Amended in Senate June 25, 2013

Amended in Assembly April 29, 2013

Amended in Assembly April 3, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 809

Introduced by Assembly Member Logue

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(Coauthor: Senator Galgiani)

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February 21, 2013

An act to amend Section 2290.5 of the Business and Professions Code, relating to telehealth, and declaring the urgency thereof, to take effect immediately.

LEGISLATIVE COUNSEL’S DIGEST

AB 809, as amended, Logue. Healing arts: telehealth.

Existing law requires a health care provider, as defined, prior to the delivery of health care services via telehealth, as defined, to verbally inform the patient that telehealth may be used and obtain verbal consent from the patient for this use. Existing law also provides that failure to comply with this requirement constitutes unprofessional conduct.

This bill would begin delete allow the verbal consent for the use of telehealth to apply in the present instance and for any subsequent use of telehealth. end delete begin insert require the health care provider initiating the use of telehealth at the originating site to obtain verbal or written consent from the patient for the use of telehealth, as specified. The bill would require that health care provider to document the consent in the patient’s medical record and to transmit that documentation with the initiation of any telehealth to any distant-site health care provider from whom telehealth is requested or obtained. The bill would require a distant- end insert begin insert site health care provider to either obtain confirmation of the patient’s consent from the originating site provider or separately obtain and document consent from the patient about the use of telehealth, as specified. end insert

This bill would declare that it is to take effect immediately as an urgency statute.

Vote: ²⁄₃. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

Section 2290.5 of the Business and Professions
Code is amended to read:

2290.5.  

(a) For purposes of this division, the following
definitions shall apply:

(1) “Asynchronous store and forward” means the transmission
of a patient’s medical information from an originating site to the
health care provider at a distant site without the presence of the
patient.

(2) “Distant site” means a site where a health care provider who
provides health care services is located while providing these
services via a telecommunications system.

(3) “Health care provider” means a person who is licensed under
this division.

(4) “Originating site” means a site where a patient is located at
the time health care services are provided via a telecommunications
system or where the asynchronous store and forward service
originates.

(5) “Synchronous interaction” means a real-time interaction
between a patient and a health care provider located at a distant
site.

(6) “Telehealth” means the mode of delivering health care
services and public health via information and communication
technologies to facilitate the diagnosis, consultation, treatment,
education, care management, and self-management of a patient’s
health care while the patient is at the originating site and the health
care provider is at a distant site. Telehealth facilitates patient
self-management and caregiver support for patients and includes
synchronous interactions and asynchronous store and forward
transfers.

(b) Prior to the delivery of health care via telehealth, the health
care provider initiating the use of telehealth at the originating site
shall begin delete verbally end delete inform the patient about the use of telehealth and
begin delete request the patient’s end delete begin insert obtain end insert verbal begin insert or written end insert consent begin delete , which may
apply in the present instance and for any subsequent use of
telehealth. end delete begin insert from the patient for the use of telehealth as an
acceptable mode of delivering health care services and public
health during a specified course of health care and treatment. end insert The
begin delete verbal end delete consent shall be documented in the patient’s medical begin delete record. end delete
begin insert record, and the documentation shall be transmitted with the
initiation of any telehealth for that specified course of health care
and treatment to any distant-site health care provider from whom
telehealth is requested or obtained. A distant-site health care
provider shall either obtain confirmation of the patient’s consent
from the originating site provider or separately obtain and
document consent from the patient about the use of telehealth as
an acceptable mode of delivering health care services and public
health during a specified course of health care and treatment. end insert

(c) Nothing in this section shall preclude a patient from receiving
in-person health care delivery services during a begin insert specified end insert course
of begin insert health care and end insert treatment after agreeing to receive services via
telehealth.

(d) The failure of a health care provider to comply with this
section shall constitute unprofessional conduct. Section 2314 shall
not apply to this section.

(e) This section shall not be construed to alter the scope of
practice of any health care provider or authorize the delivery of
health care services in a setting, or in a manner, not otherwise
authorized by law.

(f) All laws regarding the confidentiality of health care
information and a patient’s rights to his or her medical information
shall apply to telehealth interactions.

(g) This section shall not apply to a patient under the jurisdiction
of the Department of Corrections and Rehabilitation or any other
correctional facility.

(h) (1) Notwithstanding any other provision of law and for
purposes of this section, the governing body of the hospital whose
patients are receiving the telehealth services may grant privileges
to, and verify and approve credentials for, providers of telehealth
services based on its medical staff recommendations that rely on
information provided by the distant-site hospital or telehealth
entity, as described in Sections 482.12, 482.22, and 485.616 of
Title 42 of the Code of Federal Regulations.

(2) By enacting this subdivision, it is the intent of the Legislature
to authorize a hospital to grant privileges to, and verify and approve
credentials for, providers of telehealth services as described in
paragraph (1).

(3) For the purposes of this subdivision, “telehealth” shall
include “telemedicine” as the term is referenced in Sections 482.12,
482.22, and 485.616 of Title 42 of the Code of Federal Regulations.

SEC. 2.  

This act is an urgency statute necessary for the
immediate preservation of the public peace, health, or safety within
the meaning of Article IV of the Constitution and shall go into
immediate effect. The facts constituting the necessity are:

In order to protect the health and safety of the public due to a
lack of access to health care providers in rural and urban medically
underserved areas of California, the increasing strain on existing
providers expected to occur with the implementation of the federal
Patient Protection and Affordable Care Act, and the assistance that
further implementation of telehealth can provide to help relieve
these burdens, it is necessary for this act to take effect immediately.