BILL NUMBER: SB 361 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JULY 2, 2015
AMENDED IN SENATE APRIL 14, 2015
INTRODUCED BY Senator Hill
(Coauthor: Senator Nielsen)
(Coauthors: Assembly Members Rodriguez and Waldron)
FEBRUARY 24, 2015
An act to amend Section 4846.5 of the Business and
Professions Code, and to add Section 1275.4 to the Health and
Safety Code, relating to public health, and declaring the urgency
thereof, to take effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
SB 361, as amended, Hill. Skilled nursing facilities:
antimicrobial stewardship guidelines. Antimicrobial
stewardship: education and policies.
Under the Veterinary Medical Practice Act, the Veterinary Medical
Board licenses veterinarians and regulates the practice of veterinary
medicine. The act requires an applicant for a renewal license to
complete 36 hours of continuing education in the preceding 2 years.
This bill would require a veterinarian who receives his or her
license on or after January 1, 2018, to complete an approved course
on the judicious use of medically important antimicrobial drugs, as
defined, every 4 years as part of the continuing education
requirement.
Existing law provides for the licensure and regulation of skilled
nursing facilities by the State Department of Public Health. Under
existing law, a violation of the provisions governing skilled nursing
facilities constitutes a crime. Existing law also establishes the
Hospital Infectious Disease Control Program, which requires the
department and general acute care hospitals to implement various
measures relating to the prevention of health care associated
infection. The program requires, by July 1, 2015, that each general
acute care hospital adopt and implement an antimicrobial stewardship
policy, in accordance with guidelines established by the federal
government and professional organizations, that includes a process to
evaluate the judicious use of antibiotics, as specified.
This bill would require all skilled nursing facilities, as
defined, by no later than January 1, 2017, to adopt and implement an
antimicrobial stewardship policy. The bill would also require each
skilled nursing facility, within 3 months of the establishment of
antimicrobial stewardship guidelines by the federal Centers for
Disease Control and Prevention or specified professional
organizations, to amend its policy to be consistent with those
antimicrobial stewardship guidelines.
By expanding the scope of an existing crime, this bill would
impose a state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
This bill would declare that it is to take effect immediately as
an urgency statute.
Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 4846.5 of the
Business and Professions Code is amended to read:
4846.5. (a) Except as provided in this section, the board shall
issue renewal licenses only to those applicants that have completed a
minimum of 36 hours of continuing education in the preceding two
years.
(b) (1) Notwithstanding any other provision of
law, continuing education hours shall be earned by attending courses
relevant to veterinary medicine and sponsored or cosponsored by any
of the following:
(A) American Veterinary Medical Association (AVMA) accredited
veterinary medical colleges.
(B) Accredited colleges or universities offering programs relevant
to veterinary medicine.
(C) The American Veterinary Medical Association.
(D) American Veterinary Medical Association recognized specialty
or affiliated allied groups.
(E) American Veterinary Medical Association's affiliated state
veterinary medical associations.
(F) Nonprofit annual conferences established in conjunction with
state veterinary medical associations.
(G) Educational organizations affiliated with the American
Veterinary Medical Association or its state affiliated veterinary
medical associations.
(H) Local veterinary medical associations affiliated with the
California Veterinary Medical Association.
(I) Federal, state, or local government agencies.
(J) Providers accredited by the Accreditation Council for
Continuing Medical Education (ACCME) or approved by the American
Medical Association (AMA), providers recognized by the American
Dental Association Continuing Education Recognition Program (ADA
CERP), and AMA or ADA affiliated state, local, and specialty
organizations.
(2) Continuing education credits shall be granted to those
veterinarians taking self-study courses, which may include, but are
not limited to, reading journals, viewing video recordings, or
listening to audio recordings. The taking of these courses shall be
limited to no more than six hours biennially.
(3) The board may approve other continuing veterinary medical
education providers not specified in paragraph (1).
(A) The board has the authority to recognize national continuing
education approval bodies for the purpose of approving continuing
education providers not specified in paragraph (1).
(B) Applicants seeking continuing education provider approval
shall have the option of applying to the board or to a
board-recognized national approval body.
(4) For good cause, the board may adopt an order specifying, on a
prospective basis, that a provider of continuing veterinary medical
education authorized pursuant to paragraph (1) or (3) is no longer an
acceptable provider.
(5) Continuing education hours earned by attending courses
sponsored or cosponsored by those entities listed in paragraph (1)
between January 1, 2000, and January 1, 2001, shall be credited
toward a veterinarian's continuing education requirement under this
section.
