An Examination of the Department of Professional and Vocational Standards

42 AN EXAMINATION OF THE 2. Physical Therapy Examining Committee com- prised of one licensed M.D., three licensed phys- ical therapists, and one public member all ap- pointed by the Governor. ' 3. Psychology Examining Committee comprised of seven certified psychologists and one public mem- ber appointed by the Governor. These three bodies administer certain provisions of the law governing the licensing of the respective pro- fessions. The staff of the Board, which provides facilitative services for the Board and the three listed committees is under the immediate direction of the Executive Sec~ retary and consists of approximately 20 administrative and office personneL Licensing of Physicians and Surgeons Applicants for a license as a Physician and Surgeon must be graduates of an accredited medical college and pass a written examination. The Board recognizes colleges that have been accredited by the Association of American Medical Colleges and the Council of Med- ical Education and Hospitals of the American Medical Association. The written examination is prepared and administered by the Board. Provision is made for the licensing of applicants on the basis of reciprocity or endorsement either on the basis of a license issued by another state or on the basis of National Board Cre- dentiall:;.-during the past year 2,200 such licenses were granted out of a total of approximately 2,700. Nearly 500 applicants took the State Board's examination; of these, more than 99 per cent of the graduates of Cali- fornia medical colleges and 83 per cent of the appli- cants trained in foreign colleges achieved passing grades. Special requirements have been set for applicants from foreign colleges which include two years service satisfaetory to the Board in a hospital or hospitals lo- cated in the United States and approved for the train- ing of interns, one of the two years in a hospital within the State of California. Commissioned officers of the military establishment and the U.S. Public Health Service are licensed under special provisions of the law which give them a. preferred status. The Board's written examination is prepared by the Board members. One member is assigned each of the nine subject areas, personally, grading the section of the examination he constructed. Oral practical ex- aminations are given out-of-state applicants seeking a license on the basis of reciprocity or endorsement if more than five years have lapsed since they took their written examination in another state or that of the National Board of Medical Examiners. All graduates of foreign medical schools must, in addition to the written examination, pass an oral and clinical exami- nation at the completion of the required hospital service. These are conducted by two-man teams made up of members of the Board and Examination Com- missioners who are M.D. 's retained by the Board for this purpose. Podiatrists Podiatrists are licensed by the Board of Medical Examiners, assisted by the aforementioned Examining C~m~ittee. The Committee receives and approves ap- plIcatIOns, prepares and conducts examinations and recommends to the Board of Medical Examiners 'those persons .to be granted licen~es. The Board routinely concurs ill the recommendations of the Committee. To apply for such a license, a person must have at least completed a two-year college course, which has in- cluded certain specified subjects, and been graduated from a .four-year school of podiatry. There is one such school m the State of California. The examination is prepared, adn:;ini~tered, and graded by Committee members and IS gIven at the same time and place as the examinations for physicians and surgeons. Prior to 1957, licensing of podiatrists was carried ?ut directly by the Board of Medical Examiners, but l~ that year the Committee was created. The Associa- tIOn o~ Podiatrists had petitioned for a licensing board of thel; .own; however,. the I..Jegislature responded by authorIzmg the CommIttee. There are now approxi- mately 900 licenses. Registered Physical Therapists The Board of Medical Examiners has licensed "reg- istered physical therapists" since 1953. To qualify for the examination, a person must have fulfilled one of several educational options, roughly the equivalent of a Bachelors Degree. The examination used is one d~v~loped by the American Physical Therapists' Asso- CIatIOn and Professional Examination Service of the American Public Health Association with the Califor- !lia Board of Me~ical Examiners det~rmining the pass- mg grade. A regIStered physical therapist by law must work under the supervision and direction of a licensed physician and surgeon. Licensed Physical Therapist At the time the physical therapists sought licensing -in the year 1953-the members of the group could not reach agreement, particularly on the conditions under which they would be blanketed under the "grandfather" clause and on questions of supervision of their practice. This resulted in the two forms of licensing on~for registered physical therapists, noted above, and one for Ucensed physical therapists. In the latter case, an Examining Committee was estab- lished comprised of three physical therapists one physician, and one public member. When the tw~ bills were first introduced, both passed the Legislature and were vetoed by the Governor-in the following session both passed and both were approved. Although there are minor differences in the qualification standards basically the same examination is given in both cases: There is a distinction between the two groups in terms of ,their practice in that the registered physical ther- apIst must work under a. licensed physician and sur- geon whereas the licensed physical therapist may also work under a chiropractor or on his own. However in the latter ~stance, the l~w states t~at he cannot diag- nose. The lIcensed phYSICal therapIst group is on the DEPARTMENT OF PROFESSIONAL AND VOCATIONAL STANDARDS 43 decline. The last examination given was in 1963 which was passed by one person and failed by a second, thus essentially all persons now entering the field are coming in as registered physical therapists. There is a current move to consolidate the two groups, and it is likely that legislation will be introduced in the next session to accomplish this. At the present time, there are approximately 2,500 registered