Amended in Assembly August 12, 2013

Amended in Senate April 24, 2013

Amended in Senate April 16, 2013

Senate Bill No. 304

Introduced by Senator begin delete Price end delete begin insert Lieu end insert

(Principal coauthor: Assembly Member Gordon)

February 15, 2013

An act to amend Sections begin delete 651, end delete begin insert 160, 160.5, 2001, 2006, 2020, end insert 2021, begin insert 2135.7, end insert 2177, 2220.08, 2225.5, begin delete 2334, end delete 2514, begin delete and 2569 end delete begin insert 2569, 4800, 4804.5, 4809.5, 4809.7, and 4809.8 end insert of, begin insert to amend, repeal, and add Section 4836.1 of, end insert and to add Sections begin delete 2291.5 and 2403 end delete begin insert 2216.3, 2216.4, 2403, 4836.2, 4836.3, and 4836.4 end insert to, the Business and Professions Code, begin delete and end delete to amend Sections begin delete 11529 end delete begin insert 11529, 12529.6, end insert and 12529.7 of, and to amend and repeal Sections 12529 and 12529.5 of, the Government Code, begin insert to amend Section 1248.15 of the Health and Safety Code, and to amend Section 830.3 of the Penal Code, end insert relating to healing begin delete arts. end delete begin insert arts, and making an appropriation therefor. end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 304, as amended, begin delete Price end delete   begin insert Lieu end insert . Healing arts: boards.

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Existing law makes it unlawful for a healing arts practitioner to disseminate, or cause to be disseminated, any form of public communication containing a false, fraudulent, misleading, or deceptive statement, claim, or image for the purpose of, or likely to induce, the rendering of professional services or furnishing of products in connection with the professional practice or business for which he or she is licensed. Existing law provides for the licensure of physicians and surgeons by the Medical Board of California. Existing law prohibits a physician and surgeon’s advertisements from including a statement that he or she is certified or eligible for certification by a private or public board or parent association, including a multidisciplinary board or association, as defined, unless that board or association meets at least one of several standards, including being a board or association with equivalent requirements approved by that physician and surgeon’s licensing board. A violation of these requirements is a crime.

end delete begin delete

This bill would limit the application of that exception to a board or association with equivalent requirements approved by that physician and surgeon’s licensing board prior to January 1, 2014. The bill would establish that the exception continues to apply to a multidisciplinary board or association approved by the Medical Board of California prior to January 1, 2014.

end delete begin delete

Because the bill would specify additional provisions regarding the advertising practices of healing art practitioners, the violation of which would be a crime, it would impose a state-mandated local program.

end delete begin insert

(1) Existing law provides for the licensure and regulation of physicians and surgeons by the Medical Board of California within the Department of Consumer Affairs. Existing law authorizes the board to employ an executive director. Existing law provides that those provisions will be repealed on January 1, 2014, and, upon repeal, the board is subject to review by the Joint Sunset Review Committee.

end insert begin insert

This bill would instead repeal those provisions on January 1, 2018, and subject the board to review by the appropriate policy committees of the Legislature. The bill would authorize the board to employ an executive director by, and with the approval of, the Director of Consumer Affairs.

end insert begin insert

Existing law authorizes the board to issue a physician and surgeon’s license to an applicant who acquired all or part of his or her medical education at a foreign medical school that is not recognized by the board if, among other requirements, the applicant has held an unlimited and unrestricted license as a physician and surgeon in another state or federal territory and has continuously practiced for a minimum of 10 years prior to the date of application or to an applicant who acquired any part of his or her professional instruction at a foreign medical school that has previously been disapproved by the board if, among other requirements, the applicant has held an unlimited and unrestricted license as a physician and surgeon in another state or federal territory and has continuously practiced for a minimum of 20 years prior to the date of application. For the purposes of these provisions, the board may combine the period of time that the applicant has held an unlimited and unrestricted license, but requires each applicant to have a minimum of 5 years continuous licensure and practice in a single state or federal territory.

end insert begin insert

This bill would instead authorize the board to issue a physician and surgeon’s license to an applicant who acquired any part of his or her medical education from an unrecognized or disapproved medical school if, among other requirements, the applicant has held an unlimited and unrestricted license as a physician and surgeon in another state, a federal territory, or a Canadian province and has continuously practiced for a minimum of 10 years prior to the date of application. The bill would reduce the minimum number of years that each applicant must have continuous licensure and practice in a single state or federal territory to 2 years and permit the period of continuous licensure and practice to occur in a Canadian province.

end insert

Existing law authorizes the Medical Board of California, if it publishes a directory begin insert of its licensees end insert , as specified, to require persons licensed, as specified, to furnish specified information to the board for purposes of compiling the directory.

This bill would require that an applicant and licensee who has an electronic mail address report to the board that electronic mail address no later than July 1, 2014. The bill would provide that the electronic mail address is to be considered confidential, as specified.

Existing law requires an applicant for a physician and surgeon’s certificate to obtain a passing score on Step 3 of the United States Medical Licensing Examination with not more than 4 attempts, subject to an exception.

This bill would require an applicant to have obtained a passing score on all parts of that examination with not more than 4 attempts, subject to the exception.

Existing law requires that a complaint, with exceptions, received by the board determined to involve quality of care, before referral to a field office for further investigation, meet certain criteria.

This bill would expand the types of reports that are exempted from that requirement.

Existing law provides for a civil penalty of up to $1,000 per day, as specified, to be imposed on a health care facility that fails to comply with a patient’s medical record request, as specified, within 30 days.

This bill would shorten the time limit for compliance to 15 days for those health care facilities that have electronic health records.

begin delete

Under existing law, if a healing arts practitioner may be unable to practice his or her profession safely due to mental or physical illness, his or her licensing agency may order the practitioner to be examined by specified professionals.

end delete begin delete

This bill would require that a physician and surgeon’s failure to comply with an order related to these examination requirements shall result in the issuance of notification from the board to cease the practice of medicine immediately until the ordered examinations have been completed and would provide that continued failure to comply would be grounds for suspension or revocation of his or her certificate.

end delete begin delete

Existing law prohibits a party from bringing expert testimony in a matter brought by the board unless certain information is exchanged in written form with counsel for the other party, as specified, within 30 calendar days prior to the commencement of the hearing. Existing law provides that the information exchanged include a brief narrative statement of the testimony the expert is expected to bring.

end delete begin delete

This bill would instead require that information to be exchanged within 90 days from the filing of a notice of defense and would instead require the information to include a complete expert witness report.

end delete

Existing law establishes that corporations and other artificial legal entities have no professional rights, privileges, or powers.

This bill would provide that those provisions do not apply to physicians and surgeons begin insert or doctors of podiatric medicine end insert enrolled in approved residency postgraduate training programs or fellowship programs.

begin delete

Existing

end delete

begin insert (2) end insert begin insert   end insert begin insert Existing end insert law, the Licensed Midwifery Practice Act of 1993, licenses and regulates licensed midwives by the Medical Board of California. Existing law specifies that a midwife student meeting certain conditions is not precluded from engaging in the practice of midwifery as part of his or her course of study, if certain conditions are met, including, that the student is under the supervision of a licensed midwife.

This bill would require that to engage in those practices, the student is to be enrolled and participating in a midwifery education program or enrolled in a program of supervised clinical training, as provided. The bill would add that the student is permitted to engage in those practices if he or she is under the supervision of a licensed nurse-midwife.

begin delete

Existing

end delete

begin insert (3) end insert begin insert   end insert begin insert Existing end insert law provides for the regulation of registered dispensing opticians by the Medical Board of California and requires that the powers and duties of the board in that regard be subject to review by the Joint Sunset Review Committee as if those provisions were scheduled to be repealed on January 1, 2014.

This bill would instead make the powers and duties of the board subject to review by the appropriate policy committees of the Legislature as if those provisions were scheduled to be repealed on January 1, 2018.

begin insert

(4) Existing law provides for the accreditation of outpatient settings, as defined by the Medical Board of California, and requires outpatient settings to report adverse events, as defined, to the State Department of Public Health within specified time limits. Existing law provides for the imposition of a civil penalty in the event that an adverse event is not reported within the applicable time limit.

end insert begin insert

This bill would instead require those outpatient settings to report adverse events to the Medical Board of California within specified time limits and authorize the board to impose a civil penalty if an outpatient setting fails to timely report an adverse event.

end insert begin delete

Existing

end delete

begin insert (5) end insert begin insert   end insert begin insert Existing end insert law begin delete authorizes the administrative law judge of the Medical Quality Hearing Panel to issue an interim order related to licenses, as provided. end delete begin insert establishes the Medical Quality Hearing Panel, consisting of no fewer than 5 administrative law judges with certain medical training, within the Office of Administrative Hearings. Existing law authorizes those administrative law judges to issue interim orders suspending a license, or imposing drug testing, continuing education, supervision of procedures, or other license restrictions. end insert Existing law requires that in all of those cases in which an interim order is issued, and an accusation is not filed and served within 15 days of the date in which the parties to the hearing have submitted the matter, the order be dissolved.

begin insert

Under existing law, if a healing arts practitioner is unable to practice his or her profession safely due to mental or physical illness, his or her licensing agency may order the practitioner to be examined by specified professionals.

end insert

This bill would extend the time in which the accusation must be filed and served to 30 days from the date on which the parties to the hearing submitted the matter. begin insert This bill would also provide that a physician and surgeon’s failure to comply with an order related to these examination requirements may constitute grounds for an administrative law judge of the Medical Quality Hearing Panel to issue an interim suspension order. end insert

Existing law establishes the Health Quality Enforcement Section within the Department of Justice to carry out certain duties. Existing law provides for the funding for the section, and for the appointment of a Senior Assistant Attorney General to the section to carry out specified duties. Existing law requires that all complaints or relevant information concerning licensees that are within the jurisdiction of the Medical Board of California, the California Board of Podiatric Medicine, or the Board of Psychology be made available to the Health Quality Enforcement Section. Existing law establishes the procedures for processing the complaints, assisting the boards or committees in establishing training programs for their staff, and for determining whether to bring a disciplinary proceeding against a licensee of the boards. Existing law provides for the repeal of those provisions, as provided, on January 1, 2014.

This bill would extend the operation of those provisions indefinitely.

Existing law establishes, until January 1, 2014, a vertical enforcement and prosecution model for cases before the Medical Board of California and requires the board to report to the Governor and Legislature on that model by March 1, 2012.

This bill would extend the date that report is due to March 1, 2015.

