BILL ANALYSIS AB 2699 Page 1 Date of Hearing: April 20, 2010 ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER PROTECTION Mary Hayashi, Chair AB 2699 (Bass) - As Amended: April 14, 2010 SUBJECT : Healing arts: licensure exemption. SUMMARY : Creates a state license exemption for out-of state licensed health care practitioners (HCPs) who provide free services on a short term, voluntary basis. Specifically, this bill : 1)Permits a local governmental entity to allow the provision of health care services within its jurisdiction in accordance with this bill. 2)Exempts licensed HCPs in good standing in another state, district, or territory of the United States from California HCP licensing laws if both of the following requirements are met: a) Prior to providing health care services, he or she submits to the designated local agency (DLA) a valid copy of his or her state professional license or certificate and a photographic identification issued by the same state. A sponsoring entity may submit copies of those documents to the DLA on behalf of a HCP; and, b) The care is provided under all of the following circumstances: i) On a short-term voluntarily basis, not to exceed a 90-day period; ii) In association with a sponsoring entity that complies with the following: (1) Registers with the applicable DLA by completing a registration form that includes the following elements: (a) The name of the sponsoring entity; AB 2699 Page 2 (b) The name of the principal individual or individuals who are the officers or organizational officials responsible for the operation of the sponsoring entity; (c) The address of the sponsoring entity's principal office and responsible individuals, as specified; (d) The telephone number for the sponsoring entity's principal office and each principal individual, as specified; and, (e) Any additional information required by the DLA. (2) Obtains authorization from the DLA to provide health care services. iii) Without charge to the recipient or to a third party on behalf of the recipient. 3)Requires the sponsoring entity to notify the DLA in writing of any change to the information required, as specified, within 30 days. 4)Requires the sponsoring entity, within 15 days of providing health care services, to file a report with the DLA. This report shall contain the date, place, type, and general description of the care provided, along with a listing of the HCPs who participated in providing that care. 5)Requires the sponsoring entity to maintain a list of HCPs associated with the provision of health care services according to this bill. The sponsoring entity shall maintain a copy of each HCP's current license or certificate and shall require each HCP to attest in writing that his or her license or certificate is not suspended or revoked pursuant to disciplinary proceedings in any jurisdiction. The sponsoring entity shall maintain these records for a period of at least 5 years following the provision of health care services under this section and shall, upon request, furnish those records to the DLA. 6)Permits the DLA to revoke the registration of a sponsoring AB 2699 Page 3 entity that fails to comply with the specified requirements. 7)Prohibits a contract of professional liability insurance issued, amended, or renewed on or after January 1, 2011, from excluding coverage of a HCP or a sponsoring entity that provides, or arranges for the provision of, health care under this bill, provided that the practitioner or entity complies with the requirements. 8)Requires the DLA to verify the status of licensure or certification of each HCP and notify the sponsoring entity if the licensure or certification cannot be verified. 9)Defines the following terms: a) "DLA" means an office, department, agency, or other local government entity designated to act on behalf of a local government entity in accordance with this section; b) "HCP" means any person who engages in acts the subject to licensure or regulation, as specified; c) "Local government entity" means a city, county, or city and county having a public health officer; and, d) "Sponsoring entity" may include, but is not limited to, a nonprofit organization or a community-based organization. 10)Declares legislative intent. EXISTING LAW : 1)Provides for the licensure and regulation of various healing arts practitioners by boards within the Department of Consumer Affairs (DCA). 2)Provides a California license exemption for a HCP licensed in another state who offers or provides health care for which he or she is licensed during a state of emergency, as defined, and upon request of the Director of the Emergency Medical Services Authority (EMSA), as specified. FISCAL EFFECT : Unknown COMMENTS : AB 2699 Page 4 Purpose of this bill . According to the author's office, "Thousands of low-income children, families, and individuals in California are uninsured or underinsured and do not receive basic health, vision, and dental care and screenings. Lack of basic services and preventive care may lead to more serious and costly health, dental, and vision problems. In August 2009, the Remote Area Medical (RAM) Volunteer Corps conducted an eight-day health event in Los Angeles County. Volunteer medical, dental and other health care practitioners provided $2.9 million in free services to over 14,000 individuals during the event. While the event was extremely successful, RAM experienced a shortage of volunteer medical, dental, and vision providers because of restrictions in state laws which prohibit volunteer out-of-state licensed medical personnel from providing short-term services. As a result, thousands of residents needing services were turned away." Background . Under this proposal, a local government is permitted to allow a non-profit agency or other community entity to provide free healthcare services using out-of-state medical personnel. Sponsoring entities using out-of-state licensed medical personnel would be required to submit a list of health care providers along with a copy of their current license or certificate. Each health care provider would be required to attest in writing that his or her license or certificate is valid and has not been suspended or revoked pursuant to disciplinary proceedings in any jurisdiction. The county or municipality electing would be required to designate an entity to verify that licenses of the volunteers are current and valid prior to providing the services. DCA's mission is to to serve the interests of California consumers by ensuring a standard of professionalism in key industries and promoting informed consumer practices. This bill, while laudable, would bypass some of DCA's healthcare protections by allowing individuals licensed in other states to provide services to Californians. California currently permits HCPs unlicensed in the state to practice, but only in declared states of emergency, when the local HCPs are overwhelmed, and at the request of the Director of the EMSA. California has unique laws and regulations for health care providers, including professional conduct rules and scopes of practice that differ from other states. Some states license AB 2699 Page 5 different healthcare providers than California. The bill's stated intent is to provide health care services to the uninsured and underinsured, but these individuals do not deserve lesser quality healthcare because of their financial status. The author may wish to consider requiring imported HCPs to abide by California's professional conduct and scope of practice laws, and provide for a complaint process. REGISTERED SUPPORT / OPPOSITION : Support County of Los Angeles Opposition California Dental Association Analysis Prepared by : Sarah Weaver / B.,P. & C.P. / (916) 319-3301