BILL NUMBER: SB 1236 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 17, 2012
INTRODUCED BY Senator Price
FEBRUARY 23, 2012
An act to amend Sections 800, 801.01, 802.1, 802.5, 803,
803.1, 803.5, 803.6, 805, 2335, 2460, 2465, 2470, 2472,
2475, 2477, 2484, 2493, 2496, 2497.5, 3501, 3502, 3502.1, 3502.3,
3502.5, 3504 , 3504.1, 3505 , and
3506, 3507, 3508, 3509, 3509.5, 3510, 3511, 3512 ,
3513, 3514.1, 3516, 3516.5, 3517, 3518, 3519, 3519.5, 3520, 3521,
3521.1, 3521.2, 3521.5, 3522, 3523, 3524, 3524.5, 3526,
3527, 3529, 3530, 3531, 3533, 3534, 3534.1, 3534.2, 3534.3, 3534.4,
3534.5, 3534.6, 3534.7, 3534.9, 3534.10, 3535, 3537.10, 3537.20,
3537.30, 3537.50, 3540, 3546 of , and to add Sections
3521.3 and 3521.4 to, the Business and Professions Code,
relating to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
SB 1236, as amended, Price. Healing arts boards.
Existing
(1) Existing law provides for the
licensure certification and regulation
of podiatrists by the California Board of Podiatric Medicine within
the jurisdiction of the Medical Board of California.
Existing law provides for the licensure and regulation of physician
assistants by the Physician Assistant Committee of the Medical Board
of California. Under existing law, the California Board of
Podiatric Medicine and the committee will be
repealed on January 1, 2013. Existing law requires that boards
scheduled for repeal be reviewed by the Joint Sunset Review Committee
of the Legislature.
This bill would extend the operation of the California Board of
Podiatric Medicine and the committee until January
1, 2017. The bill would specify that the board and
committee are is subject to review by the
appropriate policy committees of the Legislature. The bill would
revise provisions regarding the examination of applicants
for certification to practice podiatric medicine.
(2) Existing law establishes the Physician Assistant Committee
within the jurisdiction of the Medical Board of California and
provides for its membership, operation, duties, and powers with
respect to licensure and regulation of physician assistants,
including requirements for the payment of license renewal fees. Under
existing law, the committee will be repealed on January 1, 2013.
This bill would rename the committee as the Physician Assistant
Board, make various conforming changes relative to this change in
designation, and extend the operation of the board until January 1,
2017. The bill would revise the composition of the board and would
specify exemptions to the requirements for the payment of license
renewal fees. The bill would specify that the board is subject to
review by the appropriate policy committees of the Legislature.
(3) Existing law specifies reports to be made and procedures to be
followed when a coroner receives information, as specified, that a
death may be the result of a physician and surgeon's, or podiatrist's
gross negligence or incompetence, and in connection with
disciplinary actions against those licensees.
This bill would expand those provisions to include conduct of a
physician assistant.
(4) Existing law requires a physician and surgeon, osteopathic
physician and surgeon, and a doctor of podiatric medicine to report
to his or her licensing board the occurrence of an indictment or
information charging a felony against the licensee or the conviction
of the licensee of a felony or misdemeanor. Under existing law the
failure of those licensees to submit the required report is a crime.
This bill would impose that requirement on a physician assistant.
Because a violation of this requirement by a physician assistant
would be a crime, this bill would impose a state-mandated local
program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 800 of the Business
and Professions Code is amended to read:
800. (a) The Medical Board of California, the Board of
Psychology, the Dental Board of California, the Osteopathic Medical
Board of California, the State Board of Chiropractic Examiners, the
Board of Registered Nursing, the Board of Vocational Nursing and
Psychiatric Technicians, the State Board of Optometry, the Veterinary
Medical Board, the Board of Behavioral Sciences, the Physical
Therapy Board of California, the California State Board of Pharmacy,
the Speech-Language Pathology and Audiology and Hearing Aid
Dispensers Board, the California Board of Occupational Therapy,
and the Acupuncture Board , and th
e Physician Assistant Board shall each separately create and
maintain a central file of the names of all persons who hold a
license, certificate, or similar authority from that board. Each
central file shall be created and maintained to provide an individual
historical record for each licensee with respect to the following
information:
(1) Any conviction of a crime in this or any other state that
constitutes unprofessional conduct pursuant to the reporting
requirements of Section 803.
(2) Any judgment or settlement requiring the licensee or his or
her insurer to pay any amount of damages in excess of three thousand
dollars ($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, pursuant to the
reporting requirements of Section 801 or 802.
(3) Any public complaints for which provision is made pursuant to
subdivision (b).
(4) Disciplinary information reported pursuant to Section 805,
including any additional exculpatory or explanatory statements
submitted by the licentiate pursuant to subdivision (f) of Section
805. If a court finds, in a final judgment, that the peer review
resulting in the 805 report was conducted in bad faith and the
licensee who is the subject of the report notifies the board of that
finding, the board shall include that finding in the central file.
For purposes of this paragraph, "peer review" has the same meaning as
defined in Section 805.
(5) Information reported pursuant to Section 805.01, including any
explanatory or exculpatory information submitted by the licensee
pursuant to subdivision (b) of that section.
(b) Each board shall prescribe and promulgate forms on which
members of the public and other licensees or certificate holders may
file written complaints to the board alleging any act of misconduct
in, or connected with, the performance of professional services by
the licensee.
If a board, or division thereof, a committee, or a panel has
failed to act upon a complaint or report within five years, or has
found that the complaint or report is without merit, the central file
shall be purged of information relating to the complaint or report.
Notwithstanding this subdivision, the Board of Psychology, the
Board of Behavioral Sciences, and the Respiratory Care Board of
California shall maintain complaints or reports as long as each board
deems necessary.
(c) The contents of any central file that are not public records
under any other provision of law shall be confidential except that
the licensee involved, or his or her counsel or representative, shall
have the right to inspect and have copies made of his or her
complete file except for the provision that may disclose the identity
of an information source. For the purposes of this section, a board
may protect an information source by providing a copy of the material
with only those deletions necessary to protect the identity of the
source or by providing a comprehensive summary of the substance of
the material. Whichever method is used, the board shall ensure that
full disclosure is made to the subject of any personal information
that could reasonably in any way reflect or convey anything
detrimental, disparaging, or threatening to a licensee's reputation,
rights, benefits, privileges, or qualifications, or be used by a
board to make a determination that would affect a licensee's rights,
benefits, privileges, or qualifications. The information required to
be disclosed pursuant to Section 803.1 shall not be considered among
the contents of a central file for the purposes of this subdivision.
The licensee may, but is not required to, submit any additional
exculpatory or explanatory statement or other information that the
board shall include in the central file.
Each board may permit any law enforcement or regulatory agency
when required for an investigation of unlawful activity or for
licensing, certification, or regulatory purposes to inspect and have
copies made of that licensee's file, unless the disclosure is
otherwise prohibited by law.
These disclosures shall effect no change in the confidential
status of these records.
SEC. 2. Section 801.01 of the Business
and Professions Code is amended to read:
801.01. The Legislature finds and declares that the filing of
reports with the applicable state agencies required under this
section is essential for the protection of the public. It is the
intent of the Legislature that the reporting requirements set forth
in this section be interpreted broadly in order to expand reporting
obligations.
(a) A complete report shall be sent to the Medical Board of
California, the Osteopathic Medical Board of California, or
the California Board of Podiatric Medicine, or the
Physician Assistant Board with respect to a licensee of the
board as to the following:
(1) A settlement over thirty thousand dollars ($30,000) or
arbitration award of any amount or a civil judgment of any amount,
whether or not vacated by a settlement after entry of the judgment,
that was not reversed on appeal, of a claim or action for damages for
death or personal injury caused by the licensee's alleged
negligence, error, or omission in practice, or by his or her
rendering of unauthorized professional services.
(2) A settlement over thirty thousand dollars ($30,000), if the
settlement is based on the licensee's alleged negligence, error, or
omission in practice, or on the licensee's rendering of unauthorized
professional services, and a party to the settlement is a
corporation, medical group, partnership, or other corporate entity in
which the licensee has an ownership interest or that employs or
contracts with the licensee.
(b) The report shall be sent by the following:
(1) The insurer providing professional liability insurance to the
licensee.
(2) The licensee, or his or her counsel, if the licensee does not
possess professional liability insurance.
(3) A state or local governmental agency that self-insures the
licensee. For purposes of this section "state governmental agency"
includes, but is not limited to, the University of California.
(c) The entity, person, or licensee obligated to report pursuant
to subdivision (b) shall send the complete report if the judgment,
settlement agreement, or arbitration award is entered against or paid
by the employer of the licensee and not entered against or paid by
the licensee. "Employer," as used in this paragraph, means a
professional corporation, a group practice, a health care facility or
clinic licensed or exempt from licensure under the Health and Safety
Code, a licensed health care service plan, a medical care
foundation, an educational institution, a professional institution, a
professional school or college, a general law corporation, a public
entity, or a nonprofit organization that employs, retains, or
contracts with a licensee referred to in this section. Nothing in
this paragraph shall be construed to authorize the employment of, or
contracting with, any licensee in violation of Section 2400.
(d) The report shall be sent to the Medical Board of California,
the Osteopathic Medical Board of California, or
the California Board of Podiatric Medicine, or the Physician
Assistant Board as appropriate, within 30 days after the
written settlement agreement has been reduced to writing and signed
by all parties thereto, within 30 days after service of the
arbitration award on the parties, or within 30 days after the date of
entry of the civil judgment.
(e) The entity, person, or licensee required to report under
subdivision (b) shall notify the claimant or his or her counsel, if
he or she is represented by counsel, that the report has been sent to
the Medical Board of California, the Osteopathic Medical Board of
California, or the California Board of Podiatric
Medicine , or the Physician Assistant Board . If the
claimant or his or her counsel has not received this notice within 45
days after the settlement was reduced to writing and signed by all
of the parties or the arbitration award was served on the parties or
the date of entry of the civil judgment, the claimant or the claimant'
s counsel shall make the report to the appropriate board.
(f) Failure to substantially comply with this section is a public
offense punishable by a fine of not less than five hundred dollars
($500) and not more than five thousand dollars ($5,000).
(g) (1) The Medical Board of California, the Osteopathic Medical
Board of California, and the California Board of
Podiatric Medicine , and the Physician Assistant Board may
develop a prescribed form for the report.
(2) The report shall be deemed complete only if it includes the
following information:
(A) The name and last known business and residential addresses of
every plaintiff or claimant involved in the matter, whether or not
the person received an award under the settlement, arbitration, or
judgment.
(B) The name and last known business and residential address of
every licensee who was alleged to have acted improperly, whether or
not that person was a named defendant in the action and whether or
not that person was required to pay any damages pursuant to the
settlement, arbitration award, or judgment.
(C) The name, address, and principal place of business of every
insurer providing professional liability insurance to any person
described in subparagraph (B), and the insured's policy number.
(D) The name of the court in which the action or any part of the
action was filed, and the date of filing and case number of each
action.
(E) A description or summary of the facts of each claim, charge,
or allegation, including the date of occurrence and the licensee's
role in the care or professional services provided to the patient
with respect to those services at issue in the claim or action.
(F) The name and last known business address of each attorney who
represented a party in the settlement, arbitration, or civil action,
including the name of the client he or she represented.
(G) The amount of the judgment, the date of its entry, and a copy
of the judgment; the amount of the arbitration award, the date of its
service on the parties, and a copy of the award document; or the
amount of the settlement and the date it was reduced to writing and
signed by all parties. If an otherwise reportable settlement is
entered into after a reportable judgment or arbitration award is
issued, the report shall include both the settlement and a copy of
the judgment or award.
(H) The specialty or subspecialty of the licensee who was the
subject of the claim or action.
(I) Any other information the Medical Board of California, the
Osteopathic Medical Board of California, or the
California Board of Podiatric Medicine , or the Physician
Assistant Board may, by regulation, require.
(3) Every professional liability insurer, self-insured
governmental agency, or licensee or his or her counsel that makes a
report under this section and has received a copy of any written or
electronic patient medical or hospital records prepared by the
treating physician and surgeon or podiatrist
, or physician assistant , or the staff of the treating
physician and surgeon, podiatrist, or hospital, describing the
medical condition, history, care, or treatment of the person whose
death or injury is the subject of the report, or a copy of any
deposition in the matter that discusses the care, treatment, or
medical condition of the person, shall include with the report,
copies of the records and depositions, subject to reasonable costs to
be paid by the Medical Board of California, the Osteopathic Medical
Board of California, or the California Board of
Podiatric Medicine , or the Physician Assistant Board . If
confidentiality is required by court order and, as a result, the
reporter is unable to provide the records and depositions,
documentation to that effect shall accompany the original report. The
applicable board may, upon prior notification of the parties to the
action, petition the appropriate court for modification of any
protective order to permit disclosure to the board. A professional
liability insurer, self-insured governmental agency, or licensee or
his or her counsel shall maintain the records and depositions
referred to in this paragraph for at least one year from the date of
filing of the report required by this section.
