BILL ANALYSIS Ó
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2015 - 2016 Regular
Bill No: AB 179 Hearing Date: July 6,
2015
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|Author: |Bonilla |
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|Version: |June 30, 2015 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Sarah Huchel |
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Subject: Healing arts.
SUMMARY: Extends the operation of the Dental Board of California
(DBC) until
January 1, 2020, increases statutory fee caps relating to
dentists and dental assistants, extends the operation of the
Board of Vocational Nursing and Psychiatric Technicians (BVNPT)
until January 1, 2018, merges the Vocational Nursing fund and
the Psychiatric Technician funds, and makes other changes as
specified.
Existing law:
1)Establishes the Dental Practice Act (Act), administered by the
DBC within the Department of Consumer Affairs (DCA), to
license and regulate the practice of dentistry, and sunsets
the DBC on January 1, 2016. (Business and Professions Code
(BPC) §§ 1600, et seq.)
2)Establishes the Dental Assisting Council (DAC) of the DBC,
which shall consider all matters relating to dental
assistants in this state, on its own initiative or upon the
request of the Board, and makes appropriate recommendations
to the Board and the standing committees of the Board, as
specified. (BPC § 1742)
3)Requires the DBC to establish, as necessary, the amount of
charges and fees for licensure for the purpose of carrying
AB 179 (Bonilla) Page 2
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out its responsibilities under the Act, subject to statutory
fee caps. (BPC § 1724)
4)Requires the amount of the fees prescribed by this chapter
that relate to the licensing and permitting of dental
assistants to be established by regulation and subject to
statutory fee caps. (BPC § 1725)
5)Requires for licensure as a registered dental assistant
satisfactory performance on a written and practical
examination administered by the DBC. (BPC § 1752.1)
6)Provides that a healing arts practitioner who engages in
sexual relations with a patient, client, or customer
constitutes unprofessional conduct and grounds for
disciplinary action, except as specified. (BPC § 726)
7)Establishes the BVNPT within the DCA, to license and regulate
vocational nurses under the Vocational Nursing Practice Act,
and to license and regulate psychiatric technicians under the
Psychiatric Technicians Law, and extends the operation of the
BVNPT until January 1, 2016. (BPC §§ 2840 et seq., 4500 et
seq.)
8)Establishes the Vocational Nursing and Psychiatric Technicians
Fund.
(BPC § 2890)
9)Establishes the Vocational Nursing Account and the Psychiatric
Technician Examiners Account of the Vocational Nursing and
Psychiatric Technician Fund. (BPC § 205)
This bill:
1) Merges the Vocational Nurse Account and the Psychiatric
Technician Examiners Account of the Vocational Nursing and
Psychiatric Technicians Fund on July 1, 2016 to become the
AB 179 (Bonilla) Page 3
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Vocational Nursing and Psychiatric Technicians Fund.
2) Expands the exception to all hearing arts licensees that it
is not unprofessional conduct for a healing arts licensee to
engage in consensual sexual conduct with his or her spouse or
person in an equivalent domestic relationship when that
licensee provides medical treatment, other than
psychotherapeutic treatment, for that person.
3) Extends the DBC's sunset until January 1, 2020.
4) Consolidates references to fees in the general fee provisions
section and increases fee amounts, as specified.
5) Requires every applicant and licensee who has an electronic
mail address to report to the DBC that electronic mail
address no later than July 1, 2016. The electronic mail
address shall be considered confidential and not subject to
public disclosure.
6) Requires the DBC to annually send an electronic notice to
each applicant and licensee that requests confirmation from
the applicant or licensee that his or her electronic mail
address is current.
7) Limits the term of a member of the DAC to no more than two
full terms.
8) Consolidates the funds of the BVNPT, as specified.
9) Extends the sunset date on the BVNPT until January 1, 2018.
10)Makes clarifying and technical amendments.
