BILL NUMBER: SB 1981	CHAPTERED
	BILL TEXT

	CHAPTER   736
	FILED WITH SECRETARY OF STATE   SEPTEMBER 22, 1998
	APPROVED BY GOVERNOR   SEPTEMBER 21, 1998
	PASSED THE SENATE   AUGUST 28, 1998
	PASSED THE ASSEMBLY   AUGUST 26, 1998
	AMENDED IN ASSEMBLY   AUGUST 24, 1998
	AMENDED IN ASSEMBLY   JULY 30, 1998
	AMENDED IN ASSEMBLY   JUNE 24, 1998
	AMENDED IN SENATE   APRIL 15, 1998

INTRODUCED BY   Senator Greene

                        FEBRUARY 19, 1998

   An act to amend Sections 651, 2001, 2020, 2066, 2102, 2135, 2151,
2185, 2225.5, 2428, 2460, 2462, 2472, 2475, 2496, 2569, 3501, 3504,
3505, and 3540 of, to amend and repeal Sections 3514 and 3515 of, to
amend, repeal, and add Sections 2475 and 3535 of, to add Sections
473.17, 3503.5, and 3514.1 to, to repeal Sections 2101, 2148, 2473,
and 2497.1 of, to repeal Article 23 (commencing with Section 2500) of
Chapter 5 of Division 2 of, and to repeal and add Section 3513 of,
the Business and Professions Code, relating to healing arts.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1981, Greene.  Medical boards:  sunset review.
   (1) Existing law regulating the practice of the healing arts
establishes the Medical Board of California, the California Board of
Podiatric Medicine, and the Physician Assistant Examining Committee.
The existence of these boards and committee will be terminated July
1, 1999.
   This bill would extend the existence of the boards and the
committee until July 1, 2003, and make conforming changes.
   (2) The Medical Practice Act contains various requirements
governing foreign medical graduates participating in clinical service
programs or seeking licensure in this state as a physician and
surgeon.  The act also contains various requirements governing the
issuance of a license as a physician and surgeon to a diplomate of
the National Board of Medical Examiners.
   This bill would modify these and other related requirements.
   (3) Existing law requires physicians and surgeons, podiatrists,
and health care facilities to comply with a request for the medical
records of a patient that is accompanied by the patient's written
authorization, as specified.  Existing law imposes various civil
penalties for failure to comply.
   This bill would make failure to comply with a court order, issued
in the enforcement of a subpoena, mandating the release of records to
the Medical Board of California, a misdemeanor, thereby imposing a
state-mandated local program by creating a new crime.  It would enact
related provisions.
   (4) The Medical Practice Act provides for creation of the
California Board of Podiatric Medicine within the Medical Board of
California, with various powers and duties relating to the regulation
of podiatric medicine.
   This bill would modify the membership of the board, repeal
provisions granting a limited license to certain practitioners and
requiring a special certificate for a podiatrist to perform surgical
treatment of the ankle, authorize a podiatrist certified by the board
on and after January 1, 1984, to perform surgical treatment of the
ankle, and revise requirements for continuing education and
examination.  The bill would also permit a licensed podiatrist to
include a statement in advertising that he or she is certified or
eligible or qualified for certification by a private or public board
or association, under certain conditions, and would require the Joint
Legislative Sunset Review Committee to review the expenditure of
funds for the support of educational and related programs in the
field of podiatry.  The bill would also repeal a requirement that the
board establish and administer a diversion program for podiatrists
impaired due to abuse of drugs and alcohol, among other things.
   (5) The Medical Practice Act provides for the Medical Board of
California to renew existing licenses of persons holding a drugless
practitioner's certificate, which authorizes the holder to treat
diseases, injuries, and other conditions without the use of drugs, as
regulated by the board.  Existing law provides that the
classification of drugless practitioner is otherwise abolished.
   This bill would repeal the provisions regulating drugless
practitioners.
   (6) The Physician Assistant Practice Act provides for creation of
the Physician Assistant Examining Committee, which has various powers
and duties relative to making recommendations to the Medical Board
of California concerning the regulation of physician assistants.
   This bill would rename the committee as the Physician Assistant
Committee and would modify its membership.  The bill would also
delete provisions requiring the board to approve applications of
physicians who supervise physician assistants effective July 1, 2000,
provide that a licensed physician assistant shall not be liable for
civil damages for rendering emergency care in certain cases, and
provide for the committee to recognize training programs for
physician assistants approved by a national accrediting organization
rather than approving those programs itself.  The bill would also
authorize physicians and surgeons licensed by the Osteopathic Medical
Board of California to use or employ physician assistants under
certain conditions, and would make violations of these provisions a
misdemeanor, thereby imposing a state-mandated local program by
creating a new crime.
   (7) The bill would enact other related provisions.
  (8) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state.  Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Section 473.17 is added to the Business and Professions
Code, to read:
   473.17.  The Joint Legislative Sunset Review Committee shall
review, in conjunction with the Legislative Analyst's Office, and in
consultation with the Board of Podiatric Medicine, the department,
the University of California, and the California College of Podiatric
Medicine, the expenditure of funds for the support of educational
and related programs in the field of podiatry.  The committee shall
report its findings to the Legislature by April 1, 1999.
  SEC. 2.  Section 651 of the Business and Professions Code is
amended to read:
   651.  (a) It is unlawful for any person licensed under this
division or under any initiative act referred to in this division to
disseminate or cause to be disseminated, any form of public
communication containing a false, fraudulent, misleading, or
deceptive statement or claim, for the purpose of or likely to induce,
directly or indirectly, the rendering of professional services or
furnishing of products in connection with the professional practice
or business for which he or she is licensed.  A "public communication"
as used in this section includes, but is not limited to,
communication by means of television, radio, motion picture,
newspaper, book, or list or directory of healing arts practitioners.

   (b) A false, fraudulent, misleading, or deceptive statement or
claim includes a statement or claim which does any of the following:

   (1) Contains a misrepresentation of fact.
   (2) Is likely to mislead or deceive because of a failure to
disclose material facts.
   (3) Is intended or is likely to create false or unjustified
expectations of favorable results.
   (4) Relates to fees, other than a standard consultation fee or a
range of fees for specific types of services, without fully and
specifically disclosing all variables and other material factors.
