AB179(Bonilla)Page 1 of 2
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
SenatorJerry Hill, Chair
2015 - 2016 Regular
Bill No: AB179Hearing Date: July 6, 2015
Author: / BonillaVersion: / June 30, 2015
Urgency: / No / Fiscal: / Yes
Consultant: / Sarah Huchel
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 changesas 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 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 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 licenseeprovides 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.
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:
- Purpose. This bill is sponsored by the Author. According to the Author’s office, “Thisbill 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 licensureand 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.”
- 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.
- 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 simultaneouslypursued a legislative fee increase $450 to $525. This was aligned with a DCAaudit 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 participation prior to the increase of any fee.The proposed increases are as follows:
License, Certificate or Permit / Current Fee Amt. / Statutory Limit / Proposed Fee CapElective Facial Cosmetic Surgery Permit-Initial Appl / 500.00 / 500.00 / $4,000
Initial DDS License
(pro-rated fee) / 525.00 / 525.00 / $650
DDS Biennial Renewal / 525.00 / 525.00 / $1,200
Oral & Maxillofacial Surgery Permit Renewal / 450.00 / 450.00 / $1,200
Fictitious Name Permit Initial Application / 450.00 / Not > $450
or < $5 / $1,200
Special Permit-Initial Appl. / 300.00 / 300.00 / $1,000
License by Credential Appl. / 283.00 / 0.00 / $1,000
License by Residency / 100.00 / $1,000
License by Portfolio / 350.00 / 350.00 / $1,500
Initial WREB Appl. / 100.00 / 500.00 / $1,000
Registered Provider-Initial Appl.(continuing education) / 250.00 / 250.00 / $500
Onsite Inspection Fee for GA/CS Permits / 250.00 / 350.00 / $4,500
Fictitious Name Permit Renewal / 225.00 / Not > $450 Or < $5 / $600
Conscious Sedation Permit Initial Application / 200.00 / 250.00 / $1,000
Conscious Sedation Permit Renewal / 200.00 / 250.00 / $600
General Anesthesia Permit Initial Application / 200.00 / 250.00 / $1,000
General Anesthesia Permit Renewal / 200.00 / 250.00 / $600
Oral Conscious Sedation Initial Certificate / 200.00 / Admin/Enf Costs / $1,000
Elective Facial Cosmetic Surgery Permit Renewal / 200.00 / 200.00 / $800
Oral & Maxillofacial Surgery Permit-Initial Appl. / 150.00 / 500.00 / $1,000
Additional Office Permit Initial Application / 100.00 / 200.00 / $750
Special Permit Renewal / 100.00 / 100.00 / $600
Additional Office Permit Renewal / 100.00 / 100.00 / $375
Oral Conscious Sedation Certificate Renewal / 75.00 / Admin/Enf Costs / $600
License Certification / 2.00 / 2.00 / $125
RDA Fees / Current Fee Amount / Statutory Limit / Proposed Fee Cap
RDAEF Program Curriculum / 1400.00 / 1400.00 / $7,500
RDA Program Curriculum / 1400.00 / 1400.00 / $7,500
OA Permit Course Approval / 300.00 / 300.00 / $2,000
DSA Permit Course Approval / 300.00 / 300.00 / $2,000
Infection Control Course Approval / 300.00 / 300.00 / $2,000
Coronal Polish Course Approval / 300.00 / 300.00 / $2,000
Pit and Fissure Course Approval / 300.00 / 300.00 / $2,000
Radiation Safety Course Approval / 300.00 / 300.00 / $2,000
RDA Biennial Renewal / 70.00 / 80.00 / $200
RDAEF Biennial Renewal / 70.00 / 80.00 / $200
Dental Sedation Assistant Permit Biennial Renewal / 70.00 / 80.00 / $200
Orthodontic Assistant Permit Biennial Renewal / 70.00 / 80.00 / $200
RDA Practical Exam Fee / 60.00 / 60.00 / Actual cost
Duplicate License or Permit Fee / 25.00 / 25.00 / $100
RDA Application Fee / 20.00 / 50.00 / $200
RDAEF Application Fee / 20.00 / 50.00 / $200
RDAEF2 Application Fee / 20.00 / 50.00 / $200
- Amending the Unprofessional ConductStatute. 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.
- 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.
- DAC Term limits. This bill limits the terms of the DAC to two years, which will mirror the terms of the DBC members.
- 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 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.)
- Arguments in Support. The Dental Board of Californiawrites 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.”
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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