FISCAL
EFFECT: This bill has been keyed "fiscal" by the Legislative
Counsel. According to the Assembly Appropriations Committee
analysis dated May 20, this bill will have the following fiscal
effect:
1) $14.6 million annually (State Dentistry Fund), until January
1, 2020, to maintain current operations of the DBC.
AB 179 (Bonilla) Page 4
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2) $11.2 million annually (Vocational Nursing and Psychiatric
Technicians Fund), until January 1, 2018, to maintain current
operations of the BVNPT.
3) Unknown potential increased revenues, if DBC adopts
regulations to raise fees based on the increased fee caps.
COMMENTS:
1.Purpose. This bill is sponsored by the Author. According to
the Author's office, "This bill is necessary to ensure that
consumers are protected by the continued operation of the DBC
and the BVNPT. The DBC's sunset bill raised numerous issues,
including the adequacy of the Dentistry Fund condition. The
DBC has been operating with a major structural deficit, and is
faced with impending deficits. Prior to recent increases to
its initial and renewal licensure fees, the DBC had not raised
fees for nearly two decades. A recent audit of the DBC's
finances shows that the cost for licensure and permitting
categories do not sufficiently cover the cost for that license
or permit. As a result, this bill proposes to increase
statutory fee caps across all categories to let the DBC begin
to recover its costs, help solve its structural imbalance, and
build a healthy reserve. These fee caps are intended to carry
the DBC over for many years, and any actual increase in fees
would need to go through the regulatory process, thereby
ensuring that licensees may voice any concerns to potential
increases. This bill would also extend the sunset date for
the DBC until January 1, 2020.
The Author notes that "In addition, on February 13, 2012, the
BVNPT approved a merger of the vocational nursing fund and the
psychiatric technician fund as an alternative to a statutory
amendment to raising fees for the psychiatric technician fees.
This bill would advance the fiscal solvency of the BVNPT by
merging these funds. The bill will also increase
accountability by extending the BVNPT's sunset date only until
January 1, 2018, thereby increasing legislative oversight of
the BVNPT in light of the significant issues raised in the
BVNPT's sunset background paper."
2. Background. This is one of several bills resulting from the
2015 Sunset Reviews by the Senate Committee on Business,
Professions, and Economic Development and the Assembly
Business and Professions Committee.
AB 179 (Bonilla) Page 5
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3. Dental Board Fund Condition. The Dentistry Fund is
maintained by the DBC and includes the revenues and
expenditures related to licensing dentists. For sixteen
years, the license fee for dentists was set at $365. Between
2013 and 2014, the DBC increased its license fee for dentists
from $365 to its statutory cap of $450 and simultaneously
pursued a legislative fee increase $450 to $525. This was
aligned with a DCA audit recommending that the license fees
be raised to that amount ensure solvency.
While increased fees have generated additional revenue, the
DBC's expenditures continue to outpace its revenue,
perpetuating a structural imbalance. Part of the reason for
the increase in projected and actual expenditures in recent
years has been due to funding 12.5 Consumer Protection
Enforcement Initiative (CPE) positions; funding the diversion
program; increased expenses associated with BreEZe;
unexpected litigation expenses; and the general increase in
the cost of doing business over the past 16 years. While the
DBC has expended less than what it has been authorized by the
budget due to some cost savings and reimbursements, the DBC
emphasizes that its fund ought to be able to sustain
expenditures without relying on estimated savings or
reimbursements.
The DBC shared the result of its recent fee audit, which
discovered that in addition to the DBC's operational imbalance
it is limited in its ability to recover the true cost of
licensure and regulation for dentists and dental assistants
based on many of the set fees, which do not cover the actual
costs. In light of this fee audit, the DBC is requesting an
increase in all statutory fee caps relating to dentists and
dental assistants, including, but not limited to, those fees
relating to licensure, permits, and examinations.
