BILL NUMBER: SB 1033 AMENDED
BILL TEXT
AMENDED IN SENATE MAY 10, 2016
AMENDED IN SENATE MARCH 17, 2016
INTRODUCED BY Senator Hill
FEBRUARY 12, 2016
An act to amend Sections 125.3, 803.1, 2027, 2221,
2221.05, 2228, and 3663 of, and to add Sections 1006 and 4962 to, the
Business and Professions Code, relating to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
SB 1033, as amended, Hill. Medical Board: disclosure of
probationary status. professionals: probation.
Existing
(1) Existing law, the Medical
Practice Act, establishes the Medical Board of California for the
licensing, regulation, and discipline of physicians and surgeons.
Existing law establishes the California Board of Podiatric Medicine
within the Medical Board of California for the licensing, regulation,
and discipline of podiatrists. Existing law, the Osteopathic Act,
enacted by an initiative measure, establishes the Osteopathic Medical
Board of California for the licensing and regulation of osteopathic
physicians and surgeons and requires the Osteopathic Medical Board of
California to enforce the Medical Practice Act with respect to its
licensees. Existing law, the Naturopathic Doctors Act, establishes
the Naturopathic Medicine Committee in the Osteopathic Medical Board
of California for the licensing and regulation of naturopathic
doctors. Existing law, the Chiropractic Act, enacted by an initiative
measure, establishes the State Board of Chiropractic Examiners for
the licensing and regulation of chiropractors. Existing law, the
Acupuncture Licensure Act, establishes the Acupuncture Board for the
licensing and regulation of acupuncturists. Existing law authorizes
each of these regulatory agencies entities
to discipline its licensee by placing her or him on probation,
as specified.
This bill bill, on and after January 1,
2018, would require these regulatory entities to require a
licensee to disclose on a separate document her or his probationary
status status, certain information related to
his or her probation, the address of his or her BreEze profile
Internet Web page or a specified Internet Web site, and the
regulatory entity's telephone number to a patient, the patient'
s guardian, or the health care surrogate prior to the patient's first
visit following the probationary order while the licensee is on
probation under specified circumstances, including an accusation
alleging, a statement of issues indicating, or an administrative law
judge's legal conclusion finding the licensee committed gross
negligence or the licensee having been on probation more than once,
among others. The bill would require the licensee to obtain from the
patient a signed receipt containing specified information following
the disclosure. The bill would exempt a licensee
licensee, except for a licensed chiropractor, from
disclosing her or his probationary status prior to a visit
or treatment that disclosure requirement if the
patient is unable to comprehend the disclosure or
and sign an acknowledgment and a guardian or health care
surrogate is unavailable. The bill would require in that instance
that the doctor disclose his or her status as soon as either the
patient can comprehend and sign the receipt or a guardian or health
care surrogate is available to comprehend the disclosure and sign the
receipt. The bill would also exempt a licensee from that
disclosure requirement if the visit occurs in an emergency room and
the licensee who will be treating the patient during the visit is not
known to the patient until immediately prior to the start of the
visit.
Existing
(2) Existing law requires the
Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine to
disclose to an inquiring member of the public and to post on their
Internet Web sites specified information concerning each licensee
including revocations, suspensions, probations, or limitations on
practice.
The
This bill would require the Medical Board of
California, the Osteopathic Medical Board of California, the
California Board of Podiatric Medicine, the State Board of
Chiropractic Examiners, the Naturopathic Medicine Committee, and the
Acupuncture Board by July January 1,
2018, to develop a standardized format for listing specified
information related to the probation and to provide that information
to an inquiring member of the public, on any documents informing the
public of probation orders, and on a specified profile Internet Web
page of each licensee subject to probation, or an Internet Web
site, as specified.
(3) Existing law, in any order issued in resolution of a
disciplinary proceeding before any board within the Department of
Consumer Affairs or before the Osteopathic Medical Board, upon
request of the entity bringing the proceeding unless the entity is
the Medical Board of California, authorizes the administrative law
judge to direct a licentiate found to have committed a violation or
violations of the licensing act to pay a sum not to exceed the
reasonable costs of the investigation and enforcement of the case, as
specified.
This bill would authorize the Medical Board of California to
request and obtain from a physician and surgeon the investigation and
prosecution costs for a disciplinary proceeding in which the
physician and surgeon's license is placed on probation.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 125.3 of the
Business and Professions Code is amended to read:
125.3. (a) Except as otherwise provided by law, in any order
issued in resolution of a disciplinary proceeding before any board
within the department or before the Osteopathic Medical Board, upon
request of the entity bringing the proceeding, the administrative law
judge may direct a licentiate found to have committed a violation or
violations of the licensing act to pay a sum not to exceed the
reasonable costs of the investigation and enforcement of the case.
(b) In the case of a disciplined licentiate that is a corporation
or a partnership, the order may be made against the licensed
corporate entity or licensed partnership.
(c) A certified copy of the actual costs, or a good faith estimate
of costs where actual costs are not available, signed by the entity
bringing the proceeding or its designated representative shall be
prima facie evidence of reasonable costs of investigation and
prosecution of the case. The costs shall include the amount of
investigative and enforcement costs up to the date of the hearing,
including, but not limited to, charges imposed by the Attorney
General.