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Existing law authorizes the Medical Board of California and the Dental Board of California to employ individuals who have the authority of peace officers to perform investigative services.

end delete begin delete

This bill would transfer all investigators employed by the Medical Board of California and their staff to the Department of Justice on January 1, 2014, and would provide that the transfer would not affect the status, position, or rights of those transferred. The bill would specify that individuals performing investigations would retain their status as peace officers.

end delete begin insert

Existing law creates the Division of Investigation within the Department of Consumer Affairs and requires investigators who have the authority of peace officers to be in the division, except that investigators of the Medical Board of California and the Dental Board of California who have that authority are not required to be in the division.

end insert begin insert

This bill would require that investigators of the Medical Board of California who have the authority of a peace officer be in the division and would protect the positions, status, and rights of those investigators who are subsequently transferred as a result of these provisions. This bill would also create within the Division of Investigation the Health Quality Investigation Unit.

end insert begin insert

(6) Existing law, the Veterinary Medicine Practice Act, provides for the licensure and registration of veterinarians and registered veterinary technicians and the regulation of the practice of veterinary medicine by the Veterinary Medical Board. Existing law repeals the provisions establishing the board, and authorizing the board to appoint an executive officer as of January 1, 2014. Under existing law, the board is subject to evaluation by the Joint Sunset Review Committee prior to its repeal.

end insert begin insert

This bill would provide that those provisions are instead repealed as of January 1, 2016. The bill, upon repeal of the board, would require that the board be subject to a specifically limited review by the appropriate policy committees of the Legislature.

end insert begin insert

Existing law authorizes the board, at any time, to inspect the premises in which veterinary medicine, veterinary dentistry, or veterinary surgery is being practiced.

end insert begin insert

This bill would exclude premises that are not required to be registered with the board from inspection.

end insert begin insert

Existing law requires the board to establish a regular inspection program that will provide for random, unannounced inspections.

end insert begin insert

This bill would require the board to make every effort to inspect at least 20% of veterinary premises on an annual basis.

end insert begin insert

Existing law requires the board to establish an advisory committee, the Veterinary Medicine Multidisciplinary Advisory Committee, to assist, advise, and make recommendations for the implementation of rules and regulations necessary to ensure proper administration and enforcement of specified provisions and to assist the board in its examination, licensure, and registration programs. Existing law requires the committee to consist of 7 members, with 4 licensed veterinarians, 2 registered veterinary technicians, and one public member.

end insert begin insert

This bill would expand the number of members on the committee to 9 by including one veterinarian member of the board, to be appointed by the board president, and the registered veterinary technician of the board, both of whom would serve concurrently with their terms of office on the board. The bill would additionally require that the committee serve only in an advisory capacity to the board, as specified. The bill would make other technical and conforming changes.

end insert begin insert

Existing law authorizes a registered veterinary technician or a veterinary assistant to administer a drug under the direct or indirect supervision of a licensed veterinarian when administered pursuant to the order, control, and full professional responsibility of a licensed veterinarian. Existing law limits access to controlled substances by veterinary assistants to persons who have undergone a background check and who, to the best of the licensee manager’s knowledge, do not have any drug- or alcohol-related felony convictions. Existing law repeals these provisions on January 1, 2015.

end insert begin insert

This bill would instead require, until the later of January 1, 2015, or the effective date of a specified legislative determination, a licensee manager to conduct a background check on a veterinary assistant prior to authorizing him or her to obtain or administer a controlled substance by the order of a supervising veterinarian and to prohibit the veterinary assistant from obtaining or administering controlled substances if the veterinary assistant has a drug- or alcohol-related felony conviction.

end insert begin insert

This bill would require that, upon the later of January 1, 2015, or the effective date of a specified legislative determination, a veterinary assistant be designated by a licensed veterinarian to obtain or administer controlled substances and hold a valid veterinary assistant controlled substances permit from the board. The bill would, as part of the application for a permit, require an applicant to furnish a set of fingerprints to the Department of Justice for the purposes of conducting both a state and federal criminal history record check. The bill would require an applicant for a veterinary assistant controlled substances permit to apply for a renewal of his or her permit on or before the last day of the applicant’s birthday month and to update his or her mailing or employer address with the board. The bill would authorize the board to collect a filing fee, not to exceed $100, from applicants for a veterinary assistant controlled substances permit. Because that fee would be deposited in the Veterinary Medical Board Contingent Fund, which is a continuously appropriated fund, the bill would make an appropriation.

end insert begin delete

The

end delete

begin insert (7) end insert begin insert   end insert begin insert The end insert California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: majority. Appropriation:  begin delete no end delete begin insert yes end insert . Fiscal committee: yes. State-mandated local program: yes.

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

begin delete

SECTION 1.  

Section 651 of the Business and Professions Code
is amended to read:

651.  

(a) It is unlawful for any person licensed under this
division or under any initiative act referred to in this division to
disseminate or cause to be disseminated any form of public
communication containing a false, fraudulent, misleading, or
deceptive statement, claim, or image for the purpose of or likely
to induce, directly or indirectly, the rendering of professional
services or furnishing of products in connection with the
professional practice or business for which he or she is licensed.
A “public communication” as used in this section includes, but is
not limited to, communication by means of mail, television, radio,
motion picture, newspaper, book, list or directory of healing arts
practitioners, Internet, or other electronic communication.

(b) A false, fraudulent, misleading, or deceptive statement,
claim, or image includes a statement or claim that does any of the
following:

(1) Contains a misrepresentation of fact.

(2) Is likely to mislead or deceive because of a failure to disclose
material facts.

(3) (A) Is intended or is likely to create false or unjustified
expectations of favorable results, including the use of any
photograph or other image that does not accurately depict the
results of the procedure being advertised or that has been altered
in any manner from the image of the actual subject depicted in the
photograph or image.

(B) Use of any photograph or other image of a model without
clearly stating in a prominent location in easily readable type the
fact that the photograph or image is of a model is a violation of
subdivision (a). For purposes of this paragraph, a model is anyone
other than an actual patient, who has undergone the procedure
being advertised, of the licensee who is advertising for his or her
services.

(C) Use of any photograph or other image of an actual patient
that depicts or purports to depict the results of any procedure, or
presents “before” and “after” views of a patient, without specifying
in a prominent location in easily readable type size what procedures
were performed on that patient is a violation of subdivision (a).
Any “before” and “after” views (i) shall be comparable in
presentation so that the results are not distorted by favorable poses,
lighting, or other features of presentation, and (ii) shall contain a
statement that the same “before” and “after” results may not occur
for all patients.

(4) Relates to fees, other than a standard consultation fee or a
range of fees for specific types of services, without fully and
specifically disclosing all variables and other material factors.

(5) Contains other representations or implications that in
reasonable probability will cause an ordinarily prudent person to
misunderstand or be deceived.

(6) Makes a claim either of professional superiority or of
performing services in a superior manner, unless that claim is
relevant to the service being performed and can be substantiated
with objective scientific evidence.

(7) Makes a scientific claim that cannot be substantiated by
reliable, peer reviewed, published scientific studies.

(8) Includes any statement, endorsement, or testimonial that is
likely to mislead or deceive because of a failure to disclose material
facts.

(c) Any price advertisement shall be exact, without the use of
phrases, including, but not limited to, “as low as,” “and up,”
“lowest prices,” or words or phrases of similar import. Any
advertisement that refers to services, or costs for services, and that
uses words of comparison shall be based on verifiable data
substantiating the comparison. Any person so advertising shall be
prepared to provide information sufficient to establish the accuracy
of that comparison. Price advertising shall not be fraudulent,
deceitful, or misleading, including statements or advertisements
of bait, discount, premiums, gifts, or any statements of a similar
nature. In connection with price advertising, the price for each
product or service shall be clearly identifiable. The price advertised
for products shall include charges for any related professional
services, including dispensing and fitting services, unless the
advertisement specifically and clearly indicates otherwise.

(d) Any person so licensed shall not compensate or give anything
of value to a representative of the press, radio, television, or other
communication medium in anticipation of, or in return for,
professional publicity unless the fact of compensation is made
known in that publicity.

(e) Any person so licensed may not use any professional card,
professional announcement card, office sign, letterhead, telephone
directory listing, medical list, medical directory listing, or a similar
professional notice or device if it includes a statement or claim
that is false, fraudulent, misleading, or deceptive within the
meaning of subdivision (b).

(f) Any person so licensed who violates this section is guilty of
a misdemeanor. A bona fide mistake of fact shall be a defense to
this subdivision, but only to this subdivision.

(g) Any violation of this section by a person so licensed shall
constitute good cause for revocation or suspension of his or her
license or other disciplinary action.

(h) Advertising by any person so licensed may include the
following:

(1) A statement of the name of the practitioner.

(2) A statement of addresses and telephone numbers of the
offices maintained by the practitioner.

(3) A statement of office hours regularly maintained by the
practitioner.

(4) A statement of languages, other than English, fluently spoken
by the practitioner or a person in the practitioner’s office.

(5) (A) A statement that the practitioner is certified by a private
or public board or agency or a statement that the practitioner limits
his or her practice to specific fields.

(B) A statement of certification by a practitioner licensed under
Chapter 7 (commencing with Section 3000) shall only include a
statement that he or she is certified or eligible for certification by
a private or public board or parent association recognized by that
practitioner’s licensing board.

(C) A physician and surgeon licensed under Chapter 5
(commencing with Section 2000) by the Medical Board of
California may include a statement that he or she limits his or her
practice to specific fields, but shall not include a statement that he
or she is certified or eligible for certification by a private or public
board or parent association, unless that board or association is (i)
an American Board of Medical Specialties member board, (ii) a
board or association with equivalent requirements approved by
that physician and surgeon’s licensing board prior to January 1,
2014, or (iii) a board or association with an Accreditation Council
for Graduate Medical Education approved postgraduate training
program that provides complete training in that specialty or
subspecialty. A physician and surgeon licensed under Chapter 5
(commencing with Section 2000) by the Medical Board of
California who is certified by an organization other than a board
or association referred to in clause (i), (ii), or (iii) shall not use the
term “board certified” in reference to that certification, unless the
physician and surgeon is also licensed under Chapter 4
(commencing with Section 1600) and the use of the term “board
certified” in reference to that certification is in accordance with
subparagraph (A). A physician and surgeon licensed under Chapter
5 (commencing with Section 2000) by the Medical Board of
California who is certified by a board or association referred to in
clause (i), (ii), or (iii) shall not use the term “board certified” unless
the full name of the certifying board is also used and given
comparable prominence with the term “board certified” in the
statement.

A multidisciplinary board or association approved by the Medical
Board of California prior to January 1, 2014, shall retain that
approval.

For purposes of the term “board certified,” as used in this
subparagraph, the terms “board” and “association” mean an
organization that is an American Board of Medical Specialties
member board, an organization with equivalent requirements
approved by a physician and surgeon’s licensing board prior to
January 1, 2014, or an organization with an Accreditation Council
for Graduate Medical Education approved postgraduate training
program that provides complete training in a specialty or
subspecialty.