(h) If the board, within 60 days of its receipt of a report filed
under this section, notifies a person named in the report, that
person shall maintain for the period of three years from the date of
filing of the report any records he or she has as to the matter in
question and shall make those records available upon request to the
board to which the report was sent.
(i) Notwithstanding any other provision of law, no insurer shall
enter into a settlement without the written consent of the insured,
except that this prohibition shall not void any settlement entered
into without that written consent. The requirement of written consent
shall only be waived by both the insured and the insurer.
(j) (1) A state or local governmental agency that self-insures
licensees shall, prior to sending a report pursuant to this section,
do all of the following with respect to each licensee who will be
identified in the report:
(A) Before deciding that a licensee will be identified, provide
written notice to the licensee that the agency intends to submit a
report in which the licensee may be identified, based on his or her
role in the care or professional services provided to the patient
that were at issue in the claim or action. This notice shall describe
the reasons for notifying the licensee. The agency shall include
with this notice a reasonable opportunity for the licensee to review
a copy of records to be used by the agency in deciding whether to
identify the licensee in the report.
(B) Provide the licensee with a reasonable opportunity to provide
a written response to the agency and written materials in support of
the licensee's position. If the licensee is identified in the report,
the agency shall include this response and materials in the report
submitted to a board under this section if requested by the licensee.
(C) At least 10 days prior to the expiration of the 30-day
reporting requirement under subdivision (d), provide the licensee
with the opportunity to present arguments to the body that will make
the final decision or to that body's designee. The body shall review
the care or professional services provided to the patient with
respect to those services at issue in the claim or action and
determine the licensee or licensees to be identified in the report
and the amount of the settlement to be apportioned to the licensee.
(2) Nothing in this subdivision shall be construed to modify
either the content of a report required under this section or the
timeframe for filing that report.
(k) For purposes of this section, "licensee" means a licensee of
the Medical Board of California, the Osteopathic Medical Board of
California, or the California Board of Podiatric
Medicine , or the Physician Assistant Board .
SEC. 3. Section 802.1 of the Business
and Professions Code is amended to read:
802.1. (a) (1) A physician and surgeon, osteopathic physician and
surgeon, and a doctor of podiatric medicine
, and a physician assistant shall report either of the
following to the entity that issued his or her license:
(A) The bringing of an indictment or information charging a felony
against the licensee.
(B) The conviction of the licensee, including any verdict of
guilty, or plea of guilty or no contest, of any felony or
misdemeanor.
(2) The report required by this subdivision shall be made in
writing within 30 days of the date of the bringing of the indictment
or information or of the conviction.
(b) Failure to make a report required by this section shall be a
public offense punishable by a fine not to exceed five thousand
dollars ($5,000).
SEC. 4. Section 802.5 of the Business
and Professions Code is amended to read:
802.5. (a) When a coroner receives information that is based on
findings that were reached by, or documented and approved by a
board-certified or board-eligible pathologist indicating that a death
may be the result of a physician's or
physician and surgeon's, podiatrist's , or physician
assistant's gross negligence or incompetence, a report shall be
filed with the Medical Board of California, the Osteopathic Medical
Board of California, or the California Board of
Podiatric Medicine , or the Physician Assistant Board .
The initial report shall include the name of the decedent, date and
place of death, attending physicians or podiatrists, and all other
relevant information available. The initial report shall be followed,
within 90 days, by copies of the coroner's report, autopsy protocol,
and all other relevant information.
(b) The report required by this section shall be confidential. No
coroner, physician and surgeon, or medical examiner, nor any
authorized agent, shall be liable for damages in any civil action as
a result of his or her acting in compliance with this section. No
board-certified or board-eligible pathologist, nor any authorized
agent, shall be liable for damages in any civil action as a result of
his or her providing information under subdivision (a).
SEC. 5. Section 803 of the Business and
Professions Code is amended to read:
803. (a) Except as provided in subdivision (b), within 10 days
after a judgment by a court of this state that a person who holds a
license, certificate, or other similar authority from the Board of
Behavioral Sciences or from an agency mentioned in subdivision (a) of
Section 800 (except a person licensed pursuant to Chapter 3
(commencing with Section 1200)) has committed a crime, or is liable
for any death or personal injury resulting in a judgment for an
amount in excess of thirty thousand dollars ($30,000) caused by his
or her negligence, error or omission in practice, or his or her
rendering unauthorized professional services, the clerk of the court
that rendered the judgment shall report that fact to the agency that
issued the license, certificate, or other similar authority.
(b) For purposes of a physician and surgeon, osteopathic physician
and surgeon, or doctor of podiatric medicine,
or physician assistant, who is liable for any death or
personal injury resulting in a judgment of any amount caused by his
or her negligence, error or omission in practice, or his or her
rendering unauthorized professional services, the clerk of the court
that rendered the judgment shall report that fact to the agency that
issued the license.
SEC. 6. Section 803.1 of the Business
and Professions Code is amended to read:
803.1. (a) Notwithstanding any other provision of law, the
Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric
Medicine , and the Physician Assistant Board shall
disclose to an inquiring member of the public information regarding
any enforcement actions taken against a licensee, including a former
licensee, by the board or by another state or jurisdiction, including
all of the following:
(1) Temporary restraining orders issued.
(2) Interim suspension orders issued.
(3) Revocations, suspensions, probations, or limitations on
practice ordered by the board, including those made part of a
probationary order or stipulated agreement.
(4) Public letters of reprimand issued.
(5) Infractions, citations, or fines imposed.
(b) Notwithstanding any other provision of law, in addition to the
information provided in subdivision (a), the Medical Board of
California, the Osteopathic Medical Board of California, and
the California Board of Podiatric Medicine , and the
Physician Assistant Board shall disclose to an inquiring member
of the public all of the following:
(1) Civil judgments in any amount, whether or not vacated by a
settlement after entry of the judgment, that were not reversed on
appeal and arbitration awards in any amount of a claim or action for
damages for death or personal injury caused by the physician and
surgeon's negligence, error, or omission in practice, or by his or
her rendering of unauthorized professional services.
(2) (A) All settlements in the possession, custody, or control of
the board shall be disclosed for a licensee in the low-risk category
if there are three or more settlements for that licensee within the
last 10 years, except for settlements by a licensee regardless of the
amount paid where (i) the settlement is made as a part of the
settlement of a class claim, (ii) the licensee paid in settlement of
the class claim the same amount as the other licensees in the same
class or similarly situated licensees in the same class, and (iii)
the settlement was paid in the context of a case where the complaint
that alleged class liability on behalf of the licensee also alleged a
products liability class action cause of action. All settlements in
the possession, custody, or control of the board shall be disclosed
for a licensee in the high-risk category if there are four or more
settlements for that licensee within the last 10 years except for
settlements by a licensee regardless of the amount paid where (i) the
settlement is made as a part of the settlement of a class claim,
(ii) the licensee paid in settlement of the class claim the same
amount as the other licensees in the same class or similarly situated
licensees in the same class, and (iii) the settlement was paid in
the context of a case where the complaint that alleged class
liability on behalf of the licensee also alleged a products liability
class action cause of action. Classification of a licensee in either
a "high-risk category" or a "low-risk category" depends upon the
specialty or subspecialty practiced by the licensee and the
designation assigned to that specialty or subspecialty by the Medical
Board of California, as described in subdivision (f). For the
purposes of this paragraph, "settlement" means a settlement of an
action described in paragraph (1) entered into by the licensee on or
after January 1, 2003, in an amount of thirty thousand dollars
($30,000) or more.
(B) The board shall not disclose the actual dollar amount of a
settlement but shall put the number and amount of the settlement in
context by doing the following:
(i) Comparing the settlement amount to the experience of other
licensees within the same specialty or subspecialty, indicating if it
is below average, average, or above average for the most recent
10-year period.
(ii) Reporting the number of years the licensee has been in
practice.
(iii) Reporting the total number of licensees in that specialty or
subspecialty, the number of those who have entered into a settlement
agreement, and the percentage that number represents of the total
number of licensees in the specialty or subspecialty.
(3) Current American Board of Medical Specialty certification or
board equivalent as certified by the Medical Board of California, the
Osteopathic Medical Board of California, or the California Board of
Podiatric Medicine.
(4) Approved postgraduate training.
(5) Status of the license of a licensee. By January 1, 2004, the
Medical Board of California, the Osteopathic Medical Board of
California, and the California Board of Podiatric Medicine shall
adopt regulations defining the status of a licensee. The board shall
employ this definition when disclosing the status of a licensee
pursuant to Section 2027.
(6) Any summaries of hospital disciplinary actions that result in
the termination or revocation of a licensee's staff privileges for
medical disciplinary cause or reason, unless a court finds, in a
final judgment, that the peer review resulting in the disciplinary
action was conducted in bad faith and the licensee notifies the board
of that finding. In addition, any exculpatory or explanatory
statements submitted by the licentiate electronically pursuant to
subdivision (f) of that section shall be disclosed. For purposes of
this paragraph, "peer review" has the same meaning as defined in
Section 805.
(c) Notwithstanding any other provision of law, the Medical Board
of California, the Osteopathic Medical Board of California,
and the California Board of Podiatric Medicine , and
the Physician Assistant Board shall disclose to an inquiring
member of the public information received regarding felony
convictions of a physician and surgeon or doctor of podiatric
medicine.
(d) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of
Podiatric Medicine , and the Physician Assistant Boa
rd may formulate appropriate disclaimers or explanatory
statements to be included with any information released, and may by
regulation establish categories of information that need not be
disclosed to an inquiring member of the public because that
information is unreliable or not sufficiently related to the licensee'
s professional practice. The Medical Board of California, the
Osteopathic Medical Board of California, and the
California Board of Podiatric Medicine , and the Physician
Assistant Board shall include the following statement when
disclosing information concerning a settlement:
"Some studies have shown that there is no significant correlation
between malpractice history and a doctor's competence. At the same
time, the State of California believes that consumers should have
access to malpractice information. In these profiles, the State of
California has given you information about both the malpractice
settlement history for the doctor's specialty and the doctor's
history of settlement payments only if in the
last 10 years, the doctor, if in a low-risk
specialty, has three or more settlements or the doctor, if in a
high-risk specialty, has four or more settlements. The State of
California has excluded some class action lawsuits because those
cases are commonly related to systems issues such as product
liability, rather than questions of individual professional
competence and because they are brought on a class basis where the
economic incentive for settlement is great. The State of California
has placed payment amounts into three statistical categories: below
average, average, and above average compared to others in the doctor'
s specialty. To make the best health care decisions, you should view
this information in perspective. You could miss an opportunity for
high-quality care by selecting a doctor based solely on malpractice
history.
When considering malpractice data, please keep in mind:
Malpractice histories tend to vary by specialty. Some specialties
are more likely than others to be the subject of litigation. This
report compares doctors only to the members of their specialty, not
to all doctors, in order to make an individual doctor's history more
meaningful.
This report reflects data only for settlements made on or after
January 1, 2003. Moreover, it includes information concerning those
settlements for a 10-year period only. Therefore, you should know
that a doctor may have made settlements in the 10 years immediately
preceding January 1, 2003, that are not included in this report.
After January 1, 2013, for doctors practicing less than 10 years, the
data covers their total years of practice. You should take into
account the effective date of settlement disclosure as well as how
long the doctor has been in practice when considering malpractice
averages.
The incident causing the malpractice claim may have happened years
before a payment is finally made. Sometimes, it takes a long time
for a malpractice lawsuit to settle. Some doctors work primarily with
high-risk patients. These doctors may have malpractice settlement
histories that are higher than average because they specialize in
cases or patients who are at very high risk for problems.
Settlement of a claim may occur for a variety of reasons that do
not necessarily reflect negatively on the professional competence or
conduct of the doctor. A payment in settlement of a medical
malpractice action or claim should not be construed as creating a
presumption that medical malpractice has occurred.
You may wish to discuss information in this report and the general
issue of malpractice with your doctor."
(e) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of
Podiatric Medicine , and the Physician Assistant Board
shall, by regulation, develop standard terminology that accurately
describes the different types of disciplinary filings and actions to
take against a licensee as described in paragraphs (1) to (5),
inclusive, of subdivision (a). In providing the public with
information about a licensee via the Internet pursuant to Section
2027, the Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of
Podiatric Medicine , and the Physician Assistant Board
shall not use the terms "enforcement," "discipline," or similar
language implying a sanction unless the physician and surgeon has
been the subject of one of the actions described in paragraphs (1) to
(5), inclusive, of subdivision (a).
(f) The Medical Board of California shall adopt regulations no
later than July 1, 2003, designating each specialty and subspecialty
practice area as either high risk or low risk. In promulgating these
regulations, the board shall consult with commercial underwriters of
medical malpractice insurance companies, health care systems that
self-insure physicians and surgeons, and representatives of the
California medical specialty societies. The board shall utilize the
carriers' statewide data to establish the two risk categories and the
averages required by subparagraph (B) of paragraph (2) of
subdivision (b). Prior to issuing regulations, the board shall
convene public meetings with the medical malpractice carriers,
self-insurers, and specialty representatives.
