BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 809
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 809 (Logue)
          As Amended April 29, 2013
          2/3 vote. Urgency 

           HEALTH              15-0        BUSINESS & PROFESSIONS      12-0
           
           ----------------------------------------------------------------- 
          |Ayes:|Pan, Logue, Ammiano,      |Ayes:|Gordon, Jones, Bocanegra, |
          |     |Atkins, Bonilla, Bonta,   |     |Campos, Dickinson,        |
          |     |Chesbro, Maienschein,     |     |Eggman, Hagman,           |
          |     |Mansoor, Mitchell,        |     |Maienschein, Mullin,      |
          |     |Nazarian, Nestande,       |     |Skinner, Ting, Wilk       |
          |     |V. Manuel P�rez, Wagner,  |     |                          |
          |     |Wilk                      |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires prior to the delivery of health care via  
          telehealth, the health care provider initiating the use of  
          telehealth at the originating site to verbally inform the  
          patient about the use of telehealth and request the patient's  
          verbal consent, which may apply in the present instance and for  
          any subsequent use of telehealth.  Provides that nothing in this  
          bill precludes a patient from receiving in-person health care  
          delivery services during a course of treatment after agreeing to  
          receive services via telehealth.

           EXISTING LAW  :  

          1)Defines telehealth as 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.

          2)Requires prior to the delivery of health care via telehealth,  
            the health care provider at the originating site to verbally  
            inform the patient that telehealth may be used and obtain  
            verbal consent from the patient for this use.  Requires the  
            verbal consent to be documented in the patient's medical  








                                                                  AB 809
                                                                  Page  2


            record. 

          3)States that all laws regarding the confidentiality of health  
            care information and a patient's rights to his or her medical  
            information apply to telehealth interactions. 

          4)Exempts a patient under the jurisdiction of the Department of  
            Corrections and Rehabilitation or any other correctional  
            facility. 

          5)States notwithstanding any other provision of law and for  
            purposes of 1) through 4) above that 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 federal regulations.  States legislative intent  
            to authorize a hospital to grant privileges to and verify and  
            approve credentials for providers of telehealth. 

          6)States that "telehealth" includes "telemedicine," as  
            specified.

          7)Makes the failure of a health care provider to comply with 1)  
            through 6) above unprofessional conduct. 

          8)Provides that 1) through 7) above 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.

           FISCAL EFFECT  :  None

           COMMENTS  :  According to the author, this bill would address a  
          problem in existing law amended by AB 415 (Logue), Chapter 547,  
          Statutes of 2011, the Telemedicine Advancement Act of 2011.  The  
          author states that AB 415 replaced and updated the outdated  
          terminology of "telemedicine" with "telehealth," to reflect the  
          current use of telehealth in California's healthcare system,  
          providing a broader range of services than contained in the  
          outdated 1996 model statute.  Under AB 415, in order to ensure  
          that both physicians and patients understood that telehealth may  
          be used to treat a patient, a physician is required to obtain  








                                                                  AB 809
                                                                  Page  3


          verbal consent for each and every visit with the patient.   
          Within a year after implementation, physicians have reported  
          that this constant requirement is onerous and burdensome on  
          their ability to treat patients efficiently.  This bill will  
          allow the first instance of consent to serve as consent for  
          subsequent telehealth uses.

          The California Association of Physician Groups supports this  
          bill because telehealth is a critical component of the strategy  
          to expand access to health care across California and this  
          provides important clean-up provisions to help this technology  
          come into its own.  The Association of California Healthcare  
          Districts states that eliminating the need for health care  
          workers to obtain oral consent to receive telehealth services  
          during every visit, allows a patient to be comfortable with the  
          standard, that telehealth may be used when receiving health care  
          services.
           

          Analysis Prepared by  :    Teri Boughton / HEALTH / (916) 319-2097  



                                                                FN: 0000405