physical therapists and 950 licensed physical therapists. Psychologists In 1957 the Psychologist Examining Committee was created by legislation, and although attached to the Board of Medical Examiners, was assigned the full range of functions normally exercised by an autono- mous licensing board. Its being placed under the Board of Medical Examiners simply reflected a reluc- tance on the part of the Legislature to create new autonomous boards. The law contains clear language requiring the Board of Medical Examiners to act" at the direction of the committee" and there is nothing in the law that would appear to permit the Board of Medical Examiners to disapprove any action taken by the Committee. Requirements for the examination include the pos- session of a Ph.D. in psychology or educational psy- chology, or training deemed equivalent by the Com- mittee. The law further specifies the degree shall be from the University of California, Stanford, U.S.C., or another university having an equivalent program. The applicant must possess at least one year of super- vised professional experience, as determined by the Committee. The examination is composed, adminis- tered, and graded by the members of the Committee, and includes an oral portion for which a verbatim transcript must be taken. This is not a mandatory license; it simply prevents a person from using the title Certified Psychologist unless he possesses a license. There has been discussion of making licensing mandatory but this would pose difficult problems of defining precisely what consti- tutes the practice of psychology. Registered Dispensing Opticians The Board of Medical Examiners licenses regis- tered dispensing opticians who, by legal definition, may fill prescriptions issued only by physicians and surgeons licensed by the Board of Medical Examin- ers-excluded from this group· may be those work- ing for or through optometrists. This is not conven- tional individual licensing, but rather a license to a person, partnership, or firm to do business at a par- ticular location. The requirements for registration include five years of actual experience in the fitting and adjusting any prescription lens or lenses and the submission of cer- tificates issued by three physicians who specialize in the treatment of the eye, stating that the applicant is experienced, competent, has good character, and so on. Drugless Praciitioners Drugless practitioners were licensed by the Board of Medical Examiners prior to the year 1946, at which time their licensing was discontinued. Since then licenses have been renewed but no new ones issued; the active group now numbers less than 60. Midwives Midwives are in the same category as drugless prac- tioners, although at present there remain only three active licenses. Other Activities The following functions are also required of the Board under the provisions of the Medical Practice Act: approval of hospitals for the training of interns and residents' approval of hospitals for the treat- ment of narc~tic addiction under the provisions of Section 11391 of the Health and Safety Code; and enforcement of certain provisions relating to mental illness of licentiates. Enforcement Activities-Licensed Physicians The Board learns of alleged improper or unlawful conduct of licensees through citizen of patient com- plaints, local medical societies,. other lice~sees, and law enforcement agencies. PatIent complamts most frequently relate to fees or questions of professional competence. Other comm?nl;v reported off~nses involve improper use or prescrIptIon .of narcotIc ~nd dan- gerous drugs, imtemperance, Illegal abortIons, and practicing medicine without a license. . . . . Complaints of non-licensees practIcmg medlCme when received by the Executive Secretary are screened and passed to the Division of Investigation. If suffi- cient evidence is found the case is referred to the local District Attorney' for prosecution. Alleged or reported violations of the law and regulations by licensed M.D. 's and other licentiates of the Board are similarly investigated with the Executive Secretary deciding-on the basis of the investigation report- those to be referred to the Attorney General for pro- ceedings under the Administrative Procedure Act. In the past, if the Attorney. Gene:al recommended th~t the case go to a hearing, the entIre Board membershIp was polled by mail to decide if the case would ~e heard by a hearing officer, by the Boa::~, or by a DIS- trict Review Committee. By recent deCISIOn, the Board delegated this authority to the Secretary-Treasurer (a Board member) and the Executive Secretary. The District Review Committees were created by 1965 legislation as a new approach to the. exercise of discipline. Five Committees were establIshed, each serving a defined geographic area, having as mem- bers five licensed M.D.'s appointed by the Governor £rom panels of candidates variously nominated by local medical societies, medical school deans, and the State Board. The Committees hear discipline cases assigned to them, sitting with a hearing officer, and make a proposed decision to the Board. The Board may accept the decision or order one of several types of re-hearings. The same legislation redefined and 44 AN EXAMINATION OF THE somewhat expanded the licensee actions calling for disciplinary measures in the area of imcompctence and gross negligence. These types of cases-and others involving evaluation of professional performance-- are generally heard by a Committee or the Board it- self sitting with a hearing officer, rather than solely by the latter. In recent years the Board has been participating in perhaps 20 to 25 per cent of the hear- ings; the District Committees should assume some of this activity. The 1965 legislation permits the Board to revoke a license for certain acts which formerly could be done only after a court conviction on criminal charges-as commission of any act involving moral turpitude, dishonesty, or corruption. The number of disciplinary cases processed by the Board in the year 1965 which reached the hearing sta~e totaled 131, resulting in 24 revocations, 32 revo- catIons stayed and the licensee placed on probation, 8 suspensions or other penalties, 1 dismissed, and 66 carried forward pending decision. Enforcement--Other Licensed Groups There is substatial similarity in the enforcement programs affecting all groups licensed by the Board of Medical Examiners