(g) The Medical Board of California, the Osteopathic Medical Board
of California, and the California Board of
Podiatric Medicine , the Physician Assistant Board shall
provide each licensee, including a former licensee under subdivision
(a), with a copy of the text of any proposed public disclosure
authorized by this section prior to release of the disclosure to the
public. The licensee shall have 10 working days from the date the
board provides the copy of the proposed public disclosure to propose
corrections of factual inaccuracies. Nothing in this section shall
prevent the board from disclosing information to the public prior to
the expiration of the 10-day period.
(h) Pursuant to subparagraph (A) of paragraph (2) of subdivision
(b), the specialty or subspecialty information required by this
section shall group physicians by specialty board recognized pursuant
to paragraph (5) of subdivision (h) of Section 651 unless a
different grouping would be more valid and the board, in its
statement of reasons for its regulations, explains why the validity
of the grouping would be more valid.
SEC. 7. Section 803.5 of the Business
and Professions Code is amended to read:
803.5. (a) The district attorney, city attorney, or other
prosecuting agency shall notify the Medical Board of California, the
Osteopathic Medical Board of California, the California Board of
Podiatric Medicine, the State Board of Chiropractic Examiners,
the Physician Assistant Board, or other appropriate allied
health board, and the clerk of the court in which the charges have
been filed, of any filings against a licensee of that board charging
a felony immediately upon obtaining information that the defendant is
a licensee of the board. The notice shall identify the licensee and
describe the crimes charged and the facts alleged. The prosecuting
agency shall also notify the clerk of the court in which the action
is pending that the defendant is a licensee, and the clerk shall
record prominently in the file that the defendant holds a license
from one of the boards described above.
(b) The clerk of the court in which a licensee of one of the
boards is convicted of a crime shall, within 48 hours after the
conviction, transmit a certified copy of the record of conviction to
the applicable board.
SEC. 8. Section 803.6 of the Business
and Professions Code is amended to read:
803.6. (a) The clerk of the court shall transmit any felony
preliminary hearing transcript concerning a defendant licensee to the
Medical Board of California, the Osteopathic Medical Board of
California, the California Board of Podiatric Medicine, the
Physician Assistant Board, or other appropriate allied health
board, as applicable, where the total length of the transcript is
under 800 pages and shall notify the appropriate board of any
proceeding where the transcript exceeds that length.
(b) In any case where a probation report on a licensee is prepared
for a court pursuant to Section 1203 of the Penal Code, a copy of
that report shall be transmitted by the probation officer to the
board.
SEC. 9. Section 805 of the Business and
Professions Code is amended to read:
805. (a) As used in this section, the following terms have the
following definitions:
(1) (A) "Peer review" means both of the following:
(i) A process in which a peer review body reviews the basic
qualifications, staff privileges, employment, medical outcomes, or
professional conduct of licentiates to make recommendations for
quality improvement and education, if necessary, in order to do
either or both of the following:
(I) Determine whether a licentiate may practice or continue to
practice in a health care facility, clinic, or other setting
providing medical services, and, if so, to determine the parameters
of that practice.
(II) Assess and improve the quality of care rendered in a health
care facility, clinic, or other setting providing medical services.
(ii) Any other activities of a peer review body as specified in
subparagraph (B).
(B) "Peer review body" includes:
(i) A medical or professional staff of any health care facility or
clinic licensed under Division 2 (commencing with Section 1200) of
the Health and Safety Code or of a facility certified to participate
in the federal Medicare Program as an ambulatory surgical center.
(ii) A health care service plan licensed under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that contracts with licentiates to
provide services at alternative rates of payment pursuant to Section
10133 of the Insurance Code.
(iii) Any medical, psychological, marriage and family therapy,
social work, professional clinical counselor, dental, or podiatric
professional society having as members at least 25 percent of the
eligible licentiates in the area in which it functions (which must
include at least one county), which is not organized for profit and
which has been determined to be exempt from taxes pursuant to Section
23701 of the Revenue and Taxation Code.
(iv) A committee organized by any entity consisting of or
employing more than 25 licentiates of the same class that functions
for the purpose of reviewing the quality of professional care
provided by members or employees of that entity.
(2) "Licentiate" means a physician and surgeon, doctor of
podiatric medicine, clinical psychologist, marriage and family
therapist, clinical social worker, professional clinical counselor,
or dentist , or physician assistant .
"Licentiate" also includes a person authorized to practice medicine
pursuant to Section 2113 or 2168.
(3) "Agency" means the relevant state licensing agency having
regulatory jurisdiction over the licentiates listed in paragraph (2).
(4) "Staff privileges" means any arrangement under which a
licentiate is allowed to practice in or provide care for patients in
a health facility. Those arrangements shall include, but are not
limited to, full staff privileges, active staff privileges, limited
staff privileges, auxiliary staff privileges, provisional staff
privileges, temporary staff privileges, courtesy staff privileges,
locum tenens arrangements, and contractual arrangements to provide
professional services, including, but not limited to, arrangements to
provide outpatient services.
(5) "Denial or termination of staff privileges, membership, or
employment" includes failure or refusal to renew a contract or to
renew, extend, or reestablish any staff privileges, if the action is
based on medical disciplinary cause or reason.
(6) "Medical disciplinary cause or reason" means that aspect of a
licentiate's competence or professional conduct that is reasonably
likely to be detrimental to patient safety or to the delivery of
patient care.
(7) "805 report" means the written report required under
subdivision (b).
(b) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file an 805 report
with the relevant agency within 15 days after the effective date on
which any of the following occur as a result of an action of a 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.
(c) If a licentiate takes any action listed in paragraph (1), (2),
or (3) after receiving notice of a pending investigation initiated
for a medical disciplinary cause or reason or after receiving notice
that his or her application for membership or staff privileges is
denied or will be denied for a medical disciplinary cause or reason,
the chief of staff of a medical or professional staff or other chief
executive officer, medical director, or administrator of any peer
review body and the chief executive officer or administrator of any
licensed health care facility or clinic where the licentiate is
employed or has staff privileges or membership or where the
licentiate applied for staff privileges or membership, or sought the
renewal thereof, shall file an 805 report with the relevant agency
within 15 days after the licentiate takes the action.
(1) Resigns or takes a leave of absence from membership, staff
privileges, or employment.
(2) Withdraws or abandons his or her application for staff
privileges or membership.
(3) Withdraws or abandons his or her request for renewal of staff
privileges or membership.
(d) For purposes of filing an 805 report, the signature of at
least one of the individuals indicated in subdivision (b) or (c) on
the completed form shall constitute compliance with the requirement
to file the report.
(e) An 805 report shall also be filed within 15 days following the
imposition of summary suspension of staff privileges, membership, or
employment, if the summary suspension remains in effect for a period
in excess of 14 days.
(f) A copy of the 805 report, and a notice advising the licentiate
of his or her right to submit additional statements or other
information, electronically or otherwise, pursuant to Section 800,
shall be sent by the peer review body to the licentiate named in the
report. The notice shall also advise the licentiate that information
submitted electronically will be publicly disclosed to those who
request the information.
The information to be reported in an 805 report shall include the
name and license number of the licentiate involved, a description of
the facts and circumstances of the medical disciplinary cause or
reason, and any other relevant information deemed appropriate by the
reporter.
A supplemental report shall also be made within 30 days following
the date the licentiate is deemed to have satisfied any terms,
conditions, or sanctions imposed as disciplinary action by the
reporting peer review body. In performing its dissemination functions
required by Section 805.5, the agency shall include a copy of a
supplemental report, if any, whenever it furnishes a copy of the
original 805 report.
If another peer review body is required to file an 805 report, a
health care service plan is not required to file a separate report
with respect to action attributable to the same medical disciplinary
cause or reason. If the Medical Board of California or a licensing
agency of another state revokes or suspends, without a stay, the
license of a physician and surgeon, a peer review body is not
required to file an 805 report when it takes an action as a result of
the revocation or suspension.
(g) The reporting required by this section shall not act as a
waiver of confidentiality of medical records and committee reports.
The information reported or disclosed shall be kept confidential
except as provided in subdivision (c) of Section 800 and Sections
803.1 and 2027, provided that a copy of the report containing the
information required by this section may be disclosed as required by
Section 805.5 with respect to reports received on or after January 1,
1976.
(h) The Medical Board of California, the Osteopathic Medical Board
of California, and the Dental Board of California shall disclose
reports as required by Section 805.5.
(i) An 805 report shall be maintained electronically by an agency
for dissemination purposes for a period of three years after receipt.
(j) No person shall incur any civil or criminal liability as the
result of making any report required by this section.
(k) A willful failure to file an 805 report by any person who is
designated or otherwise required by law to file an 805 report is
punishable by a fine not to exceed one hundred thousand dollars
($100,000) per violation. The fine may be imposed in any civil or
administrative action or proceeding brought by or on behalf of any
agency having regulatory jurisdiction over the person regarding whom
the report was or should have been filed. If the person who is
designated or otherwise required to file an 805 report is a licensed
physician and surgeon, the action or proceeding shall be brought by
the Medical Board of California. The fine shall be paid to that
agency but not expended until appropriated by the Legislature. A
violation of this subdivision may constitute unprofessional conduct
by the licentiate. A person who is alleged to have violated this
subdivision may assert any defense available at law. As used in this
subdivision, "willful" means a voluntary and intentional violation of
a known legal duty.
(l) Except as otherwise provided in subdivision (k), any failure
by the administrator of any peer review body, the chief executive
officer or administrator of any health care facility, or any person
who is designated or otherwise required by law to file an 805 report,
shall be punishable by a fine that under no circumstances shall
exceed fifty thousand dollars ($50,000) per violation. The fine may
be imposed in any civil or administrative action or proceeding
brought by or on behalf of any agency having regulatory jurisdiction
over the person regarding whom the report was or should have been
filed. If the person who is designated or otherwise required to file
an 805 report is a licensed physician and surgeon, the action or
proceeding shall be brought by the Medical Board of California. The
fine shall be paid to that agency but not expended until appropriated
by the Legislature. The amount of the fine imposed, not exceeding
fifty thousand dollars ($50,000) per violation, shall be proportional
to the severity of the failure to report and shall differ based upon
written findings, including whether the failure to file caused harm
to a patient or created a risk to patient safety; whether the
administrator of any peer review body, the chief executive officer or
administrator of any health care facility, or any person who is
designated or otherwise required by law to file an 805 report
exercised due diligence despite the failure to file or whether they
knew or should have known that an 805 report would not be filed; and
whether there has been a prior failure to file an 805 report. The
amount of the fine imposed may also differ based on whether a health
care facility is a small or rural hospital as defined in Section
124840 of the Health and Safety Code.
(m) A health care service plan licensed under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that negotiates and enters into a
contract with licentiates to provide services at alternative rates of
payment pursuant to Section 10133 of the Insurance Code, when
determining participation with the plan or insurer, shall evaluate,
on a case-by-case basis, licentiates who are the subject of an 805
report, and not automatically exclude or deselect these licentiates.
SEC. 10. Section 2335 of the Business
and Professions Code is amended to read:
2335. (a) All proposed decisions and interim orders of the
Medical Quality Hearing Panel designated in Section 11371 of the
Government Code shall be transmitted to the executive director of the
board, or the executive director of the California Board of
Podiatric Medicine as to the licensees of that board, within 48 hours
of filing.
(b) All interim orders shall be final when filed.
(c) A proposed decision shall be acted upon by the board or by any
panel appointed pursuant to Section 2008 or by the California Board
of Podiatric Medicine, as the case may be, in accordance with Section
11517 of the Government Code, except that all of the following shall
apply to proceedings against licensees under this chapter:
(1) When considering a proposed decision, the board or panel and
the California Board of Podiatric Medicine shall give great weight to
the findings of fact of the administrative law judge, except to the
extent those findings of fact are controverted by new evidence.
(2) The board's staff or the staff of the California Board of
Podiatric Medicine shall poll the members of the board or panel or of
the California Board of Podiatric Medicine by written mail ballot
concerning the proposed decision. The mail ballot shall be sent
within 10 calendar days of receipt of the proposed decision, and
shall poll each member on whether the member votes to approve the
decision, to approve the decision with an altered penalty, to refer
the case back to the administrative law judge for the taking of
additional evidence, to defer final decision pending discussion of
the case by the panel or board as a whole, or to nonadopt the
decision. No party to the proceeding, including employees of the
agency that filed the accusation, and no person who has a direct or
indirect interest in the outcome of the proceeding or who presided at
a previous stage of the decision, may communicate directly or
indirectly, upon the merits of a contested matter while the
proceeding is pending, with any member of the panel or board, without
notice and opportunity for all parties to participate in the
communication. The votes of a majority of the board or of the panel,
and a majority of the California Board of Podiatric Medicine, are
required to approve the decision with an altered penalty, to refer
the case back to the administrative law judge for the taking of
further evidence, or to nonadopt the decision. The votes of two
members of the panel or board are required to defer final decision
pending discussion of the case by the panel or board as a whole
; except that, in the case of the California Board of
Podiatric Medicine, the vote of only one member of that board is
required to defer final decision pending discussion of the case by
the board as a whole . If there is a vote by the specified
number to defer final decision pending discussion of the case by the
panel or board as a whole, provision shall be made for that
discussion before the 100-day period specified in paragraph (3)
expires, but in no event shall that 100-day period be extended.