   (5) Contains other representations or implications that in
reasonable probability will cause an ordinarily prudent person to
misunderstand or be deceived.
   (c) Any price advertisement shall be exact, without the use of
phrases, including, but not limited to, "as low as," "and up,"
"lowest prices" or words or phrases of similar import.  Any
advertisement that refers to services, or costs for services, and
that uses words of comparison shall be based on verifiable data
substantiating the comparison.  Any person so advertising shall be
prepared to provide information sufficient to establish the accuracy
of that comparison.  Price advertising shall not be fraudulent,
deceitful, or misleading, including statements or advertisements of
bait, discount, premiums, gifts, or any statements of a similar
nature.  In connection with price advertising, the price for each
product or service shall be clearly identifiable.  The price
advertised for products shall include charges for any related
professional services, including dispensing and fitting services,
unless the advertisement specifically and clearly indicates
otherwise.
   (d) Any person so licensed shall not compensate or give anything
of value to a representative of the press, radio, television, or
other communication medium in anticipation of, or in return for,
professional publicity unless the fact of compensation is made known
in that publicity.
   (e) Any person so licensed may not use any professional card,
professional announcement card, office sign, letterhead, telephone
directory listing, medical list, medical directory listing, or a
similar professional notice or device if it includes a statement or
claim that is false, fraudulent, misleading, or deceptive within the
meaning of subdivision (b).
   (f) Any person so licensed who violates this section is guilty of
a misdemeanor.  A bona fide mistake of fact shall be a defense to
this subdivision but only to this subdivision.
   (g) Any violation of this section by a person so licensed shall
constitute good cause for revocation or suspension of his or her
license or other disciplinary action.
   (h) Advertising by any person so licensed may include the
following:
   (1) A statement of the name of the practitioner.
   (2) A statement of addresses and telephone numbers of the offices
maintained by the practitioner.
   (3) A statement of office hours regularly maintained by the
practitioner.
   (4) A statement of languages, other than English, fluently spoken
by the practitioner or a person in the practitioner's office.
   (5) (A) A statement that the practitioner is certified by a
private or public board or agency or a statement that the
practitioner limits his or her practice to specific fields.  For the
purposes of this section, the statement of a practitioner licensed
under Chapter 4 (commencing with Section 1600) who limits his or her
practice to a specific field or fields, shall only include a
statement that he or she is certified or is eligible for
certification by a private or public board or parent association
recognized by that practitioner's licensing board.  A statement of
certification by a practitioner licensed under Chapter 7 (commencing
with Section 3000) shall only include a statement that he or she is
certified or eligible for certification by a private or public board
or parent association recognized by that practitioner's licensing
board.
   (B) A physician and surgeon licensed under Chapter 5 (commencing
with Section 2000) by the Medical Board of California may include a
statement that he or she limits his or her practice to specific
fields, but may only include a statement that he or she is certified
or eligible for certification by a private or public board or parent
association, including, but not limited to, a multidisciplinary board
or association, if that board or association is (i) an American
Board of Medical Specialties member board, (ii) a board or
association with equivalent requirements approved by that physician
and surgeon's licensing board, or (iii) a board or association with
an Accreditation Council for Graduate Medical Education approved
postgraduate training program that provides complete training in that
specialty or subspecialty.  A physician and surgeon licensed under
Chapter 5 (commencing with Section 2000) by the Medical Board of
California who is certified by an organization other than a board or
association referred to in clause (i), (ii), or (iii) shall not use
the term "board certified" in reference to that certification.
   For purposes of this subparagraph, a "multidisciplinary board or
association" means an educational certifying body that has a
psychometrically valid testing process, as determined by the Medical
Board of California, for certifying medical doctors and other health
care professionals that is based on the applicants' education,
training, and experience.
   For purposes of the term "board certified," as used in this
subparagraph, the terms "board" and "association" means an
organization that is an American Board of Medical Specialties member
board, an organization with equivalent requirements approved by a
physician and surgeon's licensing board, or an organization with an
Accreditation Council for Graduate Medical Education approved
postgraduate training program that provides complete training in a
specialty or subspecialty.
   The Medical Board of California shall adopt regulations to
establish and collect a reasonable fee from each board or association
applying for recognition pursuant to this subparagraph.  The fee
shall not exceed the cost of administering this subparagraph.
Notwithstanding Section 2 of Chapter 1660 of the Statutes of 1990,
this subparagraph shall become operative July 1, 1993.  However, an
administrative agency or accrediting organization may take any action
contemplated by this subparagraph relating to the establishment or
approval of specialist requirements on and after January 1, 1991.
   (C) A doctor of podiatric medicine licensed under Chapter 5
(commencing with Section 2000) by the Medical Board of California may
include a statement that he or she is certified or eligible or
qualified for certification by a private or public board or parent
association, including, but not limited to, a multidisciplinary board
or association, if that board or association meets one of the
following requirements:  (i) is approved by the Council on Podiatric
Medical Education, (ii) is a board or association with equivalent
requirements approved by the California Board of Podiatric Medicine,
or (iii) is a board or association with the Council on Podiatric
Medical Education approved postgraduate training programs that
provide training in podiatric medicine and podiatric surgery.  A
doctor of podiatric medicine licensed under Chapter 5 (commencing
with Section 2000) by the Medical Board of California who is
certified by an organization other than a board or association
referred to in clause (i), (ii), or (iii) shall not use the term
"board certified" in reference to that certification.
   For purposes of this subparagraph, a "multidisciplinary board or
association" means an educational certifying body that has a
psychometrically valid testing process, as determined by the
California Board of Podiatric Medicine, for certifying doctors of
podiatric medicine that is based on the applicant's education,
training, and experience.  For purposes of the term "board certified,"
as used in this subparagraph, the terms "board" and "association"
mean an organization that is a Council on Podiatric Medical Education
approved board, an organization with equivalent requirements
approved by the California Board of Podiatric Medicine, or an
organization with a Council on Podiatric Medical Education approved
postgraduate training program that provides training in podiatric
medicine and podiatric surgery.
   The California Board of Podiatric Medicine shall adopt regulations
to establish and collect a reasonable fee from each board or
association applying for recognition pursuant to this subparagraph,
to be deposited in the State Treasury in the Podiatry Fund, pursuant
to Section 2499.  The fee shall not exceed the cost of administering
this subparagraph.
