BILL NUMBER: SB 1236 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 18, 2012
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, 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 Section
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.
(1) Existing law provides for the certification and regulation of
podiatrists by the California Board of Podiatric Medicine within the
jurisdiction of the Medical Board of California. Under existing law,
the California Board of Podiatric Medicine will be repealed on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 until January 1, 2017. The bill would specify that
the board 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existing law, the committee will be repealed on January 1, 2013.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. The bill would allow the board to establish, by
regulation, a system for placement of a licensee on retired status,
as specified.
(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: 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, the
Acupuncture Board, and the 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, 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, 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, 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, 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 addresses 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, 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 , 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, 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, 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, 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 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, 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, 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, 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, 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
Specialties 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, 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, the California Board of Podiatric Medicine, and the
Physician Assistant Board 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, 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, 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, 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, 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,
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.
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 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 11340)
of Part 1 of Division 1 of Title 2 of the Government Code
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.
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 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 on Podiatric
Medical Education.
SEC. 18. Section 2493 of the Business and Professions Code is
amended to read:
2493. 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.
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 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 be increased by the board 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 Physician Assistant Board.
(2) "Approved program" means a program for the education of
physician assistants that has been formally approved by the
committee board .
(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 board .
(5) "Supervising physician" means a physician and surgeon licensed
by the 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) "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.
(8) "Routine visual screening" means uninvasive nonpharmacological
simple testing for visual acuity, visual field defects, color
blindness, and depth perception.
(9) "Program manager" means the staff manager of the diversion
program, as designated by the executive officer of the
Medical Board of California board . The program
manager shall have background experience in dealing with substance
abuse issues.
(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.
(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 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 adopted
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 Medical Board of California
adopted under this chapter 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 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 Medical Board
of California or 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 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" 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 board . 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 board
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 telephone 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 registration 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 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 Medical Board of California'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 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. 26. Section 3504 of the Business and Professions Code is
amended to read:
3504. There is established a Physician Assistant board
Board within the jurisdiction of the Medical
Board of California. The 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
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 Board 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 board 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. Upon the
expiration of the term of the member who is a member of the
Medical Board of California, above, there shall be appointed to the
board a physician and surgeon who is also a member of the Medical
Board of California who shall serve as an ex officio, nonvoting
member and whose functions shall include reporting to the Medical
Board of California on the actions or discussions of the board.
Following the expiration of the term of the member described above,
the board shall include five physician assistants , one
physician and surgeon, and four public members.
Each member of the 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 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 board, as provided in Section 106.
SEC. 31. Section 3508 of the Business and Professions Code is
amended to read:
3508. (a) The board may convene from time to time as deemed
necessary by the board.
(b) Notice of each meeting of the board shall be given at least
two weeks in advance to those persons and organizations who express
an interest in receiving notification.
(c) The board shall receive permission of the director to meet
more than six times annually. The director shall approve meetings
that are necessary for the 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 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 Medical Board of California
concerning the scope of practice for physician assistants.
(c) Make recommendations to the 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 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 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 Medical Board of California
shall adopt, amend, and repeal such regulations as may be necessary
to enable it the board 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 board shall be required to carry any motion. The
physician and surgeon who serves as an ex officio member shall not be
counted for purposes of a quorum.
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
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 Medical Board of California and board shall make all
necessary expenditures to carry out the provisions of this chapter
from the funds established by Section 3520. The 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 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 board shall be deemed
approved by the board under this section. If no national accrediting
organization is approved by the board, the 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 board standards.
SEC. 38. Section 3514.1 of the Business and Professions Code is
amended to read:
3514.1. (a) The board shall formulate by regulation guidelines
for the consideration of applications for licensure as a
physician's physician assistant.
(b) The board shall formulate by regulation guidelines for the
approval of physician's physician
assistant training programs.
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 board shall be eligible for employment or
supervision by any physician and surgeon who is not subject to a
disciplinary condition imposed by the 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 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 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 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 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 board.
Examinations for licensure as a physician assistant may be
required by the board under a uniform examination system, and for
that purpose the board may make those arrangements with organizations
furnishing examination material as may, in its discretion, be
desirable. The board shall, however, establish a passing score for
each examination. The licensure examination for physician assistants
shall be held by the board at least once a year with such additional
examinations as the board deems necessary. The time and place of
examination shall be fixed by the board.
SEC. 42. Section 3518 of the Business and Professions Code is
amended to read:
3518. The board shall keep current, two separate registers, one
for approved supervising physicians and one for licensed
physician's physician 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 board
together with a sum as may be fixed by the 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 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 board may issue under the name of the 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 board and the 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 board and the 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 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 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 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 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
board.
(b) An approval fee not to exceed one hundred dollars ($100) shall
be charged to each program upon its approval by the 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.
3521.3. (a) The board may establish, by regulation, a system for
the placement of a license on a retired status, upon application, for
a physician assistant who is not actively engaged in practice as a
physician assistant or any activity that requires them to be licensed
by the board.
(b) No licensee with a license on a retired status shall engage in
any activity for which a license is required.
(c) The board shall deny an applicant's application for a retired
status license if the license is canceled or if the license is
suspended, revoked, or otherwise punitively restricted by the board
or subject to disciplinary action under this chapter.