(3) If a majority of the board or of the panel, or a majority of
the California Board of Podiatric Medicine vote to do so, the board
or the panel or the California Board of Podiatric Medicine shall
issue an order of nonadoption of a proposed decision within 100
calendar days of the date it is received by the board. If the board
or the panel or the California Board of Podiatric Medicine does not
refer the case back to the administrative law judge for the taking of
additional evidence or issue an order of nonadoption within 100
calendar days, the decision shall be final and subject to review
under Section 2337. Members of the board or of any panel or of the
California Board of Podiatric Medicine who review a proposed decision
or other matter and vote by mail as provided in paragraph (2) shall
return their votes by mail to the board within 30 days from receipt
of the proposed decision or other matter.
(4) The board or the panel or the California Board of Podiatric
Medicine shall afford the parties the opportunity to present oral
argument before deciding a case after nonadoption of the
administrative law judge's decision.
(5) A vote of a majority of the board or of a panel, or a majority
of the California Board of Podiatric Medicine, are required to
increase the penalty from that contained in the proposed
administrative law judge's decision. No member of the board or panel
or of the California Board of Podiatric Medicine may vote to increase
the penalty except after reading the entire record and personally
hearing any additional oral argument and evidence presented to the
panel or board.
SECTION 1. SEC. 11. Section 2460 of
the Business and Professions Code is amended to read:
2460. (a) There is created within the jurisdiction of the Medical
Board of California the California Board of Podiatric Medicine.
(b) This section shall remain in effect only until January 1,
2017, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2017, deletes or extends
that date. Notwithstanding any other provision of law, the repeal of
this section renders the California Board of Podiatric Medicine
subject to review by the appropriate policy committees of the
Legislature.
SEC. 12. Section 2465 of the Business
and Professions Code is amended to read:
2465. No person who directly or indirectly owns any interest in
any college, school, or other institution engaged in podiatric
medical instruction shall be appointed to the board or
nor shall any incumbent member of the board have
or acquire any interest, direct or indirect, in any such college,
school, or institution.
SEC. 13. Section 2470 of the Business
and Professions Code is amended to read:
2470. The board may adopt, amend, or repeal, in accordance with
the provisions of the Administrative Procedure Act (Chapter 3.5
(commencing with Section 11340 of Part 1 of Division 1 of Title 2 of
the Government Code , regulations necessary to enable the board
to carry into effect the provisions of law relating to the practice
of podiatric medicine.
SEC. 14. Section 2472 of the Business
and Professions Code is amended to read:
2472. (a) The certificate to practice podiatric medicine
authorizes the holder to practice podiatric medicine.
(b) As used in this chapter, "podiatric medicine" means the
diagnosis, medical, surgical, mechanical, manipulative, and
electrical treatment of the human foot, including the ankle and
tendons that insert into the foot and the nonsurgical treatment of
the muscles and tendons of the leg governing the functions of the
foot.
(c) A doctor of podiatric medicine may not administer an
anesthetic other than local. If an anesthetic other than local is
required for any procedure, the anesthetic shall be administered by
another licensed health care practitioner who is authorized to
administer the required anesthetic within the scope of his or her
practice.
(d) (1) A doctor of podiatric medicine who is ankle
certified by the board on and after January 1, 1984, may do
the following:
(A) Perform surgical treatment of the ankle and tendons at the
level of the ankle pursuant to subdivision (e).
(B) Perform services under the direct supervision of a physician
and surgeon, as an assistant at surgery, in surgical procedures that
are otherwise beyond the scope of practice of a doctor of podiatric
medicine.
(C) Perform a partial amputation of the foot no further proximal
than the Chopart's joint.
(2) Nothing in this subdivision shall be construed to permit a
doctor of podiatric medicine to function as a primary surgeon for any
procedure beyond his or her scope of practice.
(e) A doctor of podiatric medicine may perform surgical treatment
of the ankle and tendons at the level of the ankle only in the
following locations:
(1) A licensed general acute care hospital, as defined in Section
1250 of the Health and Safety Code.
(2) A licensed surgical clinic, as defined in Section 1204 of the
Health and Safety Code, if the doctor of podiatric medicine has
surgical privileges, including the privilege to perform surgery on
the ankle, in a general acute care hospital described in paragraph
(1) and meets all the protocols of the surgical clinic.
(3) An ambulatory surgical center that is certified to participate
in the Medicare Program under Title XVIII (42 U.S.C. Sec. 1395 et
seq.) of the federal Social Security Act, if the doctor of podiatric
medicine has surgical privileges, including the privilege to perform
surgery on the ankle, in a general acute care hospital described in
paragraph (1) and meets all the protocols of the surgical center.
(4) A freestanding physical plant housing outpatient services of a
licensed general acute care hospital, as defined in Section 1250 of
the Health and Safety Code, if the doctor of podiatric medicine has
surgical privileges, including the privilege to perform surgery on
the ankle, in a general acute care hospital described in paragraph
(1). For purposes of this section, a "freestanding physical plant"
means any building that is not physically attached to a building
where inpatient services are provided.
(5) An outpatient setting accredited pursuant to subdivision (g)
of Section 1248.1 of the Health and Safety Code.
(f) A doctor of podiatric medicine shall not perform an admitting
history and physical examination of a patient in an acute care
hospital where doing so would violate the regulations governing the
Medicare program.
(g) A doctor of podiatric medicine licensed under this chapter is
a licentiate for purposes of paragraph (2) of subdivision (a) of
Section 805, and thus is a health care practitioner subject to the
provisions of Section 2290.5 pursuant to subdivision (b) of that
section.
SEC. 15. Section 2475 of the Business
and Professions Code is amended to read:
2475. Unless otherwise provided by law, no postgraduate trainee,
intern, resident postdoctoral fellow, or instructor may engage in the
practice of podiatric medicine, or receive compensation therefor, or
offer to engage in the practice of podiatric medicine unless he or
she holds a valid, unrevoked, and unsuspended certificate to practice
podiatric medicine issued by the division. However, a graduate of an
approved college or school of podiatric medicine upon whom the
degree doctor of podiatric medicine has been conferred, who is issued
a resident's license, which may be renewed annually for up
to four years for this purpose by the division upon
recommendation of the board, and who is enrolled in a postgraduate
training program approved by the board, may engage in the practice of
podiatric medicine whenever and wherever required as a part of that
program and may receive compensation for that practice under the
following conditions:
(a) A graduate with a resident's license in an approved
internship, residency, or fellowship program may participate in
training rotations outside the scope of podiatric medicine, under the
supervision of a physician and surgeon who holds a medical doctor or
doctor of osteopathy degree wherever and whenever required as a part
of the training program, and may receive compensation for that
practice. If the graduate fails to receive a license to practice
podiatric medicine under this chapter within three years from the
commencement of the postgraduate training, all privileges and
exemptions under this section shall automatically cease.
(b) Hospitals functioning as a part of the teaching program of an
approved college or school of podiatric medicine in this state may
exchange instructors or resident or assistant resident doctors of
podiatric medicine with another approved college or school of
podiatric medicine not located in this state, or those hospitals may
appoint a graduate of an approved school as such a resident for
purposes of postgraduate training. Those instructors and residents
may practice and be compensated as provided in this section, but that
practice and compensation shall be for a period not to exceed two
years.
SEC. 16. Section 2477 of the Business
and Professions Code is amended to read:
2477. Nothing in this chapter prohibits the manufacture, the
recommendation, or the sale of either corrective shoes or appliances
for the human feet to enhance comfort and performance, or
, following diagnosis and prescription by a licensed
practitioner in any case involving medical conditions .
SEC. 17. Section 2484 of the Business
and Professions Code is amended to read:
2484. In addition to any other requirements of this chapter,
before a certificate to practice podiatric medicine may be issued,
each applicant shall show by evidence satisfactory to the board,
submitted directly to the board by the sponsoring institution, that
he or she has satisfactorily completed at least two years of
postgraduate podiatric medical and podiatric surgical training in a
general acute care hospital approved by the Council of
on Podiatric Medical Education.
SEC. 18. Section 2493 of the Business
and Professions Code is amended to read:
2493. (a) An applicant for a
certificate to practice podiatric medicine shall pass an examination
in the subjects required by Section 2483 in order to ensure a
minimum of entry-level competence.
(b) The board shall require a passing score on the National Board
of Podiatric Medical Examiners Part III examination that is
consistent with the postgraduate training requirement in Section
2484. The board, as of July 1, 2005, shall require a passing score
one standard error of measurement higher than the national passing
scale score until such time as the National Board of Podiatric
Medical Examiners recommends a higher passing score consistent with
Section 2484. In consultation with the Office of Professional
Examination Services of the Department of Consumer Affairs, the board
shall ensure that the part III examination adequately evaluates the
full scope of practice established by Section 2472, including
amputation and other foot and ankle surgical procedures, pursuant to
Section 139.
SEC. 19. Section 2496 of the Business
and Professions Code is amended to read:
2496. In order to ensure the continuing competence of persons
licensed to practice podiatric medicine, the board shall adopt and
administer regulations in accordance with the Administrative
Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code) requiring
continuing education of those licensees. The board shall require
those licensees to demonstrate satisfaction of the continuing
education requirements and one of the following requirements at each
license renewal:
(a) Passage of an examination administered by the board within the
past 10 years.
(b) Passage of an examination administered by an approved
specialty certifying board within the past 10 years.
(c) Current diplomate, board-eligible, or board-qualified status
granted by an approved specialty certifying board within the past 10
years.
(d) Recertification of current status by an approved specialty
certifying board within the past 10 years.
(e) Successful completion of an approved residency or fellowship
program within the past 10 years.
(f) Granting or renewal of current staff privileges within the
past five years by a health care facility that is licensed,
certified, accredited, conducted, maintained, operated, or otherwise
approved by an agency of the federal or state government or an
organization approved by the Medical Board of California.
(g) Successful completion within the past five years of an
extended course of study approved by the board.
(h) Passage within the past 10 years of Part III of the
examination administered by the National Board of Podiatric Medical
Examiners.
SEC. 20. Section 2497.5 of the Business
and Professions Code is amended to read:
2497.5. (a) The board may request the administrative law judge,
under his or her proposed decision in resolution of a disciplinary
proceeding before the board, to direct any licensee found guilty of
unprofessional conduct to pay to the board a sum not to exceed the
actual and reasonable costs of the investigation and prosecution of
the case.
(b) The costs to be assessed shall be fixed by the administrative
law judge and shall not in any event be increased
by the board . When the board does not adopt a proposed
decision and remands the case to an administrative law judge, the
administrative law judge shall not increase the amount of any costs
assessed in the proposed decision unless the board
does not adopt a proposed decision and in making its own decision
finds grounds for increasing the costs to be assessed, not to exceed
the actual and reasonable costs of the investigation and prosecution
of the case .
(c) When the payment directed in the board's order for payment of
costs is not made by the licensee, the board may enforce the order
for payment by bringing an action in any appropriate court. This
right of enforcement shall be in addition to any other rights the
board may have as to any licensee directed to pay costs.
(d) In any judicial action for the recovery of costs, proof of the
board's decision shall be conclusive proof of the validity of the
order of payment and the terms for payment.
(e) (1) Except as provided in paragraph (2), the board shall not
renew or reinstate the license of any licensee who has failed to pay
all of the costs ordered under this section.
(2) Notwithstanding paragraph (1), the board may, in its
discretion, conditionally renew or reinstate for a maximum of one
year the license of any licensee who demonstrates financial hardship
and who enters into a formal agreement with the board to reimburse
the board within that one year period for those unpaid costs.
(f) All costs recovered under this section shall be deposited in
the Board of Podiatric Medicine Fund as a reimbursement in either the
fiscal year in which the costs are actually recovered or the
previous fiscal year, as the board may direct.
SEC. 21. Section 3501 of the Business
and Professions Code is amended to read:
3501. (a) As used in this chapter:
(1) "Board" means the Medical Board of California
Physician Assistant Boa rd .
(2) "Approved program" means a program for the education of
physician assistants that has been formally approved by the
committee.
(3) "Trainee" means a person who is currently enrolled in an
approved program.
(4) "Physician assistant" means a person who meets the
requirements of this chapter and is licensed by the committee.
(5) "Supervising physician" means a physician and surgeon licensed
by the board Medical Board of California
or by the Osteopathic Medical Board of California who
supervises one or more physician assistants, who possesses a current
valid license to practice medicine, and who is not currently on
disciplinary probation for improper use of a physician assistant.
(6) "Supervision" means that a licensed physician and surgeon
oversees the activities of, and accepts responsibility for, the
medical services rendered by a physician assistant.
(7) "Committee" or "examining committee" means the Physician
Assistant Committee.
