Amended in Assembly August 1, 2016

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 BillNo. 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 3rd-party 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:

P2    1

SECTION 1.  

Article 14 (commencing with Section 2340) is
2added to Chapter 5 of Division 2 of the Business and Professions
3Code
, to read:

 

P3    1Article 14.  Physician and Surgeon Health and Wellness Program
2

 

3

2340.  

(a) The board may establish a Physician and Surgeon
4Health and Wellness Program for the early identification of, and
5appropriate interventions to support a physician and surgeon in
6his or her rehabilitation from, substance abuse to ensure that the
7physician and surgeon remains able to practice medicine in a
8manner that will not endanger the public health and safety and that
9will maintain the integrity of the medical profession. The program,
10if established, shall aid a physician and surgeon with substance
11abuse issues impacting his or her ability to practice medicine.

12(b) For the purposes of this article, “program” shall mean the
13Physician and Surgeon Health and Wellness Program.

14(c) If the board establishes a program, the program shall meet
15the requirements of this article.

16

2340.2.  

If the board establishes a program, the program shall
17do all of the following:

18(a) Provide for the education of all licensed physicians and
19surgeons with respect to the recognition and prevention of physical,
20emotional, and psychological problems.

21(b) Offer assistance to a physician and surgeon in identifying
22substance abuse problems.

23(c) Evaluate the extent of substance abuse problems and refer
24the physician and surgeon to the appropriate treatment by executing
25a written agreement with a physician and surgeon participant.

26(d) Provide for the confidential participation by a physician and
27surgeon with substance abuse issues who does not have a restriction
28on his or her practice related to those substance abuse issues. If an
29investigation of a physician and surgeon occurs after the physician
30and surgeon has enrolled in the program, the board may inquire
31of the program whether the physician and surgeon is enrolled in
32thebegin delete program.end deletebegin insert program and the program shall respond accordingly.end insert

33(e) Comply with the Uniform Standards Regarding
34Substance-Abusing Healing Arts Licensees as adopted by the
35Substance Abuse Coordination Committee of the Department of
36Consumer Affairs pursuant to Section 315.

37

2340.4.  

(a) If the board establishes a program, the board shall
38contract for the program’s administration with a private third-party
39independent administering entity pursuant to a request for
40proposals. The process for procuring the services for the program
P4    1shall be administered by the board pursuant to Article 4
2(commencing with Section 10335) of Chapter 2 of Part 2 of
3Division 2 of the Public Contract Code. However, Section 10425
4of the Public Contract Code shall not apply to this subdivision.

5(b) The administering entity shall have expertise and experience
6in the areas of substance or alcohol abuse in healing arts
7professionals.

8(c) The administering entity shall identify and use a statewide
9treatment resource network that includes treatment and screening
10programs and support groups and shall establish a process for
11evaluating the effectiveness ofbegin delete suchend deletebegin insert thoseend insert programs.

12(d) The administering entity shall provide counseling and
13support for the physician and surgeon and for the family of any
14physician and surgeon referred for treatment.

15(e) The administering entity shall make their services available
16to all licensed California physicians and surgeons, including those
17who self-refer to the program.

18(f) The administering entity shall have a system for immediately
19reporting a physician and surgeon, including, but not limited to, a
20physician and surgeon who withdraws or is terminated from the
21program, to the board. This system shall ensure absolute
22confidentiality in the communication to the board. The
23administering entity shall not provide this information to any other
24 individual or entity unless authorized by the participating physician
25andbegin delete surgeon.end deletebegin insert surgeon or this article.end insert

26(g) The contract entered into pursuant to this section shall also
27require the administering entity to do the following:

28(1) Provide regular communication to the board, including
29annual reports to the board with program statistics, including, but
30not limited to, the number of participants currently in the program,
31the number of participants referred by the board as a condition of
32probation, the number of participants who have successfully
33completed their agreement period, and the number of participants
34terminated from the program. In making reports, the administering
35entity shall not disclose any personally identifiable information
36relating to any participant.

37(2) Submit to periodic audits and inspections of all operations,
38records, and management related to the program to ensure
39compliance with the requirements of this article and its
40implementing rules and regulations. Any audit conducted pursuant
P5    1to this section shall maintain the confidentiality of all records
2reviewed and information obtained in the course of conducting
3the audit and shall not disclose any information identifying a
4program participant.

5(h) In the event that the board determines the administering
6entity is not in compliance with the requirements of the program
7or contract entered into with the board, the board may terminate
8the contract.

9

2340.6.  

(a) A physician and surgeon shall, as a condition of
10participation in the program, enter into an individual agreement
11with the program and agree to pay expenses related to treatment,
12monitoring, laboratory tests, and other activities specified in the
13participant’s written agreement. The agreement shall include all
14of the following:

15(1) A jointly agreed-upon plan and mandatory conditions and
16procedures to monitor compliance with the program.

17(2) Compliance with terms and conditions of treatment and
18monitoring.

19(3) Criteria for program completion.

20(4) Criteria for termination of a physician and surgeon
21participant from the program.

22(5) Acknowledgment that withdrawal or termination of a
23physician and surgeon participant from the program shall be
24reported to the board.

25(6) Acknowledgment that expenses related to treatment,
26monitoring, laboratory tests, and other activities specified by the
27program shall be paid by the physician and surgeon participant.

28(b) Any agreement entered into pursuant to this section shall
29not be considered a disciplinary action or order by the board and
30shall not be disclosed to the board if both of the following apply:

31(1) The physician and surgeon did not enroll in the program as
32a condition of probation or as a result of an action by the board.

33(2) The physician and surgeon is in compliance with the
34conditions and procedures in the agreement.

35(c) Any oral or written information reported to the board shall
36remain confidential and shall not constitute a waiver of any existing
37evidentiary privileges under any other provision or rule of law.
38However, confidentiality regarding the physician and surgeon’s
39participation in the program and related records shall not apply if
40the board has referred a participant as a condition of probation.

P6    1(d) Nothing in this section prohibits, requires, or otherwise
2affects the discovery or admissibility of evidence in an action by
3the board against a physician and surgeon based on acts or
4omissionsbegin delete within the course and scope of his or her practice.end deletebegin insert that
5are grounds for discipline.end insert

6(e) Participation in the program shall not be a defense to any
7disciplinary action that may be taken by the board. This section
8does not preclude the board from commencing disciplinary action
9against a physician and surgeon who is terminated unsuccessfully
10from the program. However, that disciplinary action may not
11include as evidence any confidential information unless authorized
12by thisbegin delete section.end deletebegin insert article.end insert

13

2340.8.  

(a) The Physician and Surgeon Health and Wellness
14Program Account is hereby established within the Contingent Fund
15of the Medical Board of California. Any fees collected by the board
16pursuant to subdivision (b) shall be deposited in the Physician and
17Surgeon Health and Wellness Program Account and shall be
18available, upon appropriation by the Legislature, for the support
19of the program.

20(b) The board shall adopt regulations to determine the
21appropriate fee that a physician and surgeon participating in the
22program shall provide to the board. The fee amount adopted by
23the board shall be set at a level sufficient to cover all costs for
24participating in the program, including any administrative costs
25incurred by the board to administer the program.

26(c) Subject to appropriation by the Legislature, the board may
27use moneys from the Contingent Fund of the Medical Board of
28California to support the initial costs for the board to establish the
29program under this article, except these moneys shall not be used
30to cover any costs for individual physician and surgeon
31participation in the program.



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