(d) The administrative law judge shall make a proposed finding of
the amount of reasonable costs of investigation and prosecution of
the case when requested pursuant to subdivision (a). The finding of
the administrative law judge with regard to costs shall not be
reviewable by the board to increase the cost award. The board may
reduce or eliminate the cost award, or remand to the administrative
law judge if the proposed decision fails to make a finding on costs
requested pursuant to subdivision (a).
(e) If an order for recovery of costs is made and timely payment
is not made as directed in the board's decision, the board may
enforce the order for repayment in any appropriate court. This right
of enforcement shall be in addition to any other rights the board may
have as to any licentiate to pay costs.
(f) In any action for recovery of costs, proof of the board's
decision shall be conclusive proof of the validity of the order of
payment and the terms for payment.
(g) (1) Except as provided in paragraph (2), the board shall not
renew or reinstate the license of any licentiate who has failed to
pay all of the costs ordered under this section.
(2) Notwithstanding paragraph (1), the board may, in its
discretion, conditionally renew or reinstate for a maximum of one
year the license of any licentiate who demonstrates financial
hardship and who enters into a formal agreement with the board to
reimburse the board within that one-year period for the unpaid costs.
(h) All costs recovered under this section shall be considered a
reimbursement for costs incurred and shall be deposited in the fund
of the board recovering the costs to be available upon appropriation
by the Legislature.
(i) Nothing in this section shall preclude a board from including
the recovery of the costs of investigation and enforcement of a case
in any stipulated settlement.
(j) This section does not apply to any board if a specific
statutory provision in that board's licensing act provides for
recovery of costs in an administrative disciplinary proceeding.
(k) Notwithstanding the provisions of this section, the Medical
Board of California shall not request nor obtain from a physician and
surgeon, surgeon investigation and
prosecution costs for a disciplinary proceeding against the
licentiate. licentiate, except for a disciplinary
proceeding in which the licentiate's license is placed on probation.
The board shall ensure that this subdivision is revenue neutral
with regard to it and that any loss of revenue or increase in costs
resulting from this subdivision is offset by an increase in the
amount of the initial license fee and the biennial renewal fee, as
provided in subdivision (e) of Section 2435.
SECTION 1. SEC. 2. Section 803.1 of
the Business and Professions Code is amended to read:
803.1. (a) Notwithstanding any other provision of
law, the Medical Board of California, the Osteopathic
Medical Board of California, the California Board of Podiatric
Medicine, and the Physician Assistant Board shall disclose to an
inquiring member of the public information regarding any enforcement
actions taken against a licensee, including a former licensee, by the
board or by another state or jurisdiction, including all of the
following:
(1) Temporary restraining orders issued.
(2) Interim suspension orders issued.
(3) Revocations, suspensions, probations, or limitations on
practice ordered by the board, including those made part of a
probationary order or stipulated agreement.
(4) Public letters of reprimand issued.
(5) Infractions, citations, or fines imposed.
(b) Notwithstanding any other provision of law,
in addition to the information provided in subdivision (a), the
Medical Board of California, the Osteopathic Medical Board of
California, the California Board of Podiatric Medicine, and the
Physician Assistant Board shall disclose to an inquiring member of
the public all of the following:
(1) Civil judgments in any amount, whether or not vacated by a
settlement after entry of the judgment, that were not reversed on
appeal and arbitration awards in any amount of a claim or action for
damages for death or personal injury caused by the physician and
surgeon's negligence, error, or omission in practice, or by his or
her rendering of unauthorized professional services.
(2) (A) All settlements in the possession, custody, or control of
the board shall be disclosed for a licensee in the low-risk category
if there are three or more settlements for that licensee within the
last 10 years, except for settlements by a licensee regardless of the
amount paid where (i) the settlement is made as a part of the
settlement of a class claim, (ii) the licensee paid in settlement of
the class claim the same amount as the other licensees in the same
class or similarly situated licensees in the same class, and (iii)
the settlement was paid in the context of a case where the complaint
that alleged class liability on behalf of the licensee also alleged a
products liability class action cause of action. All settlements in
the possession, custody, or control of the board shall be disclosed
for a licensee in the high-risk category if there are four or more
settlements for that licensee within the last 10 years except for
settlements by a licensee regardless of the amount paid where (i) the
settlement is made as a part of the settlement of a class claim,
(ii) the licensee paid in settlement of the class claim the same
amount as the other licensees in the same class or similarly situated
licensees in the same class, and (iii) the settlement was paid in
the context of a case where the complaint that alleged class
liability on behalf of the licensee also alleged a products liability
class action cause of action. Classification of a licensee in either
a "high-risk category" or a "low-risk category" depends upon the
specialty or subspecialty practiced by the licensee and the
designation assigned to that specialty or subspecialty by the Medical
Board of California, as described in subdivision (f). For the
purposes of this paragraph, "settlement" means a settlement of an
action described in paragraph (1) entered into by the licensee on or
after January 1, 2003, in an amount of thirty thousand dollars
($30,000) or more.
(B) The board shall not disclose the actual dollar amount of a
settlement but shall put the number and amount of the settlement in
context by doing the following:
(i) Comparing the settlement amount to the experience of other
licensees within the same specialty or subspecialty, indicating if it
is below average, average, or above average for the most recent
10-year period.