(8)
(7) "Regulations" means the rules and regulations as
set forth in Chapter 13.8 (commencing with Section 1399.500) of Title
16 of the California Code of Regulations.
(9)
(8) "Routine visual screening" means uninvasive
nonpharmacological simple testing for visual acuity, visual field
defects, color blindness, and depth perception.
(10)
(9) "Program manager" means the staff manager of the
diversion program, as designated by the executive officer of the
board Medical Board of California . The
program manager shall have background experience in dealing with
substance abuse issues.
(11)
(10) "Delegation of services agreement" means the
writing that delegates to a physician assistant from a supervising
physician the medical services the physician assistant is authorized
to perform consistent with subdivision (a) of Section 1399.540 of
Title 16 of the California Code of Regulations.
(12)
(11) "Other specified medical services" means tests or
examinations performed or ordered by a physician assistant practicing
in compliance with this chapter or regulations of the board
Medical Board of California promulgated under
this chapter.
(b) A physician assistant acts as an agent of the supervising
physician when performing any activity authorized by this chapter or
regulations promulgated by the board under this chapter.
SEC. 22. Section 3502 of the Business
and Professions Code is amended to read:
3502. (a) Notwithstanding any other provision of law, a physician
assistant may perform those medical services as set forth by the
regulations of the board Medical Board of
California when the services are rendered under the supervision
of a licensed physician and surgeon who is not subject to a
disciplinary condition imposed by the board
Medical Board of California prohibiting that supervision or
prohibiting the employment of a physician assistant.
(b) Notwithstanding any other provision of law, a physician
assistant performing medical services under the supervision of a
physician and surgeon may assist a doctor of podiatric medicine who
is a partner, shareholder, or employee in the same medical group as
the supervising physician and surgeon. A physician assistant who
assists a doctor of podiatric medicine pursuant to this subdivision
shall do so only according to patient-specific orders from the
supervising physician and surgeon.
The supervising physician and surgeon shall be physically
available to the physician assistant for consultation when such
assistance is rendered. A physician assistant assisting a doctor of
podiatric medicine shall be limited to performing those duties
included within the scope of practice of a doctor of podiatric
medicine.
(c) (1) A physician assistant and his or her supervising physician
and surgeon shall establish written guidelines for the adequate
supervision of the physician assistant. This requirement may be
satisfied by the supervising physician and surgeon adopting protocols
for some or all of the tasks performed by the physician assistant.
The protocols adopted pursuant to this subdivision shall comply with
the following requirements:
(A) A protocol governing diagnosis and management shall, at a
minimum, include the presence or absence of symptoms, signs, and
other data necessary to establish a diagnosis or assessment, any
appropriate tests or studies to order, drugs to recommend to the
patient, and education to be provided to the patient.
(B) A protocol governing procedures shall set forth the
information to be provided to the patient, the nature of the consent
to be obtained from the patient, the preparation and technique of the
procedure, and the followup care.
(C) Protocols shall be developed by the supervising physician and
surgeon or adopted from, or referenced to, texts or other sources.
(D) Protocols shall be signed and dated by the supervising
physician and surgeon and the physician assistant.
(2) The supervising physician and surgeon shall review,
countersign, and date a sample consisting of, at a minimum, 5 percent
of the medical records of patients treated by the physician
assistant functioning under the protocols within 30 days of the date
of treatment by the physician assistant. The physician and surgeon
shall select for review those cases that by diagnosis, problem,
treatment, or procedure represent, in his or her judgment, the most
significant risk to the patient.
(3) Notwithstanding any other provision of law, the board
Medical Board of California or
committee board may establish other alternative
mechanisms for the adequate supervision of the physician assistant.
(d) No medical services may be performed under this chapter in any
of the following areas:
(1) The determination of the refractive states of the human eye,
or the fitting or adaptation of lenses or frames for the aid thereof.
(2) The prescribing or directing the use of, or using, any optical
device in connection with ocular exercises, visual training, or
orthoptics.
(3) The prescribing of contact lenses for, or the fitting or
adaptation of contact lenses to, the human eye.
(4) The practice of dentistry or dental hygiene or the work of a
dental auxiliary as defined in Chapter 4 (commencing with Section
1600).
(e) This section shall not be construed in a manner that shall
preclude the performance of routine visual screening as defined in
Section 3501.
SEC. 23. Section 3502.1 of the Business
and Professions Code is amended to read:
3502.1. (a) In addition to the services authorized in the
regulations adopted by the board Medical
Board of California , and except as prohibited by Section 3502,
while under the supervision of a licensed physician and surgeon or
physicians and surgeons authorized by law to supervise a physician
assistant, a physician assistant may administer or provide medication
to a patient, or transmit orally, or in writing on a patient's
record or in a drug order, an order to a person who may lawfully
furnish the medication or medical device pursuant to subdivisions (c)
and (d).
(1) A supervising physician and surgeon who delegates authority to
issue a drug order to a physician assistant may limit this authority
by specifying the manner in which the physician assistant may issue
delegated prescriptions.
(2) Each supervising physician and surgeon who delegates the
authority to issue a drug order to a physician assistant shall first
prepare and adopt, or adopt, a written, practice specific, formulary
and protocols that specify all criteria for the use of a particular
drug or device, and any contraindications for the selection.
Protocols for Schedule II controlled substances shall address the
diagnosis of illness, injury, or condition for which the Schedule II
controlled substance is being administered, provided, or issued. The
drugs listed in the protocols shall constitute the formulary and
shall include only drugs that are appropriate for use in the type of
practice engaged in by the supervising physician and surgeon. When
issuing a drug order, the physician assistant is acting on behalf of
and as an agent for a supervising physician and surgeon.
(b) "Drug order" for purposes of this section means an order for
medication that is dispensed to or for a patient, issued and signed
by a physician assistant acting as an individual practitioner within
the meaning of Section 1306.02 of Title 21 of the Code of Federal
Regulations. Notwithstanding any other provision of law, (1) a drug
order issued pursuant to this section shall be treated in the same
manner as a prescription or order of the supervising physician, (2)
all references to "prescription" in this code and the Health and
Safety Code shall include drug orders issued by physician assistants
pursuant to authority granted by their supervising physicians and
surgeons, and (3) the signature of a physician assistant on a drug
order shall be deemed to be the signature of a prescriber for
purposes of this code and the Health and Safety Code.
(c) A drug order for any patient cared for by the physician
assistant that is issued by the physician assistant shall either be
based on the protocols described in subdivision (a) or shall be
approved by the supervising physician and surgeon before it is filled
or carried out.
(1) A physician assistant shall not administer or provide a drug
or issue a drug order for a drug other than for a drug listed in the
formulary without advance approval from a supervising physician and
surgeon for the particular patient. At the direction and under the
supervision of a physician and surgeon, a physician assistant may
hand to a patient of the supervising physician and surgeon a properly
labeled prescription drug prepackaged by a physician and surgeon,
manufacturer as defined in the Pharmacy Law, or a pharmacist.
(2) A physician assistant may not administer, provide, or issue a
drug order to a patient for Schedule II through Schedule V controlled
substances without advance approval by a supervising physician and
surgeon for that particular patient unless the physician assistant
has completed an education course that covers controlled substances
and that meets standards, including pharmacological content, approved
by the committee. The education course shall be provided either by
an accredited continuing education provider or by an approved
physician assistant training program. If the physician assistant will
administer, provide, or issue a drug order for Schedule II
controlled substances, the course shall contain a minimum of three
hours exclusively on Schedule II controlled substances. Completion of
the requirements set forth in this paragraph shall be verified and
documented in the manner established by the committee prior to the
physician assistant's use of a registration number issued by the
United States Drug Enforcement Administration to the physician
assistant to administer, provide, or issue a drug order to a patient
for a controlled substance without advance approval by a supervising
physician and surgeon for that particular patient.
(3) Any drug order issued by a physician assistant shall be
subject to a reasonable quantitative limitation consistent with
customary medical practice in the supervising physician and surgeon's
practice.
(d) A written drug order issued pursuant to subdivision (a),
except a written drug order in a patient's medical record in a health
facility or medical practice, shall contain the printed name,
address, and phone number of the supervising physician and surgeon,
the printed or stamped name and license number of the physician
assistant, and the signature of the physician assistant. Further, a
written drug order for a controlled substance, except a written drug
order in a patient's medical record in a health facility or a medical
practice, shall include the federal controlled substances
registration number of the physician assistant and shall otherwise
comply with the provisions of Section 11162.1 of the Health and
Safety Code. Except as otherwise required for written drug orders for
controlled substances under Section 11162.1 of the Health and Safety
Code, the requirements of this subdivision may be met through
stamping or otherwise imprinting on the supervising physician and
surgeon's prescription blank to show the name, license number, and if
applicable, the federal controlled substances number of the
physician assistant, and shall be signed by the physician assistant.
When using a drug order, the physician assistant is acting on behalf
of and as the agent of a supervising physician and surgeon.
(e) The medical record of any patient cared for by a physician
assistant for whom the physician assistant's Schedule II drug order
has been issued or carried out shall be reviewed and countersigned
and dated by a supervising physician and surgeon within seven days.
(f) All physician assistants who are authorized by their
supervising physicians to issue drug orders for controlled substances
shall register with the United States Drug Enforcement
Administration (DEA).
(g) The committee board shall
consult with the Medical Board of California and report during its
sunset review required by Division 1.2 (commencing with Section 473)
the impacts of exempting Schedule III and Schedule IV drug orders
from the requirement for a physician and surgeon to review and
countersign the affected medical record of a patient.
SEC. 24. Section 3502.3 of the Business
and Professions Code is amended to read:
3502.3. (a) Notwithstanding any other provision of law, in
addition to any other practices that meet the general criteria set
forth in this chapter or the board's Medical
Board of Califo rnia's regulations for inclusion in
a delegation of services agreement, a delegation of services
agreement may authorize a physician assistant to do any of the
following:
(1) Order durable medical equipment, subject to any limitations
set forth in Section 3502 or the delegation of services agreement.
Notwithstanding that authority, nothing in this paragraph shall
operate to limit the ability of a third-party payer to require prior
approval.
(2) For individuals receiving home health services or personal
care services, after consultation with the supervising physician,
approve, sign, modify, or add to a plan of treatment or plan of care.
(b) Nothing in this section shall be construed to affect the
validity of any delegation of services agreement in effect prior to
the enactment of this section or those adopted subsequent to
enactment.
SEC. 25. Section 3502.5 of the Business
and Professions Code is amended to read:
3502.5. Notwithstanding any other provision of law, a physician
assistant may perform those medical services permitted pursuant to
Section 3502 during any state of war
emergency, state of emergency, or state of local
emergency, as defined in Section 8558 of the Government Code, and at
the request of a responsible federal, state, or local official or
agency, or pursuant to the terms of a mutual aid operation plan
established and approved pursuant to the California Emergency
Services Act (Chapter 7 (commencing with Section 8550) of Division 1
of Title 2 of the Government Code), regardless of whether the
physician assistant's approved supervising physician is available to
supervise the physician assistant, so long as a licensed physician is
available to render the appropriate supervision. "Appropriate
supervision" shall not require the personal or electronic
availability of a supervising physician if that availability is not
possible or practical due to the emergency. The local health officers
and their designees may act as supervising physicians during
emergencies without being subject to approval by the board
Medical Board of California . At all times, the
local health officers or their designees supervising the physician
assistants shall be licensed physicians and surgeons. Supervising
physicians acting pursuant to this section shall not be subject to
the limitation on the number of physician assistants supervised under
Section 3516.
No responsible official or mutual aid operation plan shall invoke
this section except in the case of an emergency that endangers the
health of individuals. Under no circumstances shall this section be
invoked as the result of a labor dispute or other dispute concerning
collective bargaining.
SEC. 2. SEC. 26. Section 3504 of the
Business and Professions Code is amended to read:
3504. There is established a Physician Assistant
Committee board wi thin the
jurisdiction of the Medical Board of California. The
committee board consists of nine members. This
section shall remain in effect only until January 1, 2017, and as of
that date is repealed, unless a later enacted statute, that is
enacted before January 1, 2017, deletes or extends that date.
Notwithstanding any other provision of law, the repeal of this
section renders the committee board
subject to review by the appropriate policy committees of the
Legislature.
SEC. 27. Section 3504.1 of the Business
and Professions Code is amended to read:
3504.1. Protection of the public shall be the highest priority
for the Physician Assistant Committee of the Medical
Board of California in exercising its
licensing, regulatory, and disciplinary functions. Whenever the
protection of the public is inconsistent with other interests sought
to be promoted, the protection of the public shall be paramount.
