BILL ANALYSIS �
AB 512
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Date of Hearing: April 9, 2013
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Richard S. Gordon, Chair
AB 512 (Rendon) - As Introduced: February 20, 2013
SUBJECT : Healing arts: licensure exemption.
SUMMARY : Extends the sunset date, from 2014 to 2018, of the
California licensure exemption for health care practitioners who
are licensed or certified in other states and who provide health
care services on a voluntary basis to uninsured or underinsured
persons in California, as specified.
EXISTING LAW :
1)Provides that a physician and surgeon or osteopathic physician
and surgeon who practices or attempts to practice medicine in
California without a license or certificate is guilty of a
public offense punishable by a fine not exceeding $10,000, by
imprisonment in the state prison, by imprisonment in a county
jail not exceeding one year, or by both fine and imprisonment.
(Business and Professions Code (BPC) BPC Section 2052)
2)Makes it unlawful for any person to practice as a dentist,
nurse, optometrist, dental hygienist, physician assistant or
vocational nurse without a valid license, certificate or
registration issued by the regulatory boards that regulate
these professionals. (BPC 1626, 2050, et al.)
3)Establishes the Chiropractic Initiative Act of California
(Initiative Act), approved by voters on November 7, 1922 to
regulate the practice of chiropractors. Requires the Board of
Chiropractic Examiners, upon receipt of a specified fee, to
issue a license to any person licensed to practice
chiropractic in another state, provided that the other state
had the same general requirements as California at the time
the license was issued, and that the other state grants
reciprocal registration. (BPC 1000, et seq.)
4)Provides that in a state of emergency, as defined, a health
care practitioner licensed in another state that offers or
provides health care for which he or she is licensed, is
exempt from licensure. (BPC 1627.5, 2395, 3502.5, et al.)
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5)Establishes reciprocity eligibility requirements for certain
health care practitioners who are licensed in other states,
including physicians and surgeons, nurses, and dentists. (BPC
2153.5, 4848, et al.)
6)Exempts from state licensure, until January 1, 2014, health
care practitioners who are licensed or certified in other
states and who provide health care services on a voluntary
basis to uninsured or underinsured persons in California. (BPC
901)
FISCAL EFFECT : Unknown
COMMENTS :
1)Purpose of this bill . This bill extends to 2018 the sunset
date of the California licensure exemption for specified
health care practitioners who are licensed or certified in
other states and who provide health care services on a
voluntary basis to uninsured or underinsured persons in
California. Prior legislation from 2010 authorized health
providers licensed in other states to do volunteer work in
California, but many Department of Consumer Affairs (DCA)
healing arts boards have yet to finalize the regulations
necessary to effectuate that bill. This bill is intended to
extend the opportunity to volunteer for professionals whose
allied California boards have already passed implementing
regulations, while giving those boards that have not yet
passed regulations more time to do so. This bill is sponsored
by the County of Los Angeles.
2)Author's statement . According to the author, "[H]ealing arts
boards were required to promulgate regulations before
out-of-state practitioners were allowed to volunteer and the
boards can also deny permission to the health care provider
from volunteering for failure to comply with California's
stringent practicing requirements. The Medical Board of
California (MBC) promulgated the regulations in August 2012.
The regulations, however, were not done in time to allow
out-of-state practitioners to volunteer at the CareNow Health
Event in Los Angeles last fall. The statute that provided for
these regulations now is set to expire. This program needs
more time to demonstrate its success."
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3)Health fair volunteer exemptions . AB 2699 (Bass), Chapter 270,
Statutes of 2010, created a four-year exemption from
California licensure for health care practitioners who are
licensed or certified in other states and who provide health
care services on a voluntary basis to uninsured or
underinsured persons in California. That bill allowed an
out-of-state healthcare provider to work in California if his
or her license is in good standing and he or she receives
permission from, and registers with, the appropriate DCA
licensing board. The entity sponsoring the free health care
event is required to notify the appropriate DCA license board
and the county health department in writing of the event and
maintain a list of its healthcare volunteers.
a) Health fair providers . Remote Area Medical (RAM)
Volunteer Corps, based in Tennessee, is a non-profit
organization founded in 1985 which has staged hundreds of
medical clinics both in the United States and worldwide.
RAM provided 19,500 California patients with nearly 46,000
vision, dental, and medical services from 2009 to 2011. RAM
is planning another event in California for 2013.
Care Harbor (previously known asCareNow), a nonprofit
supported by the Los Angeles medical, dental and vision
professional community, provided services to more than
7,400 patients from 2011-2012. Approximately 3,100
volunteers provided patients with free dental exams and
cleanings, tooth extractions, vision exams and prescription
glasses, mammograms, Pap smears, podiatry consultations and
more.
These events were staffed by California-licensed healthcare
professionals. Both organizers believe that they could
provide more services if they could attract a greater
number of volunteer healthcare professionals, including
those licensed in other states.
b) DCA healing arts boards . Many healing arts boards have
promulgated regulations to effectuate AB 2699, but not all.
MBC completed its regulations in 2012 and have one
application in process for an out-of-state physician and
surgeon volunteer. The Dental Board of California has six
volunteer dentists approved, and the Board of Optometry and
the Acupuncture Board are working on their own regulations.
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4)Arguments in support . The County of Los Angeles states, "There
are more than two million uninsured persons in Los Angeles
County. Even with the beginning of health care reform
implementation in January 2014, there will still remain a
residually uninsured population who will continue to benefit
from the health sponsored events, such as the Care Harbor
Health Events in Los Angeles. An extension date of AB 2699
will continue to provide access to needed health care and
dental services to uninsured and underinsured persons."
5)Arguments in opposition . The California Nurses Association
states, "The scope of services provided at the free events
targeted by the law is broad, and may include several invasive
procedures. Un- and underinsured patients deserve to have the
protection of state enforcement when undergoing any
procedures. It is simply unfair to burden un- and
underinsured patients with the costs and challenges of suing a
practitioner who lives in another state. These patients
should have the same rights as everyone else to seek help from
the appropriate state regulatory board if they have been
harmed or injured by a healing arts practitioner, or if they
believe that the practitioner has otherwise not practiced in
accordance with our state laws."
6)Previous legislation . AB 2699 (Bass), Chapter 270, Statutes of
2010 created a pilot program to allow exemption from
California licensure, until January 1, 2014, for health care
practitioners who are licensed or certified in other states
and who provide health care services on a voluntary basis to
uninsured or underinsured persons in California.
REGISTERED SUPPORT / OPPOSITION :
Support
Los Angeles County (sponsor)
Association of California Healthcare Districts
Opposition
California Nurses Association
American Nurses Association of California
Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
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