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)
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          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  








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          (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.