SEC. 28. Section 3505 of the Business
and Professions Code is amended to read:
3505. The members of the committee board
shall include one member of the Medical Board of
California, a physician representative of a California medical
school, an educator participating in an approved program for the
training of physician assistants, a physician who is an approved
supervising physician of a physician assistant and who is not a
member of any division of the Medical Board of California, three
physician assistants, and two public members. Upon the first
expiration of the term of the member who is a member of the Medical
Board of California, that position shall be filled by a member of the
Medical Board of California who is a physician member. Upon the
first expiration of the term of the member who is a physician
representative of a California medical school, that position shall be
filled by a public member. Upon the first expiration of the term of
the member who is an educator participating in an approved program
for the training of physician assistants, that position shall be
filled by a physician assistant. Upon the first expiration of the
term of the member who is an approved supervising physician of a
physician assistant and not a member of any division of the Medical
Board of California, that position shall be filled by a public
member. Following the expiration of the terms of the members
described above, the committee shall include four physician
assistants, one physician and surgeon who is also a
member of the Medical Board of California, and four public members.
Upon the expiration of the term of the member who is a member of
the Medical Board of California, that position shall be filled by a
physician assistant. Following the expiration of the term of the
member described above, the board shall include five physician
assistants and four public members.
Each member of the committee board
shall hold office for a term of four years expiring on January 1st,
and shall serve until the appointment and qualification of a
successor or until one year shall have elapsed since the expiration
of the term for which the member was appointed, whichever first
occurs. No member shall serve for more than two consecutive terms.
Vacancies shall be filled by appointment for the unexpired terms.
The Governor shall appoint the licensed members qualified as
provided in this section and two public members. The Senate Rules
Committee and the Speaker of the Assembly shall each appoint a public
member.
SEC. 29. Section 3506 of the Business
and Professions Code is amended to read:
3506. Each member of the committee board
shall receive a per diem and expenses as provided in Section
103.
SEC. 30. Section 3507 of the Business
and Professions Code is amended to read:
3507. The appointing power has power to remove from office any
member of the committee board , as
provided in Section 106.
SEC. 31. Section 3508 of the Business
and Professions Code is amended to read:
3508. (a) The committee board may
convene from time to time as deemed necessary by the
committee board .
(b) Notice of each meeting of the committee
board shall be given at least two weeks in advance to
those persons and organizations who express an interest in receiving
notification.
(c) The committee board shall
receive permission of the director to meet more than six times
annually. The director shall approve meetings that are necessary for
the committee board to fulfill its
legal responsibilities.
SEC. 32. Section 3509 of the Business
and Professions Code is amended to read:
3509. It shall be the duty of the committee
board to:
(a) Establish standards and issue licenses of approval for
programs for the education and training of physician assistants.
(b) Make recommendations to the board
Medical Board of California concerning the scope of practice
for physician assistants.
(c) Make recommendations to the board
Medical Board of California concerning the formulation of
guidelines for the consideration of applications by licensed
physicians to supervise physician assistants and approval of such
applications.
(d) Require the examination of applicants for licensure as a
physician assistant who meet the requirements of this chapter.
SEC. 33. Section 3509.5 of the Business
and Professions Code is amended to read:
3509.5. The committee board shall
elect annually a chairperson and a vice chairperson from among its
members.
SEC. 34. Section 3510 of the Business
and Professions Code is amended to read:
3510. The committee board may
adopt, amend, and repeal regulations as may be necessary to enable it
to carry into effect the provisions of this chapter; provided,
however, that the board Medical Board of
California shall adopt, amend, and repeal such regulations as
may be necessary to enable it to implement the provisions of this
chapter under its jurisdiction. All regulations shall be in
accordance with, and not inconsistent with, the provisions of this
chapter. Such regulations shall be adopted, amended, or repealed in
accordance with the provisions of Chapter 3.5 (commencing with
Section 11340) of Part 1 of Division 3 of Title 2 of the Government
Code.
SEC. 35. Section 3511 of the Business
and Professions Code is amended to read:
3511. Five members shall constitute a quorum for transacting any
business. The affirmative vote of a majority of those present at a
meeting of the committee board shall be
required to carry any motion.
SEC. 3. SEC. 36. Section 3512 of the
Business and Professions Code is amended to read:
3512. (a) Except as provided in Sections 159.5 and 2020, the
committee board shall employ within the
limits of the Physician Assistant Fund all personnel necessary to
carry out the provisions of this chapter including an executive
officer who shall be exempt from civil service. The board
Medical Board of California and
committee board shall make all necessary
expenditures to carry out the provisions of this chapter from the
funds established by Section 3520. The committee
board may accept contributions to effect the purposes of
this chapter.
(b) This section shall remain in effect only until January 1,
2017, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2017, deletes or extends
that date.
SEC. 37. Section 3513 of the Business
and Professions Code is amended to read:
3513. The committee board shall
recognize the approval of training programs for physician assistants
approved by a national accrediting organization. Physician assistant
training programs accredited by a national accrediting agency
approved by the committee board shall
be deemed approved by the committee board
under this section. If no national accrediting organization is
approved by the committee board , the
committee board may examine and pass
upon the qualification of, and may issue certificates of approval
for, programs for the education and training of physician assistants
that meet committee board standards.
SEC. 38. Section 3514.1 of the Business
and Professions Code is amended to read:
3514.1. (a) The committee board
shall formulate by regulation guidelines for the consideration of
applications for licensure as a physician's assistant.
(b) The committee board shall
formulate by regulation guidelines for the approval of physician's
assistant training programs.
(c) This section shall become operative on July 1, 2001.
SEC. 39. Section 3516 of the Business
and Professions Code is amended to read:
3516. (a) Notwithstanding any other provision of law, a physician
assistant licensed by the committee board
shall be eligible for employment or supervision by any
physician and surgeon who is not subject to a disciplinary condition
imposed by the board Medical Board of
California prohibiting that employment or supervision.
(b) No physician and surgeon shall supervise more than four
physician assistants at any one time, except as provided in Section
3502.5.
(c) The board Medical Board of California
may restrict a physician and surgeon to supervising specific
types of physician assistants including, but not limited to,
restricting a physician and surgeon from supervising physician
assistants outside of the field of specialty of the physician and
surgeon.
SEC. 40. Section 3516.5 of the Business
and Professions Code is amended to read:
3516.5. (a) Notwithstanding any other provision of law and in
accordance with regulations established by the board
Medical Board of California , the director of
emergency care services in a hospital with an approved program for
the training of emergency care physician assistants, may apply to the
board Medical Board of California for
authorization under which the director may grant approval for
emergency care physicians on the staff of the hospital to supervise
emergency care physician assistants.
(b) The application shall encompass all supervising physicians
employed in that service.
(c) Nothing in this section shall be construed to authorize any
one emergency care physician while on duty to supervise more than
four physician assistants at any one time.
(d) A violation of this section by the director of emergency care
services in a hospital with an approved program for the training of
emergency care physician assistants constitutes unprofessional
conduct within the meaning of Chapter 5 (commencing with Section
2000).
(e) A violation of this section shall be grounds for suspension of
the approval of the director or disciplinary action against the
director or suspension of the approved program under Section 3527.
SEC. 41. Section 3517 of the Business
and Professions Code is amended to read:
3517. The committee board shall
require a written examination of physician assistants in the manner
and under the rules and regulations as it shall prescribe, but the
examination shall be conducted in that manner as to ensure that the
identity of each applicant taking the examination will be unknown to
all of the examiners until all examination papers have been graded.
Except as otherwise provided in this chapter, or by regulation, no
physician assistant applicant shall receive approval under this
chapter without first successfully passing an examination given under
the direction of the committee board .
Examinations for licensure as a physician assistant may be
required by the committee board under a
uniform examination system, and for that purpose the
committee board may make those arrangements with
organizations furnishing examination material as may, in its
discretion, be desirable. The committee board
shall, however, establish a passing score for each
examination. The licensure examination for physician assistants shall
be held by the committee board at
least once a year with such additional examinations as the
committee board deems necessary. The time and
place of examination shall be fixed by the committee
board .
SEC. 42. Section 3518 of the Business
and Professions Code is amended to read:
3518. The committee board shall
keep current, two separate registers, one for approved supervising
physicians and one for licensed physician's assistants, by specialty
if applicable. These registers shall show the name of each licensee,
his or her last known address of record, and the date of his or her
licensure or approval. Any interested person is entitled to obtain a
copy of the register in accordance with the Information Practices Act
of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of
Part 4 of Division 3 of the Civil Code) upon application to the
committee board together with a sum as
may be fixed by the committee board ,
which amount shall not exceed the cost of this list so furnished.
SEC. 43. Section 3519 of the Business
and Professions Code is amended to read:
3519. The committee board shall
issue under the name of the Medical Board of California a license to
all physician assistant applicants who meet all of the following
requirements:
(a) Provide evidence of successful completion of an approved
program.
(b) Pass any examination required under Section 3517.
(c) Not be subject to denial of licensure under Division 1.5
(commencing with Section 475) or Section 3527.
(d) Pay all fees required under Section 3521.1.
SEC. 44. Section 3519.5 of the Business
and Professions Code is amended to read:
3519.5. (a) The committee board may
issue under the name of the board
Medical Board of California a probationary license to an
applicant subject to terms and conditions, including, but not limited
to, any of the following conditions of probation:
(1) Practice limited to a supervised, structured environment where
the applicant's activities shall be supervised by another physician
assistant.
(2) Total or partial restrictions on issuing a drug order for
controlled substances.
(3) Continuing medical or psychiatric treatment.
(4) Ongoing participation in a specified rehabilitation program.
(5) Enrollment and successful completion of a clinical training
program.
(6) Abstention from the use of alcohol or drugs.
(7) Restrictions against engaging in certain types of medical
services.
(8) Compliance with all provisions of this chapter.
(b) The committee board and the
board Medical Board of California may
modify or terminate the terms and conditions imposed on the
probationary license upon receipt of a petition from the licensee.
(c) Enforcement and monitoring of the probationary conditions
shall be under the jurisdiction of the committee
board and the board Medical Board
of California . These proceedings shall be conducted in
accordance with Chapter 5 (commencing with Section 11500) of Part 1
of Division 3 of Title 2 of the Government Code.
SEC. 45. Section 3520 of the Business
and Professions Code is amended to read:
3520. Within 10 days after the beginning of each calendar month
the board Medical Board of California
shall report to the Controller the amount and source of all
collections made under this chapter and at the same time pay all
those sums into the State Treasury, where they shall be credited to
the Physician Assistant Fund, which fund is hereby created. All money
in the fund shall be used to carry out the purpose of this chapter.
SEC. 46. Section 3521 of the Business
and Professions Code is amended to read:
3521. The fees to be paid for approval to supervise physician
assistants are to be set by the committee
board as follows:
(a) An application fee not to exceed fifty dollars ($50) shall be
charged to each physician and surgeon applicant.
(b) An approval fee not to exceed two hundred fifty dollars ($250)
shall be charged to each physician and surgeon upon approval of an
application to supervise physician assistants.
(c) A biennial renewal fee not to exceed three hundred dollars
($300) shall be paid for the renewal of an approval.
(d) The delinquency fee is twenty-five dollars ($25).
(e) The duplicate approval fee is ten dollars ($10).
(f) The fee for a letter of endorsement, letter of good standing,
or letter of verification of approval shall be ten dollars ($10).
SEC. 47. Section 3521.1 of the Business
and Professions Code is amended to read:
3521.1. The fees to be paid by physician assistants are to be set
by the committee board as follows:
(a) An application fee not to exceed twenty-five dollars ($25)
shall be charged to each physician assistant applicant.
(b) An initial license fee not to exceed two hundred fifty dollars
($250) shall be charged to each physician assistant to whom a
license is issued.
(c) A biennial license renewal fee not to exceed three hundred
dollars ($300).
(d) The delinquency fee is twenty-five dollars ($25).
(e) The duplicate license fee is ten dollars ($10).
(f) The fee for a letter of endorsement, letter of good standing,
or letter of verification of licensure shall be ten dollars ($10).
SEC. 48. Section 3521.2 of the Business
and Professions Code is amended to read:
3521.2. The fees to be paid by physician assistant training
programs are to be set by the committee board
as follows:
(a) An application fee not to exceed five hundred dollars ($500)
shall be charged to each applicant seeking program approval by the
committee board .
(b) An approval fee not to exceed one hundred dollars ($100) shall
be charged to each program upon its approval by the
committee board .
SEC. 49. Section 3521.3 is added to the
Business and Professions Code , to read:
3521.3. Every licensed physician assistant is exempt from the
payment of the renewal fee and requirement for continuing medical
education if the licensee has applied to the board for a retired
license. The holder of a retired license may not engage in the
practice of a physician assistant.
SEC. 50. Section 3521.4 is added to the
Business and Professions Code , to read:
3521.4. (a) Every licensed physician assistant is exempt from the
payment of the renewal fee specified in Section 3521.1 while engaged
in full-time training or active service in the Army, Navy, Air
Force, or Marines, or in the United States Public Health Service.
(b) Every person exempted from the payment of the renewal fee by
this section shall not engage in any private practice and shall
become liable for payment of such fee for the current renewal period
upon his or her discharge from full-time active service and shall
have a period of 60 days after becoming liable within which to pay
the renewal fee before the delinquency fee is required. Any person
who is discharged from active service within 60 days of the end of a
renewal period is exempt from the payment of the renewal fee for that
period.
(c) The time spent in full-time active service or training shall
not be included in the computation of the five-year period for
renewal and reinstatement of licensure provided in Sections 3524.