for several reasons; the Board sets general policy, the same staff serves all groups, and since all function in the field of the healing arts the punishable offenses are much the same. The more frequent disciplinary actions deal with cases of in- temperance, use of drugs, and providing services out- side those authorized by law. Perhaps two or three disciplinary cases involving members of each of the other licensed groups are processed each year under the Administrative Procedure Act. BOARD OF NURSING EDUCATION AND NURSE REGISTRATION Functions The Board of Nursing Education and Nurse Regi- stratioll regulates professional nursing in California. In so doing, the Board accredits schools of nursing and approves programs of nursing education, licenses or registers professional nurses, and otherwise ad. ministers the Nursing Practice Act. Organization The Board is comprised of five registered profes- sional nurses and one public member. Required by law to meet three times annually, the Board in prac- tice meets at least twice that often in two or three day sessions. In addition to enacting rules and regu- lations and giving general guidance to the Executive Secretary, it acts on numerous specific matters such as accreditation of nursing schools, disciplinary mat- ters, and applicant appeals. The staff of 33 includes 7 nursing education consultants who work closely with schools of nursing and office personnel engaged in licensing activities and the processing of disciplin- ary actions. Accrediting Schools of Nursing Within the State of California there are 65 ac- credited programs of nursing education within three general categories: (1) 15 schools offering the Bac- calaureate Degree, (2) 18 programs within hospitals which give a Diploma in Nursing, and (3) 32 junior college programs leading to an Associate Degree. The Board sets standards as to faculty, facilities, and curriculum and maintains a continuing supervision of the schools following the granting of Certificates of Accreditation. The nursing education consultants conduct inspections, consult with school officials, and make recommendations to the Board. The Board acts upon all matters relating to granting or withdrawal of accreditation and approves changes in school direc- tors and curriculum. Licensing A person must be licensed by the Board to engage in the practice of professional nursing. Primary re- quirements are graduation from an accredited school and successful completion of a written examination. Graduation from out-of-state schools is recognized provided those schools have programs equivalent to the minimums set for schools within California. The examination used is a national one developed by the National League for Nursing (State Board Test Pool Examination). Representatives of the Board partici. pate in its preparation and the draft examination is reviewed and approved by the Board. In recent examinations approximately 10 per cent of the Cali· fornia nurse applicants have failed, compared with a national average of 15 or more per cent failure. Registered or professional nurses from out-of·state are licensed on a reciprocal basis without examination, subject to a documentary review of their educational background. There are at present 122,500 licensed nurses. Of these an estimated 20 percent reside outside the State and roughly one-third are currently inactive (not working as nurses). The fee for examination and ini· tial licensing is $20 with a biennial renewal fee of $6. Enforcement The Nursing Practice Act specifies a number of causes for disciplinary action including unprofes- sional conduct, incompetence, gross negligence, in· temperance, narcotic or dangerous drug use or un· authorized handling, and engaging in the practice of medicine. Certain of these are not easily defined or detected. On receipt of a complaint or report of such alleged actions an investigation may be ordered by the Executive Secretary. The Division of Investiga- tion service is used. If the Investigator's report gives evidence of need for disciplinary action, the normal procedure is referral by the Executive Secretary to the Attorney General and a hearing by the Office of Administrative Procedure. The proposed decision of the hearing officer is referred to the Board for mail vote and appropriate action is taken. Cases in which DEPARTMENT OF PROFESSIONAL AND VOCATIONAL STANDARDS 45 incompetence is charged are heard by the Board sitting with the hearing officer. The more common disciplinary actions are license suspension or revocation. When a license is revoked the licensee can apply to the board for reinstatement after one year; the Board in considering such a re- quest may call the applicant before it or order a regu- lar hearing. These cases occupy a significant portion of the Board's time. Suspensions are normally "stayed" and the nurse placed on probation-under the supervision of a committee comprised of two board members and a staff representative. In the year ending June, 1966 a total of 229 cases were investi- gated, of which 72 went to formal hearings and re- sulted in 12 suspensions and 38 revocations. Com- plaints of persons practicing professional nursing without a license are frequently received, but are often difficult to resolve because of the problem of definition as to what constitutes "professional" nursing. STATE BOARD OF OPTOMETRY Functions The State Board of Optometry examines and grants licenses to optometrists and optometrist branch offices and generally regulates the practice of optometry. Organization The Board is comprised of six members appointed by the Governor for four-year overlapping terms. Five members must be practicing licensees of the Board and the sixth a public member. The Board meets five to seven times per year. The staff consists of the Executive Secretary and an office employee. Licensing An applicant for licensure is required to be 21 years of age, of good moral character, a high school graduate; and to have completed 60 semester units of collegiate work including certain required subjects and three years of instruction in an accredited school of optometry. Applicants with technically deficient applications or lacking the required educational prep- aration are so advised administratively and given an opportunity to present further information or re- quest a hearing. When an applicant does not appear to satisfy the good character requirement, the appli- cation