BILL ANALYSIS                                                                                                                                                                                                    Ó






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          |SENATE RULES COMMITTEE            |                        AB 179|
          |Office of Senate Floor Analyses   |                              |
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                                   THIRD READING 


          Bill No:  AB 179
          Author:   Bonilla (D), et al.
          Amended:  8/31/15 in Senate
          Vote:     21  

           SENATE BUS, PROF. & ECON. DEV. COMMITTEE:  7-1, 7/6/15
           AYES:  Hill, Block, Galgiani, Hernandez, Jackson, Mendoza,  
            Wieckowski
           NOES:  Bates
           NO VOTE RECORDED:  Berryhill

           SENATE APPROPRIATIONS COMMITTEE:  6-1, 8/27/15
           AYES:  Lara, Bates, Beall, Hill, Leyva, Mendoza
           NOES:  Nielsen

           ASSEMBLY FLOOR:  60-17, 6/1/15 - See last page for vote

           SUBJECT:   Healing arts


          SOURCE:    Author

          DIGEST:   This bill 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; suspends the  
          practical exam requirement for licensure as a registered dental  
          assistant (RDA) until July 1, 2017, during which time the DBC  
          must evaluate the exam; removes the requirement that the  
          executive officer of the BVNPT be a licensed vocational nurse,  
          registered nurse, or psychiatric technician; and requires the  








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          appointment of an Administrative and Enforcement Program Monitor  
          to oversee the BVNPT's disciplinary system.  

          ANALYSIS:
               
          Existing law: 

           1) Provides for the licensure and regulation of vocational  
             nurses and psychiatric technicians by the BVNPT and extends  
             the operation of the BVNPT until January 1, 2016.  (Business  
             and Professions Code (BPC)  §§ 2840-2895.5)

           2) 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.  (BPC §§ 1600, et seq.) 

          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  
             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 of the Act 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  







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             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 Dental Assisting Council  
             to no more than two full terms. 

           8) Extends the sunset date on the BVNPT until January 1, 2018.

           9) Suspends the requirement of a practical exam for licensure  
             as a RDA and related provisions of law until July 1, 2017. 

           10)Requires the DBC to, in consultation with the Office of  
             Professional Examination Services, conduct a review to  
             determine whether a practical examination is necessary to  
             demonstrate competency of RDAs, and if so, how this  
             examination should be developed and administered.  The DBC  
             shall submit its review and determination to the appropriate  
             policy committees of the Legislature on or before July 1,  
             2017.

           11)Removes the requirement that the executive officer of the  
             BVNPT be a licensed vocational nurse, a licensed professional  
             nurse, or a licensed psychiatric technician. 

           12)Extends the sunset date on provisions related to the BVNPT  
             executive officer until January 1, 2018.

           13)Requires the director of the DCA to appoint an  
             Administrative and Enforcement Program Monitor (AEPM) for  
             BVNPT no later than March 1, 2016, and authorizes the  
             director to retain a person for this position by a personal  
             services contract. 

           14)Requires the director to supervise the AEPM and authorizes  
             him or her terminate or dismiss the AEPM from this position.   
             If the director terminates the AEPM, he or she must appoint a  
             replacement AEPM within two months. 

           15)Requires the AEPM to monitor and evaluate the following: 

              a)    BVNPT's administrative processes, with specific  
                concentration on the management of staff, assistance of  
                BVNPT members, and working relationship with the  







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                Legislature, as specified. 

              b)    The BVNPT's disciplinary system and procedures, with  
                specific concentration on improving the overall efficiency  
                and consistency of the enforcement program, as specified. 

           1) Prohibits the AEPM from exercising authority over the  
             BVNPT's management or staff; however, the BVNPT and its staff  
             shall cooperate with the AEPM, and shall provide data,  
             information, and files as requested by the AEPM to perform  
             all of his or her duties.

           2) Requires the director to assist the AEPM in the performance  
             of his or her duties, and grants the AEPM the same  
             investigative authority as the director.

           3) Requires the director to specify further duties of the AEPM.

           4) Requires the AEPM to submit to the DCA, the BVNPT, and the  
             Legislature an initial written report of his or her findings  
             and conclusions no later than July 1, 2016, and subsequent  
             written reports no later than November 1, 2016, and February  
             1, 2017, and be available to make oral reports to each entity  
             if requested to do so.  The AEPM may also provide additional  
             information to either the DCA or the Legislature at his or  
             her discretion or at the request of either the DCA or the  
             Legislature.  The AEPM shall make his or her reports  
             available to the public or the media.  The AEPM shall make  
             every effort to provide the BVNPT with an opportunity to  
             reply to any facts, findings, issues, or conclusions in his  
             or her reports with which the BVNPT may disagree.

           5) Requires the AEPM to issue a final report before January 1,  
             2018 including the final findings and conclusions on the  
             topics addressed in the initial report.

           6) Requires BVNPT to pay for all of the costs associated with  
             the employment of the AEPM.

           7) Requires DCA's internal audit unit to review the BVNPT's  
             financial needs, fee structure, budget, and expenditures. The  
             DCA director shall provide to the Legislature a copy of the  
             review, no later than October 1, 2016.  The director shall  
             include with this report an overview of the estimated costs  







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             of meeting staffing and other requirements , as specified,  
             based on findings of the review.