(ii) Reporting the number of years the licensee has been in
practice.
(iii) Reporting the total number of licensees in that specialty or
subspecialty, the number of those who have entered into a settlement
agreement, and the percentage that number represents of the total
number of licensees in the specialty or subspecialty.
(3) Current American Board of Medical Specialties certification or
board equivalent as certified by the Medical Board of California,
the Osteopathic Medical Board of California, or the California Board
of Podiatric Medicine.
(4) Approved postgraduate training.
(5) Status of the license of a licensee. By January 1, 2004, the
Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine shall
adopt regulations defining the status of a licensee. The board shall
employ this definition when disclosing the status of a licensee
pursuant to Section 2027. By July January
1, 2018, the Medical Board of California, the Osteopathic
Medical Board of California, and the California Board of Podiatric
Medicine shall include the information described in subdivision (f)
of Section 2228.
(6) Any summaries of hospital disciplinary actions that result in
the termination or revocation of a licensee's staff privileges for
medical disciplinary cause or reason, unless a court finds, in a
final judgment, that the peer review resulting in the disciplinary
action was conducted in bad faith and the licensee notifies the board
of that finding. In addition, any exculpatory or explanatory
statements submitted by the licentiate electronically pursuant to
subdivision (f) of that section shall be disclosed. For purposes of
this paragraph, "peer review" has the same meaning as defined in
Section 805.
(c) Notwithstanding any other provision of law,
the Medical Board of California, the Osteopathic Medical Board of
California, the California Board of Podiatric Medicine, and the
Physician Assistant Board shall disclose to an inquiring member of
the public information received regarding felony convictions of a
physician and surgeon or doctor of podiatric medicine.
(d) The Medical Board of California, the Osteopathic Medical Board
of California, the California Board of Podiatric Medicine, and the
Physician Assistant Board may formulate appropriate disclaimers or
explanatory statements to be included with any information released,
and may by regulation establish categories of information that need
not be disclosed to an inquiring member of the public because that
information is unreliable or not sufficiently related to the licensee'
s professional practice. The Medical Board of California, the
Osteopathic Medical Board of California, the California Board of
Podiatric Medicine, and the Physician Assistant Board shall include
the following statement when disclosing information concerning a
settlement:
"Some studies have shown that there is no significant correlation
between malpractice history and a doctor's competence. At the same
time, the State of California believes that consumers should have
access to malpractice information. In these profiles, the State of
California has given you information about both the malpractice
settlement history for the doctor's specialty and the doctor's
history of settlement payments only if in the last 10 years, the
doctor, if in a low-risk specialty, has three or more settlements or
the doctor, if in a high-risk specialty, has four or more
settlements. The State of California has excluded some class action
lawsuits because those cases are commonly related to systems issues
such as product liability, rather than questions of individual
professional competence and because they are brought on a class basis
where the economic incentive for settlement is great. The State of
California has placed payment amounts into three statistical
categories: below average, average, and above average compared to
others in the doctor's specialty. To make the best health care
decisions, you should view this information in perspective. You could
miss an opportunity for high-quality care by selecting a doctor
based solely on malpractice history.
When considering malpractice data, please keep in mind:
Malpractice histories tend to vary by specialty. Some specialties
are more likely than others to be the subject of litigation. This
report compares doctors only to the members of their specialty, not
to all doctors, in order to make an individual doctor's history more
meaningful.
This report reflects data only for settlements made on or after
January 1, 2003. Moreover, it includes information concerning those
settlements for a 10-year period only. Therefore, you should know
that a doctor may have made settlements in the 10 years immediately
preceding January 1, 2003, that are not included in this report.
After January 1, 2013, for doctors practicing less than 10 years, the
data covers their total years of practice. You should take into
account the effective date of settlement disclosure as well as how
long the doctor has been in practice when considering malpractice
averages.
The incident causing the malpractice claim may have happened years
before a payment is finally made. Sometimes, it takes a long time
for a malpractice lawsuit to settle. Some doctors work primarily with
high-risk patients. These doctors may have malpractice settlement
histories that are higher than average because they specialize in
cases or patients who are at very high risk for problems.
Settlement of a claim may occur for a variety of reasons that do
not necessarily reflect negatively on the professional competence or
conduct of the doctor. A payment in settlement of a medical
malpractice action or claim should not be construed as creating a
presumption that medical malpractice has occurred.
You may wish to discuss information in this report and the general
issue of malpractice with your doctor."
(e) doctor."
(e) The Medical Board of California, the
Osteopathic Medical Board of California, the California Board of
Podiatric Medicine, and the Physician Assistant Board shall, by
regulation, develop standard terminology that accurately describes
the different types of disciplinary filings and actions to take
against a licensee as described in paragraphs (1) to (5), inclusive,
of subdivision (a). In providing the public with information about a
licensee via the Internet pursuant to Section 2027, the Medical Board
of California, the Osteopathic Medical Board of California, the
California Board of Podiatric Medicine, and the Physician Assistant
Board shall not use the terms "enforcement," "discipline," or similar
language implying a sanction unless the physician and surgeon has
been the subject of one of the actions described in paragraphs (1) to
(5), inclusive, of subdivision (a).