(D) A doctor of podiatric medicine licensed under Chapter 5
(commencing with Section 2000) by the Medical Board of
California may include a statement that he or she is certified or
eligible or qualified for certification by a private or public board
or parent association, including, but not limited to, a
multidisciplinary board or association, if that board or association
meets one of the following requirements: (i) is approved by the
Council on Podiatric Medical Education, (ii) is a board or
association with equivalent requirements approved by the
California Board of Podiatric Medicine, or (iii) is a board or
association with the Council on Podiatric Medical Education
approved postgraduate training programs that provide training in
podiatric medicine and podiatric surgery. A doctor of podiatric
medicine licensed under Chapter 5 (commencing with Section
2000) by the Medical Board of California who is certified by a
board or association referred to in clause (i), (ii), or (iii) shall not
use the term “board certified” unless the full name of the certifying
board is also used and given comparable prominence with the term
“board certified” in the statement. A doctor of podiatric medicine
licensed under Chapter 5 (commencing with Section 2000) by the
Medical Board of California who is certified by an organization
other than a board or association referred to in clause (i), (ii), or
(iii) shall not use the term “board certified” in reference to that
certification.

For purposes of this subparagraph, a “multidisciplinary board
or association” means an educational certifying body that has a
psychometrically valid testing process, as determined by the
California Board of Podiatric Medicine, for certifying doctors of
podiatric medicine that is based on the applicant’s education,
training, and experience. For purposes of the term “board certified,”
as used in this subparagraph, the terms “board” and “association”
mean an organization that is a Council on Podiatric Medical
Education approved board, an organization with equivalent
requirements approved by the California Board of Podiatric
Medicine, or an organization with a Council on Podiatric Medical
Education approved postgraduate training program that provides
training in podiatric medicine and podiatric surgery.

The California Board of Podiatric Medicine shall adopt
regulations to establish and collect a reasonable fee from each
board or association applying for recognition pursuant to this
subparagraph, to be deposited in the State Treasury in the Podiatry
Fund, pursuant to Section 2499. The fee shall not exceed the cost
of administering this subparagraph.

(6) A statement that the practitioner provides services under a
specified private or public insurance plan or health care plan.

(7) A statement of names of schools and postgraduate clinical
training programs from which the practitioner has graduated,
together with the degrees received.

(8) A statement of publications authored by the practitioner.

(9) A statement of teaching positions currently or formerly held
by the practitioner, together with pertinent dates.

(10) A statement of his or her affiliations with hospitals or
clinics.

(11) A statement of the charges or fees for services or
commodities offered by the practitioner.

(12) A statement that the practitioner regularly accepts
installment payments of fees.

(13) Otherwise lawful images of a practitioner, his or her
physical facilities, or of a commodity to be advertised.

(14) A statement of the manufacturer, designer, style, make,
trade name, brand name, color, size, or type of commodities
advertised.

(15) An advertisement of a registered dispensing optician may
include statements in addition to those specified in paragraphs (1)
to (14), inclusive, provided that any statement shall not violate
subdivision (a), (b), (c), or (e) or any other section of this code.

(16) A statement, or statements, providing public health
information encouraging preventative or corrective care.

(17) Any other item of factual information that is not false,
fraudulent, misleading, or likely to deceive.

(i) Each of the healing arts boards and examining committees
within Division 2 shall adopt appropriate regulations to enforce
this section in accordance with Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code.

Each of the healing arts boards and committees and examining
committees within Division 2 shall, by regulation, define those
efficacious services to be advertised by businesses or professions
under their jurisdiction for the purpose of determining whether
advertisements are false or misleading. Until a definition for that
service has been issued, no advertisement for that service shall be
disseminated. However, if a definition of a service has not been
issued by a board or committee within 120 days of receipt of a
request from a licensee, all those holding the license may advertise
the service. Those boards and committees shall adopt or modify
regulations defining what services may be advertised, the manner
in which defined services may be advertised, and restricting
advertising that would promote the inappropriate or excessive use
of health services or commodities. A board or committee shall not,
by regulation, unreasonably prevent truthful, nondeceptive price
or otherwise lawful forms of advertising of services or
commodities, by either outright prohibition or imposition of
onerous disclosure requirements. However, any member of a board
or committee acting in good faith in the adoption or enforcement
of any regulation shall be deemed to be acting as an agent of the
state.

(j) The Attorney General shall commence legal proceedings in
the appropriate forum to enjoin advertisements disseminated or
about to be disseminated in violation of this section and seek other
appropriate relief to enforce this section. Notwithstanding any
other provision of law, the costs of enforcing this section to the
respective licensing boards or committees may be awarded against
any licensee found to be in violation of any provision of this
section. This shall not diminish the power of district attorneys,
county counsels, or city attorneys pursuant to existing law to seek
appropriate relief.

(k) A physician and surgeon or doctor of podiatric medicine
licensed pursuant to Chapter 5 (commencing with Section 2000)
by the Medical Board of California who knowingly and
intentionally violates this section may be cited and assessed an
administrative fine not to exceed ten thousand dollars ($10,000)
per event. Section 125.9 shall govern the issuance of this citation
and fine except that the fine limitations prescribed in paragraph
(3) of subdivision (b) of Section 125.9 shall not apply to a fine
under this subdivision.

end delete

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Section 160 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

160.  

(a) The Chief and all investigators of the Division of
Investigation of the department and all investigators of begin delete the Medical
Board of California and end delete the Dental Board of California have the
authority of peace officers while engaged in exercising the powers
granted or performing the duties imposed upon them or the division
in investigating the laws administered by the various boards
comprising the department or commencing directly or indirectly
any criminal prosecution arising from any investigation conducted
under these laws. All persons herein referred to shall be deemed
to be acting within the scope of employment with respect to all
acts and matters set forth in this section.

(b) The Division of Investigation of the begin delete department, the Medical
Board of California, end delete begin insert department end insert and the Dental Board of California
may employ individuals, who are not peace officers, to provide
investigative services.

begin insert

(c) There is in the Division of Investigation the Health Quality
Investigation Unit. The primary responsibility of the unit is to
investigate violations of law or regulation by licensees and
applicants within the jurisdiction of the Medical Board of
California, the California Board of Podiatric Medicine, the Board
of Psychology, or any committee under the jurisdiction of the
Medical Board of California.

end insert

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 160.5 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

160.5.  

begin insert (a) end insert begin insert   end insert All civil service employees currently employed by
the Board of Dental Examiners of the Department of Consumer
Affairs, whose functions are transferred as a result of the act adding
this section shall retain their positions, status, and rights pursuant
to Section 19050.9 of the Government Code and the State Civil
Service begin delete Act, Part end delete begin insert Act (Part end insert 2 (commencing with Section 18500)
of Division 5 of Title 2 of the Government begin delete Code. end delete begin insert Code). end insert The
transfer of employees as a result of the act adding this section shall
occur no later than July 1, 1999.

begin insert

(b) (1) All civil service employees currently employed by the
Medical Board of California of the Department of Consumer
Affairs, whose functions are transferred as a result of the act
adding this subdivision shall retain their positions, status, and
rights pursuant to Section 19050.9 of the Government Code and
the State Civil Service Act (Part 2 (commencing with Section
18500) of Division 5 of Title 2 of the Government Code). The
transfer of employees as a result of the act adding this subdivision
shall occur no later than January 1, 2014.

end insert begin insert

(2) The transfer of employees pursuant to this subdivision shall
include all peace officer positions and staff support positions that
are identified by the department as positions whose functions are
primarily enforcement related.

end insert

begin insert

begin insert SEC. 3. end insert   

end insert

begin insert Section 2001 of the end insert begin insert Business and Professions Code end insert begin insert is
amended to read: end insert

2001.  

(a) There is in the Department of Consumer Affairs a
Medical Board of California that consists of 15 members, seven
of whom shall be public members.

(b) The Governor shall appoint 13 members to the board, subject
to confirmation by the Senate, five of whom shall be public
members. The Senate Committee on Rules and the Speaker of the
Assembly shall each appoint a public member.

begin delete

(c) Notwithstanding any other provision of law, to reduce the
membership of the board to 15, the following shall occur:

(1) Two positions on the board that are public members having
a term that expires on June 1, 2010, shall terminate instead on
January 1, 2008.

(2) Two positions on the board that are not public members
having a term that expires on June 1, 2008, shall terminate instead
on August 1, 2008.

(3) Two positions on the board that are not public members
having a term that expires on June 1, 2011, shall terminate instead
on January 1, 2008.

(d)

end delete

begin insert (c) end insert  This section shall remain in effect only until January 1, begin delete 2014, end delete
begin insert 2018, end insert and as of that date is repealed, unless a later enacted statute,
that is enacted before January 1, begin delete 2014, end delete begin insert 2018, end insert deletes or extends
that date. begin delete The end delete begin insert Notwithstanding any other law, the end insert repeal of this
section renders the board subject to begin delete the review required by Division
1.2 (commencing with Section 473). end delete begin insert review by the appropriate
policy committees of the Legislature. end insert

begin insert

begin insert SEC. 4. end insert   

end insert

begin insert Section 2006 of the end insert begin insert Business and Professions Code end insert begin insert is
amended to read: end insert

2006.  

begin delete (a) end delete begin delete   end delete Any reference in this chapter to an investigation by
the board shall be deemed to refer to a joint investigation conducted
by employees of the Department of Justice and the begin delete board end delete begin insert Health
Quality Investigation Unit end insert under the vertical enforcement and
prosecution model, as specified in Section 12529.6 of the
Government Code.

begin delete

(b) This section shall remain in effect only until January 1, 2014,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2014, deletes or extends that date.

end delete

begin insert

begin insert SEC. 5. end insert   

end insert

begin insert Section 2020 of the end insert begin insert Business and Professions Code end insert begin insert is
amended to read: end insert

2020.  

(a) The begin delete board end delete begin insert board, by and with the approval of the
director, end insert may employ an executive director exempt from the
provisions of the Civil Service Act and may also employ
investigators, legal counsel, medical consultants, and other
assistance as it may deem necessary to carry this chapter into effect.
The board may fix the compensation to be paid for services subject
to the provisions of applicable state laws and regulations and may
incur other expenses as it may deem necessary. Investigators
employed by the board shall be provided special training in
investigating medical practice activities.

(b) The Attorney General shall act as legal counsel for the board
for any judicial and administrative proceedings and his or her
services shall be a charge against it.

(c) This section shall remain in effect only until January 1, begin delete 2014, end delete
begin insert 2018, end insert and as of that date is repealed, unless a later enacted statute,
that is enacted before January 1, begin delete 2014, end delete begin insert 2018, end insert deletes or extends
that date.

begin delete SEC. 2. end delete
begin insert SEC. 6. end insert   

Section 2021 of the Business and Professions Code is
amended to read:

2021.  

(a) If the board publishes a directory pursuant to Section
112, it may require persons licensed pursuant to this chapter to
furnish any information as it may deem necessary to enable it to
compile the directory.

(b) Each licensee shall report to the board each and every change
of address within 30 days after each change, giving both the old
and new address. If an address reported to the board at the time of
application for licensure or subsequently is a post office box, the
applicant shall also provide the board with a street address. If
another address is the licensee’s address of record, he or she may
request that the second address not be disclosed to the public.