(d) Nothing in this section shall exempt a person, exempt from
renewal fees under this section, from meeting the continuing
education requirements as provided in Section 3524.5.
SEC. 51. Section 3521.5 of the Business
and Professions Code is amended to read:
3521.5. The committee board shall
report to the appropriate policy and fiscal committees of each house
of the Legislature whenever the board Medical
Board of California approves a fee increase pursuant to
Sections 3521 and 3521.1. The committee board
shall specify the reasons for each increase in the report.
Reports prepared pursuant to this section shall identify the
percentage of funds derived from an increase in fees pursuant to
Senate Bill 1077 of the 1991-92 Regular Session (Chapter 917,
Statutes of 1991) that will be used for investigational and
enforcement activities by the board Medical
Board of California and committee board
.
SEC. 52. Section 3522 of the Business
and Professions Code is amended to read:
3522. An approval to supervise physician assistants shall expire
at 12 midnight on the last day of the birth month of the physician
and surgeon during the second year of a two-year term if not renewed.
The board Medical Board of California
shall establish a cyclical renewal program, including, but not
limited to, the establishment of a system of staggered expiration
dates for approvals and a pro rata formula for the payment of renewal
fees by physician and surgeon supervisors.
To renew an unexpired approval, the approved supervising physician
and surgeon, on or before the date of expiration, shall apply for
renewal on a form prescribed by the board
Medical Board of California and pay the prescribed renewal fee.
SEC. 53. Section 3523 of the Business
and Professions Code is amended to read:
3523. All physician assistant licenses shall expire at 12
midnight of the last day of the birth month of the licensee during
the second year of a two-year term if not renewed.
The committee board shall establish
by regulation procedures for the administration of a birthdate
renewal program, including, but not limited to, the establishment of
a system of staggered license expiration dates and a pro rata formula
for the payment of renewal fees by physician assistants affected by
the implementation of the program.
To renew an unexpired license, the licensee shall, on or before
the date of expiration of the license, apply for renewal on a form
provided by the committee board ,
accompanied by the prescribed renewal fee.
SEC. 54. Section 3524 of the Business
and Professions Code is amended to read:
3524. A license or approval that has expired may be renewed at
any time within five years after its expiration by filing an
application for renewal on a form prescribed by the
committee board or board
Medical Board of California , as the case may be, and payment
of all accrued and unpaid renewal fees. If the license or approval is
not renewed within 30 days after its expiration, the licensed
physician assistant and approved supervising physician, as a
condition precedent to renewal, shall also pay the prescribed
delinquency fee, if any. Renewal under this section shall be
effective on the date on which the application is filed, on the date
on which all renewal fees are paid, or on the date on which the
delinquency fee, if any, is paid, whichever occurs last. If so
renewed, the license shall continue in effect through the expiration
date provided in Section 3522 or 3523 which next occurs after the
effective date of the renewal, when it shall expire, if it is not
again renewed.
SEC. 55. Section 3524.5 of the Business
and Professions Code is amended to read:
3524.5. The committee board may
require a licensee to complete continuing education as a condition of
license renewal under Section 3523 or 3524. The committee
board shall not require more than 50 hours of
continuing education every two years. The committee
board shall, as it deems appropriate, accept
certification by the National Commission on Certification of
Physician Assistants (NCCPA), or another qualified certifying body,
as determined by the committee board ,
as evidence of compliance with continuing education requirements.
SEC. 56. Section 3526 of the Business
and Professions Code is amended to read:
3526. A person who fails to renew his or her license or approval
within five years after its expiration may not renew it, and it may
not be reissued, reinstated, or restored thereafter, but that person
may apply for and obtain a
new license or approval if he or she:
(a) Has not committed any acts or crimes constituting grounds for
denial of licensure under Division 1.5 (commencing with Section 475).
(b) Takes and passes the examination, if any, which would be
required of him or her if application for licensure was being made
for the first time, or otherwise establishes to the satisfaction of
the committee board that, with due
regard for the public interest, he or she is qualified to practice as
a physician assistant.
(c) Pays all of the fees that would be required as if application
for licensure was being made for the first time.
SEC. 57. Section 3527 of the Business
and Professions Code is amended to read:
3527. (a) The committee board may
order the denial of an application for, or the issuance subject to
terms and conditions of, or the suspension or revocation of, or the
imposition of probationary conditions upon a physician assistant
license after a hearing as required in Section 3528 for
unprofessional conduct that includes, but is not limited to, a
violation of this chapter, a violation of the Medical Practice Act,
or a violation of the regulations adopted by the committee
board or the board
Medical Board of California .
(b) The committee board may order
the denial of an application for, or the suspension or revocation of,
or the imposition of probationary conditions upon, an approved
program after a hearing as required in Section 3528 for a violation
of this chapter or the regulations adopted pursuant thereto.
(c) The board Medical Board of California
may order the denial of an application for, or the issuance
subject to terms and conditions of, or the suspension or revocation
of, or the imposition of probationary conditions upon, an approval to
supervise a physician assistant, after a hearing as required in
Section 3528, for unprofessional conduct, which includes, but is not
limited to, a violation of this chapter, a violation of the Medical
Practice Act, or a violation of the regulations adopted by the
committee board or the board
Medical Board of California .
(d) Notwithstanding subdivision (c), the Division of Medical
Quality of the Medical Board of California, in conjunction with an
action it has commenced against a physician and surgeon, may, in its
own discretion and without the concurrence of the board
Medical Board of California , order the
suspension or revocation of, or the imposition of probationary
conditions upon, an approval to supervise a physician assistant,
after a hearing as required in Section 3528, for unprofessional
conduct, which includes, but is not limited to, a violation of this
chapter, a violation of the Medical Practice Act, or a violation of
the regulations adopted by the committee or the
board or the Medical Board of California .
(e) The committee board may order
the denial of an application for, or the suspension or revocation of,
or the imposition of probationary conditions upon, a physician
assistant license, after a hearing as required in Section 3528 for
unprofessional conduct that includes, except for good cause, the
knowing failure of a licensee to protect patients by failing to
follow infection control guidelines of the committee
board , thereby risking transmission of
blood-borne infectious diseases from licensee to patient, from
patient to patient, and from patient to licensee. In administering
this subdivision, the committee board
shall consider referencing the standards, regulations, and guidelines
of the State Department of Public Health developed pursuant to
Section 1250.11 of the Health and Safety Code and the standards,
regulations, and guidelines pursuant to the California Occupational
Safety and Health Act of 1973 (Part 1 (commencing with Section 6300)
of Division 5 of the Labor Code) for preventing the transmission of
HIV, hepatitis B, and other blood-borne pathogens in health care
settings. As necessary, the committee board
shall consult with the California Medical Board, the Board of
Podiatric Medicine, the Board of Dental Examiners, the Board of
Registered Nursing, and the Board of Vocational Nursing and
Psychiatric Technicians, to encourage appropriate consistency in the
implementation of this subdivision.
The committee board shall seek to
ensure that licensees are informed of the responsibility of licensees
and others to follow infection control guidelines, and of the most
recent scientifically recognized safeguards for minimizing the risk
of transmission of blood-borne infectious diseases.
(f) The committee board may order
the licensee to pay the costs of monitoring the probationary
conditions imposed on the license.
SEC. 58. Section 3529 of the Business
and Professions Code is amended to read:
3529. The committee board may hear
any matters filed pursuant to subdivisions (a) and (b) of Section
3527, or may assign any such the matter
to a hearing officer. The board Medical
Board of California may hear any matters filed pursuant to
subdivision (c) of Section 3527, or may assign any such
the matter to a hearing officer. If a matter is
heard by the committee board or the
board Medical Board of California , the
hearing officer who presided at the hearing shall be present during
the committee's or board's or the
Medical Board of California's consideration of the case, and,
if requested assist and advise the committee or the
board or the Medical Board of California .
SEC. 59. Section 3530 of the Business
and Professions Code is amended to read:
3530. (a) A person whose license or approval has been revoked or
suspended, or who has been placed on probation, may petition the
committee board for reinstatement or
modification of penalty, including modification or termination of
probation, after a period of not less than the following minimum
periods has elapsed from the effective date of the decision ordering
that disciplinary action:
(1) At least three years for reinstatement of a license or
approval revoked for unprofessional conduct, except that the
committee may, for good cause shown, specify in a revocation order
that a petition for reinstatement may be filed after two years.
(2) At least two years for early termination of probation of three
years or more.
(3) At least one year for modification of a condition, or
reinstatement of a license or approval revoked for mental or physical
illness, or termination of probation of less than three years.
(b) The petition shall state any facts as may be required by the
board Medical Board of California . The
petition shall be accompanied by at least two verified
recommendations from physicians licensed either by the Medical Board
of California or the Osteopathic Medical Board who have personal
knowledge of the activities of the petitioner since the disciplinary
penalty was imposed.
(c) The petition may be heard by the committee
board . The committee board
may assign the petition to an administrative law judge designated in
Section 11371 of the Government Code. After a hearing on the
petition, the administrative law judge shall provide a proposed
decision to the committee board that
shall be acted upon in accordance with the Administrative Procedure
Act.
(d) The committee board or the
administrative law judge hearing the petition, may consider all
activities of the petitioner since the disciplinary action was taken,
the offense for which the petitioner was disciplined, the petitioner'
s activities during the time the license was in good standing, and
the petitioner's rehabilitative efforts, general reputation for
truth, and professional ability. The hearing may be continued, as the
committee or administrative law judge finds necessary.
(e) The committee board or
administrative law judge, when hearing a petition for reinstating a
license or approval or modifying a penalty, may recommend the
imposition of any terms and conditions deemed necessary.
(f) No petition shall be considered while the petitioner is under
sentence for any criminal offense, including any period during which
the petitioner is on court-imposed probation or parole. No petition
shall be considered while there is an accusation or petition to
revoke probation pending against the person. The committee
board may deny, without a hearing or argument,
any petition filed pursuant to this section within a period of two
years from the effective date of the prior decision following a
hearing under this section.
(g) Nothing in this section shall be deemed to alter Sections 822
and 823.
SEC. 60. Section 3531 of the Business
and Professions Code is amended to read:
3531. A plea or verdict of guilty or a conviction following a
plea of nolo contendere made to a charge of a felony or of any
offense which is substantially related to the qualifications,
functions, or duties of the business or profession to which the
license was issued is deemed to be a conviction within the meaning of
this chapter. The committee board may
order the license suspended or revoked, or shall decline to issue a
license when the time for appeal has elapsed, or the judgment of
conviction has been affirmed on appeal or when an order granting
probation is made suspending the imposition of sentence, irrespective
of a subsequent order under the provisions of Section 1203.4 of the
Penal Code allowing such person to withdraw his plea of guilty and to
enter a plea of not guilty, or setting aside the verdict of guilty,
or dismissing the accusation, information or indictment.
SEC. 61. Section 3533 of the Business
and Professions Code is amended to read:
3533. Whenever any person has engaged in any act or practice
which constitutes an offense against this chapter, the superior court
of any county, on application of the board
Medical Board of California , may issue an injunction or other
appropriate order restraining such conduct. Proceedings under this
section shall be governed by Chapter 3 (commencing with Section 525)
of Title 7 of Part 2 of the Code of Civil Procedure. The
board or the committee Medical Board of
California or the board may commence action in the superior
court under the provisions of this section.
SEC. 62. Section 3534 of the Business
and Professions Code is amended to read:
3534. (a) It is the intent of the Legislature that the
examining committee board shall seek ways and
means to identify and rehabilitate physician assistants whose
competency is impaired due to abuse of dangerous drugs or alcohol so
that they may be treated and returned to the practice of medicine in
a manner which will not endanger the public health and safety.
SEC. 63. Section 3534.1 of the Business
and Professions Code is amended to read:
3534.1. The examining committee board
shall establish and administer a diversion program for the
rehabilitation of physician assistants whose competency is impaired
due to the abuse of drugs or alcohol. The examining
committee board may contract with any other
state agency or a private organization to perform its duties under
this article. The examining committee board
may establish one or more diversion evaluation committees to
assist it in carrying out its duties under this article. As used in
this article, "committee" means a diversion evaluation committee. A
committee created under this article operates under the direction of
the diversion program manager, as designated by the executive officer
of the examining committee board . The
program manager has the primary responsibility to review and
evaluate recommendations of the committee.
SEC. 64. Section 3534.2 of the Business
and Professions Code is amended to read:
3534.2. (a) Any committee established by the examining
committee board shall have at least three
members. In making appointments to a committee the examining
committee board shall consider the appointments
of persons who are either recovering of substance abuse and have
been free from abuse for at least three years immediately prior to
their appointment or who are knowledgeable in the treatment and
recovery of substance abuse. The examining committee
board also shall consider the appointment of a
physician and surgeon who is board certified in psychiatry.
(b) Appointments to a committee shall be by the affirmative vote
of a majority of members appointed to the examining
committee board . Each appointment shall be at
the pleasure of the examining committee board
for a term not to exceed four years. In its discretion, the
examining committee board may stagger
the terms of the initial members so appointed.
