BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           501 (Emmerson)
          
          Hearing Date:  7/6/2009         Amended: 5/26/2009
          Consultant:  Bob Franzoia       Policy Vote: B,P&ED 10-0
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          ____
          BILL SUMMARY: AB 501 would authorize an applicant for a license  
          unable to practice some aspects of medicine safely due to a  
          disability to receive a limited license if the applicant pays a  
          license fee and signs an agreement, under penalty of perjury,  
          agreeing to limit his or her practice in the manner prescribed  
          by the reviewing physician and agreed to by the Medical Board of  
          California (MBC).  This bill would authorize the MBC to require  
          the applicant to obtain an independent clinical evaluation of  
          his or her ability to practice medicine safely as a condition of  
          receiving the limited license.  This bill would require  
          specified fees to be fixed by the MBC at a maximum of $790,  
          while retaining the MBC's authority to raise those fees in  
          certain circumstances and state the intent of the Legislature  
          that, in setting those fees, the MBC shall seek to maintain a  
          reserve in the Contingent Fund of the Medical Board of  
          California (CFMBC) in an amount not less than two nor more than  
          four months' operating expenditures.  This bill would require  
          the Bureau of State Audits (BSA) to commence a review of the  
          MBC's financial status by January 1, 2012, and to report its  
          findings and recommendations to the Joint Legislative Audit  
          Committee by June 1, 2012.
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          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund
           Felony (penalty of perjury)        Unknown, up to $23-$36* per  
          year per         General
                                            conviction

          Audit                                             Up to $100 in  
          2011-12                Special**  

          * $23 is the Legislative Analyst Office estimate of the cost to  
          house an inmate for one year, $36 is the California Department  
          of Corrections and Rehabilitation estimate.
          ** Contingent Fund of the Medical Board of California










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          STAFF COMMENTS: This bill may meet the criteria for referral to  
          the Suspense File.

          This bill would authorize certain persons who are not licensed  
          as physicians and surgeons under the Medical Practice Act to use  
          the words "doctor" or "physician" the letters or prefix "Dr.,"  
          or the initials "M.D.," as specified.  

          Under current law, any licensee who demonstrates to the  
          satisfaction of the MBC that he or she is unable to practice  
          medicine due to a disability may request a waiver of the license  
          renewal fee.  The licensee signs an agreement under penalty of  
          perjury to limit his or her practice in a manner prescribed.   
          This bill would allow a physician unable to practice some  
          aspects of medicine safely due to a disability to receive a  
          limited license if the licensee signs a similar agreement.
          Page 2
          AB 501 (Emmerson)

          The penalty of perjury is a felony and carries a prison term of  
          two, three or four years.  Though the number of physicians  
          applying for a limited license and the potential for perjury is  
          likely to be small, limiting increases in the state's inmate  
          population is possible by using civil penalties as a deterrent.   
          Staff recommends that Section 2088 of the Business and  
          Professions Code, as added by this bill, be amended as follows:

              2088. (a) An applicant for a physician's and surgeon's  
          license who is otherwise eligible for that license but is unable  
          to practice some aspects of medicine safely due to a disability  
          may receive a limited license if he or she does both of the  
          following:
              (1) Pays the initial license fee.
              (2) Signs an agreement on a form prescribed by the board,  
           signed under penalty of perjury  , in which the applicant agrees  
          to limit his or her practice in the manner prescribed by the  
          reviewing physician and agreed to by the board.
              (b) The board may require the applicant described in  
          subdivision (a) to obtain an independent clinical evaluation of  
          his or her ability to practice medicine safely as a condition of  
          receiving a limited license under this section.
              (c) Any person who knowingly provides false information in  
          the agreement submitted pursuant to subdivision (a) shall be  










          subject to a civil penalty in the minimum amount of $1,000  
          dollars and the maximum amount of $25,000 dollars, in addition  
          to any other remedies available to the board.  An action for a  
          civil penalty under this provision may be brought by any public  
          prosecutor in the name of the people of the State of California.  
             

          This bill would state the intent of the Legislature that, in  
          setting fees, the MBC seek to maintain a reserve in the CFMBC in  
          an amount not less than two nor more than four months' operating  
          expenditures.

          Staff is unaware of any claims of improper activities relating  
          to the CFMBC and a BSA review may not be the best use of the  
          BSA's expertise and independence.  Additionally, Joint Rule 37.4  
          (b) requires that any bill requiring action by the BSA shall  
          contain an appropriation for the cost of any study or audit.   
          This bill does not contain an appropriation.  If the committee  
          thinks a review is warranted but would like to achieve that in a  
          more cost effective manner, staff recommends the bill be amended  
          to strike out the requirement that the BSA commence a review of  
          the MBC's financial status and instead require the Office of  
          State Audits and Evaluations within the Department of Finance,  
          which conducts audits and evaluations, to conduct a preliminary  
          review and make the results of that review available upon  
          request.