BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session SB 1033 (Hill) - Medical Board: disclosure of probationary status ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: May 10, 2016 |Policy Vote: B., P. & E.D. 7 - | | | 0 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: No | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: May 16, 2016 |Consultant: Brendan McCarthy | | | | ----------------------------------------------------------------- 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 ? 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 ? 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 ? 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. -- END --