is denied and a hearing conducted in accord- ance with the Administrative Procedure Act. The optometrist license examination, conducted once a year, is composed, administered, and graded by the Board and staff. Of about 100 candidates ex- amined each year, approximately 90 per cent are suc- cessful. The test is divided into eight parts-five wit- ten and three practical. The professional members of the Board write questions for the written parts of the examination and determine what types of forms and instructions will be needed for both the written and practical parts. They also determine procedures to be followed in the administration of the examina- tion and personally correct and grade examination 'papers. Candidates must achieve a passing score of 75 per cent on each part to pass the examination. Candidates who do not pass the entire examination are allowed conditional credit for those portions on which they received a score of 85 percent and need not retake these at the next examination. There is no reciprocity for optometrists from other states. A number of states (not California) use a standardized examination composed by the National Board of Examiners in Optometry; the Board is now exploring the possibility of recognizing the results of this examination. The law provides that any licensed optometrist, upon payment of an annual $15 registration fee, may operate a branch office in which he employs other licensed optometrists. Prior to October 1, 1959, there was no limit to the number of such branch offices but a legislative enactment at that time imposed a limit of one (in addition to the optometrist's prime place of business). A grandfather clause allowed con- tinued operation of branch offices existing prior to this date. The Board has an accreditation program for schools of optometry which includes periodic inspec- tions of those within California. Outside-of-state schools are accredited through a study of course cata- logs, course descriptions, and related materials. In approving the facilities of out-of-state schools, the Board accepts the accreditation of the Council on Op- tometric Education of the American Optometric As- sociation. Enforcement The Board uses the services of the Division of In· vestigation. A large proportion of the complaints in· vestigated deal with alleged improper advertising, among other allegations investigated are: unaccept- able or immoral conduct, frauds and misrepresenta- tions, inefficiency and incompetence, habitual intoxi· cation, unlicensed practice, and aiding and abetting unlicensed practice. Many cases are resolved with what might be termed administrative warnings by the staff of the Board. It is felt that a formal warn- ing could only result from a formal proceeding. Cases involving serious violations are referred to a formal administrative hearing; during the last three years there have been two suspensions and one revocation ordered. In addition, there have been two prosecu- tions and two convictions of unlicensed practice and five proceedings initiated by statements of issues, four of the latter having to do with the licensing of branch offices. BOARD OF PHARMACY Functions The Board of Pharmacy licenses pharmacists and other individuals and establishments engaged in the manufacture and distribution of pharmaceuticals and carries out an extensive educational and enforcement program covering all aspects of the pharmaceutical industry. 46 AN EXAMINATION OF THE Organization The Board of Pharmacy is a policy and regulatory body comprised of seven registered pharmacists and one puhlic member appointed by the Governor for four-year staggered terms. The staff includes an Exec- utive Secretary who by Board ruling is a registered pharmacist and eleven inspectors, similarly registered. The inspectors are engaged in a continuing program of pharmacy inspections and the investigation of com- plaints or reports of alleged infractions of the law or Board regulations. Licensing- Adivities The Board licenses pharmacists and issues various permits or certificates for retail pharmacies; drug manufaeturers and wholesalers; manufacturers, whole- salers, and retailers of prophylactics; retailers of hypnotic drugs; wholesalers and retailers of hypoder- mic syringes and needles; itinerant vendors; and gen- eral dealers. The requirements for certification as a registered pharmacist include graduation from an approved col- lege of pharmacy, one year of experience under the direct supervision of a registered pharmacist, good moral character and temperate habits, and successful completion of an examination. Applications are re- ceived and reviewed by the staff, a four-member cre- dentials committee of the Board, and finally the Board itself. The examination is prepared and administered by the members of the Board and is given four times a year. It contains both performance and written sec- tions. Of the 710 candidates examined in the year past, 545 passed. There are now approximately 12,000 licensees. Code provisions and Board regulations relating to the sevllral categories of permits and certificates are quite comprehensive in prescribing conditions and con- trols in connection with facilities, sanitation, security, and dispensing procedures, particularly as regards narcotic and dangerous drugs, poisons, hypodermic materials, and prophylactics. A retail pharmacy per- mit may, for example, be issued to any responsi~le person of good character, but a licensed pharmaCIst manager must be on duty in such an establishment at all times. A 1963 Act of the legislature provides that a physician may not own a pharmacy. (The Board is ap- pealing a recent superior court decision that this re- striction does not apply to a corporation owned by a group of physicians.) As already noted, special licenses are issued for handling hypnotic drugs (e.g. sleeping pills) , hypoder- mics, and prophylactics. A retail pharmacy license conveys the right to sell these items. The drug. whole- saler license conveys the right to sell hypodermlcs, but not hypnotics or prophylactics. A "general d~aler" license is issued to country grocery stores, WhICh al- lows them to sell a few prepared drugs in addition to those sold by an ordinary grocery store. Itinerant vendors are licensed to sell non-prescription drugs door-to-door. There are no established qualification standards for this, other than good character, the pur- pose of the licensing