(f) The Medical Board of California shall adopt regulations no
later than July 1, 2003, designating each specialty and subspecialty
practice area as either high risk or low risk. In promulgating these
regulations, the board shall consult with commercial underwriters of
medical malpractice insurance companies, health care systems that
self-insure physicians and surgeons, and representatives of the
California medical specialty societies. The board shall utilize the
carriers' statewide data to establish the two risk categories and the
averages required by subparagraph (B) of paragraph (2) of
subdivision (b). Prior to issuing regulations, the board shall
convene public meetings with the medical malpractice carriers,
self-insurers, and specialty representatives.
(g) The Medical Board of California, the Osteopathic Medical Board
of California, the California Board of Podiatric Medicine, and the
Physician Assistant Board shall provide each licensee, including a
former licensee under subdivision (a), with a copy of the text of any
proposed public disclosure authorized by this section prior to
release of the disclosure to the public. The licensee shall have 10
working days from the date the board provides the copy of the
proposed public disclosure to propose corrections of factual
inaccuracies. Nothing in this section shall prevent the board from
disclosing information to the public prior to the expiration of the
10-day period.
(h) Pursuant to subparagraph (A) of paragraph (2) of subdivision
(b), the specialty or subspecialty information required by this
section shall group physicians by specialty board recognized pursuant
to paragraph (5) of subdivision (h) of Section 651 unless a
different grouping would be more valid and the board, in its
statement of reasons for its regulations, explains why the validity
of the grouping would be more valid.
(i) By July January 1, 2018, the
Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine shall
include the information listed in subdivision (f) of Section 2228 on
any board documents informing the public of probation orders and
probationary licenses, including, but not limited to, newsletters.
SEC. 2. SEC. 3. Section 1006 is
added to the Business and Professions Code, to read:
1006. (a) Except On and after January 1,
2018, except as provided by subdivision (c), the State Board of
Chiropractic Examiners shall require a licensee to disclose on a
separate document her or his probationary status
status, all of the information described in subdivision (d), the
address of the board's Internet Web site, and the board's telephone
number to a patient, the patient's guardian, or health care
surrogate prior to the patient's first visit following the
probationary order while the licensee is on probation in any of the
following circumstances:
(1) The accusation alleges, the statement of issues indicates, or
the legal conclusions of an administrative law judge find that the
licensee is implicated in any of the following:
(A) Gross negligence.
(B) Repeated negligent acts involving a departure from the
standard of care with multiple patients.
(C) Repeated acts of inappropriate and excessive prescribing of
controlled substances, including, but not limited to, prescribing
controlled substances without appropriate prior examination or
without medical reason documented in medical records.
(D)
(C) Drug or alcohol abuse that threatens to impair a
licensee's ability to practice medicine
chiropractic safely, including practicing under the influence
of drugs or alcohol.
(E)
(D) Felony conviction arising from or occurring during
patient care or treatment.
(F)
(E) Mental illness or other cognitive impairment that
impedes a licensee's ability to safely practice medicine.
chiropractic.
(2) The board ordered any of the following in conjunction with
placing the licensee on probation:
(A) That a third-party chaperone be present when the licensee
examines patients as a result of sexual misconduct.
(B) That the licensee submit to drug testing as a result of drug
or alcohol abuse.
(C) That the licensee have a monitor.
(D) Restricting the licensee totally or partially from prescribing
controlled substances.
(3) The licensee has not successfully completed a
clinical training program or any associated examinations
required by the board as a condition of probation.
(4) The licensee has been on probation more than once.
(b) The licensee shall obtain from each patient a signed receipt
following the disclosure that includes a written explanation of how
the patient can find further information on the licensee's probation
on the board's Internet Web site.
(c) The licensee shall not be required to provide the disclosure
prior to the visit as required by subdivision (a) if the
patient is unconscious or otherwise unable to comprehend the
disclosure and sign the receipt pursuant to subdivision (b) and a
guardian or health care surrogate is unavailable to comprehend the
disclosure and sign the receipt. In that instance, the licensee shall
disclose her or his status as soon as either the patient can
comprehend the disclosure and sign the receipt or a guardian or
health care surrogate is available to comprehend the disclosure and
sign the receipt. visit occurs in an emergency room
and the licensee who will be treating the patient during the visit is
not known to the patient until immediately prior to the start of the
visit.
(d) By July January 1, 2018, the
board shall develop a standardized format for listing the following
information pursuant to subdivision (e):
(1) The listing of the causes for probation alleged in the
accusation, the statement of issues, or the legal conclusions of an
administrative law judge.
(2) The length of the probation and the end date.
(3) All practice restrictions placed on the licencee
licensee by the committee.
board.
(e) By July January 1, 2018, the
board shall provide the information listed in subdivision (d) as
follows:
(1) To an inquiring member of the public.
(2) On any board documents informing the public of probation
orders and probationary licenses, including, but not limited to,
newsletters.
(3) Upon availability of a licensee's BreEZe profile
Internet Web page on the BreEZe system pursuant to Section 210, in
plain view on the BreEZe profile On the board's
Internet Web page of a licensee subject to probation or a
probationary license. site.