(c) Each licensee shall report to the board each and every change
of name within 30 days after each change, giving both the old and
new names.

(d) Each applicant and licensee who has an electronic mail
address shall report to the board that electronic mail address no
later than July 1, 2014. The electronic mail address shall be
considered confidential and not subject to public disclosure.

(e) The board shall annually send an electronic notice to each
applicant and licensee that requests confirmation from the applicant
or licensee that his or her electronic mail address is current.

begin insert

begin insert SEC. 7. end insert   

end insert

begin insert Section 2135.7 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

2135.7.  

(a) Upon review and recommendation, the board may
determine that an applicant for a physician and surgeon’s certificate
who acquired his or her medical education or a portion thereof at
a foreign medical school that is not recognized or has been
previously disapproved by the board is eligible for a physician and
surgeon’s certificate if the applicant meets all of the following
criteria:

(1) Has successfully completed a resident course of medical
education leading to a degree of medical doctor equivalent to that
specified in Sections 2089 to 2091.2, inclusive.

(2) (A)  begin delete (i) end delete begin delete   end delete For an applicant who acquired any part of his or her
medical education from an unrecognized foreign medical school
begin insert or from a foreign medical school previously disapproved by the
board end insert , he or she holds an unlimited and unrestricted license as a
physician and surgeon in another begin delete state or end delete begin insert state, a end insert federal begin delete territory end delete
begin insert territory, or a Canadian province end insert and has held that license and
continuously practiced for a minimum of 10 years prior to the date
of application.

begin delete

(ii) For an applicant who acquired any part of his or her
professional instruction from a foreign medical school previously
disapproved by the board, he or she holds an unlimited and
unrestricted license as a physician and surgeon in another state or
federal territory and has held that license and continuously
practiced for a minimum of 20 years prior to the date of application.

end delete

(B) For the purposes of begin delete clauses (i) and (ii) of end delete subparagraph (A),
the board may combine the period of time that the applicant has
held an unlimited and unrestricted license in other begin delete states or end delete begin insert states, end insert
federal begin delete territories end delete begin insert territories, or Canadian provinces end insert and
continuously practiced therein, but each applicant under this section
shall have a minimum of begin delete five end delete begin insert two end insert years continuous licensure and
practice in a single begin delete state or end delete begin insert state, end insert federal begin delete territory end delete begin insert territory, or
Canadian province end insert . For purposes of this paragraph, continuous
licensure and practice includes any postgraduate training after 24
months in a postgraduate training program that is accredited by
the Accreditation Council for Graduate Medical Education
(ACGME) or postgraduate training completed in Canada that is
accredited by the Royal College of Physicians and Surgeons of
Canada (RCPSC).

(3) Is certified by a specialty board that is a member board of
the American Board of Medical Specialties.

(4) Has successfully taken and passed the examinations
described in Article 9 (commencing with Section 2170).

(5) Has not been the subject of a disciplinary action by a medical
licensing authority or of adverse judgments or settlements resulting
from the practice of medicine that the board determines constitutes
a pattern of negligence or incompetence.

(6) Has successfully completed three years of approved
postgraduate training. The postgraduate training required by this
paragraph shall have been obtained in a postgraduate training
program accredited by the ACGME or postgraduate training
completed in Canada that is accredited by the RCPSC.

(7) Is not subject to denial of licensure under Division 1.5
(commencing with Section 475) or Article 12 (commencing with
Section 2220).

(8) Has not held a healing arts license and been the subject of
disciplinary action by a healing arts board of this state or by another
begin delete state or end delete begin insert state, end insert federal begin delete territory end delete begin insert territory, or Canadian province end insert .

(b) The board may adopt regulations to establish procedures for
accepting transcripts, diplomas, and other supporting information
and records when the originals are not available due to
circumstances outside the applicant’s control. The board may also
adopt regulations authorizing the substitution of additional specialty
board certifications for years of practice or licensure when
considering the certification for a physician and surgeon pursuant
to this section.

(c) This section shall not apply to a person seeking to participate
in a program described in Sections 2072, 2073, 2111, 2112, 2113,
2115, or 2168, or seeking to engage in postgraduate training in
this state.

begin delete SEC. 3. end delete
begin insert SEC. 8. end insert   

Section 2177 of the Business and Professions Code is
amended to read:

2177.  

(a) A passing score is required for an entire examination
or for each part of an examination, as established by resolution of
the board.

(b) Applicants may elect to take the written examinations
conducted or accepted by the board in separate parts.

(c) (1) An applicant shall have obtained a passing score on all
parts of Step 3 of the United States Medical Licensing Examination
within not more than four attempts in order to be eligible for a
physician’s and surgeon’s certificate.

(2)  Notwithstanding paragraph (1), an applicant who obtains
a passing score on all parts of Step 3 of the United States Medical
Licensing Examination in more than four attempts and who meets
the requirements of Section 2135.5 shall be eligible to be
considered for issuance of a physician’s and surgeon’s certificate.

begin insert

begin insert SEC. 9. end insert   

end insert

begin insert Section 2216.3 is added to the end insert begin insert Business and Professions
Code end insert begin insert , to read: end insert

begin insert

begin insert 2216.3. end insert   

(a) An outpatient setting accredited pursuant to Section
1248.1 of the Health and Safety Code shall report an adverse event
to the board no later than five days after the adverse event has
been detected, or, if that event is an ongoing urgent or emergent
threat to the welfare, health, or safety of patients, personnel, or
visitors, not later than 24 hours after the adverse event has been
detected. Disclosure of individually identifiable patient information
shall be consistent with applicable law.

(b) For the purposes of this section, “adverse event” has the
same meaning as in subdivision (b) of Section 1279.1 of the Health
and Safety Code.

end insert

begin insert

begin insert SEC. 10. end insert   

end insert

begin insert Section 2216.4 is added to the end insert begin insert Business and
Professions Code end insert begin insert , to read: end insert

begin insert

begin insert 2216.4. end insert   

If an accredited outpatient setting fails to report an
adverse event pursuant to Section 2216.3, the board may assess
the accredited outpatient setting a civil penalty in an amount not
to exceed one hundred dollars ($100) for each day that the adverse
event is not reported following the initial five-day period or
24-hour period, as applicable. If the accredited outpatient setting
disputes a determination by the board regarding an alleged failure
to report an adverse event, the accredited outpatient setting may,
within 10 days of notification of the board’s determination, request
a hearing, which shall be conducted pursuant to the administrative
adjudication provisions of Chapter 4.5 (commencing with Section
11400) and Chapter 5 (commencing with Section 11500) of Part
1 of Division 3 of Title 2 of the Government Code. Penalties shall
be paid when appeals pursuant to those provisions have been
exhausted.

end insert

begin delete SEC. 4. end delete
begin insert SEC. 11. end insert   

Section 2220.08 of the Business and Professions Code
is amended to read:

2220.08.  

(a) Except for reports received by the board pursuant
to Section 801.01 or 805 that may be treated as complaints by the
board and new complaints relating to a physician and surgeon who
is the subject of a pending accusation or investigation or who is
on probation, any complaint determined to involve quality of care,
before referral to a field office for further investigation, shall meet
the following criteria:

(1) It shall be reviewed by one or more medical experts with
the pertinent education, training, and expertise to evaluate the
specific standard of care issues raised by the complaint to determine
if further field investigation is required.

(2) It shall include the review of the following, which shall be
requested by the board:

(A) Relevant patient records.

(B) The statement or explanation of the care and treatment
provided by the physician and surgeon.

(C) Any additional expert testimony or literature provided by
the physician and surgeon.

(D) Any additional facts or information requested by the medical
expert reviewers that may assist them in determining whether the
care rendered constitutes a departure from the standard of care.

(b) If the board does not receive the information requested
pursuant to paragraph (2) of subdivision (a) within 10 working
days of requesting that information, the complaint may be reviewed
by the medical experts and referred to a field office for
investigation without the information.

(c) Nothing in this section shall impede the board’s ability to
seek and obtain an interim suspension order or other emergency
relief.

begin delete SEC. 5. end delete
begin insert SEC. 12. end insert   

Section 2225.5 of the Business and Professions Code
is amended to read:

2225.5.  

(a) (1) A licensee who fails or refuses to comply with
a request for the certified medical records of a patient, that is
accompanied by that patient’s written authorization for release of
records to the board, within 15 days of receiving the request and
authorization, shall pay to the board a civil penalty of one thousand
dollars ($1,000) per day for each day that the documents have not
been produced after the 15th day, up to ten thousand dollars
($10,000), unless the licensee is unable to provide the documents
within this time period for good cause.

(2) A health care facility shall comply with a request for the
certified medical records of a patient that is accompanied by that
patient’s written authorization for release of records to the board
together with a notice citing this section and describing the
penalties for failure to comply with this section. Failure to provide
the authorizing patient’s certified medical records to the board
within 30 days of receiving the request, authorization, and notice
shall subject the health care facility to a civil penalty, payable to
the board, of up to one thousand dollars ($1,000) per day for each
day that the documents have not been produced after the 30th day,
up to ten thousand dollars ($10,000), unless the health care facility
is unable to provide the documents within this time period for good
cause. For health care facilities that have electronic health records,
failure to provide the authorizing patient’s certified medical records
to the board within 15 days of receiving the request, authorization,
and notice shall subject the health care facility to a civil penalty,
payable to the board, of up to one thousand dollars ($1,000) per
day for each day that the documents have not been produced after
the 15th day, up to ten thousand dollars ($10,000), unless the health
care facility is unable to provide the documents within this time
period for good cause. This paragraph shall not require health care
facilities to assist the board in obtaining the patient’s authorization.
The board shall pay the reasonable costs of copying the certified
medical records.

(b) (1) A licensee who fails or refuses to comply with a court
order, issued in the enforcement of a subpoena, mandating the
release of records to the board shall pay to the board a civil penalty
of one thousand dollars ($1,000) per day for each day that the
documents have not been produced after the date by which the
court order requires the documents to be produced, up to ten
thousand dollars ($10,000), unless it is determined that the order
is unlawful or invalid. Any statute of limitations applicable to the
filing of an accusation by the board shall be tolled during the period
the licensee is out of compliance with the court order and during
any related appeals.

(2) Any licensee who fails or refuses to comply with a court
order, issued in the enforcement of a subpoena, mandating the
release of records to the board is guilty of a misdemeanor
punishable by a fine payable to the board not to exceed five
thousand dollars ($5,000). The fine shall be added to the licensee’s
renewal fee if it is not paid by the next succeeding renewal date.
Any statute of limitations applicable to the filing of an accusation
by the board shall be tolled during the period the licensee is out
of compliance with the court order and during any related appeals.

