BILL ANALYSIS Ó
SB 1261
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Date of Hearing: June 28, 2016
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Rudy Salas, Chair
SB 1261(Stone) - As Amended May 3, 2016
SENATE VOTE: 35-0
SUBJECT: Physicians and surgeons: fee exemption: residency
SUMMARY: Removes the requirement from application and renewal
fee waivers that a physician and surgeon reside in California in
order to provide voluntary and unpaid services.
EXISTING LAW:
1) Establishes the Medical Board of California (MBC), to
regulate the practice of medicine in California. (Business
and Professions Code (BPC) § 2000 et seq.)
2) Establishes the Osteopathic Medical Board (OMBC) to enforce
provisions of law related to osteopathic physicians and
surgeons. (BPC § 2450)
3) Provides that a physician and surgeon who practices or
attempts to practice medicine in California without a license
or certificate is guilty of a public offense punishable by a
fine not exceeding $10,000, by imprisonment, or by both fine
and imprisonment. (BPC § 2052)
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4)Exempts health care practitioners licensed in another state or
territory from California licensure during a state of
emergency, as specified. (BPC § 900)
5)Authorizes the MBC and the OMBC to establish reciprocity
provisions for those individuals holding an unlimited license
to practice medicine or osteopathic medicine in another state,
as specified. (BPC §§ 2135, 2153.5)
6) Exempts from California licensure, until January 1, 2018, out
of state health care practitioners who voluntarily
participate in "sponsored events" for uninsured or
underinsured individuals for no more than ten calendar days,
as specified.
(BPC § 901)
THIS BILL:
1)Removes the requirement from application and renewal fee
waivers that a physician and surgeon reside in California in
order to provide voluntary and unpaid services.
FISCAL EFFECT: According to the Senate Appropriations
Committee, pursuant to Senate Rule 28.8, this bill will result
in negligible state costs.
COMMENTS:
Purpose. This bill is sponsored by the author. According to
the author, "In parts of the state, including parts of the 28th
Senate District, many semi-retired doctors flock to the region
during the winter time. According to many of the health clinics
in those regions, they receive numerous requests for doctors
looking to volunteer. Current law limits out of state doctors
to only practice at specified events when in California. The
amount of time these doctors are allowed to practice at these
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events is only 10 days. SB 1261 allows licensed doctors, who
are in good standing in their own state but are visiting
California, to volunteer and help alleviate the doctor shortage
at health clinics in California by simply expanding a program
that is already offered to retired California doctors that are
practicing on a volunteer basis."
Background. Prior to 2010, health care practitioners, including
physician and surgeons, osteopathic physicians, dentists,
physician assistants, nurses, and dental hygienists were
required to be licensed in California in order to practice in
the state for any length of time and in any setting. The only
exemptions included health care practitioners who provided care
during a state of emergency upon request by the Director of
Emergency Medical Services Authority, or if a physician and
surgeon who was practicing in another state had been invited by
the United States Olympic Committee to provide medical services
during in-state events sanctioned by the Committee.
In 2010, AB 2699 (Bass) Chapter 270, Statutes of 2010,
established that health care professionals who were licensed or
certified outside of California were permitted to provide health
care services to underinsured and uninsured Californians at
health care events. These professionals could only provide
these services for up to 10 days. In 2013, AB 512 (Rendon)
Chapter 111, Statutes of 2013, extended the sunset date of AB
2699 from January 1, 2014 to January 1, 2018.
Patient Protection Provisions. Current law includes a number of
provisions to ensure patient safety including:
For health care practitioners:
1) The practitioner must obtain authorization from the
respective California licensing or certifying board to
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participate in the sponsored event.
2) The practitioner must be in good standing in each state
in which the practitioner is licensed or certified.
3) The practitioner must not have committed any act or been
convicted of a crime constituting grounds for denial of
licensure or certification.
4) The practitioner must have the appropriate education and
experience to participate in a sponsored event.
5) The practitioner whose authorization to provide health
care services has been terminated and is deemed to be
practicing health care in violation of the law is subject
to any applicable administrative, civil, and criminal
fines, penalties and other sanctions.
For the Sponsors of Health Care Events:
1) Requires the sponsoring entity seeking to provide, or
arrange for the provision of, health care services to do
both of the following:
a) Register with each applicable licensing or
certifying board for which an out of state health care
practitioner is participating in the sponsored event by
completing a registration form.
b) Provide the information on the registration form
to the county health department of the county in which
the health care services will be provided.
1) Requires the sponsoring entity to notify in writing the
licensing or certifying board and the county health
department of any change to the information on the
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registration form within 30 calendar days of the change.
2) Within 15 calendar days of the provision of health care
services, the sponsoring entity must file a report with the
licensing or certifying board and the county health
department on the date, place, type and general description
of the care provided, along with a listing of the health
care practitioners who participated in providing services.
3) Requires the sponsoring entity to maintain a copy of
each health care practitioner's current license or
certification and shall require each health care
practitioner to attest in writing that his or her license
or certificate is not suspended or revoked pursuant to
disciplinary proceedings in any jurisdiction. The
sponsoring entity shall maintain these records for a period
of at least five years following the provision of health
care services and shall, upon request, furnish those
records to the licensing or certifying board or any county
health department.
For the licensing or certifying boards:
1) Authorizes the board to terminate authorization for a
health care practitioner to provide health care services
pursuant to this bill for failure to comply with the
requirements of this bill.
2) Requires the board provide both the sponsoring entity
and the health care practitioner with a written notice of
termination including the basis for that termination.
3) Allows the board to deny a health care practitioner
authorization to practice without a license if the health
care practitioner fails to comply with the requirements or
for any act that would be grounds for denial of an
application for licensure or certification.
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Free Health Clinics. Since 2010, there have been several events
held across the state. The Remote Area Medical Volunteer Corps
is a non-profit organization that has staged hundreds of medical
clinics both in the United States and worldwide. Over the past
seven years, RAM conducted health events in Los Angeles County
where volunteer health care practitioners, such as doctors,
nurses, dentists, chiropractors and optometrists provided
various medical services to over 19,000 uninsured and
underinsured residents of the county. Additionally, more than
7,000 people received free medical, vision and dental care
during a 2013 four day CareNow clinic event held at the Los
Angeles Memorial Coliseum.
Currently, it is prohibited for a licensed out of state doctor
to practice in California for an extended period of time. This
bill seeks to allow licensed doctors, who are in good standing
in their own state, and are visiting California, to volunteer
their services at free clinics with a two year limited license
issued by the MBC.
Prior Related Legislation. AB 512 (Rendon) Chapter 111,
Statutes of 2013, extended the sunset date, from January 2014,
to January 2018, on existing law permitting qualified,
out-of-state health care practitioners to volunteer their
services on a limited basis at health care events designed to
provide free services for underinsured and uninsured individuals
in California.
AB 2699 (Bass) Chapter 270, Statutes of 2010, exempted from
state licensure, until January 1, 2014, specified health care
practitioners who are licensed or certified in other states and
who provide health care services on a voluntary basis to
uninsured or underinsured persons in California, as specified.
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REGISTERED SUPPORT:
None on file.
REGISTERED OPPOSITION:
None on file.
Analysis Prepared by:Le Ondra Clark Harvey, Ph.D. / B. & P. /
(916) 319-3301