(c) Every person renewing his or her license issued pursuant to
Section 4846.4 4846.4, or any person
applying for relicensure or for reinstatement of his or her license
to active status, shall submit proof of compliance with this section
to the board certifying that he or she is in compliance with this
section. Any false statement submitted pursuant to this section shall
be a violation subject to Section 4831.
(d) This section shall not apply to a veterinarian's first license
renewal. This section shall apply only to second and subsequent
license renewals granted on or after January 1, 2002.
(e) The board shall have the right to audit the records of all
applicants to verify the completion of the continuing education
requirement. Applicants shall maintain records of completion of
required continuing education coursework for a period of four years
and shall make these records available to the board for auditing
purposes upon request. If the board, during this audit, questions
whether any course reported by the veterinarian satisfies the
continuing education requirement, the veterinarian shall provide
information to the board concerning the content of the course; the
name of its sponsor and cosponsor, if any; and specify the specific
curricula that was of benefit to the veterinarian.
(f) A veterinarian desiring an inactive license or to restore an
inactive license under Section 701 shall submit an application on a
form provided by the board. In order to restore an inactive license
to active status, the veterinarian shall have completed a minimum of
36 hours of continuing education within the last two years preceding
application. The inactive license status of a veterinarian shall not
deprive the board of its authority to institute or continue a
disciplinary action against a licensee.
(g) Knowing misrepresentation of compliance with this article by a
veterinarian constitutes unprofessional conduct and grounds for
disciplinary action or for the issuance of a citation and the
imposition of a civil penalty pursuant to Section 4883.
(h) The board, in its discretion, may exempt from the continuing
education requirement any veterinarian who for reasons of health,
military service, or undue hardship cannot meet those requirements.
Applications for waivers shall be submitted on a form provided by the
board.
(i) The administration of this section may be funded through
professional license and continuing education provider fees. The fees
related to the administration of this section shall not exceed the
costs of administering the corresponding provisions of this section.
(j) For those continuing education providers not listed in
paragraph (1) of subdivision (b), the board or its recognized
national approval agent shall establish criteria by which a provider
of continuing education shall be approved. The board shall initially
review and approve these criteria and may review the criteria as
needed. The board or its recognized agent shall monitor, maintain,
and manage related records and data. The board may impose an
application fee, not to exceed two hundred dollars ($200) biennially,
for continuing education providers not listed in paragraph (1) of
subdivision (b).
(k) (1) A veterinarian who receives his or her license on or after
January 1, 2018, shall complete an approved course on the judicious
use of medically important antimicrobial drugs every four years as
part of his or her continuing education requirements.
(2) For purposes of this subdivision, "medically important
antimicrobial drug" means an antimicrobial drug listed in Appendix A
of the federal Food and Drug Administration's Guidance for Industry
#152, including critically important, highly important, and important
antimicrobial drugs, as that appendix may be amended.
SECTION 1. SEC. 2. Section 1275.4 is
added to the Health and Safety Code, to read:
1275.4. (a) (1) On or before January 1, 2017, each skilled
nursing facility, as defined in subdivision (c) of Section 1250,
shall adopt and implement an antimicrobial stewardship policy.
(2) Within three months of the establishment of antimicrobial
stewardship guidelines specific to skilled nursing facilities by the
federal Centers for Disease Control and Prevention
(CDC) or Prevention, the Society for Healthcare
Epidemiology of America, or similar recognized
professional organizations, including the Society for
Healthcare Epidemiology of America (SHEA), establishing antimicrobial
stewardship guidelines specific to skilled nursing facilities,
each skilled nursing facility shall amend its antimicrobial
stewardship policy to be consistent with those newly established
antimicrobial stewardship guidelines.
(b) All skilled nursing facilities, as defined in subdivision (c)
of Section 1250, shall comply with this section. Failure to comply
with the requirements of this section may subject the facility to the
enforcement actions set forth in Section 1423.
SEC. 2. SEC. 3. No reimbursement is
required by this act pursuant to Section 6 of Article XIII B of the
California Constitution because the only costs that may be incurred
by a local agency or school district will be incurred because this
act creates a new crime or infraction, eliminates a crime or
infraction, or changes the penalty for a crime or infraction, within
the meaning of Section 17556 of the Government Code, or changes the
definition of a crime within the meaning of Section 6 of Article XIII
B of the California Constitution.
SEC. 3. SEC. 4. This act is an
urgency statute necessary for the immediate preservation of the
public peace, health, or safety within the meaning of Article IV of
the Constitution and shall go into immediate effect. The facts
constituting the necessity are:
In order to protect Californians from the burden and threats posed
by the national security priority of antimicrobial-resistant
infections, it is necessary that this act take effect immediately.