(3) A health care facility that fails or refuses to comply with a
court order, issued in the enforcement of a subpoena, mandating
the release of patient records to the board, that is accompanied by
a notice citing this section and describing the penalties for failure
to comply with this section, shall pay to the board a civil penalty
of up to one thousand dollars ($1,000) per day for each day that
the documents have not been produced, up to ten thousand dollars
($10,000), after the date by which the court order requires the
documents to be produced, unless it is determined that the order
is unlawful or invalid. Any statute of limitations applicable to the
filing of an accusation by the board against a licensee shall be
tolled during the period the health care facility is out of compliance
with the court order and during any related appeals.

(4) Any health care facility that fails or refuses to comply with
a court order, issued in the enforcement of a subpoena, mandating
the release of records to the board is guilty of a misdemeanor
punishable by a fine payable to the board not to exceed five
thousand dollars ($5,000). Any statute of limitations applicable to
the filing of an accusation by the board against a licensee shall be
tolled during the period the health care facility is out of compliance
with the court order and during any related appeals.

(c) Multiple acts by a licensee in violation of subdivision (b)
shall be punishable by a fine not to exceed five thousand dollars
($5,000) or by imprisonment in a county jail not exceeding six
months, or by both that fine and imprisonment. Multiple acts by
a health care facility in violation of subdivision (b) shall be
punishable by a fine not to exceed five thousand dollars ($5,000)
and shall be reported to the State Department of Public Health and
shall be considered as grounds for disciplinary action with respect
to licensure, including suspension or revocation of the license or
certificate.

(d) A failure or refusal of a licensee to comply with a court
order, issued in the enforcement of a subpoena, mandating the
release of records to the board constitutes unprofessional conduct
and is grounds for suspension or revocation of his or her license.

(e) Imposition of the civil penalties authorized by this section
shall be in accordance with the Administrative Procedure Act
(Chapter 5 (commencing with Section 11500) of Division 3 of
Title 2 of the Government Code).

(f) For purposes of this section, “certified medical records”
means a copy of the patient’s medical records authenticated by the
licensee or health care facility, as appropriate, on a form prescribed
by the board.

(g) For purposes of this section, a “health care facility” means
a clinic or health facility licensed or exempt from licensure
pursuant to Division 2 (commencing with Section 1200) of the
Health and Safety Code.

begin delete

SEC. 6.  

Section 2291.5 is added to the Business and Professions
Code, to read:

2291.5.  

A physician and surgeon’s failure to comply with an
order issued under Section 820 shall result in the issuance of
notification from the board to cease the practice of medicine
immediately upon the receipt of that notification. The physician
and surgeon shall cease the practice of medicine until the ordered
examinations have been completed. A physician and surgeon’s
continued failure to comply with an order issued under Section
820 shall constitute grounds for suspension or revocation of his
or her certificate.

end delete

begin delete

SEC. 7.  

Section 2334 of the Business and Professions Code is
amended to read:

2334.  

(a) Notwithstanding any other provision of law, with
respect to the use of expert testimony in matters brought by the
Medical Board of California, no expert testimony shall be permitted
by any party unless the following information is exchanged in
written form with counsel for the other party within 90 days from
the filing of a notice of defense:

(1) A curriculum vitae setting forth the qualifications of the
expert.

(2)  A complete expert witness report.

(3) A representation that the expert has agreed to testify at the
hearing.

(4) A statement of the expert’s hourly and daily fee for providing
testimony and for consulting with the party who retained his or
her services.

(b) The Office of Administrative Hearings may adopt regulations
governing the required exchange of the information described in
this section.

end delete

begin delete SEC. 8. end delete
begin insert SEC. 13. end insert   

Section 2403 is added to the Business and Professions
Code, to read:

2403.  

The provisions of Section 2400 do not apply to
physicians and surgeons begin insert or doctors of podiatric medicine end insert enrolled
in approved residency postgraduate training programs or fellowship
programs.

begin delete SEC. 9. end delete
begin insert SEC. 14. end insert   

Section 2514 of the Business and Professions Code
is amended to read:

2514.  

(a) Nothing in this chapter shall be construed to prevent
a bona fide student from engaging in the practice of midwifery in
this state, as part of his or her course of study, if both of the
following conditions are met:

(1) The student is under the supervision of a licensed midwife
or certified nurse-midwife, who holds a clear and unrestricted
license in this state, who is present on the premises at all times
client services are provided, and who is practicing pursuant to
Section 2507 or 2746.5, or a physician and surgeon.

(2) The client is informed of the student’s status.

(b) For the purposes of this section, a “bona fide student” means
an individual who is enrolled and participating in a midwifery
education program or who is enrolled in a program of supervised
clinical training as part of the instruction of a three year
postsecondary midwifery education program approved by the
board.

begin delete SEC. 10. end delete
begin insert SEC. 15. end insert   

Section 2569 of the Business and Professions Code
is amended to read:

2569.  

Notwithstanding any other law, the powers and duties
of the board, as set forth in this chapter, shall be subject to review
by the appropriate policy committees of the Legislature. The review
shall be performed as if this chapter were scheduled to be repealed
as of January 1, 2018.

begin insert

begin insert SEC. 16. end insert   

end insert

begin insert Section 4800 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4800.  

(a) There is in the Department of Consumer Affairs a
Veterinary Medical Board in which the administration of this
chapter is vested. The board consists of the following members:

(1) Four licensed veterinarians.

(2) One registered veterinary technician.

(3) Three public members.

(b) This section shall remain in effect only until January 1, begin delete 2014, end delete
begin insert 2016, end insert and as of that date is repealed, unless a later enacted statute,
that is enacted before January 1, begin delete 2014, end delete begin insert 2016, end insert deletes or extends
that date.

(c)  begin delete The end delete begin insert Notwithstanding any other law, the end insert repeal of this section
renders the board subject to begin delete the end delete review begin delete provided for by Division
1.2 (commencing with Section 473). end delete begin insert by the appropriate policy
committees of the Legislature. However, the review of the board
shall be limited to those issues identified by the appropriate policy
committees of the Legislature and shall not involve the preparation
or submission of a sunset review document or evaluative
questionnaire. end insert

begin insert

begin insert SEC. 17. end insert   

end insert

begin insert Section 4804.5 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4804.5.  

The board may appoint a person exempt from civil
service who shall be designated as an executive officer and who
shall exercise the powers and perform the duties delegated by the
board and vested in him or her by this chapter.

This section shall remain in effect only until January 1, begin delete 2014, end delete
begin insert 2016, end insert and as of that date is repealed, unless a later enacted statute,
that is enacted before January 1, begin delete 2014, end delete begin insert 2016, end insert deletes or extends
that date.

begin insert

begin insert SEC. 18. end insert   

end insert

begin insert Section 4809.5 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4809.5.  

The board may at any time inspect the premises in
which veterinary medicine, veterinary dentistry, or veterinary
surgery is being practiced. begin insert The board’s inspection authority does
not extend to premises that are not required to be registered with
the board. Nothing in this section shall be construed to affect the
board’s ability to investigate alleged unlicensed activity. end insert

begin insert

begin insert SEC. 19. end insert   

end insert

begin insert Section 4809.7 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4809.7.  

The board shall establish a regular inspection program
begin delete which end delete begin insert that end insert will provide for random, unannounced inspections. begin insert The
board shall make every effort to inspect at least 20 percent of
veterinary premises on an annual basis. end insert

begin insert

begin insert SEC. 20. end insert   

end insert

begin insert Section 4809.8 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4809.8.  

(a) The board shall establish an advisory committee
to assist, advise, and make recommendations for the
implementation of rules and regulations necessary to ensure proper
administration and enforcement of this chapter and to assist the
board in its examination, licensure, and registration programs. begin delete This end delete
begin insert The committee shall serve only in an advisory capacity to the board
and the objectives, duties, and actions of the committee shall not
be a substitute for or conflict with any of the powers, duties, and
responsibilities of the board. The end insert committee shall be known as the
Veterinary Medicine Multidisciplinary Advisory Committee.
begin delete Members of the end delete begin insert The multidisciplinary committee shall consist of
nine members. The following members of the end insert multidisciplinary
committee shall be appointed by the board from lists of nominees
solicited by the begin delete board. The committee shall consist of the following
seven members: end delete begin insert board: end insert four licensed veterinarians, two registered
veterinary technicians, and one public member. begin insert The committee
shall also include one veterinarian member of the board, to be
appointed by the board president, and the registered veterinary
technician member of the board. end insert Members of the multidisciplinary
committee shall represent a sufficient cross section of the interests
in veterinary medicine in order to address the issues before it, as
determined by the board, including veterinarians, registered
veterinary technicians, and members of the public.

(b) Multidisciplinary committee members begin delete shall hold office end delete
begin insert appointed by the board shall serve end insert for a term of three years and
appointments shall be staggered accordingly. A member may be
reappointed, but no person shall serve as a member of the
committee for more than two consecutive terms. Vacancies
occurring shall be filled by appointment for the unexpired term,
within 90 days after they occur. begin insert Board members of the
multidisciplinary committee shall serve concurrently with their
terms of office on the board. end insert

(c) The multidisciplinary committee shall be subject to the
requirements of Article 9 (commencing with Section 11120) of
Chapter 1 of Part 1 of Division 3 of Title 2 of the Government
Code.

(d) Multidisciplinary committee members shall receive a per
diem as provided in Section 103 and shall be compensated for their
actual travel expenses in accordance with the rules and regulations
adopted by the Department of Human Resources.

(e) The board may remove a member of the multidisciplinary
committee begin insert appointed by the board end insert for continued neglect of a duty
required by this chapter, for incompetency, or for unprofessional
conduct.

begin insert

(f) It is the intent of the Legislature that the multidisciplinary
committee, in implementing this section, give appropriate
consideration to issues pertaining to the practice of registered
veterinarian technicians.

end insert

begin insert

begin insert SEC. 21. end insert   

end insert

begin insert Section 4836.1 of the end insert begin insert Business and Professions Code end insert
begin insert is amended to read: end insert

4836.1.  

(a) Notwithstanding any other provision of law, a
registered veterinary technician or a veterinary assistant may
administer a drug, including, but not limited to, a drug that is a
controlled substance, under the direct or indirect supervision of a
licensed veterinarian when done pursuant to the order, control,
and full professional responsibility of a licensed veterinarian.
However, no person, other than a licensed veterinarian, may induce
anesthesia unless authorized by regulation of the board.

(b)  begin delete Access to controlled substances by veterinary assistants
under this section is limited to persons who have undergone a
background check and who, to the best of the licensee manager’s
knowledge, do not have any drug or alcohol related felony
convictions. end delete begin insert Prior to authorizing a veterinary assistant to obtain
or administer a controlled substance by the order of a supervising
veterinarian, the licensee manager in a veterinary practice shall
conduct a background check on that veterinary assistant. A
veterinary assistant who has a drug- or alcohol-related felony
conviction, as indicated in the background check, shall be
prohibited from obtaining or administering controlled substances. end insert

(c) Notwithstanding subdivision (b), if the Veterinary Medical
Board, in consultation with the Board of Pharmacy, identifies a
dangerous drug, as defined in Section 4022, as a drug begin delete which end delete begin insert that end insert
has an established pattern of being diverted, the Veterinary Medical
Board may restrict access to that drug by veterinary assistants.

