BILL ANALYSIS Ó
SB 304
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Date of Hearing: August 30, 2013
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Mike Gatto, Chair
SB 304 (Lieu) - As Amended: August 12, 2013
Policy Committee: Business and
Professions Vote: 11-2
Urgency: No State Mandated Local Program:
Yes Reimbursable: No
SUMMARY
This bill includes numerous provisions related to the Medical
Board of California (MBC) and the Veterinary Medical Board that
emerged during sunset review of the two boards in 2012. Major
components of this bill with a fiscal impact include the
following:
1)Transfers the Health Quality Investigation Unit (Unit) from
MBC to DOI within DCA, and requires the transfer by January 1,
2014.
2)Extends MBC's sunset date until January 1, 2018 and makes MBC
subject to review by the appropriate policy committees of the
Legislature.
3)Requires an accredited outpatient setting to report an adverse
event to MBC, and authorizes fines for failure to report.
4)Authorizes civil penalties on a health care facility with
electronic health records that fails to provide an authorizing
patient's certified medical records to MBC within 15 days of
receiving the request. Penalties are up to $1,000 per day for
each day the documents have not been produced, and after the
15th day, up to $10,000 per day.
5)Deletes the sunset date on the Health Quality Enforcement
Section in the Department of Justice (DOJ) and the Vertical
Enforcement (VE) program.
6)Extends VMB's sunset date until January 1, 2016, and makes VMB
subject to review by the appropriate policy committees of the
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Legislature.
7)Requires the VMB to make every effort to inspect at least 20%
of veterinary premises on an annual basis.
8)Establishes a veterinary assistant-controlled substance permit
(VACSP), requires background checks of veterinary assistants
designated to obtain or administer a controlled substance, and
establishes a permit fee not to exceed $100 for initial
application, and $50 for renewal.
9)Specifies that the provisions pertaining to the VACSP and the
renewal application for the VACSP become operative on January
1, 2015 or the effective date of the statute in which the
Legislature makes a determination that the VMB has sufficient
staffing to implement.
FISCAL EFFECT
Medical Board of California provisions:
1)Unknown potential new GF revenues from new authority to levy
fines on accredited outpatient settings and civil penalties on
health care facilities with electronic health records.
2)$16.7 million annually to DOJ to continue operations of the
Health Quality Enforcement Section, including approximately
$14 million annually to continue the VE program (funding for
these DOJ activities is provided by fee-supported special fund
reimbursements from the MBC, the California Board of Podiatric
Medicine, the Board of Psychology, other committees under the
jurisdiction of the MBC, in amounts proportional to services
rendered).
3)Annual fee-supported special fund costs of $58 million
associated with continued operation of the MBC. As noted, a
portion of these funds are used to support enforcement
activities at DOJ.
4)$26.6 million in position and operating expenditures will
shift from the MBC to the Division of Investigation within
DCA.
Veterinary Medical Board provisions :
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All costs will accrue to the Veterinary Medical Board Contingent
Fund.
1)Annual fee-supported special fund costs of $3 million
associated with continued operation of the VMB.
2)Cost pressure to the VMB of approximately $100,000 associated
with increased frequency of inspections of veterinary
facilities.
3)One-time costs to VMB of $550,000 to establish, and annual
costs to VMB of $200,000 per year to administer, a veterinary
assistant controlled substance permit program.
4)One-time costs of $70,000 and annual costs of $12,000 to DOJ
for background checks, supported by the Veterinary Medical
Board Contingent Fund.
COMMENTS
1)Rationale . This bill represents the combined provisions
drafted to address many of the issues raised in the 2013
Sunset Review Reports for the MBC and VMB. In addition to
extending the sunset dates for the MBC by four years and the
VMB by two years, it includes a number of reforms designed to
better protect consumers and make boards more efficient and
accountable. This measure is author-sponsored.
2)Key Medical Board Issues . This bill extends the sunset on the
MBC until 2018, as well as addresses the following key issues:
a) Vertical enforcement and prosecution (VE) . Under
current law, VE requires the coordination between MBC
investigators and the AG's Office with respect to
investigation and prosecution activities as well as its
activities. The Sunset Review found that VE has been
successful in integrating investigations and prosecutions
and has resulted in faster resolutions. This bill deletes
the sunset date on VE, extending the program indefinitely.
b) Transfer of MBC investigators to DOI . As initially
drafted in VE's enabling legislation, investigators would
have been transferred to the AG's office. This would have
placed the investigator and prosecutor in the same office
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under the same agency, a practice that is common for other
enforcement agencies. However, the program was implemented
and has been operating with investigators in MBC
cooperating with attorneys at DOJ. This bill transfers MBC
investigators to the Division of Investigation within DCA,
rather than to DOJ, allowing the Legislature to retain
oversight authority over the investigatory process.
3)Key Veterinary Medical Board Issues . The VMB licenses and
regulates 11,000 veterinarians, 6,000 RVTs, schools/programs
and veterinary premises hospitals through the enforcement of
the California Veterinary Medicine Practice Act. This bill
extends the sunset on the VMB until 2016, as well as addresses
the following key issues:
a) Veterinary Premise and Facility Inspections . During the
2004 sunset review of the VMB it was noted that 13% of
veterinary premises/facilities were inspected by the VMB
annually. Currently, the VMB inspects 7% of facilities per
year. To address these concerns, this bill requires the VMB
to make every effort to inspect at least 20% of veterinary
premises annually.
b) Veterinarian Assistants Access to Controlled Substances .
During the 2013 sunset review process, it was recommended
the VMB establish a permitting process for VAs who will
have access to controlled substances, both under direct and
indirect supervision of a veterinarian, so that the VMB can
require a fingerprint check and obtain criminal history
information from DOJ for VAs. This bill establishes the
guidelines for the program, including fingerprinting and
background checks, to protect animal welfare and prevent
inappropriate access to controlled substances.
4)Related Legislation . SB 198 (Lieu), pending on this
committee's Suspense File, extends the sunset of the Physical
Therapy Board and recasts the Physical Therapy Practice Act.
SB 305 (Lieu) extends the sunset dates for, and implements
recommendations that emerged from the legislative sunset
review of, various other boards regulated by the Department of
Consumer Affairs.
SB 307 (Price) relates to the Veterinary Medical Board. This
bill is on the inactive file on the Senate Floor.
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Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081