   (6) A statement that the practitioner provides services under a
specified private or public insurance plan or health care plan.
   (7) A statement of names of schools and postgraduate clinical
training programs from which the practitioner has graduated, together
with the degrees received.
   (8) A statement of publications authored by the practitioner.
   (9) A statement of teaching positions currently or formerly held
by the practitioner, together with pertinent dates.
   (10) A statement of his or her affiliations with hospitals or
clinics.
   (11) A statement of the charges or fees for services or
commodities offered by the practitioner.
   (12) A statement that the practitioner regularly accepts
installment payments of fees.
   (13) Otherwise lawful images of a practitioner, his or her
physical facilities, or of a commodity to be advertised.
   (14) A statement of the manufacturer, designer, style, make, trade
name, brand name, color, size, or type of commodities advertised.
   (15) An advertisement of a registered dispensing optician may
include statements in addition to those specified in paragraphs (1)
to (14), inclusive, provided that any statement shall not violate
subdivision (a), (b), (c), or (e) of this section or any other
section of this code.
   (16) A statement, or statements, providing public health
information encouraging preventative or corrective care.
   (17) Any other item of factual information that is not false,
fraudulent, misleading, or likely to deceive.
   (i) Each of the healing arts boards and examining committees
within Division 2 shall adopt appropriate regulations to enforce this
section in accordance with Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code.
   Each of the healing arts boards and committees and examining
committees within Division 2 shall, by regulation, define those
efficacious services to be advertised by business or professions
under their jurisdiction for the purpose of determining whether
advertisements are false or misleading.  Until a definition for that
service has been issued, no advertisement for that service shall be
disseminated.  However, if a definition of a service has not been
issued by a board or committee within 120 days of receipt of a
request from a licensee, all those holding the license may advertise
the service.  Those boards and committees shall adopt or modify
regulations defining what services may be advertised, the manner in
which defined services may be advertised, and restricting advertising
that would promote the inappropriate or excessive use of health
services or commodities.  A board or committee shall not, by
regulation, unreasonably prevent truthful, nondeceptive price or
otherwise lawful forms of advertising of services or commodities, by
either outright prohibition or imposition of onerous disclosure
requirements.  However, any member of a board or committee acting in
good faith in the adoption or enforcement of any regulation shall be
deemed to be acting as an agent of the state.
   (j) The Attorney General shall commence legal proceedings in the
appropriate forum to enjoin advertisements disseminated or about to
be disseminated in violation of this section and seek other
appropriate relief to enforce this section.  Notwithstanding any
other provision of law, the costs of enforcing this section to the
respective licensing boards or committees may be awarded against any
licensee found to be in violation of any provision of this section.
This shall not diminish the power of district attorneys, county
counsels, or city attorneys pursuant to existing law to seek
appropriate relief.
  SEC. 3.  Section 2001 of the Business and Professions Code is
amended to read:
   2001.  There is in the Department of Consumer Affairs a Medical
Board of California which consists of 19 members, seven of whom shall
be public members.
   The Governor shall appoint 17 members to the board, subject to
confirmation by the Senate, five of whom shall be public members.
The Senate Rules Committee and the Speaker of the Assembly shall each
appoint a public member, and their initial appointment shall be made
to fill, respectively, the first and second public member vacancies
which occur on or after January 1, 1983.
  This section shall become inoperative on July 1, 2003, and, as of
January 1, 2004, is repealed, unless a later enacted statute, which
becomes effective on or before January 1, 2004, deletes or extends
the dates on which it becomes inoperative and is repealed.  The
repeal of this section renders the board subject to the review
required by Division 1.2 (commencing with Section 473).
  SEC. 4.  Section 2020 of the Business and Professions Code is
amended to read:
   2020.  The board may employ an executive director exempt from the
provisions of the Civil Service Act and may also employ
investigators, legal counsel, medical consultants, and other
assistance as it may deem necessary to carry into effect this
chapter.  The board may fix the compensation to be paid for services
subject to the provisions of applicable state laws and regulations
and may incur other expenses as it may deem necessary.  Investigators
employed by the board shall be provided special training in
investigating medical practice activities.
   The Attorney General shall act as legal counsel for the board for
any judicial and administrative proceedings and his or her services
shall be a charge against it.
  This section shall become inoperative on July 1, 2003, and, as of
January 1, 2004, is repealed, unless a later enacted statute, which
becomes effective on or before January 1, 2004, deletes or extends
the dates on which it becomes inoperative and is repealed.
  SEC. 5.  Section 2066 of the Business and Professions Code is
amended to read:
   2066.  (a) Nothing in this chapter shall be construed to prohibit
a foreign medical graduate from engaging in the practice of medicine
whenever and wherever required as a part of a clinical service
program under the following conditions:
   (1) The clinical service is in a postgraduate training program
approved by the Division of Licensing.
   (2) The graduate is registered with the division for the clinical
service.
   (b) A graduate may engage in the practice of medicine under this
section until the receipt of his or her physician and surgeon's
certificate.  If the graduate fails to pass the examination and
receive a certificate by the completion of the graduate's second year
of postgraduate training, all privileges and exemptions under this
section shall automatically cease.
   (c) Nothing in this section shall preclude a foreign medical
graduate from engaging in the practice of medicine under any other
exemption contained in this chapter.
  SEC. 6.  Section 2101 of the Business and Professions Code is
repealed.
  SEC. 7.  Section 2102 of the Business and Professions Code is
amended to read:
   2102.  Any applicant who either (1) is a United States citizen, or
(2) has filed a declaration of intention to become a United States
citizen, a petition for naturalization, or a comparable document, or
(3) was admitted or licensed to practice medicine and surgery in a
country or other state of the United States wherein licensure
requirements are satisfactory to the Division of Licensing, whose
professional instruction was acquired in a country other than the
United States or Canada shall provide evidence satisfactory to the
division of compliance with the following requirements to be issued a
physician and surgeon's certificate:
   (a) Completion in a medical school or schools of a resident course
of professional instruction equivalent to that required by Section
2089 and issuance to the applicant of a document acceptable to the
division which shows final and successful completion of the course.
However, nothing in this section shall be construed to require the
division to evaluate for equivalency any coursework obtained at a
medical school disapproved by the division pursuant to this section.