(d) For purposes of this section, the following definitions apply:

(1) “Controlled substance” has the same meaning as that term
is defined in Section 11007 of the Health and Safety Code.

(2) “Direct supervision” has the same meaning as that term is
defined in subdivision (e) of Section 2034 of Title 16 of the
California Code of Regulations.

(3) “Drug” has the same meaning as that term is defined in
Section 11014 of the Health and Safety Code.

(4) “Indirect supervision” has the same meaning as that term is
defined in subdivision (f) of Section 2034 of Title 16 of the
California Code of Regulations.

begin delete

(e) This section shall remain in effect only until January 1, 2015,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2015, deletes or extends that date.

end delete begin insert

(e) This section shall become inoperative on the later of January
1, 2015, or the date Section 4836.2 becomes operative, and, as of
January 1 next following that date, is repealed, unless a later
enacted statute, that becomes operative on or before that date,
deletes or extends the dates on which it becomes inoperative is
repealed.

end insert

begin insert

begin insert SEC. 22. end insert   

end insert

begin insert Section 4836.1 is added to the end insert begin insert Business and
Professions Code end insert begin insert , to read: end insert

begin insert

begin insert 4836.1. end insert   

(a) Notwithstanding any other provision of law, a
registered veterinary technician or a veterinary assistant may
administer a drug, including, but not limited to, a drug that is a
controlled substance under the direct or indirect supervision of a
licensed veterinarian when done pursuant to the order, control,
and full professional responsibility of a licensed veterinarian.
However, no person, other than a licensed veterinarian, may induce
anesthesia unless authorized by regulation of the board.

(b) A veterinary assistant may obtain or administer a controlled
substance pursuant to the order, control, and full professional
responsibility of a licensed veterinarian, only if he or she meets
both of the following conditions:

(1) Is designated by a licensed veterinarian to obtain or
administer controlled substances.

(2) Holds a valid veterinary assistant controlled substance
permit issued pursuant to Section 4836.2.

(c) Notwithstanding subdivision (b), if the Veterinary Medical
Board, in consultation with the Board of Pharmacy, identifies a
dangerous drug, as defined in Section 4022, as a drug that has an
established pattern of being diverted, the Veterinary Medical Board
may restrict access to that drug by veterinary assistants.

(d) For purposes of this section, the following definitions apply:

(1) “Controlled substance” has the same meaning as that term
is defined in Section 11007 of the Health and Safety Code.

(2) “Direct supervision” has the same meaning as that term is
defined in subdivision (e) of Section 2034 of Title 16 of the
California Code of Regulations.

(3) “Drug” has the same meaning as that term is defined in
Section 11014 of the Health and Safety Code.

(4) “Indirect supervision” has the same meaning as that term
is defined in subdivision (f) of Section 2034 of Title 16 of the
California Code of Regulations.

(e) This section shall become operative on the date Section
4836.2 becomes operative.

end insert

begin insert

begin insert SEC. 23. end insert   

end insert

begin insert Section 4836.2 is added to the end insert begin insert Business and
Professions Code end insert begin insert , to read: end insert

begin insert

begin insert 4836.2. end insert   

(a) Applications for a veterinary assistant controlled
substance permit shall be upon a form furnished by the board.

(b) The fee for filing an application for a veterinary assistant
controlled substance permit shall be set by the board in an amount
the board determines is reasonably necessary to provide sufficient
funds to carry out the purposes of this section, not to exceed one
hundred dollars ($100).

(c) The board may deny, suspend, or revoke the controlled
substance permit of a veterinary assistant after notice and hearing
for any cause provided in this subdivision. The proceedings under
this section shall be conducted in accordance with the provisions
for administrative adjudication in Chapter 5 (commencing with
Section 11500) of Part 1 of Division 3 of Title 2 of the Government
Code, and the board shall have all the powers granted therein.
The board may revoke or suspend a veterinary assistant controlled
substance permit for any of the following reasons:

(1) The employment of fraud, misrepresentation, or deception
in obtaining a veterinary assistant controlled substance permit.

(2) Chronic inebriety or habitual use of controlled substances.

(3) Violating or attempts to violate, directly or indirectly, or
assisting in or abetting the violation of, or conspiring to violate,
any provision of this chapter, or of the regulations adopted under
this chapter.

(d) The board shall not issue a veterinary assistant controlled
substance permit to any applicant with a state or federal felony
controlled substance conviction.

(e) The board shall revoke a veterinary assistant controlled
substance permit upon notification that the veterinary assistant to
whom the license is issued has been convicted of a state or federal
felony controlled substance violation.

(f) (1) As part of the application for a veterinary assistant
controlled substance permit, the applicant shall submit to the
Department of Justice fingerprint images and related information,
as required by the Department of Justice for all veterinary assistant
applicants, for the purposes of obtaining information as to the
existence and content of a record of state or federal convictions
and state or federal arrests and information as to the existence
and content of a record of state or federal arrests for which the
Department of Justice establishes that the person is free on bail
or on his or her own recognizance pending trial or appeal.

(2) When received, the Department of Justice shall forward to
the Federal Bureau of Investigation requests for federal summary
criminal history information that it receives pursuant to this
section. The Department of Justice shall review any information
returned to it from the Federal Bureau of Investigation and compile
and disseminate a response to the board summarizing that
information.

(3) The Department of Justice shall provide a state or federal
level response to the board pursuant to paragraph (1) of
subdivision (p) of Section 11105 of the Penal Code.

(4) The Department of Justice shall charge a reasonable fee
sufficient to cover the cost of processing the request described in
this subdivision.

(g) The board shall request from the Department of Justice
subsequent notification service, as provided pursuant to Section
11105.2 of the Penal Code, for persons described in paragraph
(1) of subdivision (f).

(h) This section shall become operative upon the later of January
1, 2015, or the effective date of the statute in which the Legislature
makes a determination that the board has sufficient staffing to
implement this section.

end insert

begin insert

begin insert SEC. 24. end insert   

end insert

begin insert Section 4836.3 is added to the end insert begin insert Business and
Professions Code end insert begin insert , to read: end insert

begin insert

begin insert 4836.3. end insert   

(a) Each person who has been issued a veterinary
assistant controlled substance permit by the board pursuant to
Section 4836.2 shall biennially apply for renewal of his or her
permit on or before the last day of the applicant’s birthday month.
The application shall be made on a form provided by the board.

(b) The application shall contain a statement to the effect that
the applicant has not been convicted of a felony, has not been the
subject of professional disciplinary action taken by any public
agency in California or any other state or territory, and has not
violated any of the provisions of this chapter. If the applicant is
unable to make that statement, the application shall contain a
statement of the conviction, professional discipline, or violation.

(c) The board may, as part of the renewal process, make
necessary inquiries of the applicant and conduct an investigation
in order to determine if cause for disciplinary action exists.

(d) The fee for filing an application for a renewal of a veterinary
assistant controlled substance permit shall be set by the board in
an amount the board determines is reasonably necessary to provide
sufficient funds to carry out the purposes of this section, not to
exceed fifty dollars ($50).

(e) This section shall become operative on the date Section
4836.2 becomes operative.

end insert

begin insert

begin insert SEC. 25. end insert   

end insert

begin insert Section 4836.4 is added to the end insert begin insert Business and
Professions Code end insert begin insert , to read: end insert

begin insert

begin insert 4836.4. end insert   

(a) Every person who has been issued a veterinary
assistant controlled substance permit by the board pursuant to
Section 4836.2 who changes his or her mailing or employer
address shall notify the board of his or her new mailing or
employer address within 30 days of the change. The board shall
not renew the permit of any person who fails to comply with this
section unless the person pays the penalty fee prescribed in Section
4842.5. An applicant for the renewal of a permit shall specify in
his or her application whether he or she has changed his or her
mailing or employer address and the board may accept that
statement as evidence of the fact.

(b) This section shall become operative on the date Section
4836.2 becomes operative.

end insert

begin delete SEC. 11. end delete
begin insert SEC. 26. end insert   

Section 11529 of the Government Code is amended
to read:

11529.  

(a) The administrative law judge of the Medical Quality
Hearing Panel established pursuant to Section 11371 may issue
an interim order suspending a license, or imposing drug testing,
continuing education, supervision of procedures, or other license
restrictions. Interim orders may be issued only if the affidavits in
support of the petition show that the licensee has engaged in, or
is about to engage in, acts or omissions constituting a violation of
the Medical Practice Act or the appropriate practice act governing
each allied health profession, or is unable to practice safely due to
a mental or physical condition, and that permitting the licensee to
continue to engage in the profession for which the license was
issued will endanger the public health, safety, or welfare. begin insert The
failure to comply with an order issued pursuant to Section 820 of
the Business and Professions Code may constitute grounds to issue
an interim suspension order under this section. end insert

(b) All orders authorized by this section shall be issued only
after a hearing conducted pursuant to subdivision (d), unless it
appears from the facts shown by affidavit that serious injury would
result to the public before the matter can be heard on notice. Except
as provided in subdivision (c), the licensee shall receive at least
15 days’ prior notice of the hearing, which notice shall include
affidavits and all other information in support of the order.

(c) If an interim order is issued without notice, the administrative
law judge who issued the order without notice shall cause the
licensee to be notified of the order, including affidavits and all
other information in support of the order by a 24-hour delivery
service. That notice shall also include the date of the hearing on
the order, which shall be conducted in accordance with the
requirement of subdivision (d), not later than 20 days from the
date of issuance. The order shall be dissolved unless the
requirements of subdivision (a) are satisfied.

(d) For the purposes of the hearing conducted pursuant to this
section, the licentiate shall, at a minimum, have the following
rights:

(1) To be represented by counsel.

(2) To have a record made of the proceedings, copies of which
may be obtained by the licentiate upon payment of any reasonable
charges associated with the record.

(3) To present written evidence in the form of relevant
declarations, affidavits, and documents.

The discretion of the administrative law judge to permit
testimony at the hearing conducted pursuant to this section shall
be identical to the discretion of a superior court judge to permit
testimony at a hearing conducted pursuant to Section 527 of the
Code of Civil Procedure.

(4) To present oral argument.

(e) Consistent with the burden and standards of proof applicable
to a preliminary injunction entered under Section 527 of the Code
of Civil Procedure, the administrative law judge shall grant the
interim order where, in the exercise of discretion, the administrative
law judge concludes that:

(1) There is a reasonable probability that the petitioner will
prevail in the underlying action.

(2) The likelihood of injury to the public in not issuing the order
outweighs the likelihood of injury to the licensee in issuing the
order.

