BILL ANALYSIS Ó SENATE COMMITTEE ON BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT Senator Jerry Hill, Chair 2015 - 2016 Regular Bill No: AB 2745 Hearing Date: June 13, 2016 ----------------------------------------------------------------- |Author: |Holden | |----------+------------------------------------------------------| |Version: |April 25, 2016 | ----------------------------------------------------------------- ---------------------------------------------------------------- |Urgency: |No |Fiscal: |Yes | ---------------------------------------------------------------- ----------------------------------------------------------------- |Consultant|Sarah Mason | |: | | ----------------------------------------------------------------- Subject: Healing arts: licensing and certification SUMMARY: Makes various changes to the Medical Practice Act. Existing law: 1)Provides for the licensure and regulation of physicians and surgeons by the Medical Board of California (MBC) pursuant to the Medical Practice Act (Act). (Business and Professions Code (BPC) § 2000 et. seq.) 2)Authorizes an applicant for a physician's and surgeon's license who is otherwise eligible for a license but unable to practice some aspects of medicine safely due to a disability to receive a limited license (LL) according to certain requirements. (BPC § 2088) 3)Authorizes a licensee who demonstrates that he or she is unable to practice medicine due to a disability to request a waiver of the license renewal fee, and specifies that a licensee granted that waiver is prohibited from practicing medicine until he or she establishes that the disability no longer exists or signs an agreement, under penalty of perjury, agreeing to limit his or her practice in the manner prescribed by the reviewing physician. (BPC § 2441) 4)Authorizes MBC, in any investigation that involves the AB 2745 (Holden) Page 2 of ? death of a patient, to inspect and copy the medical records of the deceased patient without the authorization of the beneficiary or personal representative of the deceased patient or a court order solely to determine the extent to which the death was the result of the physician and surgeon's violation of the Medical Practice Act, if the MBC provides a written request to the physician and surgeon that includes a declaration that the MBC has been unsuccessful in locating or contacting the deceased patient's beneficiary or personal representative after reasonable efforts. (BPC § 2225(c)(1)) 5)Provides for the licensing and regulation of midwives by the MBC. (BPC § 2512 et seq.) 6)Prohibits a person from using the title "certified polysomnographic technologist" or engaging in the practice of polysomnography unless he or she is registered as a certified polysomnographic technologist, is supervised and directed by a licensed physician and surgeon, and meets certain other requirements. (BPC § 3575 et seq.) 7)Requires polysomnographic technologists to apply to and register with the MBC and to pay specified fees to be fixed by the MBC at no more than $100 each, and to renew their registration biennially for a fee of no more than $150. (BPC § 3577) This bill: 1) Authorizes all physician and surgeon licensees to apply for a LL and ensures that physicians who have a disabled status license and want to change to a LL to meet the same requirements in existing law for a LL. 2) Authorizes MBC to send a written request for medical records to the facility where the care of a deceased patient occurred, or where the records are located, in order to review medical records under Item #4, above. 3) Authorizes MBC to place the license of a midwife on probation, in addition to authority under current law to AB 2745 (Holden) Page 3 of ? suspend or revoke a license for certain acts, including unprofessional conduct and crimes of dishonesty. Authorizes MBC to revoke the midwife license of any person who has been required to register as a sex offender. 4) Clarifies MBC's authority to deny a post graduate training authorization letter for the same reasons it can deny a physician's and surgeon's license application under existing law. 5) Provides that the use of any controlled substance or the use of dangerous drugs or of alcoholic beverages, to the extent, or in such a manner as to be dangerous or injurious to a research psychoanalyst or polysomnographic technologist registrant, or to any other person or to the public, or to the extent that this use impairs the ability of the registrant to practice safely or more than one misdemeanor or any felony conviction involving the use, consumption, or self-administration of any of the substances referred to in this section, or any combination thereof, constitutes unprofessional conduct. Provides that the record of the conviction is conclusive evidence of this unprofessional conduct and provides that a plea or verdict of guilty or a conviction following a no contest plea is deemed to be a conviction for purposes of discipline for a research psychoanalyst or polysomnographic technologist registrant. 