(c) A majority of the members of a committee shall constitute a
quorum for the transaction of business. Any action requires an
affirmative vote of a majority of those members present at a meeting
constituting at least a quorum. Each committee shall elect from its
membership a chairperson and a vice chairperson. Notwithstanding
Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of
Division 3 of Title 2 of the Government Code, relating to public
meetings, a committee may convene in closed session to consider
matters relating to any physician assistant applying for or
participating in a diversion program, and a meeting which will be
convened entirely in closed session need not comply with Section
11125 of the Government Code. A committee shall only convene in
closed session to the extent it is necessary to protect the privacy
of an applicant or participant. Each member of a committee shall
receive a per diem and shall be reimbursed for expenses as provided
in Section 103.
SEC. 65. Section 3534.3 of the Business
and Professions Code is amended to read:
3534.3. Each committee has the following duties and
responsibilities:
(a) To evaluate physician assistants who request participation in
the program and to make recommendations to the program manager. In
making recommendations, a committee shall consider any
recommendations from professional consultants on the admission of
applicants to the diversion program.
(b) To review and designate treatment facilities to which
physician assistants in the diversion program may be referred, and to
make recommendations to the program manager.
(c) The receipt and review of information concerning physician
assistants participating in the program.
(d) To call meetings as necessary to consider the requests of
physician assistants to participate in the diversion program, to
consider reports regarding participants in the program, and to
consider any other matters referred to it by the examining
committee board .
(e) To consider whether each participant in the diversion program
may with safety continue or resume the practice of medicine.
(f) To set forth in writing the terms and conditions of the
diversion agreement that is approved by the program manager for each
physician assistant participating in the program, including
treatment, supervision, and monitoring requirements.
(g) To hold a general meeting at least twice a year, which shall
be open and public, to evaluate the diversion program's progress, to
prepare reports to be submitted to the examining committee
board , and to suggest proposals for changes in
the diversion program.
(h) For the purposes of Division 3.6 (commencing with Section 810)
of Title 1 of the Government Code, any member of a committee shall
be considered a public employee. No examining committee
board or committee member, contractor, or agent
thereof, shall be liable for any civil damage because of acts or
omissions which may occur while acting in good faith in a program
established pursuant to this article.
SEC. 66. Section 3534.4 of the Business
and Professions Code is amended to read:
3534.4. Criteria for acceptance into the diversion program shall
include all of the following: (a) the applicant shall be licensed as
a physician assistant by the examining committee
board and shall be a resident of California; (b) the
applicant shall be found to abuse dangerous drugs or alcoholic
beverages in a manner which may affect his or her ability to practice
medicine safely or competently; (c) the applicant shall have
voluntarily requested admission to the program or shall be accepted
into the program in accordance with terms and conditions resulting
from a disciplinary action; (d) the applicant shall agree to
undertake any medical or psychiatric examination ordered to evaluate
the applicant for participation in the program; (e) the applicant
shall cooperate with the program by providing medical information,
disclosure authorizations, and releases of liability as may be
necessary for participation in the program; and (f) the applicant
shall agree in writing to cooperate with all elements of the
treatment program designed for him or her.
An applicant may be denied participation in the program if the
examining committee board , the program
manager, or a committee determines that the applicant will not
substantially benefit from participation in the program or that the
applicant's participation in the program creates too great a risk to
the public health, safety, or welfare.
SEC. 67. Section 3534.5 of the Business
and Professions Code is amended to read:
3534.5. A participant may be terminated from the program for any
of the following reasons: (a) the participant has successfully
completed the treatment program; (b) the participant has failed to
comply with the treatment program designated for him or her; (c) the
participant fails to meet any of the criteria set forth in
subdivision (d); or (d) it is determined that the participant has not
substantially benefited from participation in the program or that
his or her continued participation in the program creates too great a
risk to the public health, safety, or welfare. Whenever an applicant
is denied participation in the program or a participant is
terminated from the program for any reason other than the successful
completion of the program, and it is determined that the continued
practice of medicine by that individual creates too great a risk to
the public health and safety, that fact shall be reported to the
executive officer of the examining committee
board and all documents and information pertaining to and
supporting that conclusion shall be provided to the executive
officer. The matter may be referred for investigation and
disciplinary action by the examining committee
board . Each physician assistant who requests
participation in a diversion program shall agree to cooperate with
the recovery program designed for him or her. Any failure to comply
with that program may result in termination of participation in the
program.
The examination committee board
shall inform each participant in the program of the procedures
followed in the program, of the rights and responsibilities of a
physician assistant in the program, and the possible results of
noncompliance with the program.
SEC. 68. Section 3534.6 of the Business
and Professions Code is amended to read:
3534.6. In addition to the criteria and causes set forth in
Section 3534.4, the examining committee board
may set forth in its regulations additional criteria for
admission to the program or causes for termination from the program.
SEC. 69. Section 3534.7 of the Business
and Professions Code is amended to read:
3534.7. All examining committee board
and committee records and records of proceedings and
participation of a physician assistant in a program shall be
confidential and are not subject to discovery or subpoena.
SEC. 70. Section 3534.9 of the Business
and Professions Code is amended to read:
3534.9. If the examining committee board
contracts with any other entity to carry out this section, the
executive officer of the examining committee
board or the program manager shall review the activities and
performance of the contractor on a biennial basis. As part of this
review, the examining committee board
shall review files of participants in the program. However, the names
of participants who entered the program voluntarily shall remain
confidential, except when the review reveals misdiagnosis, case
mismanagement, or noncompliance by the participant.
SEC. 71. Section 3534.10 of the
Business and Professions Code is amended to read:
3534.10. Participation in a diversion program shall not be a
defense to any disciplinary action which may be taken by the
examining committee board . This section does
not preclude the examining committee board
from commencing disciplinary action against a physician
assistant who is terminated unsuccessfully from the program under
this section. That disciplinary action may not include as evidence
any confidential information.
SEC. 72. Section 3535 of the Business
and Professions Code is amended to read:
3535. (a) Notwithstanding any other provision of law, physicians
and surgeons licensed by the Osteopathic Medical Board of California
may use or employ physician assistants provided (1) each physician
assistant so used or employed is a graduate of an approved program
and is licensed by the committee board
, and (2) the scope of practice of the physician assistant is the
same as that which is approved by the Division of Licensing of the
Medical Board of California for physicians and surgeons supervising
physician assistants in the same or similar specialty.
(b) Any person who violates subdivision (a) shall be guilty of a
misdemeanor punishable by imprisonment in a county jail not exceeding
six months, or by a fine not exceeding one thousand dollars
($1,000), or by both that imprisonment and fine.
(c) This section shall become operative on July 1, 2001.
SEC. 73. Section 3537.10 of the
Business and Professions Code is amended to read:
3537.10. (a) Subject to the other provisions of this article,
the Office of Statewide Health Planning and Development, hereafter in
this article referred to as the office, shall coordinate the
establishment of an international medical graduate physician
assistant training program, to be conducted at an appropriate
educational institution or institutions. The goal of the program
shall be to place as many international medical graduate physician
assistants in medically underserved areas as possible in order to
provide greater access to care for the growing population of
medically indigent and underserved. The method for accomplishing this
goal shall be to train foreign medical graduates to become licensed
as physician assistants at no cost to the participants in return for
a commitment from the participants to serve full-time in underserved
areas for a four-year period.
(b) By February 1, 1994, or one month after federal funds to
implement this article become available, whichever occurs later, the
office shall establish a training program advisory task force. The
task force shall be comprised of representatives from all of the
following groups:
(1) Physician assistant program directors.
(2) Foreign medical graduates.
(3) The California Academy of Physician Assistants.
(4) Nonprofit community health center directors.
(5) Physicians.
(6) The committee board , at the
committee's board's option.
The office may, instead, serve solely as a consultant to the task
force.
(c) The task force shall do all of the following:
(1) Develop a recommended curriculum for the training program that
shall be from 12 to 15 months in duration and shall, at a minimum,
meet curriculum standards consistent with the committee's
board's regulations. The program shall be subject
to the committee's board's approval.
By April 1, 1994, or three months after federal funds to implement
this article become available, whichever occurs later, the curriculum
shall be presented by the office to the Committee on Allied Health
Education and Accreditation of the American Medical Association, or
its successor organization, for approval.
(2) Develop recommended admission criteria for participation in
the pilot and ongoing program.
(3) Assist in development of linkages with academic institutions
for the purpose of monitoring and evaluating the pilot program.
SEC. 74. Section 3537.20 of the
Business and Professions Code is amended to read:
3537.20. Any person who has satisfactorily completed the program
established by this article shall be eligible for licensure by the
committee board as a "physician
assistant" if the person has complied with all of the following
requirements:
(a) Has successfully completed the written examination required
under Section 3517.
(b) Has successfully completed the Test of English as a Foreign
Language (TOEFL).
SEC. 75. Section 3537.30 of the
Business and Professions Code is amended to read:
3537.30. (a) The Legislature recognizes that the goal of this
program would be compromised if participants do not observe their
commitments under this program to provide the required service in a
medically underserved area. The goal of this program would not be met
if all that it accomplished was merely to license physician
assistants that served populations that are not medically
underserved.
(b) Since damages would be difficult or impossible to ascertain in
the event of default by the participant, this section shall set
forth the extent of liquidated damages that shall be recoverable by
the program in the case of default.
(c) In the case of default by a participant who has successfully
completed the program and has obtained licensure under this article,
the program shall collect the following damages from the participant:
(1) The total cost expended by the program for the training of the
applicant, and interest thereon from the date of default.
(2) The total amount needed for the program to seek cover as set
forth in subdivision (b) of Section 3537.35.
(3) The costs of enforcement, including, but not limited to, the
costs of collecting the liquidated damages, the costs of litigation,
and attorney's fees.
(d) The Attorney General may
represent the office, or the committee board
, or both in any litigation necessitated by this article, or,
if the Attorney General declines, the office, or the
committee board , or both may hire other counsel
for this purpose.
(e) Funds collected pursuant to subdivision (c) shall be allocated
as follows:
(1) Costs of training recovered pursuant to paragraph (1) of
subdivision (c) shall be allocated to the office to be used upon
appropriation for the continuing training program pursuant to this
article.
(2) Costs of seeking cover recovered pursuant to paragraph (2) of
subdivision (c) shall be deposited in the Physician Assistant
Training Fund established pursuant to Section 3537.40 for the
purposes of providing grants pursuant to subdivision (c) of Section
3537.35.
(3) Costs of enforcement recovered pursuant to paragraph (3) of
subdivision (c) shall be allocated between the office, and the
Attorney General, or other counsel, according to actual costs.
SEC. 76. Section 3537.50 of the
Business and Professions Code is amended to read:
3537.50. No General Fund revenues shall be expended to carry out
this article. The implementation of the pilot program and, if
applicable, the permanent program established by this article shall
be contingent upon the availability of federal funds, which do not
divert or detract from funds currently utilized to underwrite
existing physician assistant training programs or to fund existing
functions of the committee board . The
new funding shall be sufficient to cover the full additional cost to
the educational institution or institutions that establish the
program or programs, the cost of tuition and attendance for the
students in the program or programs, and any additional costs,
including enforcement costs, that the office or the
committee board incurs as a result of
implementing this article. Nothing in this article shall be construed
as imposing any obligations upon the office, the committee
board , or any physician assistant training
program in the absence of adequate funding as described in this
section. Nothing in this article shall be construed either as
precluding applicants for the program established by this article
from seeking state or federal scholarship funds, or state and federal
loan repayment funds available to physician assistant students, or
as requiring that any applicants be granted preference in the award
of those funds. Nothing in this article shall be construed as
impairing the autonomy of any institution that offers a physician
assistant training program.
SEC. 77. Section 3540 of the Business
and Professions Code is amended to read:
3540. A physician assistants corporation is a corporation which
is authorized to render professional services, as defined in Section
13401 of the Corporations Code, so long as that corporation and its
shareholders, officers, directors, and employees rendering
professional services who are certified physician assistants are in
compliance with the Moscone-Knox Professional Corporation Act, the
provisions of this article, and all other statutes and regulations
now or hereafter enacted or adopted pertaining to the corporation and
the conduct of its affairs.
With respect to a physician assistants corporation, the
governmental agency referred to in the Moscone-Knox Professional
Corporation Act (commencing with Section 13400) of Division 3 of
Title 1 of the Corporations Code) is the committee
board .
SEC. 78. Section 3546 of the Business
and Professions Code is amended to read:
3546. The board Medical Board of
California may adopt and enforce regulations to carry out the
purposes and objectives of this article, including regulations
requiring (a) that the bylaws of a physician assistant corporation
shall include a provision whereby the capital stock of the
corporation owned by a disqualified person (as defined in Section
13401 of the Corporations Code), or a deceased person, shall be sold
to the corporation or to the remaining shareholders of the
corporation within the time as the regulations may provide, and (b)
that a physician assistant corporation shall provide adequate
security by insurance or otherwise for claims against it by its
patients arising out of the rendering of professional services.
SEC. 79. No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.