being to know who is in the busi- ness and to impose needed controls over this activity. The law prescribes that any drug manufactured or sold in California must be prepared under the super- vision of a licensed pharmacist. The Board licenses manufacturers inside and outside of the State. After examination of such an applicant's qualifications, the Board may grant a Certificate of Exemption for a non- pharmacist to manufacture drugs. Enforcement The Board's inspectors make regular inspections of licensed pharmacies to assure compliance with code provisions and Board regulations and to provide in- formational-educational assistance to licensees. The services of the Division of Investigation are used in the investigation of alleged offenses of the type in- volving "street crimes." In fiscal year 1965-66 an estimated 1,200 complaints were received. Of these 408 were referred to the Division; 356 were investigated by Pharmacy Inspectors; the balance were otherwise disposed of; 175 formal warnings issued by Pharmacy Inspectors, and 32 administrative hearing~ held which resulted in 24 suspensions and 4 revocatIOns. Among the more frequent offenses leading to formal discipli- nary action are filling or refilling prescriptions with· out a physician's authorization, operation of a phar- macy without a registered pharmacist on duty, fa~se advertising, and conviction of a felony or offense m- dicating bad character. The code prescribed numerous grounds for action, including narcotic act. violati~ns, gross negligence or incompetence, gross ImmoralIty, and unprofessional conduct. The Board participates actively in the enforcement program-reviewing investigation reports, calling alleged offenders before it, issuing formal warnings, and acting on hearing officer recommendations. BUREAU OF PRIVATE INVESTIGATORS AND ADJUSTERS Background Private detectives were licensed by the Board of Prison Directors prior to 1947 at which time this ac- tivity was transferred to the Department of. Profes- sional and Vocational Standards and placed m a bu· reau rather than under a licensing board. Fundions The Bureau now licenses private investigators, pri- vate patrol operators, insurance adjuster~, ar:d r~­ possessors. The primary purpose of the hcens.mg IS protection of the public from fraud and deceptIOn on the part of persons engaged in the investigative busi- ness. Organization There is no licensing board, advisory or otherwise. Because of the low volume of activity, a full-time bu- reau head has not been employed in recent years-at present the Executive Secr~tary of the. Boar~ of Chiropractic Examiners acts m that capaCIty, aSSIsted by four office employees. DEPARTMENT OF PROFESSIONAL AND VOCATIONAL STANDARDS 47 Licensing Each person, partnership, or firm wishing to engage in the subject business or vocations must apply for and obtain a license. Only one person-the regUlations say the individual in charge of a firm's aetivities--need qualify by meeting the special requirements and suc- cessfully passing the examination given by the Bu- reau. Other partners and officers must be identified and copies of their fingerprints submitted with the ap- plication. Employees who would be engaged in investi- gative assignments are required to register, but not to obtain a license. This applies only to regularly em- ployed staff, defined as persons who work for at least 30 uninterrupted days. Further, persons who work exclusively for such employers as a law firm or an insurance company need not be either licensed or registered. In the past the Bureau has engaged under contract an examinations testing firm to develop and adminis- ter examinations for the several categories on a quar- terly basis. Bureau personnel did not see the examina- tions, before or after they were administered; the test- ing service simply provided the Bureau with a list of those who took the exam and the grades received. The next group of examinations to be given are being pre- pared by the Examinations Consultant of the Depart- ment of Professional and Vocational Standards (on loan from the State Personnel Board). A $25 fee is charged for the examination and a person may take it as many times as he wishes until he passes, paying -the reexamination fee is $10. It was reported that some have taken the examination as many as six or eight times. When the applicant is notified of the time and place of examination, he is given a packet of mate- rials to study and an outline of the subject matter of the examination and the weight to be given each see- tion. From 60 to 80 per cent successfully pass the examination. There is a requirement in the law that an applicant must have at least two years' prior quali- fying experience for private investigator and insur- ance adjuster and one year for private patrol opera- tor and repossessor. The Bureau now licenses approximately 1,800 per- sons and firms. Enforcement Grounds for disciplinary action against a licensee or registrant include offenses involving dishonesty or fraud, impersonation of a law enforcement officer, re- fusal to render agreed-upon services or reports to a client, undue use of force, and other such actions. The Bureau make:s use of the Division of Investiga- tion to verify complaints regarding licensees and registrants. The Bureau reviews investigative reports and takes whatever action judged appropriate, refer- ring serious cases to the Attorney General for adviee and possible action under the Administrative Proced- ure Act. In the year ending June 30, 1966, 8. rotal of 265 investigations were ordered; 12 heArings were con- duct.ed resulting in 4 revocations and 4 suspensions. CERTIFIED SHORTHAND REPORTERS BOARD Functions The Certified Shorthand Reporters Board regulates the profession of shorthand reporter and certifies the competency of its practitioners. The law requires all courts to use certified reporters with the provision that an uncertified reporter may be used when no certified reporter is available. Organization The Board is comprised of five members appointed by the Governor and confirmed by the Senate for four-year overlapping terms. Two must be members of the State Bar and three must be persons who hold certificates issued by the Board with five years' experi- ence as shorthand reporters. Staff is shared on a pro rata basis with three other licensing boards--Land- scape Architects, Veterinarians, and Yacht Brokers. Licens;ng The prerequisites