SEC. 3. SEC. 4. Section 2027 of the
Business and Professions Code is amended to read:
2027. (a) The board shall post on its Internet Web site the
following information on the current status of the license for all
current and former licensees:
(1) Whether or not the licensee is presently in good standing.
(2) Current American Board of Medical Specialties certification or
board equivalent as certified by the board.
(3) Any of the following enforcement actions or proceedings to
which the licensee is actively subjected:
(A) Temporary restraining orders.
(B) Interim suspension orders.
(C) (i) Revocations, suspensions, probations, or limitations on
practice ordered by the board or the board of another state or
jurisdiction, including those made part of a probationary order or
stipulated agreement.
(ii) By July January 1, 2018, the
board, the Osteopathic Medical Board of California, and the
California Board of Podiatric Medicine shall include, in plain view
on the BreEZe profile Internet Web page of each licensee subject to
probation or a probationary license, the information described in
subdivision (f) of Section 2228. For purposes of this subparagraph, a
BreEZe profile Internet Web page is a profile Internet Web page on
the BreEZe system pursuant to Section 210.
(D) Current accusations filed by the Attorney General, including
those accusations that are on appeal. For purposes of this paragraph,
"current accusation" means an accusation that has not been
dismissed, withdrawn, or settled, and has not been finally decided
upon by an administrative law judge and the board unless an appeal of
that decision is pending.
(E) Citations issued that have not been resolved or appealed
within 30 days.
(b) The board shall post on its Internet Web site all of the
following historical information in its possession, custody, or
control regarding all current and former licensees:
(1) Approved postgraduate training.
(2) Any final revocations and suspensions, or other equivalent
actions, taken against the licensee by the board or the board of
another state or jurisdiction or the surrender of a license by the
licensee in relation to a disciplinary action or investigation,
including the operative accusation resulting in the license surrender
or discipline by the board.
(3) Probation or other equivalent action ordered by the board, or
the board of another state or jurisdiction, completed or terminated,
including the operative accusation resulting in the discipline by the
board.
(4) Any felony convictions. Upon receipt of a certified copy of an
expungement order granted pursuant to Section 1203.4 of the Penal
Code from a licensee, the board shall, within six months of receipt
of the expungement order, post notification of the expungement order
and the date thereof on its Internet Web site.
(5) Misdemeanor convictions resulting in a disciplinary action or
accusation that is not subsequently withdrawn or dismissed. Upon
receipt of a certified copy of an expungement order granted pursuant
to Section 1203.4 of the Penal Code from a licensee, the board shall,
within six months of receipt of the expungement order, post
notification of the expungement order and the date thereof on its
Internet Web site.
(6) Civil judgments issued in any amount, whether or not vacated
by a settlement after entry of the judgment, that were not reversed
on appeal, and arbitration awards issued in any amount, for a claim
or action for damages for death or personal injury caused by the
physician and surgeon's negligence, error, or omission in practice,
or by his or her rendering of unauthorized professional services.
(7) Except as provided in subparagraphs (A) and (B), a summary of
any final hospital disciplinary actions that resulted in the
termination or revocation of a licensee's hospital staff privileges
for a medical disciplinary cause or reason. The posting shall provide
any additional explanatory or exculpatory information submitted by
the licensee pursuant to subdivision (f) of Section 805. The board
shall also post on its Internet Web site a factsheet that explains
and provides information on the reporting requirements under Section
805.
(A) If a licensee's hospital staff privileges are restored and the
licensee notifies the board of the restoration, the information
pertaining to the termination or revocation of those privileges shall
remain posted on the Internet Web site for a period of 10 years from
the restoration date of the privileges, and at the end of that
period shall be removed.
(B) If a court finds, in a final judgment, that peer review
resulting in a hospital disciplinary action was conducted in bad
faith and the licensee notifies the board of that finding, the
information concerning that hospital disciplinary action posted on
the Internet Web site shall be immediately removed. For purposes of
this subparagraph, "peer review" has the same meaning as defined in
Section 805.
(8) Public letters of reprimand issued within the past 10 years by
the board or the board of another state or jurisdiction, including
the operative accusation, if any, resulting in discipline
by the board.
(9) Citations issued within the last three years that have been
resolved by payment of the administrative fine or compliance with the
order of abatement.
(10) All settlements within the last five years in the possession,
custody, or control of the board shall be disclosed for a licensee
in the low-risk category if there are three or more settlements for
that licensee within the last five years, and for a licensee in the
high-risk category if there are four or more settlements for that
licensee within the last five years. Classification of a licensee in
either a "high-risk category" or a "low-risk" category depends upon
the specialty or subspecialty practiced by the licensee and the
designation assigned to that specialty or subspecialty by the board
pursuant to subdivision (f) of Section 803.1.
(A) For the purposes of this paragraph, "settlement" means a
settlement in an amount of thirty thousand dollars ($30,000) or more
of any claim or action for damages for death or personal injury
caused by the physician and surgeon's negligence, error, or omission
in practice, or by his or her rendering of unauthorized professional
services.