(f) In all cases where an interim order is issued, and an
accusation is not filed and served pursuant to Sections 11503 and
11505 within 30 days of the date in which the parties to the hearing
on the interim order have submitted the matter, the order shall be
dissolved.

Upon service of the accusation the licensee shall have, in addition
to the rights granted by this section, all of the rights and privileges
available as specified in this chapter. If the licensee requests a
hearing on the accusation, the board shall provide the licensee with
a hearing within 30 days of the request, unless the licensee
stipulates to a later hearing, and a decision within 15 days of the
date the decision is received from the administrative law judge, or
the board shall nullify the interim order previously issued, unless
good cause can be shown by the Division of Medical Quality for
a delay.

(g) Where an interim order is issued, a written decision shall be
prepared within 15 days of the hearing, by the administrative law
judge, including findings of fact and a conclusion articulating the
connection between the evidence produced at the hearing and the
decision reached.

(h) Notwithstanding the fact that interim orders issued pursuant
to this section are not issued after a hearing as otherwise required
by this chapter, interim orders so issued shall be subject to judicial
review pursuant to Section 1094.5 of the Code of Civil Procedure.
The relief which may be ordered shall be limited to a stay of the
interim order. Interim orders issued pursuant to this section are
final interim orders and, if not dissolved pursuant to subdivision
(c) or (f), may only be challenged administratively at the hearing
on the accusation.

(i) The interim order provided for by this section shall be:

(1) In addition to, and not a limitation on, the authority to seek
injunctive relief provided for in the Business and Professions Code.

(2) A limitation on the emergency decision procedure provided
in Article 13 (commencing with Section 11460.10) of Chapter 4.5.

begin delete SEC. 12. end delete
begin insert SEC. 27. end insert   

Section 12529 of the Government Code, as amended
by Section 112 of Chapter 332 of the Statutes of 2012, is amended
to read:

12529.  

(a) There is in the Department of Justice the Health
Quality Enforcement Section. The primary responsibility of the
section is to investigate and prosecute proceedings against licensees
and applicants within the jurisdiction of the Medical Board of
California, the California Board of Podiatric Medicine, the Board
of Psychology, or any committee under the jurisdiction of the
Medical Board of California.

begin delete

(b) On January 1, 2014, all persons employed by the Medical
Board of California who are performing investigations and those
person’s staff shall be transferred to, and shall become employees
of, the Department of Justice. The status, position, and rights of
those persons shall, upon transfer, be the same as employees of
the Department of Justice holding similar positions, and for those
persons transferred who are performing investigations shall include
the status of peace officer provided for in Section 830.1 of the
Penal Code. Nothing in this section affects or diminishes the duty
of the Medical Board of California to preserve the confidentiality
of records as otherwise required by law. On and after January 1,
2014, any reference in this code to an investigation conducted by
the Medical Board of California shall be deemed to refer to an
investigation conducted by employees of the Department of Justice.

(c)

end delete

begin insert (b) end insert  The Attorney General shall appoint a Senior Assistant
Attorney General of the Health Quality Enforcement Section. The
Senior Assistant Attorney General of the Health Quality
Enforcement Section shall be an attorney in good standing licensed
to practice in the State of California, experienced in prosecutorial
or administrative disciplinary proceedings and competent in the
management and supervision of attorneys performing those
functions.

begin delete

(d)

end delete

begin insert (c) end insert  The Attorney General shall ensure that the Health Quality
Enforcement Section is staffed with a sufficient number of
experienced and able employees that are capable of handling the
most complex and varied types of disciplinary actions against the
licensees of the board.

begin delete

(e)

end delete

begin insert (d) end insert  Funding for the Health Quality Enforcement Section shall
be budgeted in consultation with the Attorney General from the
special funds financing the operations of the Medical Board of
California, the California Board of Podiatric Medicine, the Board
of Psychology, and the committees under the jurisdiction of the
Medical Board of California, with the intent that the expenses be
proportionally shared as to services rendered.

begin delete SEC. 13. end delete
begin insert SEC. 28. end insert   

Section 12529 of the Government Code, as amended
by Section 113 of Chapter 332 of the Statutes of 2012, is repealed.

begin delete SEC. 14. end delete
begin insert SEC. 29. end insert   

Section 12529.5 of the Government Code, as amended
by Section 114 of Chapter 332 of the Statutes of 2012, is amended
to read:

12529.5.  

(a) All complaints or relevant information concerning
licensees that are within the jurisdiction of the Medical Board of
California, the California Board of Podiatric Medicine, or the
Board of Psychology shall be made available to the Health Quality
Enforcement Section.

(b) The Senior Assistant Attorney General of the Health Quality
Enforcement Section shall assign attorneys to work on location at
the intake unit of the boards described in subdivision begin delete (d) of Section
12529 end delete begin insert (a) end insert to assist in evaluating and screening complaints and to
assist in developing uniform standards and procedures for
processing complaints.

(c) The Senior Assistant Attorney General or his or her deputy
attorneys general shall assist the boards or committees in designing
and providing initial and in-service training programs for staff of
the boards or committees, including, but not limited to, information
collection and investigation.

(d) The determination to bring a disciplinary proceeding against
a licensee of the boards shall be made by the executive officer of
the boards or committees as appropriate in consultation with the
senior assistant.

begin delete SEC. 15. end delete
begin insert SEC. 30. end insert   

Section 12529.5 of the Government Code, as amended
by Section 115 of Chapter 332 of the Statutes of 2012, is repealed.

begin insert

begin insert SEC. 31. end insert   

end insert

begin insert Section 12529.6 of the end insert begin insert Government Code end insert begin insert is amended
to read: end insert

12529.6.  

(a) The Legislature finds and declares that the
Medical Board of California, by ensuring the quality and safety
of medical care, performs one of the most critical functions of state
government. Because of the critical importance of the board’s
public health and safety function, the complexity of cases involving
alleged misconduct by physicians and surgeons, and the evidentiary
burden in the board’s disciplinary cases, the Legislature finds and
declares that using a vertical enforcement and prosecution model
for those investigations is in the best interests of the people of
California.

(b) Notwithstanding any other provision of law, as of January
1, 2006, each complaint that is referred to a district office of the
board for investigation shall be simultaneously and jointly assigned
to an investigator and to the deputy attorney general in the Health
Quality Enforcement Section responsible for prosecuting the case
if the investigation results in the filing of an accusation. The joint
assignment of the investigator and the deputy attorney general
shall exist for the duration of the disciplinary matter. During the
assignment, the investigator so assigned shall, under the direction
but not the supervision of the deputy attorney general, be
responsible for obtaining the evidence required to permit the
Attorney General to advise the board on legal matters such as
whether the board should file a formal accusation, dismiss the
complaint for a lack of evidence required to meet the applicable
burden of proof, or take other appropriate legal action.

(c) The Medical Board of California, the Department of
Consumer Affairs, and the Office of the Attorney General shall,
if necessary, enter into an interagency agreement to implement
this section.

(d) This section does not affect the requirements of Section
12529.5 as applied to the Medical Board of California where
complaints that have not been assigned to a field office for
investigation are concerned.

(e) It is the intent of the Legislature to enhance the vertical
enforcement and prosecution model as set forth in subdivision (a).
The Medical Board of California shall do all of the following:

(1) Increase its computer capabilities and compatibilities with
the Health Quality Enforcement Section in order to share case
information.

(2) Establish and implement a plan to locate its enforcement
staff and the staff of the Health Quality Enforcement Section in
the same offices, as appropriate, in order to carry out the intent of
the vertical enforcement and prosecution model.

(3) Establish and implement a plan to assist in team building
between its enforcement staff and the staff of the Health Quality
Enforcement Section in order to ensure a common and consistent
knowledge base.

begin delete

(f) This section shall remain in effect only until January 1, 2014,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2014, deletes or extends that date.

end delete

begin delete SEC. 16. end delete
begin insert SEC. 32. end insert   

Section 12529.7 of the Government Code is amended
to read:

12529.7.  

By March 1, 2015, the Medical Board of California,
in consultation with the Department of Justice and the Department
of Consumer Affairs, shall report and make recommendations to
the Governor and the Legislature on the vertical enforcement and
prosecution model created under Section 12529.6.

begin insert

begin insert SEC. 33. end insert   

end insert

begin insert Section 1248.15 of the end insert begin insert Health and Safety Code end insert begin insert is
amended to read: end insert

1248.15.  

(a) The board shall adopt standards for accreditation
and, in approving accreditation agencies to perform accreditation
of outpatient settings, shall ensure that the certification program
shall, at a minimum, include standards for the following aspects
of the settings’ operations:

(1) Outpatient setting allied health staff shall be licensed or
certified to the extent required by state or federal law.

(2) (A) Outpatient settings shall have a system for facility safety
and emergency training requirements.

(B) There shall be onsite equipment, medication, and trained
personnel to facilitate handling of services sought or provided and
to facilitate handling of any medical emergency that may arise in
connection with services sought or provided.

(C) In order for procedures to be performed in an outpatient
setting as defined in Section 1248, the outpatient setting shall do
one of the following:

(i) Have a written transfer agreement with a local accredited or
licensed acute care hospital, approved by the facility’s medical
staff.

(ii) Permit surgery only by a licensee who has admitting
privileges at a local accredited or licensed acute care hospital, with
the exception that licensees who may be precluded from having
admitting privileges by their professional classification or other
administrative limitations, shall have a written transfer agreement
with licensees who have admitting privileges at local accredited
or licensed acute care hospitals.

(iii) Submit for approval by an accrediting agency a detailed
procedural plan for handling medical emergencies that shall be
reviewed at the time of accreditation. No reasonable plan shall be
disapproved by the accrediting agency.

(D) In addition to the requirements imposed in subparagraph
(C), the outpatient setting shall submit for approval by an
accreditation agency at the time of accreditation a detailed plan,
standardized procedures, and protocols to be followed in the event
of serious complications or side effects from surgery that would
place a patient at high risk for injury or harm or to govern
emergency and urgent care situations. The plan shall include, at a
minimum, that if a patient is being transferred to a local accredited
or licensed acute care hospital, the outpatient setting shall do all
of the following:

(i) Notify the individual designated by the patient to be notified
in case of an emergency.

(ii) Ensure that the mode of transfer is consistent with the
patient’s medical condition.

(iii) Ensure that all relevant clinical information is documented
and accompanies the patient at the time of transfer.

(iv) Continue to provide appropriate care to the patient until the
transfer is effectuated.

(E) All physicians and surgeons transferring patients from an
outpatient setting shall agree to cooperate with the medical staff
peer review process on the transferred case, the results of which
shall be referred back to the outpatient setting, if deemed
appropriate by the medical staff peer review committee. If the
medical staff of the acute care facility determines that inappropriate
care was delivered at the outpatient setting, the acute care facility’s
peer review outcome shall be reported, as appropriate, to the
accrediting body or in accordance with existing law.

