BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1235
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 1235 (Hayashi)
          As Amended  February 16, 2010
          Majority vote
           
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          |ASSEMBLY:  |     |(June 1, 2009)  |SENATE: |     |(August 18,    |
          |           |     |                |        |33-0 |2010)          |
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                    (vote not relevant)

          Original Committee Reference:   L. & E.  

           SUMMARY  :  Amends the medical peer review process by recommending  
          external peer review in limited circumstances, requires peer  
          review bodies to share information, establishes the duties of a  
          hearing officer, and sets parameters for attorney  
          representation.  

          The Senate amendments  delete the Senate version of the bill, and  
          instead:

          1)Find and declare that it is essential that California's peer  
            review system generate a culture of trust and safety so that  
            health care practitioners will participate robustly in the  
            process by engaging in critically important safety activities,  
            such as reporting incidents they believe to reflect  
            substandard care or unprofessional conduct and serving on peer  
            review, quality assurance, and other committees necessary to  
            protect patients.

          2)Indicate that to ensure that the peer review process is not  
            circumvented, prohibits requiring a member of a medical or  
            professional staff, by contract or otherwise, from altering or  
            surrendering staff privileges, status, or membership solely  
            due to the termination of a contract between that member and a  
            health care facility.  

          3)State that with respect to services that may only be provided  
            by members who have, or who are members of a medical group  
            that has, a current exclusive contract for those identified  
            services, termination of the contract or termination of the  
            member's employment by the medical group holding the contract,  
            may result in the member's ineligibility to provide the  
            services covered by the contract.








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          4)Entitle a peer review body of a health care facility to review  
            and make timely recommendations to the governing body of the  
            facility and its designee regarding quality considerations  
            relating to clinical services whenever the selection,  
            performance evaluation, or any change in the retention or  
            replacement of licentiates with whom the health care facility  
            has a contract occurs.  Require the governing body to give  
            great weight to the recommendations. 

          5)State that it is the policy of the state that in certain  
            limited circumstances, external peer review may be necessary  
            to promote and protect patient care in order to eliminate  
            perceived bias, obtain needed medical expertise, or respond to  
            other particular circumstances.

          6)Encourage a peer review body to obtain external peer review  
            for the evaluation or investigation of an applicant,  
            privilegeholder, or member of the medical staff in the  
            following circumstances:

             a)   Committee or department reviews that could affect a  
               licentiate's membership or privileges do not provide a  
               sufficiently clear basis for action or inaction;

             b)   No current medical staff member can provide the  
               necessary expertise in the clinical procedure or area under  
               review; and,

             c)   To promote impartial peer review.

          7)Define external peer review as peer review provided by  
            licentiates who do not practice in the same health care  
            facility as the licentiate under review, who are impartial,  
            and who have the necessary expertise in the clinical procedure  
            or area under review.

          8)Require a peer review body, upon receipt of reasonable copying  
            and processing costs, to respond to the request of another  
            peer review body and produce the records reasonably requested  
            concerning a licentiate under review to the extent not  
            otherwise prohibited by state or federal law.  

          9)Provide that the responding peer review body has the  
            discretion whether to produce minutes from peer review body  








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            meetings.  

          10)State that the records produced by a peer review body  
            pursuant to this provision will be used solely for peer review  
            purposes and not subject to discovery, as specified.  

          11)Entitle the peer review body responding to the request all  
            confidentiality protections and privileges provided by law as  
            to the information and records disclosed pursuant to this  
            provision.

          12)State that a licentiate under review by a peer review body  
            requesting records must release the responding peer review,  
            its members, and the health care entity for which the  
            responding peer review body conducts peer review, from  
            liability for the disclosure of records, and the contents of  
            the records, as specified.  

          13)Provide that if a licentiate does not provide a reasonable  
            release that is acceptable to the responding peer review body,  
            the responding peer review body is not obligated to produce  
            records.

          14)Require a hearing officer to:

             a)   Disclose all actual and potential conflicts of interest  
               within the last five years reasonably known to the hearing  
               officer;

             b)   Be an attorney licensed to practice law in the State of  
               California.  This provision does not apply to a hearing  
               held before a panel of dental professional peer review  
               body;   

             c)   States that unless agreed by the parties, an attorney  
               from a firm utilized by the hospital, the medical staff, or  
               the involved licentiate within the preceding two years is  
               not eligible to serve as a hearing officer; and,

             d)   Endeavor to ensure that all parties maintain proper  
               decorum and have a reasonable opportunity to be heard and  
               present all relevant oral and documentary evidence.   
               Entitles the hearing officer to determine the order of, or  
               procedure for, presenting evidence and argument during the  
               hearing and have the authority and discretion to make all  








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               rulings on questions pertaining to matters of law,  
               procedure, or the admissibility of evidence.  Further  
               requires the hearing officer to take all appropriate steps  
               to ensure a timely resolution of the hearing, but may not  
               terminate the hearing process, unless in the case of  
               flagrant noncompliance with the procedural rules governing  
               the hearing process or egregious interference with the  
               orderly conduct of the hearing, the hearing officer may  
               recommend that the hearing panel terminate the hearing,  
               provided that this activity is authorized by the applicable  
               bylaws of the peer review body.

          15)Give both parties the right to be represented by an attorney  
            of the party's choice at the party's expense.

          16)Prohibit a peer review body from being represented by an  
            attorney if the licentiate notifies the peer review body in  
            writing no later than 15 days prior to the hearing that he or  
            she has elected not to be represented by an attorney.  States  
            that unless otherwise agreed by the parties, this election is  
            binding.

          17)State that if a licentiate does not provide the written  
            notice, as specified within the required timeframe, the peer  
            review body may be represented by an attorney even if the  
            licentiate later elects not to be represented by an attorney.

          18)Make legislative findings and declarations.

           AS PASSED BY THE ASSEMBLY  , this bill extended, for a hospital  
          building that is owned or operated by the County of Alameda on  
          the Alameda County Medical Center's Fairmont Campus, the  
          deadline for submitting a facility master plan until July 1,  
          2010.  

           FISCAL EFFECT  :  Unknown

           COMMENTS  :  This bill was substantially amended in the Senate and  
          the Assembly-approved provisions of this bill were deleted.   
          This bill, as amended in the Senate, is inconsistent with  
          Assembly actions.  The language in this bill is similar to AB  
          120 (Hayashi), which was vetoed by the Governor. 


           Analysis Prepared by  :    Sarah Huchel / B. & P. / (916) 319-3301  








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                                                              FN:  0003679