for certification are: age 21, U.s. citizenship (or declaration of intent), good moral char- acter, high school education or equivalent, and one of several types of qualifying experience. Candidates are tested on their ability to receive and transcribe dicta- tion as well as their knowledge of grammar, punctua- tion, and spelling. The full day examination is admin- istered twice a year. The Board composes the practical portions of the examination and participates actively in the examination process. the English portions of the examination are composed and graded by an ex· amination service. The examination fee is $25; the original certificate fee and the biennial renewal fee are $40. All license applications are reviewed by the staff; questionable applications are referred to the Board. There is some question whether or not the provisions of the Administrative Procedure Act are applicable to the denial of an application by the Board. In practice, however, appeals from denied applicants are referred to an administrative hearing. All but a few of the 450 candidates examined an- nually by the Board are stenotype operators. Ap- proximately 40% of all candidates are successful in the examination. Eniorcement The Board uses the services of the Division of Investigation. There are few disciplinary actions against licensees; the bulk of enforcement activity being directed toward the restriction of the word "certified" to qualified persons. Use of the word "certified" without having qualified is a misdemeanor and persistent violators are referred to local district attorneys for prosecution. Most revocations or sus- pensions result from violation of the good moral char- acter requirement. Disciplinary proceedings are taken under the provisions of the Administrative Procedure Act. In fiscal year 1965-66 no such hearings took place. 48 AN EXAMINATION OF THE BOARD OF SOCIAL WORK EXAMINERS Functions The Board of Social Work Examiners examines and grants certificates of registration to social workers. It is not a mandatory licensing program; the preponderance of practicing social workers do not meet the standards and thus are not registered with the Board. The certificate issued by the Board entitles a person to style himself a Registered Social Worker and to use the letters RSW in connection with his name, thus identifying himself to the public as hav- ing met the state-set standards. Organization The Board is comprised of seven members appointed by the Governor for four-year overlapping terms. At least two members must represent the public and the rest must be licensees of the Board with at least five years of social work experience. The law provides that the Executive Secretary appointed by the Board must also be a licensee of the Board. Licensing The law requires only that an applicant for certi- fication be a U.S. citizen and pass the licensure ex- amination. By regulation, the Board has further pro- vided that an applicant must possess a master's de- gree in social work and have completed at least two years of graduate study. Regular examinations are scheduled in most major cities of the State, twice per year. Special examina- tions are administered any place or time, inside or outside of the State, that three or more candidates wish to take the test. From 150 to 200 candidates are examined annually of which over 95 per cent are successful. The current examination was composed by a special committee in 1963. It is graded by the Board staff. Fees consist of a $10 application fee and a $10 annual renewal fee. There are approximately 3,400 licensees in the State at this time. Enforcement There is not active enforcement program in that verY few complaints are received or offenses re- ported-none during fiscal year 196~6. The law provides that a license may be revoked for moral turpitude, fraud, sedition, and other causes but the Board has no investigative program to uncover Sllch actions. Any disciplinary actions which do arise as .a result of citizen complaints must be heard under the provisions of the Administrative Procedure Act. One license has been revoked under this. procedur~ during the last ten years. STRUCTURAL PEST CONTROL BOARD Functions '" The Structural "Pest Control Board licensesStruc. tUl'al Pest Control Operators and Field· nepresenta" .lives and" regulates licenseeS in accordance with the governing code provisiolls. Organization The Board is comprised of six members, five of whom must be Board licensed operators and one a public representative. All are appointed by the Gov- ernor for four-year staggered terms. The Board ap- points, with the approval of the Department Director. a registrar who heads a staff of 17 employees en- gaged in the processing of licenses and inspection reports. Licensing No person can engage in structural pest control work unless he is licensed by the Board, thus this is a mandatory licensing program prescribed by law. Several categories of licenses are issued, depending on the type of work to be performed. An applicant for an operators license must provide the Board with specific information concerning his business associates and place of business and, depending on the category of license, show two to four years' experience in pest control work. An examination is given covering per- tinent laws and theories, practices, and techniques of pest control. Applicants for Field Representative licenses must furnish, in addition to information on previous em- ployment and experience, a statement from employers or others as to "honesty, truthfulness, and good repu- tation. " As in the case of licensing operators an examination is given, covering much the same subject matter. Once licensed, a field representative must notify the Board of any changes in employment. Examination material is developed by an "examin- ations commission" engaged for this purpose on an as-needed basis with the Board reviewing the ma- terial prior to its inclusion in the examination. The Cooperative Personnel Service of the State Personnel Board is hired to finally prepare and grade the examination booklets but the Board administers the examinations. In the year past 994 persons were tested, 345 of whom" received pas.sing grades. At pres- ent there are 1,200 operator and 1,540 field repre- sentative licenses. SpeY:ial Services The Board receives and maintains reports of all structural pest inspections, copies of which are sold to the public-this is a well-used service. Enforcement The enforcement program is a relatively strict and comprehensive one. In the 196~6 fiscal year, for example, there were 98 license suspensions and 19 revocations. Minor infractions" are settled informally by the Board and major ones processed through the Office of Administrative Procedure with the Office of . the Attorney General acting as counsel for the -Board. The Board makes full use of the services of th"eDivision of Investigations; in the past year it referred nearly 850 complaints for such investiga- tion. The grounds for disciplinary action set forth in the cQde include all of those found in most lieeJ:\slo. ingacts as well as- failure:d.'