   (b) Certification by the Educational Commission for Foreign
Medical Graduates, or its equivalent, as determined by the division.
This subdivision shall apply to all applicants who are subject to
this section and who have not taken and passed the written
examination specified in subdivision (d) prior to June 1, 1986.
   (c) Satisfactory completion of the postgraduate training required
under Section 2096.  An applicant shall be required to have
substantially completed the professional instruction required in
subdivision (a) and shall be required to make application to the
division and have passed steps 1 and 2 of the written examination
relating to biomedical and clinical sciences prior to commencing any
postgraduate training in this state.  In its discretion, the division
may authorize an applicant who is deficient in any education or
clinical instruction required by Sections 2089 and 2089.5 to make up
any deficiencies as a part of his or her postgraduate training
program, but that remedial training shall be in addition to the
postgraduate training required for licensure.
   (d) Pass the written examination as provided under Article 9
(commencing with Section 2170).  If an applicant has not
satisfactorily completed at least two years of approved postgraduate
training, the applicant shall also pass the clinical competency
written examination.  An applicant shall be required to meet the
requirements specified in subdivision (b) prior to being admitted to
the written examination required by this subdivision.
   Nothing in this section prohibits the division from disapproving
any foreign medical school or from denying an application if, in the
opinion of the division, the professional instruction provided by the
medical school or the instruction received by the applicant is not
equivalent to that required in Article 4 (commencing with Section
2080).
  SEC. 8.  Section 2135 of the Business and Professions Code is
amended to read:
   2135.  The Division of Licensing shall issue a physician and
surgeon's certificate to an applicant who meets all of the following
requirements:
   (a) The applicant holds an unlimited license as a physician and
surgeon in another state or states, or in a Canadian province or
Canadian provinces, which was issued upon:
   (1) Successful completion of a resident course of professional
instruction equivalent to that specified in Section 2089.  However,
nothing in this section shall be construed to require the division to
evaluate for equivalency any coursework obtained at a medical school
disapproved by the division pursuant to Article 4 (commencing with
Section 2080).
   (2) Taking and passing a written examination that is recognized by
the division to be equivalent in content to that administered in
California.
   (b) The applicant has held an unrestricted license to practice
medicine, in a state or states, in a Canadian province or Canadian
provinces, or as a member of the active military, United States
Public Health Services, or other federal program, for a period of at
least four years.  Any time spent by the applicant in an approved
postgraduate training program or clinical fellowship acceptable to
the division shall not be included in the calculation of this
four-year period.
   (c) The division determines that no disciplinary action has been
taken against the applicant by any medical licensing authority and
that the applicant has not been the subject of adverse judgments or
settlements resulting from the practice of medicine that the division
determines constitutes evidence of a pattern of negligence or
incompetence.
   (d) The applicant (1) is certified by a specialty board approved
by the American Board of Medical Specialties or approved by the
division pursuant to subdivision (h) of Section 651; (2) has
satisfactorily completed at least two years of approved postgraduate
training; or (3) takes and passes the clinical competency written
examination.
   (e) The applicant has not committed any acts or crimes
constituting grounds for denial of a certificate under Division 1.5
(commencing with Section 475) or Article 12 (commencing with Section
2220).
   (f) Any application received from an applicant who has held an
unrestricted license to practice medicine, in a state or states, or
Canadian province or Canadian provinces, or as a member of the active
military, United States Public Health Services, or other federal
program for four or more years shall be reviewed and processed
pursuant to this section.  Any time spent by the applicant in an
approved postgraduate training program or clinical fellowship
acceptable to the division shall not be included in the calculation
of this four-year period.  This subdivision does not apply to
applications that may be reviewed and processed pursuant to Section
2151.
  SEC. 9.  Section 2148 of the Business and Professions Code is
repealed.
  SEC. 10.  Section 2151 of the Business and Professions Code is
amended to read:
   2151.  Notwithstanding any other provision of law, the Division of
Licensing may issue a physician and surgeon's certificate to a
diplomate of the National Board of Medical Examiners provided the
following requirements are met:
   (a) The standard of the National Board of Medical Examiners on the
date the diplomate certificate was issued was in no degree or
particular less than that which was required for a physician and
surgeon's certificate under this chapter on the same date.
   (b) The applicant shall file an application with the division as
provided in Article 4 (commencing with Section 2080).  The applicant
shall not, however, be required to comply with any provision of that
article which is inconsistent with or in conflict with the provisions
of this section.
   (c) The application shall be accompanied by the fee required in
Section 2435.
   (d) The applicant shall satisfy the division that the diplomate
certificate was procured without fraud or misrepresentation.
   (e) The applicant shall not have committed any acts or crimes
constituting grounds for denial of a certificate under Section 480 or
Article 12 (commencing with Section 2220).
  SEC. 11.  Section 2185 of the Business and Professions Code is
amended to read:
   2185.  Notwithstanding Section 135, an applicant for examination
who fails to pass any part or parts of the written examination after
two attempts shall not be eligible to be reexamined in that part or
parts of the written examination until the applicant presents
evidence satisfactory to the division that he or she has completed
additional appropriate medical instruction satisfactory to the
division in a program conducted under the auspices of a medical
school or an approved postgraduate training program.  A failure of
any part of the written examination administered in another state
shall be considered a failure of that part for purposes of this
section, if the division finds that the written examination
administered in the other state is the same examination as that
administered by the division under this chapter.
  SEC. 12.  Section 2225.5 of the Business and Professions Code is
amended to read:
   2225.5.  (a) (1) A licensee who fails or refuses to comply with a
request for the medical records of a patient, that is accompanied by
that patient's written authorization for release of records to the
board, within 15 days of receiving the request and authorization,
shall pay to the board a civil penalty of one thousand dollars
($1,000) per day for each day that the documents have not been
produced after the 15th day, unless the licensee is unable to provide
the documents within this time period for good cause.
   (2) A health care facility shall comply with a request for the
medical records of a patient that is accompanied by that patient's
written authorization for release of records to the board together
with a notice citing this section and describing the penalties for
failure to comply with this section.  Failure to provide the
authorizing patient's medical records to the board within 30 days of
receiving the request, authorization, and notice shall subject the
health care facility to a civil penalty, payable to the board, of up
to one thousand dollars ($1,000) per day for each day that the
documents have not been produced after the 30th day, up to ten
thousand dollars ($10,000), unless the health care facility is unable
to provide the documents within this time period for good cause.
