BILL NUMBER: AB 289 CHAPTERED 09/24/01 CHAPTER 321 FILED WITH SECRETARY OF STATE SEPTEMBER 24, 2001 APPROVED BY GOVERNOR SEPTEMBER 23, 2001 PASSED THE ASSEMBLY SEPTEMBER 4, 2001 PASSED THE SENATE AUGUST 30, 2001 AMENDED IN SENATE AUGUST 27, 2001 INTRODUCED BY Assembly Member Oropeza FEBRUARY 16, 2001 An act to amend Section 2401 of the Business and Professions Code, and to amend Sections 11877.6 and 11877.7 of the Health and Safety Code, relating to healing arts. LEGISLATIVE COUNSEL'S DIGEST AB 289, Oropeza. Healing arts. Existing law requires the State Department of Alcohol and Drug Programs to license and regulate narcotic treatment programs. The Medical Practice Act restricts the employment of licensed physicians and surgeons and podiatrists by a corporation or other artificial legal entity, subject to specified exemptions. This bill would exempt a narcotic treatment program regulated by the department from these restrictions on the employment of licensed physicians and surgeons and podiatrists, provided that the program does not interfere with, control, or otherwise direct the professional judgment of a physician and surgeon. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. It is the intent of the Legislature that if the State Department of Alcohol and Drug Programs discovers evidence, records, or activities indicative of fraud or abuse, as defined in Section 14043.1 of the Welfare and Institutions Code, the State Department of Alcohol and Drug Programs and the State Department of Health Services shall work cooperatively to investigate and refer fraud or abuse cases to the appropriate law enforcement agencies. SEC. 2. Section 2401 of the Business and Professions Code is amended to read: 2401. (a) Notwithstanding Section 2400, a clinic operated primarily for the purpose of medical education by a public or private nonprofit university medical school, which is approved by the Division of Licensing or the Osteopathic Medical Board of California, may charge for professional services rendered to teaching patients by licensees who hold academic appointments on the faculty of the university, if the charges are approved by the physician and surgeon in whose name the charges are made. (b) Notwithstanding Section 2400, a clinic operated under subdivision (p) of Section 1206 of the Health and Safety Code may employ licensees and charge for professional services rendered by those licensees. However, the clinic shall not interfere with, control, or otherwise direct a physician and surgeon's professional judgment in a manner prohibited by Section 2400 or any other provision of law. (c) Notwithstanding Section 2400, a narcotic treatment program operated under Section 11876 of the Health and Safety Code and regulated by the State Department of Alcohol and Drug Programs, may employ licensees and charge for professional services rendered by those licensees. However, the narcotic treatment program shall not interfere with, control, or otherwise direct a physician or surgeon's professional judgment in a manner prohibited by Section 2400 or any other provision of law. SEC. 3. Section 11877.6 of the Health and Safety Code is amended to read: 11877.6. The director may deny the application for initial issuance of a license if the applicant or any partner, officer, director, 10 percent or greater shareholder, or person proposed to be employed by the applicant under the authority of subdivision (c) of Section 2401: (a) Fails to meet the qualifications for licensure established by the department pursuant to this article. However, the director may waive any established qualification for licensure of a narcotic treatment program if he or she determines that it is reasonably necessary in the interests of the public health and welfare. (b) Was previously the holder of a license issued under this article, and the license was revoked and never reissued or was suspended and not reinstated, or the holder failed to adhere to applicable laws and regulations regarding narcotic treatment programs while the license was in effect. (c) Misrepresented any material fact in the application. (d) Committed any act involving fraud, dishonesty, or deceit, with the intent to substantially benefit himself or herself or another or substantially injure another, and the act is substantially related to the qualification, functions, or duties of, or relating to, a narcotic treatment program license. (e) Was convicted of any crime substantially related to the qualifications, functions, or duties of, or relating to, a narcotic treatment program license. (f) The director, in considering whether to deny licensure under subdivision (d) or (e), shall determine whether the applicant is rehabilitated after considering all of the following criteria: (1) The nature and severity of the act or crime. (2) The time that has elapsed since the commission of the act or crime. (3) The commission by the applicant of other acts or crimes constituting grounds for denial of the