BILL ANALYSIS                                                                                                                                                                                                    �







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        |Hearing Date:April 23, 2012        |Bill No:SB                         |
        |                                   |1575                               |
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                      SENATE COMMITTEE ON BUSINESS, PROFESSIONS 
                               AND ECONOMIC DEVELOPMENT
                          Senator Curren D. Price, Jr., Chair

                                           
               Bill No:        SB 1575Author:Business, Professions and 
                                    Economic Development Committee
                          As Amended April 16, 2012Fiscal:Yes


        SUBJECT:  Professions and vocations. 
        
        SUMMARY:  Makes several non-controversial minor, non-substantive or 
        technical changes to various provisions pertaining to the 
        health-related regulatory Boards of the Department of Consumer Affairs 
        (DCA).

        Existing law:
        
        1)Provides for the licensing and regulation of various professions and 
          businesses by some 
        23 boards, 4 committees, 8 bureaus, and 1 commission within the DCA 
          under various Business and Professions Code (BPC) licensing acts.  
          Each licensing act specifies that protection of the public shall be 
          the highest priority of the Boards or Bureaus in exercising its 
          licensing, regulatory and disciplinary functions. 

        2)Contains the following provisions relating to the Respiratory Care 
          Board:

           a)   Establishes the Respiratory Care Practice Act.  (BPC �3700 et 
             seq)

           b)   Allows the Respiratory Care Board to exercise authority over 
             licensing, regulatory and disciplinary functions.  (BPC � 3710.1)

           c)   Includes substandard care in the capacity as a respiratory 
             care practitioner (RCP) or any capacity responsible for the care 
             of another.  (BPC � 3750(p))





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           d)   Establishes that during the period of any clinical training, a 
             trainee shall be under the direct supervision of a person holding 
             a valid and current respiratory care license.  (BPC � 3742)

        3)Contains the following provisions relating to the Board of 
          Behavioral Sciences (BBS):

           a)   Licenses and regulates the following by the BBS:  marriage and 
             family therapists (LMFT), clinical social workers (LCSW) 
             educational psychologists (LEP), and licensed professional 
             clinical counselors (LPCC).  (BPC � 4980.34)

           b)   Requires that applicants complete a course in California law 
             and professional ethics.  (BPC � 4980.78)

           c)   Specifies the requirements for an applicant to pass the 
             standard written examination and the California Law and Ethics 
             Examination.  (BPC �� 4980.398, 4980.399, 4992.07, 4992.09)

           d)   Specifies the course content of the California law and ethics 
             course.  (BPC � 4999.57, 
           � 4999.58 and � 4999.59)

           e)   Requires an intern to renew his or her registration annually 
             in order to retain their intern status.  (BPC � 4999.45 (d)) 

           f)   Requires a LPCC intern to cease employment after six years 
             unless he or she obtains a new intern registration.  (BPC 
             �4999.45(e))

           g)   Specifies the grounds for refusal of registration or licensure 
             due to unprofessional conduct.  (BPC � 4999.90)

           h)   Establishes a fee for the annual renewal of licenses.  (BPC � 
             4999.120)

           i)   Discusses the provisions of supervision for credited 
             experience.  (BPC � 4980.43(c))

           j)   Describes advertisement of services for unlicensed interns and 
             trainees.  
           (BPC �� 4980.44, 4980.48)

           aa)  References the Health Insurance Portability and Accountability 
             Act as it relates to education, licensees from other states and 





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             examination eligibility or registration.  
           (BPC �� 4980.78, 4980.80, 4999.62, 4999.57, 4999.58, 4999.59, 
             4999.32)

           bb)  Defines the number of hours of clinical experience needed in 
             either a clinical setting or community mental health setting.  
             (BPC � 4999.46(b)(5))

           cc)  Requires that LPCCs, who obtained their license through grand 
             parenting, and were not already licensed by the BBS as an LMFT or 
             LCSW, must complete 18 hours of annual continuing education.  
             (BPC � 4999.76)

        4)Contains the following provisions relating to the Board of 
          Optometry:

           a)   Permits the Board to require an individual who meets all of 
             the following requirements to take the examinations for a 
             certificate of registration as an optometrist:  (BPC � 3057.5)

             i)     Is over the age of 18 years.

             ii)    Is not subject to denial of a certificate.

             iii)   Has a degree as a doctor of optometry issued by a 
               university located outside of the United States.

