BILL ANALYSIS ----------------------------------------------------------------------- |Hearing Date:March 22, 2010 |Bill No:SB | | |953 | ----------------------------------------------------------------------- SENATE COMMITTEE ON BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT Senator Gloria Negrete McLeod, Chair Bill No: SB 953Author:Walters As Amended:March 16, 2010 Fiscal: No SUBJECT: Podiatrists: liability for emergency services. SUMMARY: Removes reference to a deleted provision which would limit the care provided by a podiatrist in an emergency situation. States legislative intent that nothing in this bill is intended, nor shall it be interpreted to enlarge, reduce, or otherwise modify the scope of practice of doctors of podiatric medicine, as specified, and is intended to delete a reference to an obsolete provision of law. Existing law: 1) Establishes the Medical Practice Act to govern the licensure and regulation of physicians and surgeons by the Medical Board of California, and for the licensure and regulation of podiatrists by the California Board of Podiatric Medicine (Board). 2) Exempts the following medical emergency care from liability: a) A physician and surgeon, who in good faith renders emergency care at the scene of an emergency, shall not be liable for any civil damages as a result of any acts or omissions by such person in rendering the emergency care. Defines the scene of an emergency to include, but not be limited to, the emergency room of hospitals in the event of a medical disaster. b) A physician and surgeon who serves on an on-call basis to a hospital emergency room, who in good faith renders emergency obstetrical services to a person while serving on call shall not be liable for civil damages for any negligent act or omission in rendering the emergency obstetrical services. c) A physician and surgeon, who in good faith upon request of SB 953 Page 2 another person so licensed, renders emergency medical care to a person for medical complication arising from prior care by another person so licensed, shall not be liable for any civil damages as a result of any acts or omissions by such licensed person in rendering such emergency medical care. d) A physician and surgeon shall not be liable for civil damages for injury or death caused in an emergency situation occurring in the licensee's office or in a hospital on account of a failure to inform a patient of the possible consequences of a medical procedure where the failure to inform is caused by any of the following: 1) the patient was unconscious; 2) the medical procedure was undertaken without the patient's consent because the licensee reasonably believes that a medical procedure should be undertaken immediately, as specified; 3) a medical procedure was performed on a person legally incapable of giving consent, and the licensee reasonably believed that a medical procedure should be undertaken immediately. Specifies that these provisions apply only to actions for damages for injuries or death arising because of a licensee's failure to inform, and not to actions for damages arising because of a licensee's negligence in rendering or failing to render treatment. 3) States that nothing in the article containing the provisions specified in item # 2) above, shall be construed to authorize practice by a podiatrist beyond that set forth in the provisions detailing its scope of practice. 4) Defines podiatric medicine as the diagnosis, medical, surgical, mechanical, manipulative, and electrical treatment of the human foot, including the ankle and tendons that insert into the foot and the nonsurgical treatment of the muscles and tendons of the leg governing the functions of the foot. Specifies the type of services that a doctor of podiatric medicine who is ankle certified by the Board on and after January 1, 1984, may perform. 5) Provides that nurses, licensed vocational nurses, and physician assistants who in good faith render emergency care at the scene of an emergency which occurs outside the place and course of their employment are not liable for civil damages as the result of the acts or omissions in rendering that care. Provides that no immunity exists for acts that constitute gross negligence. 6) Provides that a veterinarian who on his or her own initiative, at the request of an owner, or at the request of someone other than the owner, renders emergency treatment to a sick or injured animal SB 953 Page 3 at the scene of an accident shall not be liable in damages to the owner of that animal in the absence of gross negligence. 7) Provides that no disaster service worker who is performing disaster services ordered by lawful authority during a state of war emergency, a state of emergency, or a local emergency, as defined, shall be liable for civil damage on account of personal injury to or death of any person or damage to property resulting from any act or omission while performing disaster services, unless the act or omission is willful. 