While some of these fee increases are dramatic, they reflect
the fact that many of these fee caps have not been raised in
nearly up to two decades. The DBC's intent is for this large
increase in statutory fee caps to cover its potential need to
increase fees over a period of many years, including beyond
the next sunset period. The DBC would have to raise any fees
through the regulatory process, however, ensuring that there
will be additional time and robust opportunity for public
AB 179 (Bonilla) Page 6
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participation prior to the increase of any fee. The proposed
increases are as follows:
---------------------------------------------------
| License, Certificate |Current |Statutor| |
| or Permit | Fee |y Limit | |
| | Amt. | | Proposed |
| | | | Fee Cap |
|----------------------+--------+--------+----------|
|Elective Facial | 500.00| 500.00| |
|Cosmetic Surgery | | | |
|Permit-Initial Appl | | | $4,000|
|----------------------+--------+--------+----------|
|Initial DDS License | 525.00| 525.00| |
|(pro-rated fee) | | | $650|
|----------------------+--------+--------+----------|
| | 525.00| 525.00| |
|DDS Biennial Renewal | | | $1,200|
|----------------------+--------+--------+----------|
|Oral & Maxillofacial | 450.00| 450.00| |
|Surgery Permit | | | $1,200|
|Renewal | | | |
|----------------------+--------+--------+----------|
|Fictitious Name | 450.00| Not > | |
|Permit Initial | | $450 | $1,200|
|Application | | or < $5| |
|----------------------+--------+--------+----------|
|Special | 300.00| 300.00| |
|Permit-Initial Appl. | | | $1,000|
|----------------------+--------+--------+----------|
|License by Credential | 283.00| 0.00| |
|Appl. | | | $1,000|
|----------------------+--------+--------+----------|
| | 100.00| | |
|License by Residency | | | $1,000|
|----------------------+--------+--------+----------|
| | 350.00| 350.00| |
|License by Portfolio | | |$1,500 |
|----------------------+--------+--------+----------|
| | 100.00| 500.00| |
|Initial WREB Appl. | | |$1,000 |
|----------------------+--------+--------+----------|
|Registered | 250.00| 250.00| |
AB 179 (Bonilla) Page 7
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|Provider-Initial | | | |
|Appl.(continuing | | | $500|
|education) | | | |
|----------------------+--------+--------+----------|
|Onsite Inspection Fee | 250.00| 350.00| |
|for GA/CS Permits | | | $4,500|
|----------------------+--------+--------+----------|
|Fictitious Name | 225.00| Not > | |
|Permit Renewal | |$450 Or | $600|
| | | < $5| |
|----------------------+--------+--------+----------|
| | 200.00| 250.00| |
|Conscious Sedation | | | $1,000|
|Permit Initial | | | |
|Application | | | |
|----------------------+--------+--------+----------|
|Conscious Sedation | 200.00| 250.00| |
|Permit Renewal | | | $600|
|----------------------+--------+--------+----------|
|General Anesthesia | 200.00| 250.00| |
|Permit Initial | | | $1,000|
|Application | | | |
|----------------------+--------+--------+----------|
|General Anesthesia | 200.00| 250.00| |
|Permit Renewal | | | $600|
|----------------------+--------+--------+----------|
|Oral Conscious | 200.00|Admin/En| |
|Sedation Initial | | f Costs| $1,000|
|Certificate | | | |
|----------------------+--------+--------+----------|
|Elective Facial | | | |
|Cosmetic Surgery | 200.00| 200.00| $800|
|Permit Renewal | | | |
|----------------------+--------+--------+----------|
|Oral & Maxillofacial | 150.00| 500.00| |
|Surgery | | | |
|Permit-Initial Appl. | | | $1,000|
|----------------------+--------+--------+----------|
|Additional Office | 100.00| 200.00| |
|Permit Initial | | | $750|
|Application | | | |
|----------------------+--------+--------+----------|
| | 100.00| 100.00| |
|Special Permit | | | $600|
AB 179 (Bonilla) Page 8
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|Renewal | | | |