        5)Contains the following provisions relating to the Medical Board of 
          California (MBC):

           a)   Permits the MBC to regulate physician and surgeon certificate 
             holders.  (BPC � 2220)

           b)   Grants the MBC jurisdiction over all of its licensees.  (BPC � 
             2220)

           c)   Allows the MBC to license midwives.  (BPC � 2518)

           d)   Specifies the period of validity for the United States Medical 
             Licensing Examination (USMLE) test scores extension.  (BPC � 
             2184)

           e)   Uses the term "infant" to describe a newborn in the first four 
             weeks of life.  (BPC � 2516)

           f)   Specifies the process for physicians to report change of 





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             address, received renewal and delinquency notices and pay renewal 
             and delinquency fees to the MBC.  
           (BPC �� 2021, 2424)

        6)Contains the following provisions relating to the Board of 
          Psychology:

           a)   Specifies that a licensed psychologist is a health care 
             practitioner that may utilize telehealth.  (BPC � 2904.5)

        7)Contains the following provisions relating to the Board of Pharmacy:

           a)   Describes the number of practice hours required for an intern 
             pharmacist.  
           (BPC � 4209(a))

           b)   Ensures that final disciplinary action taken on a licensee's 
             record, even if that license is cancelled, is documented.  (BPC � 
             4300.1)

        8)Contains the following provisions relating to the Dental Hygiene 
          Committee of California (DHCC):

           a)   Specifies supervision and coursework requirements for 
             trainees.  (BPC � 1909.5)

           b)   Indicates that a licensee that changes his/her physical 
             address and/or legal name is required to report this to the DHCC. 
              (BPC � 1934)

           c)   Defines unprofessional conduct for dental hygienists.  (BPC � 
             1950.5)

        9)Contains the following provisions relating to the California Massage 
          Therapy Council (Council):

           a)   Specifies the examination that an applicant has to pass in 
             order to receive a certificate.  (BPC � 4601(c)(2)(B)) 

           b)   Describes the minimum number of hours that an applicant must 
             complete in order to receive a certificate.  (BPC � 
             4601(b)(1)(B), (c )(2)(A))

           c)   Establishes that a city, county or city and county may charge 
             a massage business or establishment a business licensing fee 
             providing that the fee be no different than the fee that is 





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             uniformly applied to all other individuals and businesses 
             providing professional services.  (BPC � 4612 (b)(3))

           d)   Specifies the requirements for obtaining an application for a 
             business license.  
           (BPC �  4612(b)(7))

           e)   Indicates that an owner or operator of a massage business or 
             establishment shall be responsible for the conduct of all 
             employees or independent contractors working on the premises of 
             the business.  (BPC � 4612 (c))

           f)   Specifies what a background check of an owner of a massage 
             establishment may include.  (BPC � 4612 (e))

        This bill:

        1)Makes the following changes relating to the Respiratory Care Board: 

           a)   Includes illegal possession of drug paraphernalia as grounds 
             to take disciplinary action. (BPC � 3750(a))

           b)   Includes substandard care or negligence in the capacity as a 
             RCP or any capacity responsible for the care of another.  (BPC � 
             3750(p))

           c)   Specifies that the person providing supervision to a RCP must 
             hold an unrestricted license.  (BPC � 3742)

           d)   Ensures that all boards and bureaus can obtain certified 
             criminal records necessary to complete an applicant or licensee 
             investigation.  (BPC � 144.5)

        2)Makes the following changes relating to the Board of Behavioral 
          Sciences:  

           a)   Adds LPCCs to the list of groups licensed by the Board.  (BPC 
             � 4980.34)

           b)   Requires the California law and professional ethics course to 
             be 18 hours in length.  
           (BPC � 4980.78)

           c)   Requires an 18 hour course in California law and professional 
             ethics if the applicant has completed a 2 quarter unit or 3 
             semester unit course that does not meet the requirements as 





