BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 526
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          Date of Hearing:   April 28, 2009

                            ASSEMBLY COMMITTEE ON HEALTH
                                  Dave Jones, Chair
                    AB 526 (Fuentes) - As Amended:  April 16, 2009
           
          SUBJECT  :   Public Protection and Physician Health Program Act of  
          2009.

           SUMMARY  :   Establishes a voluntary physician health program  
          (PHP) within the State and Consumer Services Agency (SCSA) to  
          assist physicians and surgeons impaired by alcohol and substance  
          abuse or mental health disorders.  Specifically,  this bill  :  


          1)Establishes the Public Protection and Physician Health  
            Committee (committee) within the SCSA, comprised of 14  
            appointed members, as specified.


          2)Requires the committee to prepare and adopt rules and  
            regulations that provide clear guidance and measurable  
            outcomes to ensure patient safety and the health and wellness  
            of physicians and surgeons by June 30, 2010.  Requires the  
            rules and regulations to include:


             a)   Minimum standards, criteria, and guidelines for the  
               acceptance, denial, referral to treatment, and monitoring  
               of physicians and surgeons in the PHP;


             b)   Standards for requiring that a physician and surgeon  
               (physician) agree to cease practice to obtain appropriate  
               treatment services;


             c)   Criteria that must be met prior to a physician returning  
               to practice;


             d)   Standards, requirements, and procedures for random  
               testing for the use of banned substances and protocols to  
               follow if that use has occurred;









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             e)   Worksite monitoring requirements and standards;


             f)   The manner, protocols, and timeliness of reports  
               required;


             g)   Appropriate requirements for clinical diagnostic  
               evaluations of program participants;


             h)   Requirements for a physician's termination from, and  
               reinstatement to, the program;


             i)   Requirements that govern the ability of the program to  
               communicate with a participant's employer or organized  
               medical staff about the participant's status and condition;


             j)   Group meeting and other self-help requirements,  
               standards, protocols, and qualifications;


             aa)  Minimum standards and qualifications of any vendor,  
               monitor, provider, or entity contracted with by the SCSA;


             bb)  A requirement that all PHP services must be available to  
               all licensed physicians with a qualifying illness;


             cc)  A requirement that any PHP must do all of the following:


               i)     Promote, facilitate, or provide information that can  
                 be used for the education of physicians with respect to  
                 the recognition and treatment of alcohol dependency,  
                 chemical dependency, or mental disorders, and the  
                 availability of the PHP for qualifying illnesses;

               ii)    Offer assistance to any person in referring a  
                 physician for purposes of assessment or treatment, or  
                 both, for a qualifying illness;








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               iii)   Monitor the status during treatment of a physician  
                 who enters treatment for a qualifying illness pursuant to  
                 a written, voluntary agreement;

               iv)    Monitor the compliance of a physician who enters  
                 into a written, voluntary agreement for a qualifying  
                 illness with the PHP setting forth a course of recovery;

               v)     Agree to accept referrals from the Medical Board of  
                 California (MBC) to provide monitoring services pursuant  
                 to a MBC order; and,

               vi)    Provide a clinical diagnostic evaluation of  
                 physicians entering the program.


             dd)  Rules and procedures to comply with auditing  
               requirements, as specified;


             ee)  A definition of the standard of "reasonably likely to be  
               detrimental to patient safety or the delivery of patient  
               care," relying, to the extent practicable, on standards  
               used by hospitals, medical groups, and other employers of  
               physicians; and,


             ff)  Any other provision necessary for the implementation of  
               this article.


          3)Requires the committee, on or after July 1, 2010, to recommend  
            one or more non-profit PHPs to the SCSA, and permits the SCSA  
            to contract with the recommended PHPs.


          4)Requires the PHP to:


             a)   Report the following statistics annually to the  
               committee:


               i)     The number of participants served;








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               ii)    The number of compliant participants;

               iii)   The number of participants who have successfully  
                 completed their agreement period; and, 

               iv)    The number of participants reported to MBC for  
                 suspected noncompliance.


             b)   Agree to submit to periodic audits and inspections of  
               all operations, records, and management related to the PHP  
               to ensure compliance with the requirements of this article  
               and it's implementing rules and regulations.


          5)Requires SCSA, in conjunction with the committee, to monitor  
            compliance of the PHP, including making periodic inspections  
            and onsite visits.


          6)Permits a physician to enter into a voluntary agreement with a  
            PHP which must include a jointly agreed upon treatment program  
            and mandatory conditions and procedures to monitor compliance  
            with the treatment program.


          7)Requires a physician's voluntary participation in the PHP to  
            be confidential unless waived by the physician or otherwise  
            specified.


