BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           674 (Negrete-McLeod)
          
          Hearing Date:  5/28/2009        Amended: 5/20/2009
          Consultant:  Bob Franzoia       Policy Vote: BP&ED 8-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY: SB 674, relating to healing arts, would do the  
          following:
          - Require the Medical Board of California (MBC) to adopt  
          regulations by July 1, 2010, regarding the appropriate level of  
          physician availability needed within clinics and other settings  
          using certain laser or intense pulse light devices for cosmetic  
          procedures.
          - Modify the definition of "outpatient setting" to include  
          facilities that offer in vitro fertilization and assisted  
          reproduction technology treatments.
          - Delete existing MBC notice and identification requirements and  
          instead require that every outpatient setting that is accredited  
          be periodically inspected by the MBC or the accreditation  
          agency.
          - Make an evaluation of approved accreditation agencies by the  
          MBC mandatory.
          - Require the accrediting agency to immediately report to the  
          MBC if the outpatient setting's certificate for accreditation  
          has been denied.
          - Require the MBC, absent inquiry, to notify the public whether  
          a setting is accredited, certified, or licensed, or the  
          setting's accreditation, certification, or license has been  
          revoked, suspended, or placed on probation, or the setting has  
          received a reprimand by the accreditation agency.
          - Include, as part of the submission for approval by an  
          accrediting agency, at the time of accreditation, a detailed  
          plan, standardized procedures, and protocols to be followed in  
          the event of serious complications or side effects from surgery.
          - Require the Department of Public Health, when conducting an  
          inspection of an acute care hospital, to inspect the peer review  
          process utilized by the hospital.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund
           Outpatient facility inspections   $170        $464       










          $350Special* 
                                                        
          * Medical Board of California Contingent Fund
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: SUSPENSE FILE.
          
          This bill amends Health and Safety Code 1248 to add:
             (b) (2) Outpatient setting also means facilities that offer  
          in vitro fertilization, as defined
          in subdivision 9b) of Section 1374.55, or facilities that offer  
          assisted reproduction technology treatments.

          The MBC is budgeted for 16 inspector positions as part of its  
          probation monitoring program.  Currently, there are 1,230  
          outpatient settings that would be inspected every three years  
          (and as often as necessary to ensure the quality of care  
          provided).  This bill would add an estimated 65 outpatient  
          settings that offer in vitro fertilization or assisted  
          reproduction technology treatments for a total of 432  
          inspections annually.  This number 
          Page 2
          SB 674 (Negrete McLeod)

          of inspections would require an estimated three inspectors and  
          two administrative and support staff.  As part of their duties,  
          the inspectors would assist in maintaining the MBC website and  
          the inspection log on the Consumer Affairs System with periodic  
          findings.  This would involve a one time cost of $15,000 for a  
          contract to put all outpatient settings online or a separate  
          database and to establish enforcement tracking records for those  
          settings inspected.

          This bill amends Health and Safety Code 1248.35 to read:
            (a) Every outpatient setting which is accredited shall  be  
          periodically inspected by the Medical Board of California or  be  
          inspected by the accreditation agency  .  and may also be inspected  
          by the Medical Board of California.  The Medical Board of  
          California shall ensure that accreditation agencies inspect  
          outpatient settings.

            (b) (2) Inspections shall be conducted no less often than once  
          every three years by the accreditation agency and as often as  
          necessary by the Medical Board of California to ensure the  
          quality of care provided.