BILL ANALYSIS Ó
AB 2346
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Date of Hearing: May 14, 2014
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
AB 2346 (Gonzalez) - As Amended: May 5, 2014
Policy Committee: Business and
Professions Vote: 10-0
Urgency: No State Mandated Local Program:
No Reimbursable: No
SUMMARY
This bill authorizes the Medical Board of California (MBC) to
establish a voluntary and confidential program to aid physicians
struggling with substance abuse, mental health concerns, or
other issues, and specifies the program is to be modeled after
the State Bar's Lawyer Assistance Program.
It also authorizes the MBC to charge a reasonable administrative
fee to support the program, and requires participants in the
program to pay all expenses relating to treatment and recovery.
FISCAL EFFECT
1)Estimated one-time costs of $250,000 to the MBC (Contingent
Fund of the MBC) associated with developing the program.
2)Ongoing costs associated with the program of $2 million
annually (Contingent Fund of the MBC), likely offset by some
level of increased fee revenue. The bill authorizes the MBC
to charge a reasonable administrative fee to support the
program, but does not require the program to be fully
fee-supported.
3)Given the bill requires participants in the program to pay all
expenses relating to treatment and recovery, treatment costs
are assumed to be off-budget and privately, directly paid for
by program participants.
COMMENTS
1)Purpose . The author argues the 2007 dissolution of a
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problem-plagued physician diversion program previously
operated by the MBC left a gap in the state's ability to
address serious physician health conditions. She indicates
since the program ended, physicians dealing with alcohol or
substance abuse issues, mental illness, or other health
conditions that may interfere with their ability to practice
medicine safely have not had a centralized resource to assist
them in seeking private treatment and monitoring services. The
author contends this is a serious public health risk for the
state, as troubled practitioners present a threat to patients.
This bill is sponsored by the California Medical Association.
2)Background . The MBC voted to allow California's previous
physician health program to sunset in 2008 after reports by
the California State Auditor cited numerous problems,
including inconsistent monitoring of doctors and poor
oversight. This program was run by the MBC itself, and
functioned as an option for diversion from enforcement. Since
the program was terminated and a transition plan was
established for participants, there has not been a diversion
from the discipline process for physician with substance abuse
or mental health problems.
Many other states offer centralized physician health programs
that offer assistance to physicians struggling with health
conditions that impair their ability to care for patients.
Other California boards offer similar programs, some of which
actually divert professionals from discipline.
3)Opposition . The Center for Public Interest Law opposes this
bill, arguing the state need not be involved in a personal
journey to recovery.
In addition, consumer groups, consumer attorneys, the
University of San Diego, and senior advocacy groups oppose
this bill, indicating suspicion that information about failed
drug tests would be kept secret from MBC enforcement personnel
under the bill. Staff notes this bill states participation in
the program shall not "relieve the physician or surgeon of any
lawful duties and obligations under this chapter or otherwise
under any disciplinary action."
4)Previous Legislation . Since the dissolution of the prior
program, there have been several legislative attempts to
reestablish a program. SB 1483 (Steinberg) of 2012 required
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the Department of Consumer Affairs to contract with a vendor
to administer a physician health program. That bill was held
on the Assembly Floor.
AB 214 (Fuentes) in 2008 established a voluntary program
within the Department of Public Health, and was vetoed due to
concerns that physician oversight would be fragmented without
MBC involvement.
AB 526 (Fuentes) in 2009 established a voluntary program
within the State and Consumer Services Agency, and was held on
the Suspense File in Senate Appropriations Committee.
SB 1441 (Ridley-Thomas), Chapter 548, Statutes of 2008 created
the Substance Abuse Coordination Committee (SACC) and required
the committee to formulate uniform and specific standards in
specified areas that each healing arts board shall use in
dealing with substance-abusing licensees, whether or not a
board chooses to have a formal diversion program.
Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081