          8)Prohibits any voluntary agreement from being considered a  
            disciplinary action or order by MBC, prohibits the agreement  
            from being disclosed to MBC, and states that such agreement  
            shall not be public information if all of the following are  
            true:


             a)   The voluntary agreement is the result of the physician  
               self-enrolling or voluntarily participating in the PHP;


             b)   MBC has not referred a complaint against the physician  
               to a district office of MBC for investigation for conduct  








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               involving or alleging an impairment adversely affecting the  
               care and treatment of patients; and,


             c)   The physician is complying with the treatment program  
               and the conditions and procedures to monitor compliance.


          9)Requires each participant, prior to entering into a voluntary  
            agreement, to disclose to the committee whether he or she is  
            under investigation by MBC.  Specifies that if a participant  
            fails to disclose such an investigation, upon enrollment or at  
            any time while a participant, the participant must be  
            terminated from the PHP. 


          10)Permits a participant who discloses he or she is under  
            investigation by MBC to participate in, and enter into a  
            voluntary agreement with, the PHP.


          11)Permits the PHP to:


             a)   Report to the committee the name and results of any  
               contact or information received regarding a physician who  
               is suspected of being, or is, impaired and, as a result,  
               whose competence or professional conduct is reasonably  
               likely to be detrimental to patient safety or to the  
               delivery of patient care; and,


             b)   Report to the committee if the physician fails to  
               cooperate with any of the requirements of the PHP; fails to  
               cease practice when required; fails to submit to  
               evaluation, treatment, or biological fluid testing when  
               required; or, whose impairment is not substantially  
               alleviated through treatment, or who, in the opinion of the  
               PHP, is unable to practice medicine with reasonable skill  
               and safety, or who withdraws or is terminated from the PHP  
               prior to completion.


          12)States that any oral or written information reported to MBC,  
            as specified, shall remain confidential unless MBC has  








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            referred a complaint against the physician for investigation  
            for conduct involving or alleging an impairment adversely  
            affecting the care and treatment of patients.


          13)Requires the committee to report statistics received from the  
            PHP to the SCSA and the Legislature.


          14)Requires a physician participating in a voluntary agreement  
            to be responsible for all expenses relating to chemical or  
            biological fluid testing, treatment, and recovery as provided  
            in the written agreement between the physician and the PHP.


          15)Requires MBC to increase licensing fees no less than $22 but  
            no more than 2.5% of the license fee, to be expended solely  
            for the purposes of the PHP. 


          16)Requires the SCSA to contract for a biennial audit to assess  
            the effectiveness, efficiency, and overall performance of the  
            program and make recommendations. 


          17)Sunsets the provisions of this bill on January 1, 2021.


          18)Makes various legislative findings and declarations relating  
            to the need for, and value of, a PHP in California.


          19)Defines specified terms for purposes of this bill.

           EXISTING LAW  :

          1)Provides for the licensure and regulation of physicians by MBC  
            pursuant to the Medical Practice Act.

          2)Requires MBC to oversee a diversion program for physicians  
            with alcohol and other substance abuse problems until July 1,  
            2008, and specifies that after this date MBC is no longer  
            responsible for a diversion program.

          3)Specifies other regulatory boards that have established  








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            criteria for the acceptance, denial, or termination of  
            licentiates in a diversion program.

           FISCAL EFFECT  :   This bill has not yet been analyzed by a fiscal  
          committee.

           COMMENTS  :    

           1)PURPOSE OF THIS BILL  .  According to the author, current law  
            does not provide a publicly accountable program for physicians  
            to be referred to treatment and to be safely and effectively  
            monitored for substance abuse or mental illnesses that may  
            impair their ability to practice medicine safely.  The author  
            asserts that, without such a program, physicians are more  
            likely to hide these problems until they pose a risk of harm  
            to patients.

           2)BACKGROUND  .  MBC's diversion program, established in 1980, was  
            designed to rehabilitate doctors with mental illness and  
            substance abuse problems without endangering public health and  
            safety.  According to MBC, the diversion program was a  
            monitoring program that provided a pathway for physicians  
            impaired by alcohol and other substance abuse who were  
            violating the Medical Practice Act to divert away from  
            appropriate disciplinary action.  The MBC program required  
            participants to sign contracts requiring them to adhere to  
            strict conditions, including an evaluation by an evaluation  
            committee, random biological fluid testing, in-patient  
            treatment, psychiatric care, group therapy sessions,  
            Alcoholics or Narcotics Anonymous meetings, and worksite  
            monitors.  The program was responsible for monitoring impaired  
            physicians to ensure they were complying with their contract.

          Physicians entered the program by self-referral, as an  
            alternative to discipline during an MBC investigation, or as  
            required by a probationary order.  Participants in the program  
            were only known to the public if they were in the program as a  
            condition of probation.  During their enrollment, the MBC  
            program monitored the participants' sobriety through  
            biological fluid testing.  Physicians were required to remain  
            in the program for a minimum of five years and had to have at  
            least three years sobriety before they could be considered for  
            completion.  Participants who were terminated for  
            noncompliance were referred to MBC's Enforcement Branch for  
            the filing of appropriate disciplinary charges seeking  








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            revocation of the license or probation.