|----------------------+--------+--------+----------|
|Additional Office | 100.00| 100.00| |
|Permit Renewal | | | $375|
|----------------------+--------+--------+----------|
|Oral Conscious | 75.00|Admin/En| |
|Sedation Certificate | | f Costs| $600|
|Renewal | | | |
|----------------------+--------+--------+----------|
| | 2.00| 2.00| |
|License Certification | | | $125|
|----------------------+--------+--------+----------|
| RDA Fees |Current |Statutor| |
| | Fee |y Limit | |
| | Amount | | Proposed |
| | | | Fee Cap |
|----------------------+--------+--------+----------|
|RDAEF Program | 1400.00|1400.00 | |
|Curriculum | | | $7,500|
|----------------------+--------+--------+----------|
|RDA Program | 1400.00|1400.00 | |
|Curriculum | | | $7,500|
|----------------------+--------+--------+----------|
|OA Permit Course | 300.00|300.00 | |
|Approval | | | $2,000|
|----------------------+--------+--------+----------|
| | | | |
|DSA Permit Course | 300.00|300.00 | $2,000|
|Approval | | | |
|----------------------+--------+--------+----------|
|Infection Control | 300.00|300.00 | |
|Course Approval | | | $2,000|
|----------------------+--------+--------+----------|
|Coronal Polish Course | 300.00|300.00 | |
|Approval | | | $2,000|
|----------------------+--------+--------+----------|
|Pit and Fissure | 300.00|300.00 | |
|Course Approval | | | $2,000|
|----------------------+--------+--------+----------|
|Radiation Safety | 300.00|300.00 | |
|Course Approval | | | $2,000|
|----------------------+--------+--------+----------|
| | 70.00| 80.00 | |
|RDA Biennial Renewal | | | $200|
AB 179 (Bonilla) Page 9
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|----------------------+--------+--------+----------|
|RDAEF Biennial | 70.00| 80.00 | |
|Renewal | | | $200|
|----------------------+--------+--------+----------|
|Dental Sedation | 70.00| 80.00 | |
|Assistant Permit | | | $200|
|Biennial Renewal | | | |
|----------------------+--------+--------+----------|
|Orthodontic Assistant | 70.00| 80.00 | |
|Permit Biennial | | | $200|
|Renewal | | | |
|----------------------+--------+--------+----------|
|RDA Practical Exam | 60.00| 60.00 | |
|Fee | | | Actual |
| | | | cost|
|----------------------+--------+--------+----------|
|Duplicate License or | 25.00| 25.00 | |
|Permit Fee | | | $100|
|----------------------+--------+--------+----------|
| | 20.00| 50.00 | |
|RDA Application Fee | | | $200|
|----------------------+--------+--------+----------|
| | 20.00| 50.00 | |
|RDAEF Application Fee | | | $200|
|----------------------+--------+--------+----------|
| | 20.00| 50.00 | |
|RDAEF2 Application | | |$200 |
|Fee | | | |
---------------------------------------------------
4.Amending the Unprofessional Conduct Statute. Current law
prohibits "The commission of any act of sexual abuse,
misconduct, or relations with a patient, client, or customer
constitutes unprofessional conduct and grounds for
disciplinary action" for any healing arts professional.
However, it exempts sexual contact between a physician and
surgeon and his or her spouse, or person in an equivalent
domestic relationship, when providing non-psychotherapeutic
medical treatment.
This bill will extend the exemption to all healing arts
licensees who do not provide psychotherapeutic medical
treatment to spouses or persons in equivalent domestic
relationships.
AB 179 (Bonilla) Page 10
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5.Fund Merger. Both the LVN and PT programs are at the
statutory maximums for licensing fees. In July of 2012, the
Board submitted a Budget Change Proposal (BCP) requesting the
merger of the LVN and PT funds. The BCP was denied because the
PTs fund condition was expected to remain solvent through FY
2015/16. The Board was advised to seek a statutory proposal
to merge the funds versus a BCP.