.8r.,licensee. fully ""tQ " ' _ " " " " " r ' . ,'>. DEPARTMENT OF PROFESSIONAL .A..~D VOCATIONAL STANDARDS 49 conform with the terms of contracts executed with clients, negligence, and misrepresentation. In part because of code provisions relating to work- manship, prices, and performance according to con- tracts, the Board functions in the role of a conciliator in processing many complaints. In these cases the operator generally complies with suggestions to cor- rect any deficiencies in his performance rather than face formal disciplinary proceedings. Operators are required to post a $2,000 surety bond and to carry insurance in the minimum amount of $25,000 bodily injury and $25,000 property dam- age. After a license suspension, an operator must also post an additional bond of from $1,000 to $8,000, depending on the seriousness of the violation leading to the suspension. BOARD OF EXAMINERS IN VETERINARY MEDICINE Functions The Board of Examiners in Veterinary Medicine examines and licenses qualified persons to practice veterinary medicine and regulates such practice. The Board is also charged with the inspection and regis- tration of all premises where veterinary medicine is carried out. Organization The Board is comprised of six members appointed by the Governor for four-year overlapping terms. Five of the members must be veterinarians who have been residents of, and engaged in the practice of veterinary medicine in, California for at least five years prior to appointment. The sixth is a public member. No two members may reside in the· same congressional district. Staff is shared on a pro rata basis with three other boards-Landscape Architects, Shorthand Reporters,and Ship and Yacht Brokers. Licensing The Board conducts semiannual examinations which include theoretical and practical sections. The former is part of a standard examination composed and graded by the Professional Examination Service, a division of the American Public Health Association. The two day practical portion of the test is prepared by the Board and administered and graded by the Board and staff. Some 200 candidates are examined each year, with approximately 80 per cent passing. There are now 2,642 licenses in effect. There is a $30 application fee and $351icense and biennial renewal fee. To qualify for a veterinary license an applicant must demonstrate that he is of good moral character and be a graduate of a veterinary college recognized and approved by the Board. Application deniaL pro- eeedings are conducted under the provisions of the Administrative Procedure Act, although the Board ~s nQtrequired by law to do .so, . . c· All veterinary . premises must .be registered with the Board, for which a fee of $10 is assessed Enforcement Each of the 950 registered animal hospitals is in- spected on an average of once per year, by personnel of the Division of Investigation. Inspectors typically examine sanitary conditions and the degree of com- pliance with code provisions and Board rules and regulations. As a result of infractions discovered dur- ing these inspections the Board may issue warnings or order a more intensive investigation. Infractions involve sanitary deficiencies, fraud, deceit, negligence, incompetence, drunkenness, the improper use of drugs and conduct reflecting unfavorably on the profession. Serious or repeated violations may result in the sus- pension or revocation of a license, after a hearing conducted under the provisions of the Administrative Procedure Act. BOARD OF VOCATIONAL NURSE EXAMINERS Functions The Board of Vocational Nurse Examiners examines and licenses vocational nurses and psychiatric techni- cians. The duties of a psychiatric technician are simi- lar to those of a vocational nurse, except that they specialize in the care of mentally ill and retarded patients. Licensing of psychiatric technicians was instituted in 1959 and then suspended in 1963 due to a lack of funds to administer the program. The program was re- activated on R. trial basis in 1965; in 1968 the Legis- lature will re-evaluate the financial condition of the program and determine whether it will be extended. Organization The Board is comprised of eleven members ap- pointed by the Governor for four-year overlapping terms. Five members must be licensed vocational nurses two certified psychiatric technicians, one phy- sician ~nd surgeon, one registered nurse with experi- ence as a teacher or administrator, one hospital ad- ministrator and one public school administrator. The vocational ~urse staff consists of an Executive Secre- tary (i time), an administrative assistant (t time), two nursing education consultants, and five office per- sonnel; the psychiatric staff consists of the Executive Secretary (l time), administrative assistant (i time) one nursing education consultant and one office work~r. The Executive Secretary is required by law to be either a registered nurse or else a licensed voca- tional nurse. Licfinsing The requirements for licensure as a Licensed Voca- tional Nurse are: age 17, citizen of U.S. or declaration of intention, equivalent of a tenth grade education, good character, and completion of a 12-mollth accred- ited course in vQcational nursing or. the equivalent. The Board's interpretation of the latter requirement, until recently, limited candidates to graduation from sallle type of vocational nursing school. This year the 130ard adopted. a policy that six an-done·halfye.ai:'l;! of paid nursing experience is qual~png. There has, 50 AN EXAMINATION OF THE therefore, been a large increase in the number of ap- plicants: 1,350 applications were accepted for the Oc- ber 1966 examination. In recent years the Board has exa~ined from 1 500 t(l 2,000 candidates annually, the