BILL NUMBER: SB 1325 CHAPTERED
BILL TEXT
CHAPTER 699
FILED WITH SECRETARY OF STATE SEPTEMBER 22, 2004
APPROVED BY GOVERNOR SEPTEMBER 22, 2004
PASSED THE SENATE AUGUST 17, 2004
PASSED THE ASSEMBLY AUGUST 12, 2004
AMENDED IN ASSEMBLY JUNE 22, 2004
AMENDED IN ASSEMBLY JUNE 9, 2004
INTRODUCED BY Senator Kuehl
FEBRUARY 18, 2004
An act to add Section 2282.5 to the Business and Professions Code,
relating to medicine.
LEGISLATIVE COUNSEL'S DIGEST
SB 1325, Kuehl. Hospitals: physicians and surgeons:
self-governance.
The Medical Practice Act provides for licensing and regulation of
physicians and surgeons by the Medical Board of California. Existing
law provides that the practice of medicine in a licensed general or
specialized hospital having 5 or more physicians and surgeons on the
medical staff without provision for organization and self-governance
of the medical staff under certain rules constitutes unprofessional
conduct subject to discipline by the board under the act. A
violation of the Medical Practice Act is a crime.
This bill would specify certain rights that would be included in a
hospital medical staff self-governance. The bill would require the
medical staff and the hospital governing board to meet and confer to
resolve disputes related to these provisions, and would authorize
court relief in certain circumstances. The bill would make findings
and declarations of the Legislature in this regard.
Because the bill would change the definition of a crime, it would
impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. (a) The Legislature finds and declares that providing
quality medical care in hospitals depends on the mutual
accountability, interdependence, and responsibility of the medical
staff and the hospital governing board for the proper performance of
their respective obligations.
(b) The Legislature further finds and declares that the governing
board of a hospital must act to protect the quality of medical care
provided and the competency of its medical staff, and to ensure the
responsible governance of the hospital in the event that the medical
staff fails in any of its substantive duties or responsibilities.
Nothing in this act shall be construed to undermine this authority.
The final authority of the hospital governing board may be exercised
for the responsible governance of the hospital or for the conduct of
the business affairs of the hospital; however, that final authority
may only be exercised with a reasonable and good faith belief that
the medical staff has failed to fulfill a substantive duty or
responsibility in matters pertaining to the quality of patient care.
It would be a violation of the medical staff's self-governance and
independent rights for the hospital governing board to assume a duty
or responsibility of the medical staff precipitously, unreasonably,
or in bad faith.
(c) Finally, the Legislature finds and declares that the specific
actions that would constitute bad faith or unreasonable action on the
part of either the medical staff or hospital governing board will
always be fact-specific and cannot be precisely described in statute.
The provisions set forth in this act do nothing more than provide
for the basic independent rights and responsibilities of a
self-governing medical staff. Ultimately, a successful relationship
between a hospital's medical staff and governing board depends on the
mutual respect of each for the rights and responsibilities of the
other.
SEC. 2. Section 2282.5 is added to the Business and Professions
Code, to read:
2282.5. (a) The medical staff's right of self-governance shall
include, but not be limited to, all of the following:
(1) Establishing, in medical staff bylaws, rules, or regulations,
criteria and standards, consistent with Article 11 (commencing with
Section 800) of Chapter 1 of Division 2, for medical staff membership
and privileges, and enforcing those criteria and standards.
(2) Establishing, in medical staff bylaws, rules, or regulations,
clinical criteria and standards to oversee and manage quality
assurance, utilization review, and other medical staff activities
including, but not limited to, periodic meetings of the medical staff
and its committees and departments and review and analysis of
patient medical records.
(3) Selecting and removing medical staff officers.
(4) Assessing medical staff dues and utilizing the medical staff
dues as appropriate for the purposes of the medical staff.
(5) The ability to retain and be represented by independent legal
counsel at the expense of the medical staff.
(6) Initiating, developing, and adopting medical staff bylaws,
rules, and regulations, and amendments thereto, subject to the
approval of the hospital governing board, which approval shall not be
unreasonably withheld.
(b) The medical staff bylaws shall not interfere with the
independent rights of the medical staff to do any of the following,
but shall set forth the procedures for:
(1) Selecting and removing medical staff officers.
(2) Assessing medical staff dues and utilizing the medical staff
dues as appropriate for the purposes of the medical staff.
(3) The ability to retain and be represented by independent legal
counsel at the expense of the medical staff.
(c) With respect to any dispute arising under this section, the
medical staff and the hospital governing board shall meet and confer
in good faith to resolve the dispute. Whenever any person or entity
has engaged in or is about to engage in any acts or practices that
hinder, restrict, or otherwise obstruct the ability of the medical
staff to exercise its rights, obligations, or responsibilities under
this section, the superior court of any county, on application of the
medical staff, and after determining that reasonable efforts,
including reasonable administrative remedies provided in the medical
staff bylaws, rules, or regulations, have failed to resolve the
dispute, may issue an injunction, writ of mandate, or other
appropriate order. Proceedings under this section shall be governed
by Chapter 3 (commencing with Section 525) of Title 7 of Part 2 of
the Code of Civil Procedure.
SEC. 3. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.