BILL NUMBER: SB 700	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Negrete McLeod

                        FEBRUARY 27, 2009

   An act to amend Sections 805 and 805.1 of the Business and
Professions Code, relating to healing arts.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 700, as introduced, Negrete McLeod. Healing arts: peer review.
    Existing law provides for the professional review of specified
healing arts licentiates through a peer review process. Existing law
defines the term "peer review body" as including a medical or
professional staff of any health care facility or clinic licensed by
the State Department of Public Health.
   This bill would define the term "peer review" and would revise the
definition of the term "peer review body" to include a medical or
professional staff of other specified health care facilities or
clinics.
    Under existing law, specified persons are required to file a
report, designated as an "805 report," with a licensing board if a
peer review body takes one of several specified actions against a
person licensed by that board. Existing law requires the board to
maintain the report for a period of 3 years after receipt.
   This bill would require the board to maintain the report
electronically.
   Existing law authorizes the Medical Board of California, the
Osteopathic Medical Board of California, and the Dental Board of
California to inspect and copy certain documents in the record of any
disciplinary proceeding resulting in action that is required to be
reported in an 805 report.
   This bill would authorize those boards to also inspect any peer
review minutes or reports in those records.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


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

  SECTION 1.  Section 805 of the Business and Professions Code is
amended to read:
   805.  (a) As used in this section, the following terms have the
following definitions: 
   (1) (A) "Peer review" means a process in which a peer review body
reviews the basic qualifications, staff privileges, employment,
medical outcomes, and professional conduct of licentiates to
determine whether the licentiate may practice or continue to practice
in a health care facility, clinic, or other setting providing
medical services and, if so, to determine the parameters of that
practice.  
   (1) 
    (B)  "Peer review body" includes: 
   (A) 
    (i)  A medical or professional staff of any health care
facility or clinic  licensed   specified 
under Division 2 (commencing with Section 1200) of the Health and
Safety Code or of a facility certified to participate in the federal
Medicare Program as an ambulatory surgical center. 
   (B) 
    (ii)  A health care service plan registered under
Chapter 2.2 (commencing with Section 1340) of Division 2 of the
Health and Safety Code or a disability insurer that contracts with
licentiates to provide services at alternative rates of payment
pursuant to Section 10133 of the Insurance Code. 
   (C) 
    (iii)  Any medical, psychological, marriage and family
therapy, social work, dental, or podiatric professional society
having as members at least 25 percent of the eligible licentiates in
the area in which it functions (which must include at least one
county), which is not organized for profit and which has been
determined to be exempt from taxes pursuant to Section 23701 of the
Revenue and Taxation Code. 
   (D) 
    (iv)  A committee organized by any entity consisting of
or employing more than 25 licentiates of the same class that
functions for the purpose of reviewing the quality of professional
care provided by members or employees of that entity.
   (2) "Licentiate" means a physician and surgeon, doctor of
podiatric medicine, clinical psychologist, marriage and family
therapist, clinical social worker, or dentist. "Licentiate" also
includes a person authorized to practice medicine pursuant to Section
2113.
   (3) "Agency" means the relevant state licensing agency having
regulatory jurisdiction over the licentiates listed in paragraph (2).

