BILL ANALYSIS
------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 969|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 445-6614 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
THIRD READING
Bill No: SB 969
Author: Bowen (D), et al
Amended: 5/8/03
Vote: 21
SENATE BUSINESS & PROFESSIONS COMMITTEE : 6-0, 4/28/03
AYES: Figueroa, Aanestad, Brulte, Cedillo, Machado, Murray
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
SUBJECT : Telephone medical advice services
SOURCE : Author
DIGEST : This bill applies the current definition of
telephone medical advice" to health care service plans, and
further defines as including assessment, evaluation, or
advice to patients or their family members. Also, requires
health plans to use licensed health care practitioners to
provide telephone medical advice and prohibits unlicensed
health plan staff or staff of a telephone medical advice
service from using titles or designations that would
mislead a person to believe that they are a licensed health
professional. Permits, however, unlicensed staff to ask
questions so that a patient can be properly referred to a
licensed practitioner as long as they do not attempt to
assess, evaluate or advise a patient.
ANALYSIS :
Existing Law
CONTINUED
SB 969
Page
2
1.Provides for the licensing and regulation of health care
service plans by the State Department of Managed Health
Care.
2.Requires that every health care service plan that
provides, operates, or contracts for in-state and
out-of-state telephone medical advice services for its
enrollees and subscribers to register with the Telephone
Medical Advice Services Bureau under the State Department
of Consumer Affairs, as specified.
3.Requires staff providing telephone medical advice
services for full service health care service plans, to
hold a valid California license as a registered nurse, or
a valid license in the state within which they provide
the services as a physician and surgeon, or physician
assistant, and that they are operating consistent with
the laws governing their respective scopes of practice.
4.Requires staff providing telephone medical advice
services for specialized health care service plans that
are providing, operating, or contracting for these
services in California, to be licensed, registered or
certified as the respective health care practitioner
within California, and are operating consistent with the
laws governing their respective scopes of practice.
5.Requires staff providing telephone medical advice
services for specialized health care service plans that
are providing, operating, or contracting for these
services out-of-state, to be licensed, registered or
certified as the respective health care practitioner
within the state they are providing such services and
operating consistent with the laws governing their
respective scopes of practice.
6.Requires registered nurses providing telephone medical
advice services to both in-state and out-of-state
specialized health care plans to hold a valid California
license.
7.Defines "telephone medical advice," for purposes of any
business entity providing telephone medical advice, as a
SB 969
Page
3
telephonic communication between a patient and a health
care professional, wherein the health care professional's
primary function is to provide to the patient a
telephonic response to the patient's questions regarding
his or her or a family member's medical care or
treatment.
This bill:
1.Requires a health care service plan that provides,
operates, or contracts for telephone medical advice
services to ensure that only staff who are licensed,
certified or registered in a specified health care
profession provide medical advice to an enrollee or a
subscriber.
2.Allows unlicensed staff members to ask questions on
behalf of licensed
staff in order to ascertain the condition of the patient
for purposes of referring the patient to the appropriate
licensed practitioner.
3.Restricts unlicensed staff members from using answers
given in response to their questions to assess, evaluate,
advise, or make any decision regarding the condition of
the patient, or to provide advice or schedule
appointments based on those answers.
4.Requires a health care service plan or a telephone
medical advice service to ensure that no staff member
uses a title or designation that would cause a reasonable
person to believe the staff member is licensed, certified
or registered as a specified type of health care
professional unless the person meets those requirements.
5.Defines "telephone medical advice," for purposes of
health care service plans, as a means of telephonic
communication between a patient and a health care
professional, wherein the health care professional's
primary function is to provide to the patient a
telephonic response to the patient's questions regarding
his or her or a family member's medical care or
treatment.
SB 969
Page
4
6.States that "telephone medical advice" includes
assessment, evaluation, referral, or advice to patients
or their family members.
Comments
According to the author's office, the purpose of this
measure is to deal with health care service plans, such as
Kaiser Permanente, that are using their call takers (i.e.,
so called "Health Care Specialists") to assess, evaluate,
and advise patients who contact their call centers. These
persons are not licensed healthcare professionals and are
in effect providing medical advice and assessing a
patient's condition. By providing a clearer definition of
"medical advice" this will assure that unlicensed persons
will immediately refer patients to an appropriate licensed
health care professional so they can receive the
appropriate assessment, evaluation, or advice to patients
or their family members. Also this bill, as the author's
office indicates, will prevent persons from using
misleading titles which imply that they are licensed health
care professionals.
Related Legislation
AB 1392 (Bermudez) - 2003-04 Session . Authorizes the State
Department of Consumer Affairs (DCA) to suspend, revoke, or
discipline a Telephone Medical Advice Services provider
registered with DCA, if the registrant provides financial
incentives to employees for limiting a patients access to
health care.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 5/19/03)
American Nurses Association of California
California Alliance for Consumer Protection
California Nurses Association
Congress of California Seniors
Kaiser Permanente (if amended)
ARGUMENTS IN SUPPORT : The California Nurses Association
SB 969
Page
5
(CNA) strongly supports this measure and indicates that it
will provide additional consumer protections for patients
that access health plan "call centers" for medical advice
or for the advice nurse. CNA argues that the current law
doesn't provide a clear definition of what constitutes
medical advice and as a result, often times non-medically
licensed call center operators are charged with assessing a
patient's medical condition and making determinations about
if and when callers need to talk or see a nurse or doctor
and in some instances these could involve decisions that
could be life threatening to patients. As further argued,
the changes provided in this bill will provide important
protections for patients, especially for elderly patients
who may not have family advocates to assist them in
obtaining needed health care services.
CP:cm 5/19/03 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****