This paragraph shall not require health care facilities to assist the
board in obtaining the patient's
        authorization.  The board shall pay the reasonable costs of
copying the medical records.
   (b) (1) A licensee who fails or refuses to comply with a court
order, issued in the enforcement of a subpoena, mandating the release
of records to the board shall pay to the board a civil penalty of
one thousand dollars ($1,000) per day for each day that the documents
have not been produced after the date by which the court order
requires the documents to be produced, unless it is determined that
the order is unlawful or invalid.  Any statute of limitations
applicable to the filing of an accusation by the board shall be
tolled during the period the licensee is out of compliance with the
court order and during any related appeals.
   (2) Any licensee who fails or refuses to comply with a court
order, issued in the enforcement of a subpoena, mandating the release
of records to the board is guilty of a misdemeanor punishable by a
fine payable to the board not to exceed five thousand dollars
($5,000).  The fine shall be added to the licensee's renewal fee if
it is not paid by the next succeeding renewal date.  Any statute of
limitations applicable to the filing of an accusation by the board
shall be tolled during the period the licensee is out of compliance
with the court order and during any related appeals.
   (3) A health care facility that fails or refuses to comply with a
court order, issued in the enforcement of a subpoena, mandating the
release of patient records to the board, that is accompanied by a
notice citing this section and describing the penalties for failure
to comply with this section, shall pay to the board a civil penalty
of up to one thousand dollars ($1,000) per day for each day that the
documents have not been produced, up to ten thousand dollars
($10,000), after the date by which the court order requires the
documents to be produced, unless it is determined that the order is
unlawful or invalid.  Any statute of limitations applicable to the
filing of an accusation by the board against a licensee shall be
tolled during the period the health care facility is out of
compliance with the court order and during any related appeals.
   (4) Any health care facility that fails or refuses to comply with
a court order, issued in the enforcement of a subpoena, mandating the
release of records to the board, is guilty of a misdemeanor
punishable by a fine payable to the board not to exceed five thousand
dollars ($5,000).  Any statute of limitations applicable to the
filing of an accusation by the board against a licensee shall be
tolled during the period the health care facility is out of
compliance with the court order and during any related appeals.
   (c) Multiple acts by a licensee in violation of subdivision (b)
shall be punishable by a fine not to exceed five thousand dollars
($5,000), or by imprisonment in a county jail not exceeding six
months, or by both that fine and imprisonment.  Multiple acts by a
health care facility in violation of subdivision (b) shall be
punishable by a fine not to exceed five thousand dollars ($5,000) and
reported to the State Department of Health Services and shall be
considered as grounds for disciplinary action with respect to
licensure, including suspension or revocation of the license or
certificate.
   (d) A failure or refusal of a licensee to comply with a court
order, issued in the enforcement of a subpoena, mandating the release
of records to the board constitutes unprofessional conduct and is
ground for suspension or revocation of his or her license.
   (e) Imposition of the civil penalties authorized by this section
shall be in accordance with the Administrative Procedure Act (Chapter
5 (commencing with Section 11500) of Division 3 of Title 2 of the
Government Code).
   (f) For purposes of this section, a "health care facility" means a
clinic or health facility licensed or exempt from licensure pursuant
to Division 2 (commencing with Section 1200) of the Health and
Safety Code.
  SEC. 14.  Section 2428 of the Business and Professions Code is
amended to read:
   2428.  (a) A person who fails to renew his or her license within
five years after its expiration may not renew it, and it may not be
reissued, reinstated, or restored thereafter, but that person may
apply for and obtain a new license if he or she:
   (1) Has not committed any acts or crimes constituting grounds for
denial of licensure under Division 1.5 (commencing with Section 475).

   (2) Takes and passes the examination, if any, which would be
required of him or her if application for licensure was being made
for the first time, or otherwise establishes to the satisfaction of
the licensing authority that passes on the qualifications of
applicants for the license that, with due regard for the public
interest, he or she is qualified to practice the profession or
activity for which the applicant was originally licensed.
   (3) Pays all of the fees that would be required if application for
licensure was being made for the first time.
   The licensing authority may provide for the waiver or refund of
all or any part of an examination fee in those cases in which a
license is issued without an examination pursuant to this section.
   Nothing in this section shall be construed to authorize the
issuance of a license for a professional activity or system or mode
of healing for which licenses are no longer required.
   (b) In addition to the requirements set forth in subdivision (a),
an applicant shall establish that he or she meets one of the
following requirements:  (1) satisfactory completion of at least two
years of approved postgraduate training; (2) certification by a
specialty board approved by the American Board of Medical Specialties
or approved by the Division of Licensing pursuant to subdivision (h)
of Section 651; or (3) passing of the clinical competency written
examination.
   (c) Subdivision (a) shall apply to persons who held licenses to
practice podiatric medicine except that those persons who failed to
renew their licenses within three years after its expiration may not
renew it, and it may not be reissued, reinstated, or restored, except
in accordance with subdivision (a).
  SEC. 15.  Section 2460 of the Business and Professions Code is
amended to read:
   2460.  There is created within the jurisdiction of the Medical
Board of California and its divisions the California Board of
Podiatric Medicine.
  This section shall become inoperative on July 1, 2003, and, as of
January 1, 2004, is repealed, unless a later enacted statute, which
becomes effective on or before January 1, 2004, deletes or extends
the dates on which it becomes inoperative and is repealed.  The
repeal of this section renders the California Board of Podiatric
Medicine subject to the review required by Division 1.2 (commencing
with Section 473).
  SEC. 16.  Section 2462 of the Business and Professions Code is
amended to read:
   2462.  The board shall consist of seven members, three of whom
shall be public members.  Not more than one member of the board shall
be a full-time faculty member of a college or school of podiatric
medicine.  The Governor shall give consideration to recommendations
of the board after the division has consulted with the board, except
with regard to the public members.
   The Governor shall appoint the four members qualified as provided
in Section 2463 and one public member.  The Senate Rules Committee
and the Speaker of the Assembly shall each appoint a public member.

  SEC. 17.  Section 2472 of the Business and Professions Code is
amended to read:
   2472.  (a) The certificate to practice podiatric medicine
authorizes the holder to practice podiatric medicine.