According to the Board, current budget projections indicate
that the LVN program fund reserve will remain solvent past FY
2020/21. The PTs program fund reserve will be exhausted by
2017/18. On February 13, 2012, the Board approved a merger of
the funds as an alternative to a statutory amendment to raise
the PTs fee ranges. The Board has been advised by the DCA
Budget Office that the merger would delay a deficit and the
need to increase fees for three to four years.
This bill will merge the LVN and PT funds. Delaying the merger
until the new fiscal year will ease the accounting transition.
6.DAC Term limits. This bill limits the terms of the DAC to two
years, which will mirror the terms of the DBC members.
7.Related Legislation This Year. SB 465 (Hill) extends the
operation of the Contractors' State License Board until 2020
and makes various changes to the Contractors' State License
Law. ( Status: The bill is pending in the Assembly Committee
on Business and Professions.)
SB 466 (Hill) sunsets the Board of Registered Nursing.
( Status: The bill is pending in the Assembly Committee on
Business and Professions.)
SB 467 (Hill) extends the operation of the California Board
of Accountancy until 2020 and makes various changes in
regards to the DCA. ( Status: The bill is pending in the
Assembly Committee on Business and Professions.)
SB 468 (Hill) extends the operation of the Bureau of Security
and Investigative Services and the Alarm Company Act,
Locksmith Act, Private Investigator Act, Private Security
Services Act, Proprietary Security Services Act, and
Collateral Recovery Act until January 1, 2020. It also
AB 179 (Bonilla) Page 11
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subjects the Bureau to review by the appropriate committees
of the Legislature and makes various changes to provisions in
the aforementioned Acts to improve the oversight, enforcement
and regulation by the Bureau of licensees under each Act.
( Status: The bill is pending in the Assembly Committee on
Business and Professions.)
SB 469 (Hill) extends the operation of the California State
Athletic Commission until January 1, 2020. Makes changes to
the laws governing the Commission's operations and the
Commission's oversight of professional and amateur boxing,
professional and amateur kickboxing, all forms and
combinations of full contact martial arts contests, including
mixed martial arts and matches or exhibitions conducted, held
or given in California. ( Status: The bill is pending in the
Assembly Committee on Business and Professions.)
AB 177 (Bonilla) extends the operation of the Board for
Professional Engineers, Land Surveyors and Geologists and
California Architects Board and Landscape Architects
Committee until January 1, 2020. ( Status: The bill is also
set for a hearing before this Committee on July 6.)
AB 178 (Bonilla) extends the operation of the Board of
Vocational Nursing and Psychiatric Technicians until January
1, 2020. ( Status: The bill is pending in the Senate
Appropriations Committee.)
AB 180 (Bonilla) extends the operation of the Cemetery and
Funeral Bureau until January 1, 2020. ( Status: The bill is
also set for a hearing before this Committee on July 6.)
AB 181 (Bonilla) extends the operation of the California
State Board of Barbering and Cosmetology (BBC) until January
1, 2020. Makes changes to the laws governing the Board's
regulation of barbers, cosmetologists, estheticians,
electrologists, manicurists, apprentices and establishments.
( Status: The bill is also set for a hearing before this
Committee on July 6.)
8. Arguments in Support. The Dental Board of California writes
in support, "This important measure would extend the
licensing and regulation functions as well as other
provisions relating to the Board until January 1, 2020,
AB 179 (Bonilla) Page 12
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increase the allowable maximum fee ceilings the Board is
authorized to assess, and authorize the Board to collect
electronic mail addresses of applicants and licensees. These
provisions will provide the resources necessary for the Board
to continue its mission of protecting the public."
The Dental Hygiene Committee of California (DHCC) writes,
"DHCC members strongly feel that the extension of the Dental
Board of California is essential in order to continue to
protect consumers."
SUPPORT AND OPPOSITION:
Support:
Dental Board of California
Dental Hygiene Committee of California
Opposition:
None on file as of June 30, 2015.
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