   (4) "Staff privileges" means any arrangement under which a
licentiate is allowed to practice in or provide care for patients in
a health facility. Those arrangements shall include, but are not
limited to, full staff privileges, active staff privileges, limited
staff privileges, auxiliary staff privileges, provisional staff
privileges, temporary staff privileges, courtesy staff privileges,
locum tenens arrangements, and contractual arrangements to provide
professional services, including, but not limited to, arrangements to
provide outpatient services.
   (5) "Denial or termination of staff privileges, membership, or
employment" includes failure or refusal to renew a contract or to
renew, extend, or reestablish any staff privileges, if the action is
based on medical disciplinary cause or reason.
   (6) "Medical disciplinary cause or reason" means that aspect of a
licentiate's competence or professional conduct that is reasonably
likely to be detrimental to patient safety or to the delivery of
patient care.
   (7) "805 report" means the written report required under
subdivision (b).
   (b) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file an 805 report
with the relevant agency within 15 days after the effective date of
any of the following that occur as a result of an action of a peer
review body:
   (1) A licentiate's application for staff privileges or membership
is denied or rejected for a medical disciplinary cause or reason.
   (2) A licentiate's membership, staff privileges, or employment is
terminated or revoked for a medical disciplinary cause or reason.
   (3) Restrictions are imposed, or voluntarily accepted, on staff
privileges, membership, or employment for a cumulative total of 30
days or more for any 12-month period, for a medical disciplinary
cause or reason.
   (c) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file an 805 report
with the relevant agency within 15 days after any of the following
occur after notice of either an impending investigation or the denial
or rejection of the application for a medical disciplinary cause or
reason:
   (1) Resignation or leave of absence from membership, staff, or
employment.
   (2) The withdrawal or abandonment of a licentiate's application
for staff privileges or membership.
   (3) The request for renewal of those privileges or membership is
withdrawn or abandoned.
   (d) For purposes of filing an 805 report, the signature of at
least one of the individuals indicated in subdivision (b) or (c) on
the completed form shall constitute compliance with the requirement
to file the report.
   (e) An 805 report shall also be filed within 15 days following the
imposition of summary suspension of staff privileges, membership, or
employment, if the summary suspension remains in effect for a period
in excess of 14 days.
   (f) A copy of the 805 report, and a notice advising the licentiate
of his or her right to submit additional statements or other
information pursuant to Section 800, shall be sent by the peer review
body to the licentiate named in the report.
   The information to be reported in an 805 report shall include the
name and license number of the licentiate involved, a description of
the facts and circumstances of the medical disciplinary cause or
reason, and any other relevant information deemed appropriate by the
reporter.
   A supplemental report shall also be made within 30 days following
the date the licentiate is deemed to have satisfied any terms,
conditions, or sanctions imposed as disciplinary action by the
reporting peer review body. In performing its dissemination functions
required by Section 805.5, the agency shall include a copy of a
supplemental report, if any, whenever it furnishes a copy of the
original 805 report.
   If another peer review body is required to file an 805 report, a
health care service plan is not required to file a separate report
with respect to action attributable to the same medical disciplinary
cause or reason. If the Medical Board of California or a licensing
agency of another state revokes or suspends, without a stay, the
license of a physician and surgeon, a peer review body is not
required to file an 805 report when it takes an action as a result of
the revocation or suspension.
   (g) The reporting required by this section shall not act as a
waiver of confidentiality of medical records and committee reports.
The information reported or disclosed shall be kept confidential
except as provided in subdivision (c) of Section 800 and Sections
803.1 and 2027, provided that a copy of the report containing the
information required by this section may be disclosed as required by
Section 805.5 with respect to reports received on or after January 1,
1976.
   (h) The Medical Board of California, the Osteopathic Medical Board
of California, and the Dental Board of California shall disclose
reports as required by Section 805.5.
   (i) An 805 report shall be maintained  electronically  by
an agency for dissemination purposes for a period of three years
after receipt.
   (j) No person shall incur any civil or criminal liability as the
result of making any report required by this section.
   (k) A willful failure to file an 805 report by any person who is
designated or otherwise required by law to file an 805 report is
punishable by a fine not to exceed one hundred thousand dollars
($100,000) per violation. The fine may be imposed in any civil or
administrative action or proceeding brought by or on behalf of any
agency having regulatory jurisdiction over the person regarding whom
the report was or should have been filed. If the person who is
designated or otherwise required to file an 805 report is a licensed
physician and surgeon, the action or proceeding shall be brought by
the Medical Board of California. The fine shall be paid to that
agency but not expended until appropriated by the Legislature. A
violation of this subdivision may constitute unprofessional conduct
by the licentiate. A person who is alleged to have violated this
subdivision may assert any defense available at law. As used in this
subdivision, "willful" means a voluntary and intentional violation of
a known legal duty.
   () Except as otherwise provided in subdivision (k), any failure by
the administrator of any peer review body, the chief executive
officer or administrator of any health care facility, or any person
who is designated or otherwise required by law to file an 805 report,
shall be punishable by a fine that under no circumstances shall
exceed fifty thousand dollars ($50,000) per violation. The fine may
be imposed in any civil or administrative action or proceeding
brought by or on behalf of any agency having regulatory jurisdiction
over the person regarding whom the report was or should have been
filed. If the person who is designated or otherwise required to file
an 805 report is a licensed physician and surgeon, the action or
proceeding shall be brought by the Medical Board of California. The
fine shall be paid to that agency but not expended until appropriated
by the Legislature. The amount of the fine imposed, not exceeding
fifty thousand dollars ($50,000) per violation, shall be proportional
to the severity of the failure to report and shall differ based upon
written findings, including whether the failure to file caused harm
to a patient or created a risk to patient safety; whether the
administrator of any peer review body, the chief executive officer or
administrator of any health care facility, or any person who is
designated or otherwise required by law to file an 805 report
exercised due diligence despite the failure to file or whether they
knew or should have known that an 805 report would not be filed; and
whether there has been a prior failure to file an 805 report. The
amount of the fine imposed may also differ based on whether a health
care facility is a small or rural hospital as defined in Section
124840 of the Health and Safety Code.
   (m) A health care service plan registered under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that negotiates and enters into a
contract with licentiates to provide services at alternative rates of
payment pursuant to Section 10133 of the Insurance Code, when
determining participation with the plan or insurer, shall evaluate,
on a case-by-case basis, licentiates who are the subject of an 805
report, and not automatically exclude or deselect these licentiates.
  SEC. 2.  Section 805.1 of the Business and Professions Code is
amended to read:
   805.1.  (a) The Medical Board of California, the Osteopathic
Medical Board of California, and the Dental Board of California shall
be entitled to inspect and copy the following documents in the
record of any disciplinary proceeding resulting in action that is
required to be reported pursuant to Section 805:
   (1) Any statement of charges.
   (2) Any document, medical chart, or exhibits in evidence.
   (3) Any opinion, findings, or conclusions. 
   (4) Any peer review minutes or reports. 
   (b) The information so disclosed shall be kept confidential and
not subject to discovery, in accordance with Section 800, except that
it may be reviewed, as provided in subdivision (c) of Section 800,
and may be disclosed in any subsequent disciplinary hearing conducted
pursuant to the Administrative Procedure Act (Chapter 5 (commencing
with Section 11500) of Part 1 of Division 3 of Title 2 of the
Government Code).