BILL NUMBER: SB 1851	CHAPTERED  09/26/06

	CHAPTER  485
	FILED WITH SECRETARY OF STATE  SEPTEMBER 26, 2006
	APPROVED BY GOVERNOR  SEPTEMBER 26, 2006
	PASSED THE ASSEMBLY  AUGUST 17, 2006
	PASSED THE SENATE  MAY 25, 2006
	AMENDED IN SENATE  MAY 1, 2006

INTRODUCED BY   Committee on Health (Senators Ortiz (Chair),
Aanestad, Alquist, Chesbro, Cox, Figueroa, Kuehl, Maldonado, and
Runner)

                        MARCH 27, 2006

   An act to amend Sections 109275, 109277, and 109280 of the Health
and Safety Code, relating to public health.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1851, Committee on Health  Cancer: informed consent.
   Existing law requires physicians and surgeons to inform patients
being treated for breast cancer about alternative efficacious
treatments. Violation of these requirements constitutes
unprofessional conduct and is a crime. Existing law requires the
State Department of Health Services to develop a summary of
alternative efficacious methods of treatment for breast cancer and
requires the Medical Board of California to provide the summary to
physicians and surgeons.
   Existing law requires every health facility, clinic, and physician
and surgeon's office to post a prescribed notice where outpatient
breast cancer screening or biopsy is performed, informing patients
that the physician and surgeon has a duty to provide a copy of the
department's summary to the patient prior to performance of a biopsy.
Existing law further requires the physician and surgeon to note on
the patient's written record that the summary was so provided.
   This bill would, instead, require the physician and surgeon, upon
a diagnosis of breast cancer, to provide the summary. It would permit
the physician to choose to provide the summary prior to performance
of a screening or biopsy and would require conforming changes to the
notice. The bill would require the department and the Medical Board
of California to each post the summary on its Internet Web site.
   Existing law requires the department to approve a standardized
written summary containing specified information about prostate
cancer treatment options, and requires the Medical Board of
California to provide the summary to physicians and surgeons.
   This bill would require the department and the Medical Board of
California to each post the summary on its Internet Web site for
public use.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Section 109275 of the Health and Safety Code is amended
to read:
   109275.  (a) Upon a diagnosis of breast cancer, the physician and
surgeon, meaning the primary provider who initially referred the
patient for the screening or biopsy or, if different, the provider
who has made the diagnosis of breast cancer and initially consulted
with the patient about treatment, shall give the patient the written
summary described in subdivision (c) and required by this section and
shall note on the patient's chart that he or she has given the
patient the written summary. The physician and surgeon may choose to
provide the summary prior to the performance of a screening or biopsy
for breast cancer upon a patient's request or at the discretion of
the physician and surgeon in appropriate cases, including, but not
limited to, instances when a patient has demonstrated risk factors,
has a family history of breast cancer, or is otherwise susceptible.
   (b) The failure of a physician and surgeon to inform a patient, by
means of a standardized written summary developed by the department
on the recommendation of the Cancer Advisory Council in accordance
with subdivision (c), in layperson's language and in a language
understood by the patient, of alternative efficacious methods of
treatment that may be medically viable, including surgical,
radiological, or chemotherapeutic treatments or combinations thereof,
when the patient is being treated for any form of breast cancer,
constitutes unprofessional conduct within the meaning of Chapter 5
(commencing with Section 2000) of Division 2 of the Business and
Professions Code.
   (c) (1) A standardized written summary in layperson's language and
in a language understood by the patient shall be developed by the
department with the recommendations of the Cancer Advisory Council,
and shall be printed and made available by the Medical Board of
California to physicians and surgeons, for the purposes of informing
the patient of the advantages, disadvantages, risks, and descriptions
of the procedures with regard to medically viable and efficacious
alternative methods of treatment for breast cancer as required by
subdivision (a).
   (2) Commencing no later than January 1, 1995, and every three
years thereafter, the department shall review the written summary and
shall revise the written summary if the department determines that
new or revised information should be included in the written summary,
and shall provide a copy of the revised summary to the Medical Board
of California.
   (3) At the next revision of the standardized written summary
required by this section, the department shall incorporate all of the
following additional information:
   (A) Information regarding methods of treatment for breast cancer
that are in the investigational or clinical trial stage and are
recognized for treatment by the Physician's Data Query of the
National Cancer Institute.
   (B) Available reference numbers, including, but not limited to,
the "800" telephone numbers for the National Cancer Institute and the
American Cancer Society, in order for breast cancer patients to
obtain the most recent information.
   (C) A discussion of breast reconstruction surgery, including, but
not limited to, problems, benefits, and alternatives.
   (D) Statistics on the incidence of breast cancer.
   (d) The Medical Board of California shall establish a distribution
system for the breast cancer treatment alternatives written summary,
and shall provide a link to its Internet Web site that may be
accessed by consumers interested in viewing and obtaining a copy of
the summary.
   (e) The department and the Medical Board of California shall each
post the summary on its Internet Web site.
  SEC. 2.  Section 109277 of the Health and Safety Code is amended to
read:
   109277.  (a) Every person or entity who owns or operates a health
facility or a clinic, or who is licensed as a physician and surgeon
and rents or owns the premises where his or her practice is located,
shall cause a sign or notice to be posted where a physician and
surgeon performs breast cancer screening or biopsy as an outpatient
service, or in a reasonably proximate area to where breast cancer
screening or biopsy is performed. A sign or notice posted at the
patient registration area of the health facility, clinic, or
physician and surgeon's office shall constitute compliance with this
section.
   (b) The sign or notice shall read as follows:
      "BE INFORMED"

"Upon a diagnosis of breast cancer, your physician and surgeon is
required to provide you a written summary of alternative efficacious
methods of treatment, pursuant to Section 109275 of the California
Health and Safety Code.  Your physician and surgeon may choose to
provide the summary prior to the performance of a screening or biopsy
for breast cancer at your request or at the physician and surgeon's
discretion, when appropriate."   "The information about methods of
treatment was developed by the State Department of Health Services to
inform patients of the advantages, disadvantages, risks, and
descriptions of procedures."

   (c) The sign shall be not less than eight and one-half inches by
11 inches and shall be conspicuously displayed so as to be readable.
The words "BE INFORMED" shall not be less than one-half inch in
height and shall be centered on a single line with no other text. The
message on the sign shall appear in English, Spanish, and Chinese.

  SEC. 3.  Section 109280 of the Health and Safety Code is amended to
read:
   109280.  (a) A standardized written summary in layperson's
language and in a language understood by patients shall be approved
by the department. The department may approve the use of an existing
publication from a recognized cancer authority as the written
summary. Commencing on January 1, 2003, and every three years
thereafter, the department shall review its approval of the use of an
existing publication from a recognized cancer authority as the
written summary to ensure that the approved written summary comprises
timely, new, and revised information regarding prostate cancer
treatment options as the department determines is necessary. The
written summary shall be printed or made available by the Medical
Board of California to physicians and surgeons, concerning the
advantages, disadvantages, risks, and descriptions, of procedures
with regard to medically viable and efficacious alternative methods
of treatment of prostate cancer. Physicians and surgeons are urged to
make the summary available to patients when appropriate.
   (b) The department and the Medical Board of California shall each
post this summary on its Internet Web site for public use.
   (c) If the department updates this summary, it shall send the
updated summary to the Medical Board of California and both the
department and the Medical Board of California shall each post this
updated summary on its Internet Web site.