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             specified.  (BPC � 4980.8)

           d)   Clarifies that if an applicant has previously passed the 
             standard written examination, but not the clinical vignette 
             examination, then under the examination restructure, he or she 
             would need to pass the new clinical examination.  However, he or 
             she would not need to take the new California Law and Ethics 
             Examination because the previously passed standard written 
             examination had already fulfilled this requirement.  
           (BPC � 4980.398, � 4980.399, � 4992.07 and  � 4992.09)

           e)   References the fingerprinting requirement in regulations.  
             (BPC � 4984.4 (LMFTs), � 4989.42 (LEPs), � 4996.6 (Licensed 
             Clinical Social Workers) and � 4999.106 (LPCCs))

           f)   References the Licensed Marriage and Family Therapist Act.  
             (BPC � 4980.04 and � 4999.22)

           g)   Deletes an obsolete reference to the 18 hour California law 
             and ethics course requirement as these sections already specify 
             that the applicant must meet the requirements of BPC � 4999.32 
             (e) which requires the same course.  (BPC � 4999.57, � 4999.58 
             and � 4999.59)

           h)   Specifies that the course content of the California law and 
             ethics course must contain the elements that were previously 
             listed in BPC � 4999.57, � 4999.58 and � 4999.59. (BPC � 4999.32 
             (e) (6))  

           i)   Replaces the term "Health Insurance Portability and 
             Accountability Act" with the clause "state and federal laws 
             related to confidentiality of patient health information."  
           (BPC � 4999.57, � 4999.58, � 4999.59 and � 4999.32)

           j)   Clarifies that a PCC intern must renew annually in order to 
             retain their intern status.  
           (BPC � 4999.45 (d)) 

           aa)  Deletes an obsolete reference in BPC �4999.45(e) which 
             requires  a PCC intern to cease employment after six years unless 
             he or she obtains a new intern registration as subsections (d) 
             and (f) already cover this requirement.

           bb)  Adds language ensuring conformity with existing laws regarding 
             substance abuse, supervision and inclusion of LPCCs.  (BPC � 
             4999.90)





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           cc)  Adds a provision stating that it is unprofessional conduct for 
             an LPCC applicant or registrant to violate the law regarding 
             patient access to his or her records.  
           (BPC � 4999.90)

           dd)  Removes the fee established in subsection (h) of LPCC code.  
             (BPC � 4999.120)

           ee)  Specifies the type of supervision that is required for 
             credited experience.  
           (BPC � 4980.43(c))

           ff)  Adds LPCCs to the list of supervisors.  (BPC � 4980.44 and 
             4980.48)

           gg)  Removes the reference to Health Insurance Portability and 
             Accountability Act and replaces it with the clause: "state and 
             federal laws related to confidentiality of patient health 
             information."  (BPC � 4980.78, 4980.80, and 4999.62)

           hh)  Defines the terms "clinical setting" and "community mental 
             health setting."  
           (BPC � 4999.46(b)(5))

           ii)  Deletes the requirement that LPCCs who obtained their license 
             through grand parenting, and who were not already licensed by the 
             Board as an LMFT or LCSW, must complete 18 hours of annual 
             continuing education.  If this provision is deleted, these 
             licensees would be required to show completion of 36 hours of 
             continuing education every two years upon license renewal, as is 
             required of all other LPCCs.  (BPC � 4999.76)

        1)Makes the following changes relating to the Board of Optometry:

             a)     Amends language to explicitly state "graduate of a foreign 
               university" instead of "person" when referring to who is 
               eligible to sit for the examinations for a certificate of 
               registration as an optometrist.  (BPC � 3057.5)

        1)Makes the following changes relating to the Medical Board:

             a)     Clarifies existing law to make it clear that the Board has 
               jurisdiction over all licenses it issues regardless of the type 
               of license.  (BPC � 2220)






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             b)     Adds language, similar to that in existing law for 
               physicians, which will create a retired license status for 
               licensed midwives.  (BPC � 2518)

             c)     Makes technical code maintenance changes.  (BPC � 2064)

             d)     Clarifies that clinical training should be included as a 
               way an applicant may have spent time in a postgraduate training 
               program, in order to qualify an applicant to have the period of 
               validity for the United States Medical Licensing Examination 
               (USMLE) scores extended.  (BPC � 2184)

             e)     Uses the term "neonate" in place of "infant" to describe a 
               newborn in the first four weeks of life.  (BPC � 2516)

             f)     Allows physicians the choice to be sent renewal and 
               delinquency notices via electronic mail.  (BPC � 2021 and � 
               2424)

        1)Makes the following changes relating to the Board of Psychology:

                a) Makes technical changes to the BPC � 2904.5 dealing with 
          telehealth services.

