BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | AB 179| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- 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 AB 179 Page 2 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 AB 179 Page 3 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 AB 179 Page 4 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 AB 179 Page 5 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 AB 179 Page 6 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 AB 179 Page 7 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, AB 179 Page 8 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 **** END ****