   (b) As used in this chapter, "podiatric medicine" means the
diagnosis, medical, surgical, mechanical, manipulative, and
electrical treatment of the human foot, including the ankle and
tendons that insert into the foot and the nonsurgical treatment of
the muscles and tendons of the leg governing the functions of the
foot.
   (c) No podiatrist shall do any amputation or administer an
anesthetic other than local.  If an anesthetic other than local is
required for any procedure, the anesthetic shall be administered by
another health care practitioner licensed under this division, who is
authorized to administer the required anesthetic within the scope of
his or her practice.
   (d) Surgical treatment of the ankle and tendons at the level of
the ankle may be performed by a doctor of podiatric medicine who was
certified by the board on and after January 1, 1984.
   (e) Surgical treatment by a podiatrist of the ankle and tendons at
the level of the ankle shall be performed only in the following
locations:
   (1) A licensed general acute care hospital, as defined in Section
1250 of the Health and Safety Code.
   (2) A licensed surgical clinic, as defined in Section 1204 of the
Health and Safety Code, if the podiatrist has surgical privileges,
including the privilege to perform surgery on the ankle, in a general
acute care hospital described in subparagraph (1) and meets all the
protocols of the surgical clinic.
   (3) An ambulatory surgical center that is certified to participate
in the Medicare program under Title XVIII (42 U.S.C. Sec. 1395 et
seq.) of the federal Social Security Act, if the podiatrist has
surgical privileges, including the privilege to perform surgery on
the ankle, in a general acute care hospital described in subparagraph
(1) and meets all the protocols of the surgical center.
   (4) A freestanding physical plant housing outpatient services of a
licensed general acute care hospital, as defined in Section 1250 of
the Health and Safety Code, if the podiatrist has surgical
privileges, including the privilege to perform surgery on the ankle,
in a general acute care hospital described in paragraph (1).  For
purposes of this section, a "freestanding physical plant" means any
building that is not physically attached to a building where
inpatient services are provided.
   (f) The amendment of this section made at the 1983-84 Regular
Session of the Legislature is intended to codify existing practice.

  SEC. 18.  Section 2473 of the Business and Professions Code is
repealed.
  SEC. 19.  Section 2475 of the Business and Professions Code is
amended to read:
   2475.  (a) Unless otherwise provided by law, no postgraduate
trainee, intern, resident postdoctoral fellow, or instructor may
engage in the practice of podiatric medicine, or receive compensation
therefor, or offer to engage in the practice of podiatric medicine
unless he or she holds a valid, unrevoked, and unsuspended
certificate to practice podiatric medicine issued by the division.
However, a graduate of an approved college or school of podiatric
medicine upon whom the degree doctor of podiatric medicine, doctor of
podiatry, or doctor of surgical chiropody has been conferred, who is
issued a limited license, which may be renewed annually for up to
four years, for this purpose by the division upon recommendation of
the board, and who is enrolled in a postgraduate training program
approved by the board, may engage in the practice of podiatric
medicine whenever and wherever required as a part of that program
under the following conditions:
   (1) A graduate with a limited license in an approved internship,
residency, or fellowship program may participate in training
rotations outside the scope of podiatric medicine, under the
supervision of a physician and surgeon who holds a medical doctor or
doctor of osteopathy degree wherever and whenever required as a part
of the training program, and may receive compensation for that
practice.  If the graduate fails to receive a license to practice
podiatric medicine under this chapter within two years from the
commencement of the postgraduate training, all privileges and
exemptions under this section shall automatically cease.
   (2) Podiatric hospitals functioning as a part of the teaching
program of an approved college or school of podiatric medicine in
this state may exchange instructors or resident or assistant resident
podiatrists with another approved college or school of podiatric
medicine not located in this state, or those hospitals may appoint a
graduate of an approved school as such a resident for purposes of
postgraduate training.  Those instructors and residents may practice
and be compensated as provided in paragraph (1), but that practice
and compensation shall be for a period not to exceed one year.
   (b) This section shall become inoperative on July 1, 2000, and as
of January 1, 2001, is repealed, unless a later enacted statute,
which becomes effective on or before January 1, 2001, deletes or
extends the dates on which it becomes inoperative and is repealed.
  SEC. 20.  Section 2475 is added to the Business and Professions
Code, to read:
   2475.  (a) Unless otherwise provided by law, no postgraduate
trainee, intern, resident postdoctoral fellow, or instructor may
engage in the practice of podiatric medicine, or receive compensation
therefor, or offer to engage in the practice of podiatric medicine
unless he or she holds a valid, unrevoked, and unsuspended
certificate to practice podiatric medicine issued by the division.
However, a graduate of an approved college or school of podiatric
medicine upon whom the degree doctor of podiatric medicine, doctor of
podiatry, or doctor of surgical chiropody has been conferred, who is
enrolled in a postgraduate training program approved by the board,
may engage in the practice of podiatric medicine whenever and
wherever required as a part of that program under the following
conditions:
   (1) A graduate in an approved internship, residency, or fellowship
program may participate in training rotations outside the scope of
podiatric medicine, under the supervision of a physician and surgeon
who holds a medical doctor or doctor of osteopathy degree wherever
and whenever required as a part of the training program, and may
receive compensation for that practice.  If the graduate fails to
receive a license to practice podiatric medicine under this chapter
within two years from the commencement of the postgraduate training,
all privileges and exemptions under this section shall automatically
cease.
   (2) Podiatric hospitals functioning as a part of the teaching
program of an approved college or school of podiatric medicine in
this state may exchange instructors or resident or assistant resident
podiatrists with another approved college or school of podiatric
medicine not located in this state, or those hospitals may appoint a
graduate of an approved school as such a resident for purposes of
postgraduate training.  Those instructors and residents may practice
and be compensated as provided in paragraph (1), but that practice
and compensation shall be for a period not to exceed one year.
   (b) This section shall become operative on July 1, 2000.
  SEC. 21.  Section 2496 of the Business and Professions Code is
amended to read:
   2496.  In order to insure the continuing competence of persons
licensed to practice podiatric medicine, the board shall adopt and
administer regulations in accordance with the Administrative
Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code) requiring continuing
education of those licensees.  The board shall require those
licensees to demonstrate satisfaction of the continuing education
requirements and one of the following requirements at each license
renewal:
   (a) Passage of an examination administered by the board within the
past 10 years.
