Amended in Assembly June 23, 2016

Amended in Senate June 1, 2016

Amended in Senate May 4, 2016

Amended in Senate April 20, 2016

Amended in Senate April 4, 2016

Senate Bill No. 1177

Introduced by Senator Galgiani

February 18, 2016

An act to add Article 14 (commencing with Section 2340) to Chapter 5 of Division 2 of the Business and Professions Code, relating to healing arts.

LEGISLATIVE COUNSEL’S DIGEST

SB 1177, as amended, Galgiani. Physician and Surgeon Health and Wellness Program.

Existing law establishes in the Department of Consumer Affairs the Substance Abuse Coordination Committee, comprised of the executive officers of the department’s healing arts boards and a designee of the State Department of Health Care Services. Existing law requires the committee to formulate, by January 1, 2010, uniform and specific standards in specified areas that each healing arts board is required to use in dealing with substance-abusing licensees, whether or not a healing arts board has a formal diversion program.

Existing law, the Medical Practice Act, provides for the licensure and regulation of physicians and surgeons by the Medical Board of California within the department. Existing law requires all moneys paid to and received by the Medical Board of California to be paid into the State Treasury and credited to the Contingent Fund of the Medical Board of California, which, except for fine and penalty money, is a continuously appropriated fund.

This bill would authorize the board to establish a Physician and Surgeon Health and Wellness Program for the early identification of, and appropriate interventions to support a physician and surgeon in his or her rehabilitation from, substance abuse, as specified. If the board establishes a program, the bill would require the board to contract for the program’s administration with a private begin delete third-party end delete begin insert 3rd-party end insert independent administering entity meeting certain requirements. The bill would require program participants to enter into an individual agreement with the program that includes, among other things, a requirement to pay expenses related to treatment, monitoring, and laboratory tests, as provided.

This bill would create the Physician and Surgeon Health and Wellness Program Account within the Contingent Fund of the Medical Board of California. The bill would require the board to adopt regulations to determine the appropriate fee for a physician and surgeon to participate in the program, as specified. The bill would require these fees to be deposited in the Physician and Surgeon Health and Wellness Program Account and to be available, upon appropriation by the Legislature, for the support of the program. Subject to appropriation by the Legislature, the bill would authorize the board to use moneys from the Contingent Fund of the Medical Board of California to support the initial costs for the board to establish the program, except the bill would prohibit these moneys from being used to cover any costs for individual physician and surgeon participation in the program.

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.  

Article 14 (commencing with Section 2340) is
added to Chapter 5 of Division 2 of the Business and Professions
Code, to read:

 

Article 14.  Physician and Surgeon Health and Wellness Program

 

2340.  

(a) The board may establish a Physician and Surgeon
Health and Wellness Program for the early identification of, and
appropriate interventions to support a physician and surgeon in
his or her rehabilitation from, substance abuse to ensure that the
physician and surgeon remains able to practice medicine in a
manner that will not endanger the public health and safety and that
will maintain the integrity of the medical profession. The program,
if established, shall aid a physician and surgeon with substance
abuse issues impacting his or her ability to practice medicine.

(b) For the purposes of this article, “program” shall mean the
Physician and Surgeon Health and Wellness Program.

(c) If the board establishes a program, the program shall meet
the requirements of this article.

2340.2.  

If the board establishes a program, the program shall
do all of the following:

(a) Provide for the education of all licensed physicians and
surgeons with respect to the recognition and prevention of physical,
emotional, and psychological problems.

(b) Offer assistance to a physician and surgeon in identifying
substance abuse problems.

(c) Evaluate the extent of substance abuse problems and refer
the physician and surgeon to the appropriate treatment by executing
a written agreement with a physician and surgeon participant.

(d) Provide for the confidential participation by a physician and
surgeon with substance abuse issues who does not have a restriction
on his or her practice related to those substance abuse issues. begin insert If an
investigation of a physician and surgeon occurs after the physician
and surgeon has enrolled in the program, the board may inquire
of the program whether the physician and surgeon is enrolled in
the program. end insert

(e) Comply with the Uniform Standards Regarding
Substance-Abusing Healing Arts Licensees as adopted by the
Substance Abuse Coordination Committee of the Department of
Consumer Affairs pursuant to Section 315.

2340.4.  

(a) If the board establishes a program, the board shall
contract for the program’s administration with a private third-party
independent administering entity pursuant to a request for
proposals. The process for procuring the services for the program
shall be administered by the board pursuant to Article 4
(commencing with Section 10335) of Chapter 2 of Part 2 of
Division 2 of the Public Contract Code. However, Section 10425
of the Public Contract Code shall not apply to this subdivision.

(b) The administering entity shall have expertise and experience
in the areas of substance or alcohol abuse in healing arts
professionals.

