BILL ANALYSIS Ó AB 2214 Page 1 Date of Hearing: April 29, 2014 ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER PROTECTION Susan A. Bonilla, Chair AB 2214 (Fox) - As Amended: April 21, 2014 SUBJECT : Emergency room physicians and surgeons: continuing medical education: geriatric care. SUMMARY : Enacts the Dolores H. Fox Act to require the Medical Board of California (MBC) to consider including a course in geriatric care for emergency room physicians and surgeons as part of its continuing education requirements. EXISTING LAW : 1)Establishes MBC to administer and enforce the provisions of the Medical Practice Act. (Business and Professions Code (BPC) Section 2001, 2004) 2)Requires MBC to adopt and administer standards for the continuing education of licensees, and requires each licensee to demonstrate satisfaction of the requirements at regular intervals. (BPC 2190) 3)Requires all general internists and family physicians who have a patient population of which over 25% are 65 years of age or older to complete at least 20% of all mandatory continuing education hours in a course in the field of geriatric medicine or the care of older patients. (BPC 2190.3) 4)Requires all physicians and surgeons to complete a mandatory continuing education course in the subjects of pain management and the treatment of terminally ill and dying patients, as specified. (BPC 2190.5) 5)Requires MBC to consider including a course in the following subjects when determining its continuing education requirements: a) Human sexuality; b) Child abuse detection; AB 2214 Page 2 c) Acupuncture; d) Elder abuse detection and treatment, e) Early detection and treatment of substance abusing pregnant women; f) Special care needs of drug addicted infants; g) How to routinely screen for signs exhibited by abused women; h) Special care needs of individuals and their families facing end-of-life issues; and, i) Pain management. (BPC 2191) FISCAL EFFECT : Unknown COMMENTS : 1)Purpose of this bill . This bill directs MBC to consider including a course in geriatric care for emergency room physicians and surgeons for its continuing education requirements. This bill is author-sponsored. 2)Author's statement . According to the author's office, "Elderly patients do not exhibit the same signs or symptoms of illnesses as younger patients, often times causing the elderly patients [to be] misdiagnosed. This bill requires the California Medical Board to consider including a course in geriatric care for emergency room doctors when establishing continuing education requirements. This bill highlights the importance of geriatric care in emergency rooms in an aging society." 3)Geriatric medicine . According to the American Medical Student Association, "'Geriatrics is medical practice that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic disease. It requires an interdisciplinary approach between physicians, nurses, social workers, occupational therapists, and family members in order to provide comprehensive care for these patients with multiple needs. AB 2214 Page 3 "Geriatric medicine is its own specialty. After an internal medicine or family practice residency, physicians can complete a one or two year fellowship to become certified in geriatrics. Geriatricians are primary care doctors for older patients and can also serve as consultants to other physicians and to hospital programs that work with the elderly." 4)Continuing education requirements . MBC requires all physicians to complete at least 50 hours of approved continuing education for each two-year period immediately preceding the expiration date of the license. MBC approves continuing education providers and establishes criteria for acceptable courses. MBC requires all physicians to complete a mandatory continuing education course in the subjects of pain management and the treatment of terminally ill and dying patients. It also requires all general internists and family physicians who have a patient population of which over 25% are 65 years of age or older to complete at least 20% of all mandatory continuing education hours in a course in the field of geriatric medicine or the care of older patients. Current law also establishes a list of courses that MBC shall consider including when establishing continuing education requirements. This bill would require MBC to add geriatric care for ER physicians to that consideration list, but would not require that the actual courses be required. . 5)Arguments in support . California Communities United Institute writes, "Emergency rooms need to have physicians who are trained in geriatric medicine so they will be up to the challenge of caring for older patients in the pressured atmosphere of an emergency room. And yet, according to the American Geriatrics Society, there are currently about 7,500 certified geriatricians in the nation, but approximately 17,000 are needed. Emergency rooms need doctors trained in care for elder Americans. AB 2214 is a first step towards reaching that AB 2214 Page 4 goal." REGISTERED SUPPORT / OPPOSITION : Support California Commission on Aging California Communities United Institute California Long-Term Care Ombudsman Association 64 individuals Opposition None on file Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916) 319-3301