BILL ANALYSIS
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
1150 (Negrete McLeod)
Hearing Date: 4/26/2010 Amended: A I
Consultant: Bob Franzoia Policy Vote: B,P&ED 6-1
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BILL SUMMARY: SB 1150 would do the following:
- Require certain healing arts licensees to include in
advertisements, certain words or designations following their
names indicating the particular educational degree they hold or
healing art they practice. By changing the definition of a
crime, this bill would impose a state mandated local program.
- Require the Medical Board of California (MBC) to adopt
regulations by January 1, 2012 regarding the appropriate level
of physician availability needed within clinics using certain
laser or intense pulse light devices for cosmetic procedures.
- Require the MBC to post on its Internet Web site an easy to
understand factsheet to educate the public about cosmetic
surgery and procedures.
- Require the MBC to ensure its certification program includes,
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.
- Modify the definition of outpatient setting to include
facilities that offer in vitro fertilization, as defined.
- 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setting's accreditation, certification, or license has been
revoked, suspended, or placed on probation, or the setting has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.
- Require the accrediting agency to immediately report to the
MBC if the outpatient setting's certificate for accreditation
has been denied.
- 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. This bill would require the MBC to ensure that
accreditation agencies inspect outpatient settings.
- Make an evaluation of approved accreditation agencies by the
MBC mandatory.
- Express the intent of the Legislature that the Department of
Public Health (DPH), when conducting an inspection of an acute
care hospital, inspects the peer review process utilized by the
hospital.
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Fiscal Impact (in thousands)
Major Provisions 2010-11 2011-12 2012-13 Fund
Outpatient facility inspections $289 $213
$213Special*
(MBC)
* Medical Board of California Contingent Fund
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STAFF COMMENTS: This bill meets the criteria for referral to the
Suspense File.
Page 2
SB 1150 (Negrete McLeod)
The MBC is budgeted for 16 inspector positions as part of its
probation monitoring program. Currently, there are 1,315
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 for a total of 460
inspections annually which would require an estimated three
inspectors or approximately 153 inspections per inspector. 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.
During periodic inspections of acute care hospitals, DPH ensures
that the hospitals have a peer review process. As noted by the
intent language, this is a requirement of existing regulations.
The regulations allow DPH to identify and assure elements of
professional review by peers. State and federal regulations do
not dictate a specific format for the review, only that the
hospital and the medical staff have developed, implemented, and
utilize a process that meets the regulations.
This bill is similar to SB 674 (Negrete McLeod) 2009 which was
vetoed by the Governor with the following message:
While some provisions may provide marginal improvements to
consumer protection, I cannot support this bill when it fails to
address the need for stronger licensing and oversight of
outpatient surgical centers. The continued reliance by the
medical community on external accreditation agencies without
enforcement capability is an insufficient solution for
protecting patients. As outpatient surgeries continue to
increase in number and complexity, surgical centers cannot
continue to perform procedures in an unregulated and unenforced
environment.
I ask the medical community to work with my Administration next
year to bring consistent and effective oversight to this growing
industry in the shared interest of protecting patient safety.