address continuing competency, and what it
expects to accomplish in near future regarding this issue.
e) Issue : What is the status of pending regulations?
Background : The BOP has reviewed and implemented a number of
rulemaking changes since the previous sunset review. The two
regulatory packages noted above were "pending" at the time the
Sunset Report was submitted to the Committee. The BOP should
update the Committee about the status of these two regulatory
proposals, especially the regulations which would streamline and
augment the BOP's enforcement processes.
This regulatory proposal is in response to the DCA's request to
implement regulations to enhance the BOP's mandate of consumer
protection. The DCA launched the Consumer Protection Enforcement
SB 1238
Page 19
Initiative (CPEI) to overhaul the enforcement processes used by
healing arts boards within the Department, in order to reduce the
average enforcement completion timeline from 36 months to between
12 and 18 months. The regulations implement certain elements
that were reflected in SB 1111 (Negrete McLeod) from 2010, and SB
1441 (Ridley-Thomas, Chapter 548, Statutes of 2008). The former
DCA Director encouraged the boards in the Department to develop
regulatory changes, as needed, to implement the changes that
could be adopted through the regulatory process.
The regulations would make the following changes to enhance the
BOP's mandate of consumer protection:
i. Delegate authority to the executive officer to approve
settlement agreements for revocation, surrender, or interim
suspension of a license or registration.
ii. Delegate authority to the executive officer to order
an applicant or licensee to submit to a physical or mental
examination if it appears the person may be unable to safely
perform licensed duties and functions due to physical or
mental illness.
iii. Clarify the authority of the executive officer to deny
an application if the applicant is unable to safely practice,
based on the review of the evaluation report.
iv. Prohibit "gag clauses" in civil settlement agreements
that forbid a party from contacting, cooperating with, or
filing a complaint with the BOP, or that require a person to
withdraw a complaint filed with the BOP.
v. Define as unprofessional conduct failure to provide
the BOP with copies of documents within 15 days of receipt of
a request.
vi. Define as unprofessional conduct the failure to
cooperate and participate in any BOP investigation pending
against a licensee or registrant.
Recommendation : The BOP should inform the Committee of the
current status of the proposed regulations relating to delegation
of functions to the executive officer and regarding
unprofessional conduct for licensees.
7.Related Legislation. In the current legislative session, other
SB 1238
Page 20
sunset review bills to be presented before the BPED Committee
include:
SB 1236 which deals with the Board of Podiatric Medicine and the
Physician Assistant Board.
SB 1237 which deals with the Board of Pharmacy and the Court
Reporters Board.
SB 1239 which deals with the Acupuncture Board.
SUPPORT AND OPPOSITION:
Support:
Board of Behavioral Sciences
Board of Psychology
Alameda County Psychological Association
California Psychological Association- Independent Practice Division
Contra Costa Psychological Association
Los Angeles County Psychological Association
Marin County Psychological Association
Monterey Bay Psychological Association
Redwood Psychological Association
Sacramento Valley Psychological Association
San Joaquin Valley Psychological Association
San Mateo County Psychological Association
Opposition: None on file as of April 18, 2012
Consultant:Le Ondra Clark