BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 577
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          SENATE THIRD READING
          SB 577 (Burton)
          As Amended June 28, 2002
          Majority vote 

           SENATE VOTE  : 33-0  
           
           HEALTH              15-0                                        
           
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          |Ayes:|Thomson, Robert Pacheco,  |     |                          |
          |     |Aanestad, Bates, Chan,    |     |                          |
          |     |Chavez, Cohn, Frommer,    |     |                          |
          |     |Goldberg, Koretz,         |     |                          |
          |     |Negrete McLeod, Salinas,  |     |                          |
          |     |Strom-Martin, Washington, |     |                          |
          |     |Zettel                    |     |                          |
          |     |                          |     |                          |
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           SUMMARY  :  Specifies that a person who complies with the  
          requirements of this bill, and who does not perform specified  
          actions such as puncturing the skin or prescribing drugs, is not  
          in violation of specified provisions of the Medical Practice Act  
          (MPA).  Requires a person who provides services pursuant to this  
          bill to, provide specified information to the client in a  
          written statement using plain language, including that he or she  
          is not a licensed physician.  Specifically,  this bill  :   

          1)Specifies that notwithstanding any other provision of law, a  
            person who complies with the requirements of #3 and 4 below is  
            not in violation of specified provisions MPA which prohibit  
            the practice of medicine without a license, unless that person  
            does any of the following:

             a)   Conducts surgery or any other procedure on another  
               person that punctures the skin or harmfully invades the  
               body;

             b)   Administers or prescribes x-ray radiation to another  
               person; 

             c)   Prescribes or administers legend (prescription) drugs or  
               controlled substances to another person;

             d)   Recommends the discontinuance of legend drugs or  








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               controlled substances prescribed by an appropriately  
               licensed practitioner;

             e)   Willfully diagnoses and treats a physical or mental  
               condition of any person under circumstances or conditions  
               that cause or create a risk of great bodily harm, serious  
               physical or mental illness, or death; 

             f)   Sets fractures;

             g)   Treats lacerations or abrasions through electrotherapy;  
               or,

             h)   Holds out, states, indicates, advertises, or implies to  
               a client or prospective client that he or she is a  
               physician.

          2)Requires a person who advertises any services that are not  
            unlawful under specified provisions of MPA pursuant to #1  
            above, to disclose in the advertisement that he or she is not  
            licensed by the state as a healing arts practitioner.  

          3)Requires a person who provides services pursuant to this bill  
            that are not unlawful under specified provisions of MPA, prior  
            to providing these services, to do the following:

             a)   Disclose to the client in a written statement using  
               plain language the following information:

               i)     That he or she is not a licensed physician;

               ii)    That the treatment is alternative or complementary  
                 to healing art services licensed by the state;

               iii)   That the services to be provided are not licensed by  
                 the state;

               iv)    The nature of the services to be provided;

               v)     The theory of treatment upon which the services are  
                 based; and, 

               vi)    His or her educational, training, experience, and  
                 other qualifications regarding the services to be  
                 provided; and, 








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             b)   Obtain a written acknowledgement form the client stating  
               that he or she has been provided with the information  
               described in a) above.  Requires the client to be provided  
               with a copy of the written acknowledgement, which is  
               required to be maintained by the person providing the  
               service for three years.  

          4)Requires the information required by 3) a) above to be  
            provided in a language that the client understands.

          5)Prohibits anything in this bill from being construed to:

             a)   Affect the scope of practice of licensed physicians and  
               surgeons; and, 

             b)   Limit the right of any person to seek relief for  
               negligence or any other civil remedy against a person  
               providing services subject to the requirements of this  
               bill.  

          6)Makes various legislative findings and declarations, including  
            that perhaps more than five million, are presently receiving a  
            substantial volume of health care services from complementary  
            and alternative health care practitioners, and states the  
            legislature's intent, by enactment of this bill, to allow  
            access by California residents to complementary and  
            alternative health care practitioners who are not providing  
            services that require medical training and credentials.




           EXISTING LAW  :  

          1)Makes it a misdemeanor for any person to practice or attempt  
            to practice, or to advertise or hold themselves out as  
            practicing, any system or mode of treating the sick or  
            afflicted in this state, or who diagnoses, treats, operates  
            for, or prescribes for any ailment, blemish, deformity,  
            disease, disfigurement, disorder, injury, or other physical or  
            mental condition of any person, without having a valid license  
            as a physician or without being authorized to perform such  
            services pursuant to a certificate authorized by another  
            provision of law.  








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          2)Makes it a misdemeanor or a felony for any person who  
            willfully, under circumstances or conditions which cause or  
            create risk of great bodily harm, serious physical or mental  
            illness, or death, takes any of these actions.

           FISCAL EFFECT  :  None
           
          COMMENTS  :  According to the author, this bill is sponsored by  
          the California Health Freedom Coalition (CHFC) to amend MPA so  
          that practitioners of complementary and alternative medicine  
          will not be in violation of MPA's prohibition against practicing  
          medicine without a medical license, as long as the practitioner  
          informs his or her clients that he or she is not a licensed  
          physician and does not perform specified procedures (i.e.,  
          punctures the skin or harmfully invades the body, administers or  
          prescribes x-ray radiation, or prescribes or administers  
          prescription drugs).  CHFC states that because of the broad  
          wording of MPA, most, if not all of the activities of natural  
          medicine could be technically illegal, and that this bill  
          clarifies MPA so that episodes of natural medicine that are not  
          potentially harmful would no longer be technically illegal.   
          CHFC argues that this bill would remove the stigma of technical  
          illegality from the practices of natural medicine, which are a  
          basic element of health care for millions of Californians.

          This bill is supported by numerous organizations and  
          individuals.  The Coalition for Natural Health states that  
          several million people in this state are already receiving  
          services from unlicensed natural health practitioners, such as  
          homeopaths, naturopaths, reiki healers, or ayurvedics.  Given  
          that the vast majority of physicians have no training in most  
          alternative modalities, the Council for Homeopathic  
          Certification argues that it seems sensible to allow those who  
          are trained to be able to freely practice their skills, as long  
          as they offer full disclosure and are not practicing  
          conventional medicine as currently defined.  The North American  
          Society of Homeopaths states that the overly broad wording in  
          MPA has driven alternative and complementary medicine practices  
          underground, and that this bill will give people greater choice  
          to access the types of health care they seek.

          The California Medical Association (CMA) is opposed to this  
          bill, stating that it effectively removes any education and  
          training qualifications from the law for a modality of practice  








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          that is only defined by what it is not.  CMA asserts that this  
          bill stands legal licensure standards on its head.  Currently,  
          every health professional, including physicians and the allied  
          health professions such as nursing, optometry, podiatry, and  
          acupuncture, has a specific scope of practice that delineates  
          what procedures or activities can be performed.  CMA states that  
          licensing standards have been the cornerstone to improving  
          health care in California, and that this bill lacks any  
          licensing standards or oversight by the state of California,  
          unlike all other health care provider.

           Analysis Prepared by  :    Vincent D. Marchand / HEALTH / (916)  
          319-2097                                          FN: 0005725