BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 1033 (Hill) - Medical Board: disclosure of probationary
status
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|Version: May 10, 2016 |Policy Vote: B., P. & E.D. 7 - |
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|Urgency: No |Mandate: No |
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|Hearing Date: May 16, 2016 |Consultant: Brendan McCarthy |
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This bill meets the criteria for referral to the Suspense File.
Bill
Summary: SB 1033 would require physicians, osteopathic
physicians, podiatrists, acupuncturists, chiropractors, and
naturopathic doctors to notify patients of their probationary
status before a patient visit occurs.
Fiscal
Impact:
Ongoing costs of about $1 million per year for additional
disciplinary hearings for physicians licensed by the Medical
Board (Contingent Fund of the Medical Board of California).
See below.
Ongoing costs in the tens of thousands per year, on average,
for additional disciplinary hearings by the Osteopathic
Medical Board (Osteopathic Medical Board of California
Contingent Fund).
Ongoing costs in the low tens thousands per year, on average,
SB 1033 (Hill) Page 1 of
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for additional disciplinary hearings by the Board of Podiatric
Medicine (Board Podiatric Medicine Fund).
Ongoing costs in the tens of thousands per year, on average,
for additional disciplinary hearings by the Board of
Chiropractic Examiners (State Board of Chiropractic Examiners
Fund).
Minor average annual costs for additional disciplinary
hearings by the Naturopathic Medical Committee (Naturopathic
Doctors Fund).
Background: Under current law, certain boards committees within the
Department of Consumer Affairs license and regulate the practice
of medicine, osteopathic medicine, podiatric medicine,
acupuncture, chiropractic, and naturopathic medicine. Under
current law and regulation, licensees are subject to
disciplinary action by their licensing board or committee for
actions in violation of law or regulation. Depending on the
severity of the violation and the licensee's past disciplinary
history, a licensing board or committee can suspend or revoke a
license, place the licensee on probation, or issue a citation.
Generally, the licensing boards and committees make information
about disciplinary actions available on their websites, although
consumers may have difficulty finding such information.
Proposed Law:
SB 1033 would require physicians, osteopathic physicians,
podiatrists, acupuncturists, chiropractors, and naturopathic
doctors to notify patients of their probationary status before a
patient visit occurs.
Specific provisions of the bill would:
Authorize the Medical Board to seek recovery for the
costs of a disciplinary proceeding against a physician, in
cases where the licensee is placed on probation;
Require physicians and surgeons, osteopathic physicians,
podiatrists, acupuncturists, chiropractors, and
naturopathic doctors to disclose his or her probationary
status (including the causes for probation listed in the
accusation) to a patient, guardian, or health care
surrogate prior to the patient's first visit, under
specified circumstances, after January 1, 2018;
SB 1033 (Hill) Page 2 of
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Require the licensee to obtain from each patient a
signed receipt of the disclosure;
Exempt licensees from the disclosure requirement under
certain circumstances (e.g. when a patient is unconscious
or for visits occurring in an emergency room);
Require the appropriate licensing board to develop a
standardized format for listing required information in the
disclosure to patients by January 1, 2018;
Require the appropriate licensing board to make
specified information regarding licensee probation status
available to the public by January 1, 2018.
Staff
Comments: Under current practice, many disciplinary actions
against physicians licensed by the Medical Board are resolved
through a stipulated settlement. In those cases the accused
physician stipulates to one or more lesser disciplinary charges
and accepts probation. Under this bill, the requirement to
notify patients of a physician's probationary status and the
reasons for probation listed in the accusation is likely to
result in some accused physicians forgoing a stipulated
settlement and seeking an administrative hearing on the case.
The average cost difference between a full administrative
proceeding versus a stipulated settlement is about $35,000 per
case. There are about 130 cases per year that result in
probation. Of those, about 30 cases result in a stipulated
settlement for a probationary period of less than three years.
Generally, those cases result from first-time offenses or
accusations of lesser significance. Under the bill, it is likely
that most of those cases would result in a full administrative
hearing. Cases resulting in a probation period of more than
three years are less likely to proceed to a full administrative
hearing under the bill, because a licensee in those cases has a
greater chance of losing his or her license in the
administrative hearing process and so would likely be less
willing to forgo a stipulated settlement resulting in probation.
The cost estimates above for the boards other than the Medical
Board are based on cost information provided by the Medical
Board. The costs above assume that the number of additional
administrative hearings per year is proportional to the size of
the board's licensed population and that the costs are similar
to those experienced by the Medical Board.
SB 1033 (Hill) Page 3 of
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Under current law, most licensing boards and bureaus except for
the Medical Board can seek to recover the cost of a disciplinary
proceeding. This bill would extend this authority to the Medical
Board. Therefore, the Medical Board and other licensing boards
would be able to recover some to the additional costs identified
above, for those cases that are found in favor of the licensing
board.
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