        2)Makes the following changes relating to the Board of Pharmacy:

             a)     Streamlines the processing of applicants for the 
               pharmacist licensure examination, and ensures that applicants 
               who submit verification of intern hours worked from another 
               state board of pharmacy have met the California requirements.  
               (BPC � 4209(a))

             b)     Ensures that final disciplinary action taken on a 
               licensee's record, even if that license is cancelled, is 
               documented.  (BPC � 4300.1)

        1)Makes the following changes relating to the Dental Hygiene Committee 
          of California (DHCC):

             a)     Authorizes the DHCC to obtain and keep required employment 
               records.  
             (BPC � 1902.2(a))

             b)     Deletes BPC � 1909.5 pertaining to supervision and 
               coursework as the requirements are now obsolete. 






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             c)     Clarifies that a licensee that changes his/her physical 
               address and electronic mail information is required to report 
               this to the DHCC.  (BPC � 1934)

             d)     Deletes obsolete language as the State Dental Auxiliary 
               Fund no longer exists.  
             (BPC � 1945)

             e)     Clarifies that this section applies to dental hygiene.  
               Makes changes to technical terminology such as: "radiograms" to 
               "radiographs."  Clarifies that the DHCC is to determine 
               permitting standards.  Conforms to Dental Board language 
               regarding failure to follow infection control guidelines.  (BPC 
               � 1950.5)

             f)     Applies existing unprofessional conduct language relating 
               to dentists to dental hygienists.  (BPC � 1958.1 (a))

        1)Makes the following changes relating to the California Massage 
          Therapy Council (Council):

             a)     Allows for the investigation of a person who has 
               substantial authority over the operation of the establishment 
               including hiring and firing of certified massage professionals. 
                (BPC � 4600(e))

             b)     Provides clarifying language to prevent someone from 
               qualifying without any massage training by passing one of the 
               examinations that require no proof of education.  
             (BPC � 4601(c)(2)(B)) 

             c)     The U.S. Department of Education has issued new rules for 
               recognizing school credits issued.  Currently, the California 
               Massage Therapy Council (CAMTC) converts credits to hours but 
               some states have recognized in rules that they will accept 
               both.  Two schools have suggested that the CAMTC do the same to 
               avoid confusion regarding student financial aid.  (BPC � 
               4601(b) (1)(B) and BPC � 4601 (c)(2)(A))

             d)     Standardizes practices for suspended or revoked 
               certifications and licenses.  
             (BPC � 4601(h))

             e)     Indicates that a city, county or city and county may 
               charge a massage business or establishment a business licensing 
               fee providing that the fee be no higher than the fee that is 





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               uniformly applied to all other individuals and businesses 
               providing professional services.  (BPC � 4612 (b)(3))

             f)     Clarifies relevant information for a business license 
               application.  (BPC �  4612(b)(7))

             g)     Clarifies that an owner or operator of a massage business 
               or establishment who is certified shall be responsible for the 
               conduct of all employees or independent contractors working on 
               the premises of the business.  (BPC � 4612 (c))

             h)     Specifies what a background check of an owner of a massage 
               establishment may include as well as actions taken against the 
               establishment if the background check results in a relevant 
               finding.  (BPC � 4612 (e))

        FISCAL EFFECT:  Unknown.  This bill has been keyed "fiscal" by 
        legislative counsel.

        
        COMMENTS:
        
        1.Purpose.  This bill is the annual Omnibus Committee bill authored by 
          the Business, Professions and Economic Development Committee which 
          consolidates a number of non-controversial provisions related to 
          various regulatory programs and professions governed by the Business 
          and Professions Code.  Consolidating the provisions in one bill is 
          designed to relieve the various licensing boards, bureaus and 
          professions from the necessity and burden of having separate 
          measures for a number of non-controversial revisions.

