BILL ANALYSIS                                                                                                                                                                                                    Ó



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          SENATE THIRD READING


          SB  
          672 (Hernandez)


          As Amended  May 13, 2015


          Majority vote


          SENATE VOTE:  36-0


           ------------------------------------------------------------------ 
          |Committee       |Votes|Ayes                  |Noes                |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |----------------+-----+----------------------+--------------------|
          |Judiciary       |10-0 |Mark Stone, Wagner,   |                    |
          |                |     |Alejo, Chau, Chiu,    |                    |
          |                |     |Gallagher,            |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
          |                |     |Cristina Garcia,      |                    |
          |                |     |Holden, Maienschein,  |                    |
          |                |     |O'Donnell             |                    |
          |                |     |                      |                    |
           ------------------------------------------------------------------ 


          SUMMARY:  Adds "pharmacist" to the existing list of medical  
          professionals whose peer review proceedings and records are  
          exempt from civil discovery and required testimony.










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          EXISTING LAW:   


          1)Exempts from civil discovery requests the peer review  
            proceedings and records of various medical professionals.   
            Specifies that any person in attendance at a meeting of any of  
            these organized committees shall not be required to testify as  
            to what transpired at that meeting.  


          2)Specifies that the prohibition against discovery and testimony  
            as to peer review records and proceedings does not apply to  
            the statements of a person at a peer review meeting if that  
            person is a party to an action or proceeding, the subject  
            matter of which was reviewed at the meeting, or to a person  
            requesting staff privileges, or in an action against an  
            insurance carrier alleging bad faith by the carrier in  
            refusing to accept a settlement offer within the policy  
            limits.  


          3)Requires a pharmacy, as defined, to establish a quality  
            assurance program that shall, at a minimum, document  
            medication errors attributable, in whole or in part, to the  
            pharmacy or its personnel.  Specifies that records generated  
            for and maintained as a component of a pharmacy's ongoing  
            quality assurance program shall be considered peer review  
            documents and not subject to discovery in any arbitration,  
            civil, or other proceeding, except as provided.  


          4)Defines "peer review," for purposes of the healing arts, to  
            mean a process by which a peer review body reviews basic  
            qualifications, staff privileges, employment, medical  
            outcomes, or professional conduct of medical professionals in  
            order to make recommendations for quality improvement or  
            education; determine whether a medical professional may  
            continue to practice, or determine the parameters of that  
            practice; assess and improve the quality of care rendered in a  








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            health care facility, clinic, or other setting providing  
            medical services; or to engage in other activities, as  
            specified.  Requires the medical chief of staff, executive  
            officer, medical director or other administrator of a peer  
            review body to file a report with the appropriate licensing  
            board, as specified.  


          FISCAL EFFECT:  None


          COMMENTS:  Existing law provides for the establishment of peer  
          review committees in order to evaluate the performance of  
          licensed medical professionals, assess and improve the quality  
          of medical care, and, if necessary, determine whether a medical  
          professional may continue to practice.  Medical peer review  
          bodies must submit reports to their appropriate licensing boards  
          whenever taking disciplinary action, including the denial of  
          staff privileges or employment to a medical professional.  


          Because an effective peer review process is essential to patient  
          safety and quality of care, the Legislature has exempted medical  
          peer review records from the usual rules governing the discovery  
          and admissibility of evidence in litigation.  Evidence Code  
          Section 1157, in particular, expressly exempts from discovery  
          the peer review proceedings and records of many different  
          medical professionals: doctors, dentists, podiatrists,  
          dieticians, psychologists, marriage and family therapists,  
          clinical social workers, veterinarians, chiropractors, and  
          acupuncturists, among others.  Evidence Code Section 1157 also  
          specifies that any person in attendance at a meeting of any of  
          these organized committees cannot be required to testify as to  
          what transpired at that meeting.  The policy rationale for  
          exempting medical peer review records and not compelling  
          testimony from peer review participants is to encourage maximum  
          candor in the evaluation of medical professionals.  However,  
          pharmacists are notably absent from the list of medical  
          professionals currently covered by Evidence Code Section 1157. 








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          This non-controversial bill would add pharmacists to the list of  
          medical professionals whose peer review records are exempt from  
          discovery requests.  Although pharmacists are not among the  
          medical professionals listed in the existing provisions of the  
          Evidence Code, their peer review and quality control records are  
          already exempted from discovery requests under provisions of the  
          Business and Professions (B&P) Code.  However, the B&P Code  
          provisions only apply to pharmacists who practice in a  
          "pharmacy," which is generally defined as the physical premises  
          of a licensed pharmacy.  The B&P Code provisions do not apply,  
          therefore, to other pharmacists - especially certified "advanced  
          practice pharmacists" - who work outside of a pharmacy in a  
          hospital or clinical setting, often in collaboration with other  
          health care providers.  Because board recognition of "advanced  
          practice pharmacists" came about relatively recently, with the  
          enactment of SB 493 (Roger Hernández), Chapter 469, Statutes of  
          2013, the provisions of the B&P Code Section (that has not been  
          amended since it was enacted in 2000) exempting pharmacy peer  
          review records, do not apply to them.  Peer review records  
          relating to advanced practice pharmacists, therefore, are  
          protected by neither the provisions of the B&P Code, nor the  
          Evidence Code.  This bill sensibly addresses this gap by simply  
          adding pharmacists - whether advanced practice pharmacists or  
          those practicing in a traditional pharmacy - to the list of  
          medical professionals whose peer review records are generally  
          exempted from discovery and whose testimony cannot be compelled  
          under the Evidence Code.  




          Analysis Prepared by:                                             
                          Thomas Clark / JUD. / (916) 319-2334  FN:  
          0001020











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