examination giv;n at roughly four-month intervals. The application fee for the Licensed Voc!ltional Nur~e examination is $15. A candidate who falls the examl- nation may take it twice more at a cost of $5 per test and after a third failure must take or repeat an ac- credited course before again being re-examined. The biennial license renewal fee is $15. The requirements for licensure (certification) as a psychiatric technician are: age 19, citizen of U.S. or declaration of intention, equivalent of a twelfth-grade education, good character, and co~pletion of a 12- month accredited course or the eqUIvalent. In regard to the latter requirement, there are now no courses ac- credited by the Board. The staff training programs at several State mental hospitals are now under consider- ation for accreditation. The Board has set the equiva- lent to the required training course at two years' em- ployment in a psychiatric nursing unit. Both licensed vocational nurses and psychiatric technicians are required to take licensure examina- tions. The licensed vocational nurse examination is a standardized national test composed and graded by the American Nurses' Association and the National League for Nursing in cooperation with the .vario:ns state licensing boards. Each st.ate ~oax:d est~bhshes Its own passing score. The exammatIOn IS reVIsed ev~ry two years. The failure percentage tends to dechne from about 14 per cent when the test is first adminis- tered to 6 per cent the sixth time it is administered. The Board grants licenses to qualified candidates from other states without examination if they had at- tained a passing score on the national examination equal to that flet for California applicants. No standardized examination is available for psy- chiatric technicians because no other state has a psy- chiatric technician licensing program. When the Board began licensing psychiatric technicians in 1959, it adopted a variation of th~ State 1?epa!tment of M~n­ tal Hygiene's comprehensIve exammatIOn for psychIa- tric technicians. The examination is now in need of revision. Because some of the Department of Me~tal Hygiene's training courses may shortly be a~credlted by the Board, it is no longer conside!ed . des~rable to use examinations prepared by that mstItutIon. The failure rate for the current examination is tbree per cent. The psychiatric technician application and an- nuallicense renewal fees are both $10. The Board is not required by law to conduct license denial proceedings under the provision~ of the Ad- minifltrative Procedure Act; m practice, however, denial proceedings involving the applicant's character are so conducted. The Board is responsible for t.he accreditation ?f vocational nursing schools of WhICh there are 65 m California-all associated with hospitals and other health agencies. Background work for accreditation is performed by the Board's two full-time nursing edu- cation consultants. Enforcement The Board uses the services of the Division of In~ vestigation. A small percentage of enforcement work is devoted to restriction of the unlicensed use of the title Licensed Vocational Nurse. Most enforcement ac- tivity involves background investigations of licensees or applicants to determine compliance with the good character requirement. All disciplinary actions are conducted under the provision of the Administrative Procedure Act. YACHT AND SHIP BROKERS COMMISSION Functions The Yacht and Ship Brokers Commission licenses and regulates brokers and salesmen who, for others, sell, purchase, rent, lease, charter, or negotiate loans on yachts or ships. Organization The Commission is comprised of five members ap- pointed by the Governor for four-year overlapping terms. Four of the members must be persons who have for a period of not less than five years preceding the date of their appointment been actively engaged and licensed as yacht and ship brokers. The fifth is a public member. Staff is shared on a pro rata basis with three other licensing boards-Landscape Architects, Veter- inarians, and Shorthand Reporters. Licensing The basic licenses issued by the Board are broker licenses, salesmen licenses, and broker branch office. The prerequisites for licensure as a broker are: age 21, good moral character, and one of several types of ship- ping or ship sales related experience. The qualifica- tions for a salesman are: age 21 and good moral char- acter. An application for a broker's license must be accompanied by two character references from yacht brokers or real estate brokers of the county in which the applicant resides. The Commission is not required by law to refer application denial appeals to an ad. ministrative hearing, but in practice does so. Both brokers and salesmen are required to take ex- aminations, composed by the Com~is~ion, which cover basic questions on the law of prInCIple and agency, sales tax regulations, boating regulat~ons, Ya~ht and Ship Brokers Act provisions, and marme termmology. Approximately 200 candidates per yea~ are examined with an average of 65 per cent passIng. There are now 680 outstanding broker, salesman, and branch office licenses. The examination fee for both broker and salesman is $15. The original license fees are: broker, $100; salesman, $25 j and branch office $10; annual renewal fees are: broker, $25; salesman, $15; and branch office, $10. Licensed salesmen must work for a licensed broker and a salesman '8 license is automatically cancelled when he leaves the employ of a broker. Through pay- ment of a $5 fee a license may be reinstated under another broker. DEPARTMEN'l' OF PROFESSIONAL AND VOCATION.AL S'l'ANDARDS 51 Enforcement Yacht and ship brokers are frequently required to act in a fiduciary capacity for their clients and thus are required to post a $2,500 surety bond with the ,Commission. Any person injured by the actions of a broker may bring action against this bond. The Commission uses the services of the Division of Investigation. Enforcement work is divided about o equally between licensed and unlicensed activities. Disciplinary actions are taken under the Administra- tive Procedure Act. Two actions by the Commission against the surety in the last year resulted in $5,000 being distributed to members of the public who were financially harmed in their dealing with brokers, who subsequently sur- rendered their licenses. pri"tea in cALIFoaNlA OFFICE 01' STATE Ps.tNTINC 75323--404 8-67 2![