          MBC's diversion program was audited four times between 1982 and  
            2007 by the Bureau of State Audits and once in 2005 by a  
            legislatively mandated enforcement monitor; all reports  
            concluded that the program was fraught with problems and in  
            need of significant improvements.  Some of the key  
            shortcomings that were identified included the following: a)  
            the diversion program did not receive required monitoring  
            reports from some participants' treatment providers and  
            work-site monitors; b) it reduced work restrictions and  
            requirements originally placed on some physicians without  
            evidence that participants attended meetings and individual  
            therapy sessions as required; c) it did not always require  
            physicians to immediately stop practicing medicine after  
            testing positive for alcohol or a nonprescribed or prohibited  
            drug; d) it failed to perform a significant percentage of  
            random drug testing of participants; e) it failed to quickly  
            identify missed drug tests or data inconsistencies between  
            collectors' reports or lab results; and, f) it lacked  
            consistent and effective oversight from MBC.  In light of  
            these ongoing issues, MBC voted unanimously on July 26, 2007,  
            to terminate the diversion program.  A transition plan for the  
            program was established and approved by MBC in November 2007.   
            The plan identified the different groups of program  
            participants and determined a course of action for each group  
            following the program's sunset on July 1, 2008.  

           3)PHPs  .  A diversion program generally refers to a program in  
            which doctors agree to a rehabilitative plan in lieu of  
            discipline for mental health or substance abuse issues.  Many  
            states operate similar programs but they are referred to as  
            PHPs.  PHPs are not rigidly defined and may include education  
            and outreach in addition to diversion and monitoring.

          The American Medical Association began encouraging states to  
            develop PHPs as early as 1974 to address physician impairment,  
            but the movement did not gain momentum until the 1990s.   
            Today, 48 of 50 states have PHPs.  The basic PHP model  
            consists of a referral, an investigation to determine if  
            participation is warranted, followed by an intervention,  
            evaluation, and treatment based on a monitoring contract.  The  
            typical duration of participation is five years.

          According to a 2007 nationwide survey, in cooperation with the  








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            Federation of State Physician Health Programs, 54% of PHPs are  
            managed by independent, nonprofit foundations, and the  
            remainder are operated by state medical associations or  
            regulatory licensing boards.  All the programs surveyed had  
            some agreement, formal or otherwise, with their state  
            licensing board, and all require random drug testing.  A study  
            in the March 2009 issue of the Journal of Substance Abuse  
            Treatment that evaluated a sample of 904 physicians  
            participating in 16 state PHPs that required the physicians to  
            abstain from any use of alcohol or other drugs, as determined  
            by frequent random drug tests, found that 78% of participants  
            had no positive test for either alcohol or drugs over the  
            five-year period of monitoring.  Additionally, the study noted  
            that, at post-treatment follow-up, 72% of the physicians were  
            continuing to practice medicine. 

           4)SUPPORT  .  The sponsors of this bill, the California Medical  
            Association, the California Academy of Family Physicians, and  
            the California Psychiatric Association, state that the need  
            for this bill arises from the decision of MBC to terminate its  
            diversion program on June 31, 2008.  The sponsors note,  
            however, that this bill creates a program that is  
            significantly different than the former MBC program in that  
            the PHP created by this bill does not divert or defer  
            physicians from any enforcement by MBC.  According to the  
            sponsors, the PHP in this bill will be purely voluntary for  
            licensed physicians who recognize they may have an addiction,  
            disease, or mental illness and want to come forward  
            voluntarily to get the treatment and monitoring they need to  
            practice safely.  The sponsors stress that this bill is not an  
            alternative to discipline and all current laws leading to  
            physician discipline are maintained.

           5)PRIOR LEGISLATION  .  AB 214 (Fuentes) of 2008, which would have  
            created the Physician Diversion Program under the Department  
            of Public Health, was vetoed by Governor Schwarzenegger.  In  
            his veto message, the Governor stated that it is inappropriate  
            to separate the program from MBC because it is critical that  
            the licensing agency be directly involved in monitoring  
            participation in the diversion program to protect patients and  
            enable timely enforcement actions.  

           6)SECOND COMMITTEE OF REFERENCE  .  This bill was previously heard  
            in the Assembly Business and Professions Committee on April  
            21, 2009, and was approved on an 11-0 vote. 








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           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          California Academy of Family Physicians (sponsor)
          California Medical Association (sponsor)
          California Psychiatric Association (sponsor)
          California Society of Addiction Medicine

           Opposition 
           
          None on file.
           
          Analysis Prepared by :    Cassie Rafanan / HEALTH / (916)  
          319-2097