license under this section. (4) The extent to which the applicant has complied with terms of restitution, probation, parole, or any other sanction or order lawfully imposed against the applicant. (5) Other evidence of rehabilitation submitted by the applicant. (g) With respect to any other license issued to an applicant to provide narcotic treatment services, violated any provision of this article or regulations adopted under this article that relate to the health and safety of patients, the local community, or the general public. Violations include, but are not limited to, violations of laws and regulations applicable to take-home doses of methadone, urinalysis requirements, and security against redistribution of replacement narcotic drugs. In these cases, the department shall deny the application for an initial license unless the department determines that all other licensed narcotic treatment programs maintained by the applicant have corrected all deficiencies and maintained compliance for a minimum of six months. SEC. 4. Section 11877.7 of the Health and Safety Code is amended to read: 11877.7. (a) The director shall suspend or revoke any license issued under the provisions of this article, or deny an application to renew a license or to modify the terms and conditions of a license, upon any violation by the licensee of any provision of this article or regulations adopted under this article that presents an imminent danger of death or severe harm to any participant of the program or a member of the general public. (b) The director may suspend or revoke any license issued under this article, or deny an application to renew a license or to modify the terms and conditions of a license, upon any of the following grounds and in the manner provided in this article: (1) Violation by the licensee of any laws or regulations of the United States Food and Drug Administration or the United States Department of Justice, Drug Enforcement Administration that are applicable to narcotic treatment programs. (2) Any violation that relates to the operation or maintenance of the program that has an immediate relationship to the physical health, mental health, or safety of the program participants or general public. (3) Aiding, abetting, or permitting the violation of, or any repeated violation of, any of the provisions set forth in subdivision (a) or in paragraph (1) or (2). (4) Conduct in the operation of a narcotic treatment program that is inimical to the health, welfare, or safety of either an individual in, or receiving services from, the program, the local community, or the people of the State of California. (5) The conviction of the licensee or any partner, officer, director, 10 percent or greater shareholder, or person employed under the authority of subdivision (c) of Section 2401 of the Business and Professions Code at any time during licensure, of a crime substantially related to the qualifications, functions, or duties of, or relating to, a narcotic treatment program licensee. (6) The commission by the licensee or any partner, officer, director, 10 percent or greater shareholder, or person employed under the authority of subdivision (c) of Section 2401 of the Business and Professions Code at any time during licensure, of any act involving fraud, dishonesty, or deceit, with the intent to substantially benefit himself or herself or another, or substantially to injure another and which act is substantially related to the qualifications, functions, or duties of, or relating to, a narcotic treatment program licensee. (7) Diversion of narcotic drugs. A program's failure to maintain a narcotic drug reconciliation system that accounts for all incoming and outgoing narcotic drugs, as required by departmental or federal regulations, shall create a rebuttable presumption that narcotic drugs are being diverted. (8) Misrepresentation of any material fact in obtaining the narcotic treatment program license. (9) Failure to comply with a department order to cease admitting patients or to cease providing patients with take-home dosages of replacement narcotic drugs. (10) Failure to pay any civil penalty assessed pursuant to paragraph (3) of subdivision (a) of Section 11877.14 where the penalty has become final, unless payment arrangements acceptable to the department have been made. (11) The suspension or exclusion of the licensee or any partner, officer, director, 10 percent or greater shareholder, or person employed under the authority of subdivision (c) of Section 2401 of the Business and Professions Code from the Medicare, Medicaid, or Medi-Cal programs. (c) Prior to issuing an order pursuant to this section, the director shall ensure continuity of patient care by the program's guarantor or through the transfer of patients to other licensed programs. The director may issue any needed license or amend any other license in an effort to ensure that patient care is not impacted adversely by an order issued pursuant to this section.