(B) For the purposes of this paragraph, "settlement" does not
include a settlement by a licensee, regardless of the amount paid,
when (i) the settlement is made as a part of the settlement of a
class claim, (ii) the amount paid in settlement of the class claim is
the same amount paid by the other licensees in the same class or
similarly situated licensees in the same class, and (iii) the
settlement was paid in the context of a case for which the complaint
that alleged class liability on behalf of the licensee also alleged a
products liability class action cause of action.
(C) The board shall not disclose the actual dollar amount of a
settlement, but shall disclose settlement information in the same
manner and with the same disclosures required under subparagraph (B)
of paragraph (2) of subdivision (b) of Section 803.1.
(11) Appropriate disclaimers and explanatory statements to
accompany the information described in paragraphs (1) to (10),
inclusive, including an explanation of what types of information are
not disclosed. These disclaimers and statements shall be developed by
the board and shall be adopted by regulation.
(c) The board shall provide links to other Internet Web sites that
provide information on board certifications that meet the
requirements of subdivision (h) of Section 651. The board may also
provide links to any other Internet Web sites that provide
information on the affiliations of licensed physicians and surgeons.
The board may provide links to other Internet Web sites on the
Internet that provide information on health care service plans,
health insurers, hospitals, or other facilities.
SEC. 4. SEC. 5. Section 2221 of the
Business and Professions Code is amended to read:
2221. (a) The board may deny a physician's and surgeon's
certificate to an applicant guilty of unprofessional conduct or of
any cause that would subject a licensee to revocation or suspension
of his or her license.
(b) The board in its sole discretion, may issue a probationary
physician's and surgeon's certificate to an applicant subject to
terms and conditions, including, but not limited to, any of the
following conditions of probation:
(1) Practice limited to a supervised, structured environment where
the licensee's activities shall be supervised by another physician
and surgeon.
(2) Total or partial restrictions on drug prescribing privileges
for controlled substances.
(3) Continuing medical or psychiatric treatment.
(4) Ongoing participation in a specified rehabilitation program.
(5) Enrollment and successful completion of a clinical training
program.
(6) Abstention from the use of alcohol or drugs.
(7) Restrictions against engaging in certain types of medical
practice.
(8) Compliance with all provisions of this chapter.
(9) Payment of the cost of probation monitoring.
(10) Disclosing probationary license status to patients, pursuant
to subdivision (b) of Section 2228.
(c) The board may modify or terminate the terms and conditions
imposed on the probationary certificate upon receipt of a petition
from the licensee; however, the provisions of subdivision (b) of
Section 2228 are mandatory with any probationary licensee. The board
may assign the petition to an administrative law judge designated in
Section 11371 of the Government Code. After a hearing on the
petition, the administrative law judge shall provide a proposed
decision to the board.
(d) The board shall deny a physician's and surgeon's certificate
to an applicant who is required to register pursuant to Section 290
of the Penal Code. This subdivision does not apply to an applicant
who is required to register as a sex offender pursuant to Section 290
of the Penal Code solely because of a misdemeanor conviction under
Section 314 of the Penal Code.
(e) An applicant shall not be eligible to reapply for a physician'
s and surgeon's certificate for a minimum of three years from the
effective date of the denial of his or her application, except that
the board may, in its discretion and for good cause demonstrated,
permit reapplication after not less than one year has elapsed from
the effective date of the denial.
SEC. 5. SEC. 6. Section 2221.05 of
the Business and Professions Code is amended to read:
2221.05. (a) Notwithstanding subdivisions (a) and (b) of Section
2221, the board may issue a physician's and surgeon's certificate to
an applicant who has committed minor violations that the board deems,
in its discretion, do not merit the denial of a certificate or
require probationary status under Section 2221, and may concurrently
issue a public letter of reprimand.
(b) A public letter of reprimand issued concurrently with a
physician's and surgeon's certificate shall be purged three years
from the date of issuance.
(c) A public letter of reprimand issued pursuant to this section
shall be disclosed to an inquiring member of the public and shall be
posted on the board's Internet Web site.
(d) Nothing in this section shall be construed to affect the board'
s authority to issue an unrestricted license.
SEC. 6. SEC. 7. Section 2228 of the
Business and Professions Code is amended to read:
2228. (a) The authority of the board or the California Board of
Podiatric Medicine to discipline a licensee by placing him or her on
probation includes, but is not limited to, the following:
(1) Requiring the licensee to obtain additional professional
training and to pass an examination upon the completion of the
training. The examination may be written or oral, or both, and may be
a practical or clinical examination, or both, at the option of the
board or the administrative law judge.
(2) Requiring the licensee to submit to a complete diagnostic
examination by one or more physicians and surgeons appointed by the
board. If an examination is ordered, the board shall receive and
consider any other report of a complete diagnostic examination given
by one or more physicians and surgeons of the licensee's choice.
(3) Restricting or limiting the extent, scope, or type of practice
of the licensee, including requiring notice to applicable patients
that the licensee is unable to perform the indicated treatment, where
appropriate.
(4) Providing the option of alternative community service in cases
other than violations relating to quality of care.
