BILL ANALYSIS Ó Senate Appropriations Committee Fiscal Summary Senator Kevin de León, Chair SB 304 (Price) - Healing arts: boards. Amended: April 24, 2013 Policy Vote: B&P 9-0 Urgency: No Mandate: Yes Hearing Date: May 13, 2013 Consultant: Brendan McCarthy This bill meets the criteria for referral to the Suspense File. Bill Summary: SB 304 would make several changes to the responsibilities and processes of the Medical Board of California. In particular, the bill would transfer all staff currently performing investigations of physicians from the Medical Board to the Department of Justice. Fiscal Impact: Ongoing costs up to $1.8 million per year for investigations, based on differences in employee classifications between the Medical Board and the Department of Justice (Contingent Fund of the Medical Board of California). Increased costs of about $1.1 million per year for additional support staff at the Department of Justice (Contingent Fund of the Medical Board of California). The Department indicates that it currently does not have some of the Medical Board's technical expertise and therefore the Department would need to add some additional staff to provide technical expertise to investigators. Ongoing costs of about $2.5 million per year for the continued operation of the vertical enforcement program by the Department of Justice (Contingent Fund of the Medical Board of California). A report commissioned by the Medical Board indicates that eight investigator and ten attorney positions have been authorized to support this program. Background: Under current law, the Medical Board of California licenses and regulates the conduct of physicians and surgeons. State law includes requirements on the practice of medicine by physicians and surgeons, the regulatory procedures of the Medical Board, and requirements for the investigation of SB 304 (Price) Page 1 physicians and surgeons by the Medical Board. The Medical Board is authorized to investigate physicians and surgeons for violations of the law or other licensing requirements. Current law authorizes a vertical enforcement and prosecution model for such cases, under which staff of the Medical Board work with staff from the Department of Justice to investigate and prosecute allegations against physicians and surgeons. Proposed Law: SB 304 would make several changes to the responsibilities and processes of the Medical Board of California. The bill would transfer all staff currently performing investigations from the Medical Board to the Department of Justice. The bill would also delete the sunset on the vertical enforcement and prosecution program. In addition, specific provisions of the bill would: Repeal the authority of the Medical Board to approve equivalent certification boards; Require licensees to provide email addresses to the Medical Board; Clarify that licensees must pass all parts of USMLE licensing exams; Limit the requirement for review of reports by a medical expert, under certain circumstances; Authorize the Medical Board to issue a notification to cease practice to a licensee who fails to comply with an order related to an examination required of the licensee; Provide that the prohibition on the corporate practice of medicine does not apply to medical residents; Clarify the requirements for midwife training; Make certain authorities of the Medical Board relating to Registered Dispensing Opticians subject to Legislative Review; Make other changes to Medical Board procedures and authorities. Related Legislation: This bill is one of several bills introduced this session to extend the sunset on licensing boards within the Department of Consumer Affairs - including SB 305 SB 304 (Price) Page 2 (Price), SB 307 (Price), SB 308 (Price), and SB 309 (Price). Staff Comments: Most of the changes made in this bill will have minor fiscal impacts on the Medical Board. There will be a fiscal impact from shifting investigatory positions from the Medical Board to the Department of Justice. Because there are salary differences between the personnel classifications used by the Medical Board and the Department of Justice for generally similar positions, there is an anticipated increase in costs from shifting positions between the agencies. For example, the Medical Board employs 76 investigators with a top step salary of $68,000 per year. The equivalent Department of Justice classification is a special agent position, with an top step salary of $88,000. The cost estimate above assumes that all positions are paid at the top step salary. In reality, the actual increase in costs will depend on individual salaries. The only costs that may be incurred by a local agency relate to crimes and infractions. Under the California Constitution, such costs are not reimbursable by the state.