BILL ANALYSIS
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THIRD READING
Bill No: AB 2386
Author: Gilmore (R) and Cook (R)
Amended: 5/28/10 in Senate
Vote: 21
SENATE BUS., PROF. & ECON. DEVEL. COMMITTEE : 7-0, 6/14/10
AYES: Negrete McLeod, Aanestad, Calderon, Correa, Florez,
Walters, Yee
NO VOTE RECORDED: Wyland, Oropeza
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 75-0, 5/13/10 - See last page for vote
SUBJECT : Armed Forces: medical personnel
SOURCE : Author
DIGEST : This bill authorizes a hospital to enter into an
agreement with the Armed Forces of the Untied States to
authorize a physician and surgeon, physician assistant, or
a registered nurse to provide medical care in the hospital
under specified conditions.
ANALYSIS :
Existing federal law
1. States that a person under the jurisdiction of the
Secretary of a military department may not provide
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health care independently as a health-care professional
unless the person has a current license to provide such
care. Provides that in the case of a physician, the
physician may not provide health care as a physician
unless the current license is an unrestricted license
that is not subject to limitation on the scope of
practice, as specified. Allows the Secretary of Defense
to waive these provisions in unusual circumstances, as
specified.
2. Allows a health care professional who has a current
license to practice medicine, osteopathic medicine,
dentistry, or another health profession, and who is
performing authorized duties of the Department of
Defense, to practice the health profession or
professions of the healthcare professional in any State,
the District of Columbia, or a Commonwealth, territory,
or possession of the United States, regardless of
whether the practice occurs in a health care facility of
the Department of Defense, a civilian facility
affiliated with the Department of Defense, or any other
location authorized by the Secretary of Defense.
3. Defines a health care professional for purposes of item
#1) above as a physician, dentist, clinical
psychologist, marriage and family therapist certified as
such by a certification recognized by the Secretary of
Defense, or nurse and any other person providing direct
patient care as may be designated by the Secretary of
Defense in regulations.
Existing state law
1. States that it is the policy of the state that,
consistent with high quality health care services,
persons with skills, knowledge and experience obtained
in the armed services of the United States should be
permitted to apply such learning and contribute to the
health manpower needs of the state at the maximum level
of responsibility and skill for which they are
qualified.
2. States that the rules and regulations of boards within
the Department of Consumer Affairs (DCA) shall provide
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for methods of evaluating education, training, and
experience obtained in military service if such training
is applicable to the requirements of that profession.
3. Prohibits, unless otherwise required by federal law or
regulations, a board within the DCA which licenses
dentists, physicians and surgeons, podiatrists, or
nurses, from requiring a person to obtain or maintain
any license to practice a profession or render services
in California if one of the following applies:
A. The person practicing a profession or rendering
services does so exclusively as an employee of a
department, bureau, office, division, or similarly
constituted agency of the federal government, and
provides medical services exclusively on a federal
reservation or at any facility wholly supported by
and maintained by the United States government.
B. The person practicing a profession or rendering
services does so solely pursuant to a contract with
the federal government on a federal reservation or
at any facility wholly supported and maintained by
the United States government.
C. The person practicing a profession or rendering
services does so pursuant to, or as a part of a
program or project conducted or administered by a
department, bureau, office, division, or similarly
constituted agency of the federal government which
by federal statute expressly exempts persons
practicing a profession or rendering services as
part of the program or project from state laws
requiring licensure.
4. Allows a board to deny issuance of a license to an
applicant or take disciplinary action against the holder
of a California license for acts or omissions committed
by the applicant or licensee in the course of
professional practice or rendering services described in
item #3) above if both of the following apply:
A. The acts or omissions committed by the applicant
or licensee constituted grounds for denial or
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discipline pursuant to the laws of this state
governing licensees or applicants for licensure for
the profession or vocation in question.
B. The acts or omissions constituting the basis for
denial or discipline by the agency were not
authorized, exempted or rendered inconsistent by
federal statute.
