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
          _________________________________________________________________ 
          ____
          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          setting's accreditation, certification, or license has been  
          revoked, suspended, or placed on probation, or the setting has  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  
          _________________________________________________________________ 
          ____
          
          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.