BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2699
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          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;









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                    (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  








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            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  :   








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           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  








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          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