(b) The On and after January 1, 2018,
except as provided by subdivision (d), the board or the
California Board of Podiatric Medicine shall require a licensee to
disclose on a separate document her or his probationary
status status, all of the information described in
subdivision (f), the address of his or her BreEZe profile Internet
Web page, and the telephone number of the board, if the probation was
imposed by the board, or the California Board of Podiatric Medicine,
if the probation was imposed by the California Board of Podiatric
Medicine, to a patient, the patient's guardian, or health care
surrogate prior to the patient's first visit following the
probationary order while the licensee is on probation in any of the
following circumstances:
(1) The accusation alleges, the statement of issues indicates, or
the legal conclusions of an administrative law judge finds
find that the licensee is implicated in any of
the following:
(A) Gross negligence.
(B) Repeated negligent acts involving a departure from the
standard of care with multiple patients.
(C) Repeated acts of inappropriate and excessive prescribing of
controlled substances, including, but not limited to, prescribing
controlled substances without appropriate prior examination or
without medical reason documented in medical records.
(D) Drug or alcohol abuse that threatens to impair a licensee's
ability to practice medicine safely, including practicing under the
influence of drugs or alcohol.
(E) Felony conviction arising from or occurring during patient
care or treatment.
(F) Mental illness or other cognitive impairment that impedes a
licensee's ability to safely practice medicine.
(2) The board ordered any of the following in conjunction with
placing the licensee on probation:
(A) That a third-party chaperone be present when the licensee
examines patients as a result of sexual misconduct.
(B) That the licensee submit to drug testing as a result of drug
or alcohol abuse.
(C) That the licensee have a monitor.
(D) Restricting the licensee totally or partially
the licensee from prescribing controlled
substances.
(3) The licensee has not successfully completed a
clinical training program or any associated examinations
required by the board as a condition of probation.
(4) The licensee has been on probation more than once.
(c) The licensee shall obtain from each patient a signed receipt
following the disclosure that includes a written explanation of how
the patient can find further information on the licensee's probation
on the board's Internet Web site.
(d) A The licensee shall not be
required to provide the disclosure prior to a
the visit as required by subdivision (b) if the
either of the following applies:
(1) The patient is unconscious or
otherwise unable to comprehend the disclosure and sign the receipt
pursuant to subdivision (c) and a guardian or health care surrogate
is unavailable to comprehend the disclosure and sign the receipt. In
that instance, the licensee shall disclose her or his status as soon
as either the patient can comprehend the disclosure and sign the
receipt or a guardian or health care surrogate is available to
comprehend the disclosure and sign the receipt.
(2) The visit occurs in an emergency room and the licensee who
will be treating the patient during the visit is not known to the
patient until immediately prior to the start of the visit.
(e) Section 2314 shall not apply to subdivision (b), (c), or (d).
(f) By July January 1, 2018, the
board shall develop a standardized format for listing the following
information pursuant to paragraph (5) of subdivision (b) of Section
803.1, subdivision (i) of Section 803.1, and clause (ii) of
subparagraph (C) of paragraph (1) of subdivision (a) of Section 2027:
(1) The listing of the causes for probation alleged in the
accusation, the statement of issues, or the legal conclusions of an
administrative law judge.
(2) The length of the probation and the end date.
(3) All practice restrictions placed on the licensee by the board.
SEC. 7. SEC. 8. Section 3663 of the
Business and Professions Code is amended to read:
3663. (a) The committee shall have the responsibility for
reviewing the quality of the practice of naturopathic medicine
carried out by persons licensed as naturopathic doctors pursuant to
this chapter.
(b) The committee may discipline a naturopathic doctor for
unprofessional conduct. After a hearing conducted in accordance with
the Administrative Procedure Act (Chapter 5 (commencing with Section
11500) of Part 1 of Division 3 of Title 2 of the Government Code),
the committee may deny, suspend, revoke, or place on probation the
license of, or reprimand, censure, or otherwise discipline a
naturopathic doctor in accordance with Division 1.5 (commencing with
Section 475).
(c) Except On and after January
1, 2018, except as provided by subdivision (e), the committee
shall require a naturopathic doctor to disclose on a separate
document her or his probationary status
status, all of the information described in subdivision (f), the
address of his or her BreEZe profile Internet Web page, and the
committee's telephone number to a patient, the patient's
guardian, or health care surrogate prior to the patient's first visit
following the probationary order while the naturopathic doctor is on
probation in any of the following circumstances:
(1) The accusation alleges, the statement of issues indicates, or
the legal conclusions of an administrative law judge find that the
naturopathic doctor is implicated in any of the following:
(A) Gross negligence.
(B) Repeated negligent acts involving a departure from the
standard of care with multiple patients.
(C) Repeated acts of inappropriate and excessive prescribing of
controlled substances, including, but not limited to, prescribing
controlled substances without appropriate prior examination or
without medical reason documented in medical records.
(D) Drug or alcohol abuse that threatens to impair a naturopathic
doctor's ability to practice medicine safely, including practicing
under the influence of drugs or alcohol.
(E) Felony conviction arising from or occurring during patient
care or treatment.
(F) Mental illness or other cognitive impairment that impedes a
naturopathic doctor's ability to safely practice medicine.
(2) The committee ordered any of the following in conjunction with
placing the naturopathic doctor on probation:
(A) That a third-party chaperone be present when the naturopathic
doctor examines patients as a result of sexual misconduct.
(B) That the naturopathic doctor submit to drug testing as a
result of drug or alcohol abuse.