6) Authorizes MBC to suspend or revoke the registration of a polysomnographic technologist, polysomnographic technician, or polysomnographic trainee for unprofessional conduct as specified. 7) Authorizes a person whose polysomnographic technologist registration has been voluntarily surrendered while under investigation or while charges are pending or whose registration has been revoked or suspended or placed on probation, to petition MBC for reinstatement or modification of penalty, including modification or termination of AB 2745 (Holden) Page 4 of ? probation. 8) Permits MBC to revoke the research psychoanalyst or polysomnographic technologist registration of any person who has been required to register as a sex offender. 9) Specifies that the fee for monitoring a registrant on probation shall be the cost of monitoring, as fixed by the MBC. 10)Makes other technical, updating, and clarifying changes. FISCAL EFFECT: This bill is keyed "fiscal" by Legislative Counsel. According to the Assembly Committee on Appropriations analysis dated May 4, 2016, this bill will result in minor costs and revenues to MBC and potential minor information technology costs if changes are needed to the BrEZe licensing system. COMMENTS: 1. Purpose. MBC is the sponsor of this bill. According to the Author, the bill is intended to make clarifying changes to the Act in order to assist MBC in its licensing and enforcement functions. According to the Author, MBC is responsible for licensing and regulating allied health licensees, which include Licensed Midwives, Polysomnographic Technologists, Technicians and Trainees, and Research Psychoanalysts. The Author asserts that there are some provisions that apply to physicians and surgeons in the Act that MBC also applies to allied health licensees and as such, this bill is necessary to clarify MBC's authority to: revoke or deny a license for registered sex offenders; take AB 2745 (Holden) Page 5 of ? disciplinary action for excessive use of drugs or alcohol; allow allied health licensees to petition for license reinstatement; and allow MBC to use probation as a disciplinary option for allied health licensees, including procuring payment for the costs of probation monitoring. 2. Background. a) Limited License (LL). The Board offers a LL to applicants or disabled status licensees if they are otherwise eligible for licensure, but unable to practice all aspects of medicine safely due to a disability. Currently, only new licensees or disabled status licensees can apply for this LL. To allow all licensees the ability to apply for a LL at any time, this bill provides the changes to law necessary so that the LL is an option for all licensees. The bill also makes necessary changes to allow physicians with a disabled status license to change to a LL. b) Post Graduate Training Authorization. Provision in the Act specify reasons MBC is authorized to deny a physician's and surgeon's application for licensure. Amendments to the Act contained in this bill clarify that the Board can deny a post graduate training authorization letter for the same reasons it can deny a physician's and surgeon's license application. c) Obtaining Records for a Deceased Patient. For investigations involving the death of a patient, MBC is authorized to inspect and copy the medical records of the deceased patient without the approval of the next of kin of the deceased patient or court order. MBC only uses this authority when determining whether the death stemmed from violation of the Act by a physician or surgeon. In these instances, MBC must provide a written request to the physician that owns the records, declaring that MBC has been unsuccessful in locating or contacting the patient's next of kin after reasonable efforts. According to MBC, in many cases, the patient's medical records do not reside with the physician but rather at the facility where the care of the deceased patient occurred. MBC notes that the language in this bill will ensure that investigations are not hindered by allowing MBC to send a written request to AB 2745 (Holden) Page 6 of ? the facility where the care actually occurred or where the records are truly located. d) Allied Health Professions. MBC is responsible for licensing and regulating allied health licensees, which include Licensed Midwives, Polysomnographic Technologists, Technicians and Trainees, and Research Psychoanalysts. Amendments to the Act in this bill clarify MBC's enforcement authority for these professions. 1. Arguments in Support. The American Federation of State, County and Municipal Employees (AFSCME) notes that the organization promotes clarity within the medical field and this measure will ensure MBC's authority to perform their duties is clear. MBC , the Sponsor of this bill, believes that it clarifies MBC's authority for allied health licensees MBC licenses. According to MBC, this bill will clean up existing law to ensure that MBC's authority to perform its regulatory oversight of licensees is clearly defined and aligned with the Act. SUPPORT AND OPPOSITION: Support: AFSCME Medical Board of California Opposition: None on file as of June 7, 2016. -- END --