BILL ANALYSIS                                                                                                                                                                                                    






                             SENATE JUDICIARY COMMITTEE
                           Senator Ellen M. Corbett, Chair
                              2009-2010 Regular Session


          AB 1730 (Emmerson)
          As Amended March 17, 2010
          Hearing Date: June 15, 2010
          Fiscal: No
          Urgency: No
          TW:jd
                    

                                        SUBJECT
                                           
            Personal Rights:  Monetary Liability:  Peer Review Committee

                                      DESCRIPTION  

          This bill, sponsored by the California Association of Marriage  
          and Family Therapists, clarifies that the peer review liability  
          exemption applies to review of psychotherapy services and  
          marriage and family therapists. 

                                      BACKGROUND  

          Enacted in 1961, Civil Code Section 43.7 provides a conditional  
          immunity to members of a duly appointed committee of a state or  
          local professional society or a hospital medical staff committee  
          performing peer review services.  This immunity was thought  
          necessary to combat the conspiracy of silence among professional  
          colleagues and to encourage them to offer candid remarks about  
          the possible incompetency of a colleague without fear of being  
          sued for defamation.

          Originally enacted to provide immunity protection to the members  
          of medical peer review committees delegated with the  
          responsibility of evaluating the competency of hospital staff  
          practitioners, the list of protected groups has grown to include  
          lawyers, accountants, engineers, psychologists, dieticians,  
          chiropractors, optometrists, veterinarians, dentists, dental  
          hygienists, podiatrists, pharmacists, and physical therapists.   
          Civil Code Section 43.7 references psychologists, but does not  
          specifically reference services for psychotherapy.  This section  
          also references "marriage and family therapists" but does not  
          consistently list them throughout the statute. 
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          This bill would clarify that the peer review liability exemption  
          contained in Civil Code Section 43.7 includes psychotherapy  
          services and marriage and family therapists. 
           
           
                                CHANGES TO EXISTING LAW
           
           Existing law  requires specified licensing entities to maintain a  
          central file on the disciplinary history of their respective  
          licensees.  (Bus. & Prof. Code Sec. 800 et seq.)

           Existing law  defines "peer review body" to include, among other  
          things, a marriage and family therapy professional society that:  
          (1) has as members at least 25 percent of the eligible  
          licentiates in the area in which it functions; (2) is not  
          organized for profit; and (3) has been determined to be  
          tax-exempt pursuant to Section 23701 of the Revenue and Taxation  
          Code.  (Bus. & Prof. Code Sec. 805(a)(1)(C).)

           Existing law  provides, generally, that there shall be no  
          monetary liability on the part of, and no cause of action for  
          damages against, any member of a mental health professional  
          quality assurance committee for actions taken pursuant to a  
          review or evaluation of mental health care or treatment.  (Civ.  
          Code Sec. 43.7(a).)

           Existing law  provides, generally, that there shall be no  
          monetary liability on the part of, and no cause of action for  
          damages against, a professional or medical society, or member of  
          any committee thereof, for any action taken to maintain the  
          professional  standards of the society.  (Civ. Code Sec.  
          43.7(b).)

           Existing law  defines "professional society" to include legal,  
          medical,  psychological, dental, dental hygiene, dietetic,  
          accounting, optometric, acupuncture, podiatric, pharmaceutic,   
          chiropractic, physical therapist, veterinary, licensed  marriage  
          and family therapy, licensed clinical social work, and  
          engineering organizations having as members at least 25  percent  
          of the eligible persons or licentiates in the  geographic area  
          served by the particular society.  (Civ. Code Sec. 43.7(b).)

           Existing law  requires the Board of Behavioral Sciences to create  
          and maintain a central file of the names of all persons who hold  
          a license from the Board in order to provide a record for each   
                                                                      



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          licensee with respect to any: (1) criminal conviction that  
          constitutes unprofessional conduct; (2) judgment or settlement  
          for damages in excess of $3,000 for any claim that injury or  
          death was proximately caused by the licensee's negligence, error  
          or omission in practice, or by rendering unauthorized  
          professional services; (3) public complaints; or (4)  
          disciplinary information reported pursuant to Business and  
          Professions Code Section 805.  (Bus. & Prof. Code Sec. 800.)

           Existing law  requires the administrator of a peer review body to  
          file an "805 report" with the relevant state licensing agency  
          within 15 days after the effective date of any of the following  
          that occur as a result of an action of the peer review body:
             1)   A licentiate's application for staff privileges or  
               membership is denied or rejected for a medical disciplinary  
               cause or reason. 
             2)   A licentiate's membership, staff privileges, or  
               employment is terminated or revoked for a medical  
               disciplinary cause or reason. 
             3)   Restrictions are imposed, or voluntarily accepted, on  
               staff privileges, membership, or employment for a  
               cumulative total of 30 days or more for any 12-month  
               period, for a medical disciplinary cause or reason.  (Bus.  
               & Prof. Code Sec. 805(b).)