(C) That the naturopathic doctor have a monitor.
(D) Restricting the naturopathic doctor totally or partially from
prescribing controlled substances.
(3) The naturopathic doctor has not successfully completed a
clinical training program or any associated
examinations required by the committee as a condition of probation.
(4) The naturopathic doctor has been on probation more than once.
(d) The naturopathic doctor shall obtain from each patient a
signed receipt following the disclosure that includes a written
explanation of how the patient can find further information on the
naturopathic doctor's probation on the committee's Internet Web site.
(e) The naturopathic doctor shall not be required to provide the
disclosure prior to the visit as required by subdivision (c) if
the either of the following applies:
(1) The patient is unconscious or
otherwise unable to comprehend the disclosure or
and sign the receipt pursuant to subdivision (d) and a
guardian or health care surrogate is unavailable to comprehend the
disclosure or and sign the receipt. In
such an that instance, the naturopathic
doctor shall disclose her or his status as soon as either the
patient can comprehend the disclosure and sign the receipt or a
guardian or health care surrogate is available to comprehend the
disclosure and sign the receipt.
(2) The visit occurs in an emergency room and the naturopathic
doctor who will be treating the patient during the visit is not known
to the patient until immediately prior to the start of the visit.
(f) By July January 1, 2018, the
committee shall develop a standardized format for listing the
following information pursuant to: to
subdivision (g):
(1) The listing of the causes for probation alleged in the
accusation, the statement of issues, or the legal conclusions of an
administrative law judge.
(2) The length of the probation and the end date.
(3) All practice restrictions placed on the naturopathic doctor by
the committee.
(g) By July January 1, 2018, the
committee shall provide the information listed in subdivision (f) as
follows:
(1) To an inquiring member of the public.
(2) On any committee documents informing the public of probation
orders and probationary licenses, including, but not limited to,
newsletters.
(3) In plain view on the BreEZe profile Internet Web page of a
naturopathic doctor subject to probation or a probationary license.
SEC. 8. SEC. 9. Section 4962 is
added to the Business and Professions Code, to read:
4962. (a) Except On and after January 1,
2018, except as provided by subdivision (c), the board shall
require a licensee to disclose on a separate document her or his
probationary status status, all of the
information described in subdivision (e), the add ress of
his or her BreEZe profile Internet Web page, and the board's
telephone number to a patient, the patient's guardian, or
health care surrogate prior to the patient's first visit following
the probationary order while the licensee is on probation in any of
the following circumstances:
(1) The accusation alleges, the statement of issues indicates, or
the legal conclusions of an administrative law judge find that the
licensee is implicated in any of the following:
(A) Gross negligence.
(B) Repeated negligent acts involving a departure from the
standard of care with multiple patients.
(C) Drug or alcohol abuse that threatens to impair a licensee's
ability to practice acupuncture safely, including practicing under
the influence of drugs or alcohol.
(D) Felony conviction arising from or occurring during patient
care or treatment.
(E) Mental illness or other cognitive impairment that impedes a
licensee's ability to safely practice acupuncture.
(2) The board ordered any of the following in conjunction with
placing the licensee on probation:
(A) That a third-party chaperone be present when the licensee
examines patients as a result of sexual misconduct.
(B) That the licensee submit to drug testing as a result of drug
or alcohol abuse.
(C) That the licensee have a monitor.
(3) The licensee has not successfully completed a training program
or any associated examinations required by the board as a condition
of probation.
(4) The licensee has been on probation more than once.
(b) The licensee shall obtain from each patient a signed receipt
following the disclosure that includes a written explanation of how
the patient can find further information on the licensee's probation
on the board's Internet Web site.
(c) The licensee shall not be required to provide the disclosure
prior to the visit as required by subdivision (a) if the
either of the following applies:
(1) The patient is unconscious or
otherwise unable to comprehend the disclosure or
and sign the receipt pursuant to subdivision (b) and a
guardian or health care surrogate is unavailable to comprehend the
disclosure or and sign the receipt. In
such an that instance, the licensee
shall disclose her or his status as soon as either the patient can
comprehend the disclosure and sign the receipt or a guardian or
health care surrogate is available to comprehend the disclosure and
sign the receipt.
(2) The visit occurs in an emergency room and the licensee who
will be treating the patient during the visit is not known to the
patient until immediately prior to the start of the visit.
(d) Section 4935 shall not apply to subdivision (a) or
(b). (a), (b), or (c).
(e) By July January 1, 2018, the
committee board shall develop a
standardized format for listing the following information pursuant to
subdivision (f):
(1) The listing of the causes for probation alleged in the
accusation, the statement of issues, or the legal conclusions of an
administrative law judge.
(2) The length of the probation and the end date.
(3) All practice restrictions placed on the licencee
licensee by the committee.
board.
(f) By July January 1, 2018, the
board shall provide the information listed in subdivision (e) as
follows:
(1) To an inquiring member of the public.
(2) On any board documents informing the public of probation
orders and probationary licenses, including, but not limited to,
newsletters.
(3) Upon availability of a licensee's BreEZe profile Internet Web
page on the BreEZe system pursuant to Section 210, in plain view on
the BreEZe profile Internet Web page of a licensee subject to
probation or a probationary license.