(d) Beginning one year from the effective date of the regulations
adopted pursuant to subdivision (a), if an applicant's license is
delinquent, the board shall deny an applicant's application for a
retired status license.
(e) The board shall establish minimum qualifications for a retired
status license.
(f) The board may exempt the holder of a retired status license
from the renewal requirements described in Section 3524.5.
(g) The board shall establish minimum qualifications for the
restoration of a license in a retired status to an active status.
These minimum qualifications shall include, but are not limited to,
continuing education and payment of a fee as provided in subdivision
(c) of Section 3521.1.
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. SEC. 50. Section 3521.5 of
the Business and Professions Code is amended to read:
3521.5. The board shall report to the appropriate policy and
fiscal committees of each house of the Legislature whenever the
Medical Board of California approves a fee increase pursuant to
Sections 3521 and 3521.1. The 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 Medical Board of
California and board.
SEC. 52. SEC. 51. 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 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 Medical Board of California and
pay the prescribed renewal fee.
SEC. 53. SEC. 52. 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 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 board, accompanied by the prescribed renewal fee.
SEC. 54. SEC. 53. 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 board or 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. SEC. 54. Section 3524.5 of
the Business and Professions Code is amended to read:
3524.5. The board may require a licensee to complete continuing
education as a condition of license renewal under Section 3523 or
3524. The board shall not require more than 50 hours of continuing
education every two years. The 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 board, as evidence of compliance with continuing
education requirements.
SEC. 56. SEC. 55. 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 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. SEC. 56. Section 3527 of
the Business and Professions Code is amended to read:
3527. (a) The 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 board or the
Medical Board of California.
(b) The 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 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 board or the 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 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 board or the Medical
Board of California.
(e) The 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
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 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 board shall consult with the
California Medical Board of California , 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 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 board may order the licensee to pay the costs of
monitoring the probationary conditions imposed on the license.
(g) The expiration, cancelation, forfeiture, or suspension of a
physician assistant license by operation of law or by order or
decision of the board or a court of law, the placement of a license
on a retired status, or the voluntary surrender of a license by a
licensee shall not deprive the board of jurisdiction to commence or
proceed with any investigation of, or action or disciplinary
proceeding against, the licensee or to render a decision suspending
or revoking the license.
SEC. 58. SEC. 57. Section 3529 of the
Business and Professions Code is amended to read:
3529. The board may hear any matters filed pursuant to
subdivisions (a) and (b) of Section 3527, or may assign the matter to
a hearing officer. The Medical Board of California may hear any
matters filed pursuant to subdivision (c) of Section 3527, or may
assign the matter to a hearing officer. If a matter is heard by the
board or the Medical Board of California, the hearing officer who
presided at the hearing shall be present during the board's or the
Medical Board of California's consideration of the case, and, if
requested , assist and advise the board or the Medical
Board of California.
SEC. 59. SEC. 58. 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
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 board 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
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 board. The 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
board that shall be acted upon in accordance with the Administrative
Procedure Act.
(d) The 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
board or administrative law judge finds necessary.
(e) The 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 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. SEC. 59. 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 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 or her 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. SEC. 60. 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 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 Medical Board of California or the board may
commence action in the superior court under the provisions of this
section.
SEC. 62. SEC. 61. Section 3534 of
the Business and Professions Code is amended to read:
3534. (a) It is the intent
of the Legislature that the 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. SEC. 62. Section 3534.1 of
the Business and Professions Code is amended to read:
3534.1. The 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
board may contract with any other state agency or a private
organization to perform its duties under this article. The 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 board. The program manager has the primary responsibility to
review and evaluate recommendations of the committee.
SEC. 64. SEC. 63. Section 3534.2 of
the Business and Professions Code is amended to read:
3534.2. (a) Any committee established by the board shall have at
least three members. In making appointments to a committee the 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 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 board. Each appointment
shall be at the pleasure of the board for a term not to exceed four
years. In its discretion, the 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. SEC. 64. 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 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 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 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. SEC. 65. 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 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
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. SEC. 66. 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 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 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 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. SEC. 67. 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 board may set forth in its regulations additional
criteria for admission to the program or causes for termination from
the program.
SEC. 69. SEC. 68. Section 3534.7 of
the Business and Professions Code is amended to read:
3534.7. All 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. SEC. 69. Section 3534.9 of
the Business and Professions Code is amended to read:
3534.9. If the board contracts with any other entity to carry out
this section, the executive officer of the board or the program
manager shall review the activities and performance of the contractor
on a biennial basis. As part of this review, the 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. SEC. 70. 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 board.
This section does not preclude the 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. SEC. 71. 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 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. SEC. 72. 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 board, at the 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 board's regulations.
The program shall be subject to the 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. SEC. 73. 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
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. SEC. 74. 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 board,
or both in any litigation necessitated by this article, or, if the
Attorney General declines, the office, or the 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. SEC. 75. 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 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 board incurs as a result of implementing this article.
Nothing in this article shall be construed as imposing any
obligations upon the office, the 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. SEC. 76. 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 board.
SEC. 78. SEC. 77. Section 3546 of
the Business and Professions Code is amended to read:
3546. The 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. SEC. 78. 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.