   (b) Passage of an examination administered by an approved
specialty certifying board within the past 10 years.
   (c) Current diplomate, board-eligible, or board-qualified status
granted by an approved specialty certifying board within the past 10
years.
   (d) Recertification of current status by an approved specialty
certifying board within the past 10 years.
   (e) Successful completion of an approved residency or fellowship
program within the past 10 years.
   (f) Granting or renewal of current staff privileges within the
past five years by a health care facility that is licensed,
certified, accredited, conducted, maintained, operated, or otherwise
approved by an agency of the federal or state government or an
organization approved by the Medical Board of California.
   (g) Successful completion of an approved course of study of at
least four weeks' duration at an approved school within the past five
years.
  SEC. 22.  Section 2497.1 of the Business and Professions Code is
repealed.
  SEC. 23.  Article 23 (commencing with Section 2500) of Chapter 5 of
Division 2 of the Business and Professions Code is repealed.
  SEC. 24.  Section 2569 of the Business and Professions Code is
amended to read:
   2569.  The powers and duties of the board, as set forth in this
chapter, shall be subject to the review required by Division 1.2
(commencing with Section 473).  The review shall be performed as if
this chapter were scheduled to become inoperative on July 1, 2003,
and would be repealed as of January 1, 2004, as described in Section
473.1.
  SEC. 25.  Section 3501 of the Business and Professions Code is
amended to read:
   3501.  As used in this chapter:
   (a) "Board" means the Division of Licensing of the Medical Board
of California.
   (b) "Approved program" means a program for the education of
physician assistants which has been formally approved by the
committee.
   (c) "Trainee" means a person who is currently enrolled in an
approved program.
   (d) "Physician assistant" means a person who meets the
requirements of this chapter and is licensed by the committee.
   (e) "Supervising physician" means a physician and surgeon licensed
by the board or by the Osteopathic Medical Board of California who
supervises one or more physician assistants, who possesses a current
valid license to practice medicine, and who is not currently on
disciplinary probation for improper use of a physician assistant.
   (f) "Supervision" means that a licensed physician and surgeon
oversees the activities of, and accepts responsibility for, the
medical services rendered by a physician assistant.
   (g) "Committee" or "examining committee" means the Physician
Assistant Committee.
   (h) "Regulations" means the rules and regulations as contained in
Chapter 13.8 (commencing with Section 1399.500) of Title 16 of the
California Code of Regulations.
   (i) "Routine visual screening" means uninvasive nonpharmacological
simple testing for visual acuity, visual field defects, color
blindness, and depth perception.
  SEC. 26.  Section 3503.5 is added to the Business and Professions
Code, to read:
   3503.5.  (a) A person licensed under this chapter who in good
faith renders emergency care at the scene of an emergency that occurs
outside both the place and course of that person's employment shall
not be liable for any civil damage as a result of any acts or
omissions by that person in rendering the emergency care.
   (b) This section shall not be construed to grant immunity from
civil damages to any person whose conduct in rendering emergency care
is grossly negligent.
   (c) In addition to the immunity specified in subdivision (a), the
provisions of Article 17 (commencing with Section 2395) of Chapter 5
shall apply to a person licensed under this chapter when acting
pursuant to delegated authority from an approved supervising
physician.
  SEC. 27.  Section 3504 of the Business and Professions Code is
amended to read:
   3504.  There is established a Physician Assistant Committee of the
Medical Board of California.  The committee consists of nine
members.
  This section shall become inoperative on July 1, 2003, and, as of
January 1, 2004, is repealed, unless a later enacted statute, which
becomes effective on or before January 1, 2004, deletes or extends
the dates on which it becomes inoperative and is repealed.  The
repeal of this section renders the committee subject to the review
required by Division 1.2 (commencing with Section 473).
  SEC. 28.  Section 3505 of the Business and Professions Code is
amended to read:
   3505.  The members of the committee shall include one member of
the Medical Board of California, a physician representative of a
California medical school, an educator participating in an approved
program for the training of physician assistants, a physician who is
an approved supervising physician of a physician assistant and who is
not a member of any division of the Medical Board of California,
three physician assistants, and two public members.  Upon the first
expiration of the term of the member who is a member of the Medical
Board of California, that position shall be filled by a member of the
Medical Board of California who is a physician member.  Upon the
first expiration of the term of the member who is a physician
representative of a California medical school, that position shall be
filled by a public member.  Upon the first expiration of the term of
the member who is an educator participating in an approved program
for the training of physician assistants, that position shall be
filled by a physician assistant.  Upon the first expiration of the
term of the member who is an approved supervising physician of a
physician assistant and not a member of any division of the Medical
Board of California, that position shall be filled by a public
member.  Following the expiration of the terms of the members
described above, the committee shall include four physician
assistants, one physician who is also a member of the Medical Board
of California, and four public members.
   Each member of the committee shall hold office for a term of four
years expiring on January 1st, and shall serve until the appointment
and qualification of a successor or until one year shall have elapsed
since the expiration of the term for which the member was appointed,
whichever first occurs.  No member shall serve for more than two
consecutive terms.  Vacancies shall be filled by appointment for the
unexpired terms.
   The Governor shall appoint the licensed members qualified as
provided in this section and two public members.  The Senate Rules
Committee and the Speaker of the Assembly shall each appoint a public
member.
  SEC. 29.  Section 3513 of the Business and Professions Code is
repealed.
  SEC. 30.  Section 3513 is added to the Business and Professions
Code, to read:
   3513.  The committee shall recognize the approval of training
programs for physician assistants approved by a national accrediting
organization.  Physician assistant training programs accredited by a
national accrediting agency approved by the committee shall be deemed
approved by the committee under this section. If no national
accrediting organization is approved by the committee, the committee
may examine and pass upon the qualification of, and may issue
certificates of approval for, programs for the education and training
of physician assistants that meet committee standards.
  SEC. 31.  Section 3514 of the Business and Professions Code is
amended to read:
   3514.  (a) The board shall formulate by regulation guidelines for
the approval of licensed physicians to supervise a physician's
assistant.  Each physician desiring to supervise a physician's
assistant shall file a separate application, except as provided in
Section 3516.5.