           Existing law  contains findings of the Legislature stating that:
             1)   Peer review, fairly conducted, is essential to  
               preserving the highest standards of medical practice. 
             2)   Peer review, fairly conducted, will aid the appropriate  
               state licensing boards in their responsibility to regulate  
               and discipline errant healing arts practitioners. 
             3)   To protect the health and welfare of the people of  
               California, it is the policy of the State of California to  
               exclude, through the peer review mechanism as provided for  
               by California law, those healing arts practitioners who  
               provide substandard care or who engage in professional  
               misconduct, regardless of the effect of that exclusion on  
               competition.  (Bus. & Prof. Code Sec. 809(a).)

           This bill  would clarify that the peer review liability exemption  
          contained in Civil Code Section 43.7 includes psychotherapy  
          services.

           This bill  would clarify an ambiguity regarding the existing  
          reference to the liability exemption for licensed marriage and  
          family therapy contained in the definition of "professional  
                                                                      



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          society" by adding marriage and family therapists to the list of  
          peer review groups that comprise the professional society.  

                                        COMMENT
           
          1.  Stated need for the bill  
          
          The author writes:
          
            AB 1730 adds marriage and family therapists to the list of  
            health-related professionals that receive qualified immunity  
            for their peer review activities as outlined in Civil Code  
            Section. 43.7.

            While licensed marriage and family therapists are included in  
            the law's definition of "professional society," they are not  
            mentioned in other relevant parts of the statute.  It should  
            also be noted that Business and Professions Code Section 805  
            includes a marriage and family therapist professional society  
            as a "peer review body" for the purpose of reporting  
            disciplinary actions to the Board of Behavioral Sciences.  AB  
            1730 will correct this oversight in current law by  
            specifically including marriage and family therapists in Civil  
            Code Section 43.7 thereby ensuring that they are clearly  
            protected from liability for their peer review activities.

          The sponsor of this bill states the need for this bill as  
          follows:

            With regard to professional society peer review committees  
            that are addressed in 43.7(b) of the Civil Code, marriage and  
            family therapists are omitted from the listing of professions  
            afforded immunity from liability, even though this section of  
            law covers marriage and family therapy professional societies.  
             It is important for members of marriage and family therapist  
            ethics committees to be assured that the specified immunity  
            from liability is applicable to them and the actions they  
            take.  This change in law will assure that there is no  
            ambiguity with respect to this protection for those who  
            volunteer to perform this important function that helps to  
            protect the public and assure that members adhere to  
            established codes of ethics.

          Consumer Attorneys of California, which is neutral to this bill,  
          states that it is satisfied with this bill because it meets the  
          requirements of adding specific professionals to existing  
                                                                      



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          immunity statutes.  These qualifications are as follows:  1) the  
          peer review committee is required to file an 805 report so that  
          the licensing entity has appropriate information to evaluate  
          licensees and to track patterns of misconduct; 2) the peer  
          review bodies are composed of volunteer, not paid, reviews; and  
          3) the licensing entity has a basic track record of public  
          protection, including making information about disciplinary  
          actions available to the public.
          
          2.  Clarifying existing law regarding marriage and family  
            therapists  

          Since 1986, Civil Code Section 43.7 has provided immunity from  
          liability to members of a marriage and family therapy  
          "professional society" (as defined) generally, but not  
          specifically to members of a peer review committee in the field  
          whose purpose is to review the quality of services rendered by  
          marriage and family therapists. (AB 2858 (Felando, Ch. 669,  
          Stats. 1986).)  The reason for this apparent oversight is  
          unknown.  

          Subsequently, SB 2026 (Committee on Business and Professions,  
          Ch. 1013, Stats. 2002) substituted the term "marriage and family  
          therapy" for "marriage, family, and child counseling" without  
          broadening immunity from liability, giving the statute the  
          wording it retains to this day.  Section 43.7 has not been  
          amended since.

          This bill would clarify the ambiguity regarding the existing  
          liability exemption for licensed marriage and family therapy  
          contained in the definition of "professional society" by adding  
          marriage and family therapists to the list of peer review groups  
          that comprise the professional society.   

          3.  Clarifying existing law regarding psychotherapy
           
          When Civil Code Section 43.7 was amended to include marriage and  
          family counselors in 1986, psychologists had already been added  
          to this section.   Given that Civil Code Section 43.7 had been  
          amended 27 times before 1986, committee staff was unable to  
          pinpoint exactly when psychologists were added.  As occurred  
          with marriage and family counselors, psychotherapy services were  
          inadvertently omitted from various provisions of this section.   
          Under existing law, psychologists are listed as providers of  
          services who are immune from liability under Civil Code Section  
          43.7, but the specific service provided by psychologists is  
                                                                      



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          missing from the list of services that can be reviewed by  
          psychologist peer review groups.  This bill would clarify an  
          existing immunity rather than adding a new profession to this  
          immunity.


           Support  :  California Hospital Association; Civil Justice  
          Association of California

           Opposition  :  None Known

                                        HISTORY
           
           Source  :  California Association of Marriage and Family  
          Therapists

           Related Pending Legislation  :  None Known

           Prior Legislation  :  See Background.

           Prior Vote  :

          Assembly Judiciary Committee (Ayes 10, Noes 0)
          Assembly Floor (Ayes 76, Noes 0)

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