(c) The administering entity shall identify and use a statewide
treatment resource network that includes treatment and screening
programs and support groups and shall establish a process for
evaluating the effectiveness of such programs.

(d) The administering entity shall provide counseling and
support for the physician and surgeon and for the family of any
physician and surgeon referred for treatment.

(e) The administering entity shall make their services available
to all licensed California physicians and surgeons, including those
who self-refer to the program.

(f) The administering entity shall have a system for immediately
reporting a physician and begin delete surgeon end delete begin insert surgeon, including, but not
limited to, a physician and surgeon end insert who withdraws or is terminated
from the begin delete program end delete begin insert program, end insert to the board. This system shall ensure
absolute confidentiality in the communication to the board. The
administering entity shall not provide this information to any other
individual or entity unless authorized by the participating physician
and surgeon.

(g) The contract entered into pursuant to this section shall also
require the administering entity to do the following:

(1) Provide regular communication to the board, including
annual reports to the board with program statistics, including, but
not limited to, the number of participants currently in the program,
the number of participants referred by the board as a condition of
probation, the number of participants who have successfully
completed their agreement period, and the number of participants
terminated from the program. In making reports, the administering
entity shall not disclose any personally identifiable information
relating to any participant.

(2) Submit to periodic audits and inspections of all operations,
records, and management related to the program to ensure
compliance with the requirements of this article and its
implementing rules and regulations. Any audit conducted pursuant
to this section shall maintain the confidentiality of all records
reviewed and information obtained in the course of conducting
the audit and shall not disclose any information identifying a
program participant.

(h) In the event that the board determines the administering
entity is not in compliance with the requirements of the program
or contract entered into with the board, the board may terminate
the contract.

2340.6.  

(a) A physician and surgeon shall, as a condition of
participation in the program, enter into an individual agreement
with the program and agree to pay expenses related to treatment,
monitoring, laboratory tests, and other activities specified in the
participant’s written agreement. The agreement shall include all
of the following:

(1) A jointly begin delete agreed upon end delete begin insert agreed-upon end insert plan and mandatory
conditions and procedures to monitor compliance with the program.

(2) Compliance with terms and conditions of treatment and
monitoring.

(3) Criteria for program completion.

(4) Criteria for termination of a physician and surgeon
participant from the program.

(5) Acknowledgment that withdrawal or termination of a
physician and surgeon participant from the program shall be
reported to the board.

(6) Acknowledgment that expenses related to treatment,
monitoring, laboratory tests, and other activities specified by the
program shall be paid by the physician and surgeon participant.

(b) Any agreement entered into pursuant to this section shall
not be considered a disciplinary action or order by the board and
shall not be disclosed to the board if both of the following apply:

(1) The physician and surgeon did not enroll in the program as
a condition of probation or as a result of an action by the board.

(2) The physician and surgeon is in compliance with the
conditions and procedures in the agreement.

(c) Any oral or written information reported to the board shall
remain confidential and shall not constitute a waiver of any existing
evidentiary privileges under any other provision or rule of law.
However, confidentiality regarding the physician and surgeon’s
participation in the program and related records shall not apply if
the board has referred a participant as a condition of probation.

(d) Nothing in this section prohibits, requires, or otherwise
affects the discovery or admissibility of evidence in an action by
the board against a physician and surgeon based on acts or
omissions within the course and scope of his or her practice.

begin delete

(e) Any information received, developed, or maintained
regarding a physician and surgeon in the program shall not be used
for any other purposes.

end delete begin delete

(f)

end delete

begin insert (e) end insert  Participation in the program shall not be a defense to any
disciplinary action that may be taken by the board. This section
does not preclude the board from commencing disciplinary action
against a physician and surgeon who is terminated unsuccessfully
from the program. However, that disciplinary action may not
include as evidence any confidential information unless authorized
by this section.

2340.8.  

(a) The Physician and Surgeon Health and Wellness
Program Account is hereby established within the Contingent Fund
of the Medical Board of California. Any fees collected by the board
pursuant to subdivision (b) shall be deposited in the Physician and
Surgeon Health and Wellness Program Account and shall be
available, upon appropriation by the Legislature, for the support
of the program.

(b) The board shall adopt regulations to determine the
appropriate fee that a physician and surgeon participating in the
program shall provide to the board. The fee amount adopted by
the board shall be set at a level sufficient to cover all costs for
participating in the program, including any administrative costs
incurred by the board to administer the program.

(c) Subject to appropriation by the Legislature, the board may
use moneys from the Contingent Fund of the Medical Board of
California to support the initial costs for the board to establish the
program under this article, except these moneys shall not be used
to cover any costs for individual physician and surgeon
participation in the program.

begin delete

2340.10.  

The Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title
2 of the Government Code) shall apply to regulations adopted
pursuant to this article.

end delete