          Many of the provisions of this bill are minor, technical and 
          updating changes, while other provisions are substantive consensus 
          changes intended to improve the ability of various licensing 
          programs and other entities to efficiently and effectively 
          administer their respective laws.

          As a Committee bill, this measure is jointly authored by each of the 
          members of the Committee.  As such, by its very nature, it is a 
          consensus bill.  If controversy or opposition should arise regarding 
          any provision in this bill that cannot be resolved, then that 
          provision will be removed from the bill.  This will eliminate the 
          chance of placing any of the other provisions in jeopardy.

        2.Background.  The Board of Behavioral Sciences is the only board 
          which appears to have the more significant and substantive 





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          provisions in this measure :

           a)   Board of Behavioral Sciences (BBS).   Addition of LPCC.   
             Section 4980.34 states that it is the intent of the Legislature 
             that the BBS license LMFTs, LCSWs, and LEPs.  It does not 
             currently include licensure of LPCCs.  The BBS was given the 
             authority to license LPCCs with SB 788 (Chapter 619, Statutes of 
             2009).  As such, the BBS has proposed changing several sections 
             within the BPC to reflect the addition of this new group.

                Delete References to HIPAA.  Certain sections of the BBS's 
               licensing laws require coursework in California law and ethics 
               that covers, among other topics, the Health Insurance 
               Portability and Accountability Act (HIPAA).

               According to the BBS, during previous discussions of the 2012 
               omnibus bill at the BBS's October 13, 2011 Policy and Advocacy 
               Committee Meeting and the November 9, 2011 Board Meeting, it 
               was requested that reference to HIPAA in code sections 4999.32, 
               4999.57, 4999.58 and 4999.59 be removed and replaced with the 
               term "state and federal laws related to confidentiality of 
               patient health information."  The BBS's reasoning is that HIPAA 
               is a federal law which in the future could be repealed or 
               replaced with a different title, therefore making the reference 
               obsolete.

               Amendments deleting the reference to HIPAA in Sections 4999.57, 
               4999.58, and 4999.59 and instead including the new reference 
               term in Section 4999.32 have already been approved by the BBS.  
               However, there are three other code sections in LPCC licensing 
               law that also reference HIPAA and are proposed changes within 
               this bill.
        3.        Current Related Legislation.   SB 1527  (Negrete McLeod, 2012) 
          requires an out of state licensee, under the jurisdiction of the 
          Board of Behavioral Sciences (BBS), to be in good standing.  
          Requires the individual to pass the California law and ethics 
          examination, but would exempt the person from the clinical 
          examination if the person has previously obtained a passing score on 
          an examination accepted by the BBS as provided by a regulation 
          adopted by the BBS.  The bill also provides that a passing score on 
          the clinical examination shall be accepted by the BBS for a period 
          of 7 years after the examination date.  It also exempts an 
          applicant, who received their license out of state, from the 
          clinical examination if the person has previously obtained a passing 
          score on an examination accepted by the BBS, pursuant to a 
            regulation adopted by the BBS. The bill provides that a passing 





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          score on the clinical examination shall be accepted by the BBS for a 
          period of 7 years after the examination date.

         SB 1202  (Leno and Wyland, 2012) Makes a number of clean up changes 
          regarding the licensure and regulation of registered dental 
          hygienists by the Dental Hygiene Committee of California; increases 
          various regulatory fee ceilings.

           AB 2579  (Skinner, 2012) requires that on or after January 1, 2014, a 
          Marriage and Family Therapist license be issued to qualified 
          applicants upon the passage of a clinical examination and a 
          California law and ethics examination, subject to specified fees, 
          and requires applicants for licensure to retake the law and ethics 
          examination under certain circumstances, as specified.  Also 
          requires that on or after January 1, 2014, marriage and family 
          therapist interns must take the law and ethics examination, subject 
          to specified fees.


        SUPPORT AND OPPOSITION:
        
         Support:  

        Medical Board of California

         Opposition:   

        None received as of April 16, 2012



        Consultant:Le Ondra Clark