8) States that no person who in good faith, and not for compensation, renders emergency medical or nonmedical care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission. States that the scene of emergency does not include emergency department and other places where medical care is usually offered, and that this provision applies only to medical, law enforcement, and emergency personnel, as specified. 9) Provides that any person, other than medical, law enforcement, and emergency personnel, who in good faith and not for compensation renders emergency medical or nonmedical care or assistance at the scene of an emergency shall not be liable for civil damages resulting from any act or omission other than an act or omission constituting gross negligence or willful or wanton misconduct. 10)Specifies the intent of the Legislature to encourage other individuals to volunteer, without compensation, to assist others in need during an emergency, while ensuring that those volunteers who provide care or assistance act responsibly. This bill, removes reference to a deleted provision which would limit the care provided by a podiatrist in an emergency situation. States legislative intent that nothing in this bill is intended, nor shall it be interpreted to enlarge, reduce, or otherwise modify the scope of practice of doctors of podiatric medicine, as specified, and is intended to delete a reference to an obsolete provision of law. FISCAL EFFECT: None. This bill has been keyed non-fiscal by Legislative Counsel. COMMENTS: 1. Purpose. According to the Sponsor of this measure, the California Board of Podiatric Medicine (Board), this measure is necessary to delete limitations on the ability of podiatrists to provide care in SB 953 Page 4 an emergency situation. The Board points out that doctors of podiatric medicine (DPMs) are the only licensed health professionals prohibited from assisting beyond their normal scope of practice during a medical emergency. The Board states that there is no basis for excluding one of the more highly trained provider groups and this could cost the lives of Californians, unnecessarily, in the event of a disaster. The Board further indicates that no other state is known to restrict DPMs in the event of medical disasters. The Board points out that the Governor's Office initiated a healthcare surge project coordinated by the Department of Public Health. Health licensing boards were encouraged to identify and correct barriers to the provision of assistance during an emergency and to prepare their licensees to be ready. A medical disaster might significantly impact the number of available providers just when caseloads could skyrocket. Good Samaritan statutes are intended to allow health professionals to assist beyond their normal scope of practice during an emergency. Currently, there are over 2,000 highly-trained DPMs who could provide necessary care in an emergency. 2. Background. Good Samaritan statutes are laws which protect from liability those individuals who choose to aid others who are injured or ill. The Business and Professions Code contains several provisions limiting the civil liability, except in cases of gross negligence, of certain health care practitioners including nurses, licensed vocational nurses, and physician assistants who in good faith render emergency care at the scene of an emergency which occurs outside the place and course of their employment. Similarly, the Medical Practice Act contains exemptions from liability for physicians and surgeons under certain circumstances, as described above in item #2) of existing law. These provisions were adopted to encourage these professionals to render care during an emergency. Similarly, Health and Safety Code Section 1799.102, amended by AB 83 (Feuer, Chapter 77, Statutes of 2009) provides that no person who in good faith, and not for compensation, renders emergency medical or nonmedical care at the scene of an emergency shall be liable for any civil damages resulting from any act or omission. AB 83 amended Health and Safety Code Section 1799.102 in response to a California Supreme Court decision in Van Horn v. Watson (2008) 45 Ca.4th 322, which limited the application of the immunity from civil liability only for those individuals who render emergency medical care. SB 953 Page 5 According to the Board, current limitations on DPMs to provide care during an emergency were enacted in 1980, when DPMs were viewed to be less trained and less competent that medical doctors, and were added without question or debate. The Board points out that these limitations are now without merit and with the current emphasis on emergency preparedness, it is necessary to remove barriers for one of the more highly-trained medical professionals in the state. 3. Related Legislation this Session. SB 1489 (Committee on Business, Professions & Economic Development), an omnibus bill, mirrors the provisions of this bill. However, SB 1489 will be amended to remove the duplicate provision. SB 1489 is currently awaiting hearing in this Committee. NOTE : Double-referral to Judiciary Committee (second.) SUPPORT AND OPPOSITION: Support: California Board of Podiatric Medicine (Sponsor) Opposition: None on file as of March 31, 2010 Consultant:Rosielyn Pulmano