BILL ANALYSIS
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UNFINISHED BUSINESS
Bill No: SB 1456
Author: Kuehl (D)
Amended: 8/23/04
Vote: 21
PRIOR SENATE VOTES NOT RELEVANT
ASSEMBLY FLOOR : 53-22, 8/24/04 - See last page for vote
SUBJECT : Hospitals: physicians and surgeons:
self-governance
SOURCE : Author
DIGEST : Assembly Amendments delete the contents of the
bill. Previously, the bill prohibited an owner or operator
of the Santa Susana Field Laboratory site in Ventura County
from using, selling, transferring, or leasing any part of
that site for residential use unless certain findings were
met.
This bill now clarifies the medical staff's right of
self-governance and makes various findings and
declarations.
ANALYSIS :
This bill:
1. Requires the medical staff's right of self-governance to
include, but not be limited to, all of the following:
CONTINUED
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A. Establishing in medical bylaws, rules or
regulation, criteria and standards consistent with
the medical peer review process, for medical staff
membership and privileges.
B. Establishing in medical staff bylaws, rules or
regulations, clinical criteria and standards to
oversee and manage quality assurance, utilization
review, and other medical staff activities including,
but not limited to, periodic meetings of the medical
staff and its committees and departments and review
and analysis of patient medical records.
C. Selecting and removing medical staff officers.
D. Assessing medical staff dues and utilizing the
medical staff dues as appropriate for the purposes of
the medical staff.
E. The ability to retain and be represented by
independent legal counsel at the expense of the
medical staff, provided that medical staff at the
University of California (UC) have the right to
retain and be represented by independent legal
counsel at the expense of the medical staff upon
approval by the Regents of the UC or their designee
in accordance with the bylaws of the Regents, which
approval shall not be unreasonably denied.
F. Initiating, developing, and adopting medical staff
bylaws, rules and regulation, and amendments thereto,
subject to approval of the hospital governing board,
which approval shall not be unreasonably withheld.
2. Prohibits the medical bylaws from interfering with the
independent rights of the medical staff to do any of the
following, but requires the procedures for:
A. Selecting and removing medical staff officers/
B. Assessing medical staff dues and utilizing medical
staff dues as appropriate for the purposes of the
medical staff.
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C. The ability to retain and be represented by
independent legal counsel at the expense of the
medical staff.
3. Requires, that with respect to any dispute arising, the
medical staff and hospital governing board to meet and
confer in good faith to resolve the dispute. Allows a
superior court of any county to issue an injunction,
writ of mandate, or other appropriate order whenever a
person or entity has engaged in or is about to engage in
any acts or practices that hinder, restrict, or
otherwise obstruct the ability of the medical staff to
exercise its rights, obligations, or responsibilities,
as specified.
4. Makes legislative findings and declarations on the
following:
A. That providing quality medical care in hospitals
depends on the mutual accountability,
interdependence, and responsibility, of the medical
staff and the hospital governing body for the proper
performance of their respective obligations.
B. That the governing board of a hospital must act to
protect the quality of medical care provided and the
competency of its medical staff, and the responsible
governance of the hospital in the event that the
medical staff fails in any of its substantive duties
or responsibilities, and nothing in this bill
undermines their authority. The final authority of
the hospital governing board may be exercised for the
responsible governance of the hospital or for the
conduct of the business affairs of the hospital but
such final authority may only be exercised with a
reasonable and good faith belief that the medical
staff has failed to fulfill a substantive duty or
responsibility in matters pertaining to the quality
of patient care. Specifies that it would be a
violation of the medical staff's self-governance and
independent rights for the hospital governing board
to assume a duty or responsibility of the medical
staff precipitously, unreasonably, or in bad faith.
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C. That the specific actions that would constitute
bad faith or unreasonable action on the part of
either the medical staff, or hospital governing board
will always be fact specific and cannot be precisely
described in statute, and that the provisions set
forth herein do nothing more than provide for the
basic independent rights and responsibilities of a
self-governing medical staff. Specifies that a
successful relationship between a hospital's medical
staff and governing board depends on the mutual
respect for the rights and responsibilities of the
other.
5. Makes the bill's enactment contingent on the passage of
SB 1325 (Kuehl).
Comments
This bill is substantially similar to the provisions of SB
1325 (Kuehl), pending the Governor's action, but includes
clarifying amendments dealing with the medical staff of UC
hospitals. The amendments indicate that UC medical staff's
right to retain and be represented by independent legal
counsel must be approved by the Regents of the UC or its
designee in accordance with the bylaws of the Regents. UC
believes these amendments are necessary to address the
unique relationship between the UC and its faculty
physicians and make this bill consistent with the bylaws
governing the UC. The UC specifies that its faculty
physicians enjoy certain rights and privileges that are not
common to other medical staff including access to legal
counsel under the UC Regents' Bylaws and Standing Orders,
the provision of medical malpractice insurance, and benefit
of internal grievance processes designed to address and
resolve quality issues and concerns.
Without the amendments, the provisions of the SB 1325 would
have an adverse impact on the relationship of faculty
physicians and the UC Board of Regents or its designees.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
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ASSEMBLY FLOOR :
AYES: Berg, Bermudez, Calderon, Canciamilla, Chan, Chavez,
Chu, Cohn, Corbett, Correa, Diaz, Dutra, Firebaugh,
Frommer, Garcia, Goldberg, Hancock, Jerome Horton,
Shirley Horton, Houston, Jackson, Kehoe, Laird, Leno,
Levine, Lieber, Liu, Longville, Lowenthal, Maldonado,
Montanez, Mullin, Nakanishi, Nakano, Nation, Negrete
McLeod, Oropeza, Parra, Reyes, Richman, Ridley-Thomas,
Salinas, Samuelian, Simitian, Spitzer, Steinberg, Vargas,
Wesson, Wiggins, Wolk, Wyland, Yee, Nunez
NOES: Aghazarian, Bates, Benoit, Bogh, Campbell, Cogdill,
Cox, Dutton, Harman, Haynes, Keene, La Malfa, La Suer,
Leslie, Matthews, Maze, McCarthy, Mountjoy, Pacheco,
Plescia, Runner, Strickland
NO VOTE RECORDED: Daucher, Dymally, Koretz, Maddox, Pavley
CP:mel 8/25/04 Senate Floor Analyses
SUPPORT/OPPOSITION: NONE RECEIVED
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