(3) The outpatient setting shall permit surgery by a dentist acting
within his or her scope of practice under Chapter 4 (commencing
with Section 1600) of Division 2 of the Business and Professions
Code or physician and surgeon, osteopathic physician and surgeon,
or podiatrist acting within his or her scope of practice under
Chapter 5 (commencing with Section 2000) of Division 2 of the
Business and Professions Code or the Osteopathic Initiative Act.
The outpatient setting may, in its discretion, permit anesthesia
service by a certified registered nurse anesthetist acting within his
or her scope of practice under Article 7 (commencing with Section
2825) of Chapter 6 of Division 2 of the Business and Professions
Code.

(4) Outpatient settings shall have a system for maintaining
clinical records.

(5) Outpatient settings shall have a system for patient care and
monitoring procedures.

(6) (A)  Outpatient settings shall have a system for quality
assessment and improvement.

(B) Members of the medical staff and other practitioners who
are granted clinical privileges shall be professionally qualified and
appropriately credentialed for the performance of privileges
granted. The outpatient setting shall grant privileges in accordance
with recommendations from qualified health professionals, and
credentialing standards established by the outpatient setting.

(C) Clinical privileges shall be periodically reappraised by the
outpatient setting. The scope of procedures performed in the
outpatient setting shall be periodically reviewed and amended as
appropriate.

(7) Outpatient settings regulated by this chapter that have
multiple service locations shall have all of the sites inspected.

(8) Outpatient settings shall post the certificate of accreditation
in a location readily visible to patients and staff.

(9) Outpatient settings shall post the name and telephone number
of the accrediting agency with instructions on the submission of
complaints in a location readily visible to patients and staff.

(10) Outpatient settings shall have a written discharge criteria.

(b) Outpatient settings shall have a minimum of two staff
persons on the premises, one of whom shall either be a licensed
physician and surgeon or a licensed health care professional with
current certification in advanced cardiac life support (ACLS), as
long as a patient is present who has not been discharged from
supervised care. Transfer to an unlicensed setting of a patient who
does not meet the discharge criteria adopted pursuant to paragraph
(10) of subdivision (a) shall constitute unprofessional conduct.

(c) An accreditation agency may include additional standards
in its determination to accredit outpatient settings if these are
approved by the board to protect the public health and safety.

(d) No accreditation standard adopted or approved by the board,
and no standard included in any certification program of any
accreditation agency approved by the board, shall serve to limit
the ability of any allied health care practitioner to provide services
within his or her full scope of practice. Notwithstanding this or
any other provision of law, each outpatient setting may limit the
privileges, or determine the privileges, within the appropriate scope
of practice, that will be afforded to physicians and allied health
care practitioners who practice at the facility, in accordance with
credentialing standards established by the outpatient setting in
compliance with this chapter. Privileges may not be arbitrarily
restricted based on category of licensure.

(e) The board shall adopt standards that it deems necessary for
outpatient settings that offer in vitro fertilization.

(f) The board may adopt regulations it deems necessary to
specify procedures that should be performed in an accredited
outpatient setting for facilities or clinics that are outside the
definition of outpatient setting as specified in Section 1248.

(g) As part of the accreditation process, the accrediting agency
shall conduct a reasonable investigation of the prior history of the
outpatient setting, including all licensed physicians and surgeons
who have an ownership interest therein, to determine whether there
have been any adverse accreditation decisions rendered against
them. For the purposes of this section, “conducting a reasonable
investigation” means querying the Medical Board of California
and the Osteopathic Medical Board of California to ascertain if
either the outpatient setting has, or, if its owners are licensed
physicians and surgeons, if those physicians and surgeons have,
been subject to an adverse accreditation decision.

begin delete

(h) An outpatient setting shall be subject to the reporting
requirements in Section 1279.1 and the penalties for failure to
report specified in Section 1280.4.

end delete

begin insert

begin insert SEC. 34. end insert   

end insert

begin insert Section 830.3 of the end insert begin insert Penal Code end insert begin insert is amended to read: end insert

830.3.  

The following persons are peace officers whose authority
extends to any place in the state for the purpose of performing
their primary duty or when making an arrest pursuant to Section
836 as to any public offense with respect to which there is
immediate danger to person or property, or of the escape of the
perpetrator of that offense, or pursuant to Section 8597 or 8598 of
the Government Code. These peace officers may carry firearms
only if authorized and under those terms and conditions as specified
by their employing agencies:

(a) Persons employed by the Division of Investigation of the
Department of Consumer Affairs and investigators of begin delete the Medical
Board of California and end delete the Board of Dental Examiners, who are
designated by the Director of Consumer Affairs, provided that the
primary duty of these peace officers shall be the enforcement of
the law as that duty is set forth in Section 160 of the Business and
Professions Code.

(b) Voluntary fire wardens designated by the Director of
Forestry and Fire Protection pursuant to Section 4156 of the Public
Resources Code, provided that the primary duty of these peace
officers shall be the enforcement of the law as that duty is set forth
in Section 4156 of that code.

(c) Employees of the Department of Motor Vehicles designated
in Section 1655 of the Vehicle Code, provided that the primary
duty of these peace officers shall be the enforcement of the law as
that duty is set forth in Section 1655 of that code.

(d) Investigators of the California Horse Racing Board
designated by the board, provided that the primary duty of these
peace officers shall be the enforcement of Chapter 4 (commencing
with Section 19400) of Division 8 of the Business and Professions
Code and Chapter 10 (commencing with Section 330) of Title 9
of Part 1 of this code.

(e) The State Fire Marshal and assistant or deputy state fire
marshals appointed pursuant to Section 13103 of the Health and
Safety Code, provided that the primary duty of these peace officers
shall be the enforcement of the law as that duty is set forth in
Section 13104 of that code.

(f) Inspectors of the food and drug section designated by the
chief pursuant to subdivision (a) of Section 106500 of the Health
and Safety Code, provided that the primary duty of these peace
officers shall be the enforcement of the law as that duty is set forth
in Section 106500 of that code.

(g) All investigators of the Division of Labor Standards
Enforcement designated by the Labor Commissioner, provided
that the primary duty of these peace officers shall be the
enforcement of the law as prescribed in Section 95 of the Labor
Code.

(h) All investigators of the State Departments of Health Care
Services, Public Health, Social Services, Mental Health, and
Alcohol and Drug Programs, the Department of Toxic Substances
Control, the Office of Statewide Health Planning and Development,
and the Public Employees’ Retirement System, provided that the
primary duty of these peace officers shall be the enforcement of
the law relating to the duties of his or her department or office.
Notwithstanding any other provision of law, investigators of the
Public Employees’ Retirement System shall not carry firearms.

(i) The Chief of the Bureau of Fraudulent Claims of the
Department of Insurance and those investigators designated by the
chief, provided that the primary duty of those investigators shall
be the enforcement of Section 550.

(j) Employees of the Department of Housing and Community
Development designated under Section 18023 of the Health and
Safety Code, provided that the primary duty of these peace officers
shall be the enforcement of the law as that duty is set forth in
Section 18023 of that code.

(k) Investigators of the office of the Controller, provided that
the primary duty of these investigators shall be the enforcement
of the law relating to the duties of that office. Notwithstanding any
other law, except as authorized by the Controller, the peace officers
designated pursuant to this subdivision shall not carry firearms.

(l) Investigators of the Department of Corporations designated
by the Commissioner of Corporations, provided that the primary
duty of these investigators shall be the enforcement of the
provisions of law administered by the Department of Corporations.
Notwithstanding any other provision of law, the peace officers
designated pursuant to this subdivision shall not carry firearms.

(m) Persons employed by the Contractors State License Board
designated by the Director of Consumer Affairs pursuant to Section
7011.5 of the Business and Professions Code, provided that the
primary duty of these persons shall be the enforcement of the law
as that duty is set forth in Section 7011.5, and in Chapter 9
(commencing with Section 7000) of Division 3, of that code. The
Director of Consumer Affairs may designate as peace officers not
more than 12 persons who shall at the time of their designation be
assigned to the special investigations unit of the board.
Notwithstanding any other provision of law, the persons designated
pursuant to this subdivision shall not carry firearms.

(n) The Chief and coordinators of the Law Enforcement Branch
of the California Emergency Management Agency.

(o) Investigators of the office of the Secretary of State designated
by the Secretary of State, provided that the primary duty of these
peace officers shall be the enforcement of the law as prescribed
in Chapter 3 (commencing with Section 8200) of Division 1 of
Title 2 of, and Section 12172.5 of, the Government Code.
Notwithstanding any other provision of law, the peace officers
designated pursuant to this subdivision shall not carry firearms.

(p) The Deputy Director for Security designated by Section
8880.38 of the Government Code, and all lottery security personnel
assigned to the California State Lottery and designated by the
director, provided that the primary duty of any of those peace
officers shall be the enforcement of the laws related to assuring
the integrity, honesty, and fairness of the operation and
administration of the California State Lottery.

(q) Investigators employed by the Investigation Division of the
Employment Development Department designated by the director
of the department, provided that the primary duty of those peace
officers shall be the enforcement of the law as that duty is set forth
in Section 317 of the Unemployment Insurance Code.

Notwithstanding any other provision of law, the peace officers
designated pursuant to this subdivision shall not carry firearms.

(r) The chief and assistant chief of museum security and safety
of the California Science Center, as designated by the executive
director pursuant to Section 4108 of the Food and Agricultural
Code, provided that the primary duty of those peace officers shall
be the enforcement of the law as that duty is set forth in Section
4108 of the Food and Agricultural Code.

(s) Employees of the Franchise Tax Board designated by the
board, provided that the primary duty of these peace officers shall
be the enforcement of the law as set forth in Chapter 9
(commencing with Section 19701) of Part 10.2 of Division 2 of
the Revenue and Taxation Code.

(t) Notwithstanding any other provision of this section, a peace
officer authorized by this section shall not be authorized to carry
firearms by his or her employing agency until that agency has
adopted a policy on the use of deadly force by those peace officers,
and until those peace officers have been instructed in the employing
agency’s policy on the use of deadly force.

Every peace officer authorized pursuant to this section to carry
firearms by his or her employing agency shall qualify in the use
of the firearms at least every six months.

(u) Investigators of the Department of Managed Health Care
designated by the Director of the Department of Managed Health
Care, provided that the primary duty of these investigators shall
be the enforcement of the provisions of laws administered by the
Director of the Department of Managed Health Care.
Notwithstanding any other provision of law, the peace officers
designated pursuant to this subdivision shall not carry firearms.

(v) The Chief, Deputy Chief, supervising investigators, and
investigators of the Office of Protective Services of the State
Department of Developmental Services, provided that the primary
duty of each of those persons shall be the enforcement of the law
relating to the duties of his or her department or office.

begin delete SEC. 17. end delete
begin insert SEC. 35. end insert   

No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of
the Government Code, or changes the definition of a crime within
the meaning of Section 6 of Article XIII B of the California
Constitution.