   (b) The committee shall formulate by regulation guidelines for the
consideration of applications for licensure as a physician's
assistant.
   (c) The committee shall formulate by regulation guidelines for the
approval of physician's assistant training programs.
   (d) This section shall become inoperative on July 1, 2001, and, as
of January 1, 2002, is repealed, unless a later enacted statute,
which becomes effective on or before January 1, 2002, deletes or
extends the dates on which it becomes inoperative and is repealed.
  SEC. 32.  Section 3514.1 is added to the Business and Professions
Code, to read:
   3514.1.  (a) The committee shall formulate by regulation
guidelines for the consideration of applications for licensure as a
physician's assistant.
   (b) The committee shall formulate by regulation guidelines for the
approval of physician's assistant training programs.
   (c) This section shall become operative on July 1, 2001.
  SEC. 33.  Section 3515 of the Business and Professions Code is
amended to read:
   3515.  (a) The board shall approve an application by a licensed
physician to supervise a physician's assistant, where the applicant
has met all of the requirements of this chapter and the board's
regulations.
   (b) This section shall become inoperative on July 1, 2001, and, as
of January 1, 2002, is repealed, unless a later enacted statute,
which becomes effective on or before January 1, 2002, deletes or
extends the dates on which it becomes inoperative and is repealed.
  SEC. 34.  Section 3535 of the Business and Professions Code is
amended to read:
   3535.  Notwithstanding any other provision of law, physicians and
surgeons licensed by the Osteopathic Medical Board of California may
employ physician's assistants provided:
   (a) Each physician's assistant so employed is a graduate of an
approved program and is licensed by the committee.
   (b) The scope of practice of the physician's assistant shall be
the same as that which is approved by the Division of Licensing of
the Medical Board of California for physicians and surgeons
supervising physician's assistants in the same or a similar
specialty.
   (c) The supervising physician and surgeon is approved by the
Osteopathic Medical Board of California.  The Osteopathic Medical
Board of California may deny an application, or suspend or revoke or
impose probationary conditions upon any osteopathic physician and
surgeon approved to supervise any physician's assistant in any
decision made after a hearing as provided in Section 3528.
   (d) Any physician's assistant licensed by the committee shall be
eligible for employment by any physician and surgeon approved by the
Osteopathic Medical Board of California; except that no physician and
surgeon shall supervise more than two physician's assistants.  The
Osteopathic Medical Board of California may restrict physicians and
surgeons to supervising specific types of physician's assistants
including, but not limited to, restricting physicians and surgeons
from supervising physician's assistants outside of the physician's
and surgeon's field of specialty.
   (e) Each physician and surgeon desiring to supervise a physician's
assistant under this section shall file a separate application.  The
fees to be paid to the Osteopathic Medical Board of
                         California for approval to supervise a
physician's assistant are to be set as follows:  An application fee
not to exceed fifty dollars ($50) shall be charged to each physician
and surgeon applicant.  An approval fee not to exceed one hundred
dollars ($100) shall be charged to each physician and surgeon upon
approval of an application to supervise a physician's assistant.  If
the approval will expire less than one year after its issuance, the
fee shall be 50 percent of the initial approval fee currently in
effect.  The Osteopathic Medical Board of California shall renew
approval to supervise physician's assistants upon application for
that renewal.  A biennial renewal fee not to exceed one hundred fifty
dollars ($150) shall be paid for the renewal of that approval.  The
delinquency fee is twenty-five dollars ($25).  The duplicate license
fee is ten dollars ($10).  The fees collected by the Osteopathic
Medical Board of California pursuant to this subdivision shall be
deposited in the Osteopathic Medical Board of California Contingent
Fund.
   (f) Any person who violates subdivision (a), (b), (c), or (d) of
this section shall be guilty of a misdemeanor punishable by
imprisonment in the county jail not exceeding six months, or by a
fine not exceeding one thousand dollars ($1,000) or by both that
imprisonment and fine.
   (g) This section shall become inoperative on July 1, 2001, and, as
of January 1, 2002, is repealed, unless a later enacted statute,
which becomes effective on or before January 1, 2002, deletes or
extends the dates on which it becomes inoperative and is repealed.
  SEC. 35.  Section 3535 is added to the Business and Professions
Code, to read:
   3535.  (a) Notwithstanding any other provision of law, physicians
and surgeons licensed by the Osteopathic Medical Board of California
may use or employ physician assistants provided (1) each physician
assistant so used or employed is a graduate of an approved program
and is licensed by the committee, and (2) the scope of practice of
the physician assistant is the same as that which is approved by the
Division of Licensing of the Medical Board of California for
physicians and surgeons supervising physician assistants in the same
or similar specialty.
   (b) Any person who violates subdivision (a) shall be guilty of a
misdemeanor punishable by imprisonment in a county jail not exceeding
six months, or by a fine not exceeding one thousand dollars
($1,000), or by both that imprisonment and fine.
   (c) This section shall become operative on July 1, 2001.
  SEC. 36.  Section 3540 of the Business and Professions Code is
amended to read:
   3540.  A physician assistants corporation is a corporation which
is authorized to render professional services, as defined in Section
13401 of the Corporations Code, so long as that corporation and its
shareholders, officers, directors, and employees rendering
professional services who are certified physician assistants are in
compliance with the Moscone-Knox Professional Corporation Act, the
provisions of this article, and all other statutes and regulations
now or hereafter enacted or adopted pertaining to the corporation and
the conduct of its affairs.
   With respect to a physician assistants corporation, the
governmental agency referred to in the Moscone-Knox Professional
Corporation Act (commencing with Section 13400) of Division 3 of
Title 1 of the Corporations Code) is the committee.
  SEC. 37.  No reimbursement is required by this act pursuant to
Section 6 of Article XIIIB of the California Constitution because the
only costs that may be incurred by a local agency or school district
will be incurred because this act creates a new crime or infraction,
eliminates a crime or infraction, or changes the penalty for a crime
or infraction, within the meaning of Section 17556 of the Government
Code, or changes the definition of a crime within the meaning of
Section 6 of Article XIIIB of the California Constitution.
   Notwithstanding Section 17580 of the Government Code, unless
otherwise specified, the provisions of this act shall become
operative on the same date that the act takes effect pursuant to the
California Constitution.