BILL ANALYSIS Ó
SB 100
Page 1
Date of Hearing: August 17, 2011
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Felipe Fuentes, Chair
SB 100 (Price) - As Amended: July 12, 2011
Policy Committee: Business and
Professions Vote: 9-0
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill increases oversight of outpatient settings by the
Medical Board of California (Board), the Department of Public
Health, and the bodies that accredit outpatient settings.
Specifically, this bill:
1)Requires the Board to adopt regulations governing physician
availability in settings using laser or intense pulse light
devices (so-called "medical spa" treatments), adopt standards
governing in vitro fertilization in outpatient settings, and
make publicly available specified information regarding
accreditation of outpatient settings on its web site.
2)Authorizes the Board to specify procedures that should be
provided in accredited facilities.
3)Defines additional standards for outpatient settings,
including adoption of protocols for urgent care situations and
reporting of adverse events to the Department of Public
Health.
4)Requires accrediting agencies to perform a variety of
activities that increase oversight of outpatient settings,
including complaint investigation, investigation of the prior
history of the setting and its licensees, communication to the
Board about accreditation status and the results of
inspections.
5)Defines processes and protocols that accrediting agencies and
outpatient settings must use when outpatient settings do not
comply with accreditation standards, including corrective
SB 100
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action plans, reprimands, and public posting of information.
6)Includes clinics that provide in vitro fertilization in the
definition of "outpatient setting."
FISCAL EFFECT
1)The requirement to provide data via a publicly accessible
website will result in one-time workload cost pressure in the
range of $50,000. The actual cost pressure may be more or
less depending on the complexity of the website development
and initial data entry needs.
2)The bill's other requirements, as well as ongoing maintenance
of the website, will result in minor and absorbable costs.
COMMENTS
1)Rationale . According to the author, this bill provides for
greater oversight and regulation of outpatient settings,
including "medical spa" facilities and in vitro fertilization
clinics, and ensures that quality of care standards are in
place at these clinics and checked by the appropriate
accrediting agency. The author indicates that this bill
increases consumer protections and increases consumer
awareness to protect individuals from unscrupulous providers.
2)Background . Outpatient medical care is generally performed in
either clinics licensed by DPH, or in outpatient settings that
are not licensed by the state but operate under an individual
licensed by the Medical Board of California (Board). In
addition to operating under a Board licensee, outpatient
settings that perform procedures using a specified level of
anesthesia must be accredited by one of four private
accrediting agencies approved by the Board.
In recent years, there has been a significant increase in the
volume of elective cosmetic surgeries performed in these
outpatient settings, and there is evidence of consumer harm
associated with this increase. The well-publicized death of
musician Kanye West's mother Donda West in 2007 following a
cosmetic procedure in an outpatient setting raised the public
profile of these procedures and their safety risks.
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Additionally, new technology used in cosmetic procedures is
rapidly being introduced, causing concern that there is little
oversight over these newer procedures that could pose safety
risks to the public. Many of these new technologies do not
require the level of anesthesia that would trigger an
accreditation requirement. Finally, there is concern that
even accredited facilities do not have adequate patient
protections in place. By requiring certain patient safety
protocols, increased oversight by accrediting agencies, and
increased communication between these agencies and the Board,
this bill seeks to increase consumer protection for procedures
performed in an outpatient setting without requiring more
stringent facility licensure.
3)Prior Legislation .
a) SB 1150 (Negrete McLeod) in 2010 contained a number
similar provisions to this bill as well as some provisions
not in this bill, including a provision regarding
professional designation health care practitioner
advertising. SB 1150 was held on the suspense file of this
committee.
b) SB 674 (Negrete McLeod) in 2009 was similar to SB 1150.
SB 674 was vetoed due to concerns about reliance on
external accreditation agencies. Neither SB 1150 nor SB
100 modifies the role of accreditation agencies.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081