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
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|Author: |Holden |
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|Version: |April 25, 2016 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant|Sarah Mason |
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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
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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
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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
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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
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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
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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.
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