5. States that a physician and surgeon who is not licensed
in this state but who is a commissioned officer on
active duty in the medical corps of any branch of the
armed forces of the United States may engage in the
practice of medicine as part of a residency, fellowship,
or clinical training program if specified conditions are
met.
This bill:
1. Authorizes a hospital to enter into an agreement with
the Armed Forces of the United States to authorize a
physician and surgeon, physician assistant, or
registered nurse to provide medical care in the hospital
if all of the following apply:
A. The physician and surgeon, physician assistant,
or registered nurse holds a valid license in good
standing to provide medical care in the District of
Columbia or any state or territory of the United
States.
B. The medical care is provided as part of a
training or educational program designed to promote
the combat readiness of the physician and surgeon,
physician assistant, or registered nurse.
C. The agreement complies with federal law and any
regulations or guidelines adopted pursuant to this
bill.
2. Requires a physician and surgeon, physician assistant,
or registered nurse who is authorized to practice
pursuant to item #1) above to disclose, while working,
on a name tag in at least 18-point type, his or her name
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and license status, his or her state of licensure, and a
statement that he or she is a member of the Armed Forces
of the United States.
3. States that if an agreement is entered into pursuant to
item #1) above, no board under this division that
licenses physicians and surgeons, physician assistants,
or registered nurses may require such person to obtain
or maintain any license to practice his or her
profession or render services in the State of
California.
4. Requires a physician and surgeon, physician assistant,
or registered nurse who enters into an agreement with a
hospital pursuant to item #1) above, to register with
the board that licenses his or her respective health
care profession in this state on a form provided by that
board.
5. Sunsets the provisions of this bill on January 1, 2016.
Background
Existing law allows physician and surgeons, podiatrists,
nurses, or dentists who are licensed in other states to
practice their professions in California without obtaining
state licensure as long as they are practicing or rendering
services as an employee of, or pursuant to a contract with
the federal government, and provides health care services
at facilities supported or maintained by the United States
government. However, existing law does not permit these
health care practitioners, who may also be military
personnel, to be afforded an opportunity to receive their
training or education in California hospitals. This bill
allows, pursuant to an agreement between a hospital and the
Armed Forces of the United States, physicians and surgeons,
physician assistants, or nurses licensed in other states to
provide medical care at California hospitals as part of a
training or educational program designed to promote the
combat readiness of these heath care practitioners.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
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SUPPORT : (Verified 6/29/10)
California Academy of Physicians Assistants
California Association of County Veterans Service Officers
California Medical Board
California Military Officers Association of America
California State Commanders Veteran's Council
Solano County Board of Supervisors
ARGUMENTS IN SUPPORT : According to the author's office
who is the sponsor of this bill states, this bill provides
the statutory framework to allow military health care
professionals to improve their skills prior to being
deployed to war. The author's office also states that a
similar successful model was achieved in Nevada in 2009, in
which a program was created at the UMC Trauma Center near
Nellis Air Force Base. The program was very popular and
mutually beneficial to the hospital because the Air Force
was able to provide fully-trained and certified physicians
free of charge.
ASSEMBLY FLOOR :
AYES: Adams, Anderson, Arambula, Bass, Beall, Bill
Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,
Bradford, Brownley, Buchanan, Charles Calderon, Carter,
Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon,
DeVore, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,
Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,
Gilmore, Hall, Harkey, Hayashi, Hernandez, Hill, Huber,
Huffman, Jeffries, Jones, Knight, Lieu, Logue, Bonnie
Lowenthal, Ma, Mendoza, Miller, Monning, Nava, Nestande,
Niello, Nielsen, Norby, V. Manuel Perez, Portantino,
Ruskin, Salas, Saldana, Silva, Smyth, Solorio, Audra
Strickland, Swanson, Torlakson, Torres, Torrico, Tran,
Villines, Yamada, John A. Perez
NO VOTE RECORDED: Ammiano, Caballero, Hagman, Skinner,
Vacancy
JJA:do 6/29/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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