          Background
          
          In 2015, the Senate Business, Professions and Economic  
          Development Committee and the Assembly Business and Professions  
          Committee (Committees) conducted joint oversight hearings to  
          review 12 regulatory entities including DBC and BVNPT.  This  
          bill is intended to implement legislative changes as recommended  
          by staff of the Committees reflected in a Background Paper and  
          in discussions stemming from an oversight hearing on these  
          entities. 

          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   No

          According to the Senate Appropriations Committee:

           No significant costs are anticipated due to the extension of  
            the sunset on the DBC (State Dentistry Fund).  Current law  
            imposes a sunset on the existence of the DBC as an appointed  
            board. However, there is no sunset on the larger body of law  
            requiring licensure and oversight of the practice of  
            dentistry.  If the DBC was allowed to sunset, the overall  
            licensing and regulatory program would still exist in law.

           Significant increases in licensing fee revenues to the DBC are  
            possible under this bill (State Dentistry Fund).  This bill  
            authorizes the DBC, through regulation, to raise a number of  
            licensing fees currently capped in statute.  If the DBC were  
            to raise the fees to the maximum level authorized in this  
            bill, additional annual revenues would be about $2.8 million  
            per year for dentist licensing fees and $2.7 million per year  
            for other regulatory fees (State Dentistry Fund).  The actual  
            amount of fee revenue collected by the DBC will depend on the  
            actual fee levels set through regulation.

           No significant costs are anticipated due to the extension of  
            the sunset on the BVNPT (Vocational Nursing and Psychiatric  
            Technicians Fund).  Current law imposes a sunset on the  
            existence of the BVNPT as an appointed board. However, there  
            is no sunset on the larger body of law requiring licensure and  
            oversight of the practice of vocational nurses or psychiatric  







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            technicians.  If the BVNPT was allowed to sunset, the overall  
            licensing and regulatory program would still exist in law.

           No significant fiscal impact on licensing fees is anticipated  
            due to the merger of the Vocational Nurses Account and the  
            Psychiatric Technician Examiners Account.  The BVNPT operates  
            the licensing and enforcement programs for vocational nurses  
            and psychiatric technicians as one administrative program.  
            Thus the current practice of separating licensing fees into  
            separate accounts does not reflect the BVNPT's current  
            business practices.  Merging the two accounts is not  
            anticipated to require licensing fees from one group of  
            licensees to subsidize another group of licensees.

           One-time costs of $140,000 to change the information  
            technology systems used by the DBC to accommodate the  
            suspension of the practical examination (State Dentistry  
            Fund).  The cost to modify information technology systems  
            includes changes to the system currently in use by the DBC and  
            updates to the BreEZe system, which the DBC will begin using  
            to process licensing applications and renewals in 2016.

           No significant additional costs are anticipated to review the  
            current practical examination in use by the DBC, as it has  
            already begun this process.

           Annual costs of about $180,000 per year to support the  
            Executive Officer position at the BVNPT, including salary,  
            benefits, and overhead costs (Vocational Nursing and  
            Psychiatric Technicians Fund).  Existing law sunsets the  
            statutory authority for the Executive Officer position on  
            January 1, 2016. This bill extends the authority to employ  
            this position until January 1, 2018.

           Total costs of about $350,000 over three fiscal years to  
            employ an AEPM over the enforcement program at the BVNPT  
            (Vocational Nursing and Psychiatric Technicians Fund).


          SUPPORT:   (Verified8/31/15)


          Board of Vocational Nursing and Psychiatric Technicians
          California Dental Assistants Association







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          California Dental Assisting Teachers Association
          Dental Board of California
          Dental Hygiene Committee of California
          Foundation for Allied Dental Education
          Pasadena City College


          OPPOSITION:   (Verified8/31/15)


          Numerous individuals

          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, 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."

          ARGUMENTS IN OPPOSITION:Numerous individuals express concern  
          that the lack of a practical exam will place patients in harm's  
          way for lack of competency.  "Not having an unbiased third party  
          to evaluate the testing candidate is not in the interest of  
          public safety (you and myself included).  To allow a candidate  
          the right to become an RDA without a practical exam will prove  
          to be harmful to the public and paying consumer."


          ASSEMBLY FLOOR:  60-17, 6/1/15
          AYES:  Alejo, Baker, Bigelow, Bloom, Bonilla, Bonta, Brown,  
            Burke, Calderon, Campos, Chang, Chau, Chiu, Chu, Cooley,  
            Cooper, Dababneh, Daly, Dodd, Eggman, Frazier, Cristina  
            Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez,  
            Gordon, Gray, Hadley, Roger Hernández, Holden, Jones,  
            Jones-Sawyer, Kim, Levine, Linder, Lopez, Low, Mathis,  
            McCarty, Medina, Mullin, Nazarian, Obernolte, O'Donnell,  
            Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas,  
            Santiago, Mark Stone, Thurmond, Ting, Weber, Williams, Wood,  
            Atkins
          NOES:  Achadjian, Travis Allen, Brough, Chávez, Beth Gaines,  
            Grove, Harper, Irwin, Lackey, Maienschein, Mayes, Melendez,  







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            Olsen, Patterson, Steinorth, Wagner, Wilk
          NO VOTE RECORDED:  Dahle, Gallagher, Waldron

          Prepared by:Sarah Huchel / B., P. & E.D. / (916) 651-4104
          8/31/15 19:35:13


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