BILL ANALYSIS �
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THIRD READING
Bill No: SB 1236
Author: Price (D)
Amended: 4/17/12
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMM. : 7-0, 4/23/12
AYES: Price, Emmerson, Corbett, Correa, Hernandez,
Strickland, Wyland
NO VOTE RECORDED: Negrete McLeod, Vargas
SENATE APPROPRIATIONS COMMITTEE : 7-0, 5/24/12
AYES: Kehoe, Walters, Alquist, Dutton, Lieu, Price,
Steinberg
SUBJECT : Healing arts boards
SOURCE : Author
DIGEST : This bill extends the provisions establishing
the California Board of Podiatric Medicine, and extends the
Physician Assistant Committee, and its executive officer,
and makes other changes, as specified.
ANALYSIS :
Existing law:
1. Licenses and regulates some 2,000 doctors of podiatric
medicine (DPMs) by the California Board of Podiatric
Medicine (BPM) under the Medical Board of California
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(MBC) within the Department of Consumer Affairs (DCA),
and makes the BPM inoperative and repealed on January 1,
2013. (Business and Professions Code (BPC) � 2460)
2. Provides that the BPM is composed of seven members,
three public members, and four professional members.
The Governor appoints five members, and the Senate Rules
Committee and the Assembly Speaker each appoints a
public member. (BPC � 2462)
3. Provides that protection of the public shall be the
highest priority for the BPM in exercising its
licensing, regulatory, and disciplinary functions, and
whenever the protection of the public is inconsistent
with other interests sought to be promoted, the
protection of the public shall be paramount. (BPC �
2460.1)
4. Defines the practice of "podiatric medicine" to mean 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. (BPC � 2472
(b))
5. Licenses and regulates more than 7,500 physician
assistants (PAs) under the Physician Assistant Practice
Act by the Physician Assistant Committee (PAC) within
the MBC, and makes the PAC inoperative and repealed on
January 1, 2013. (BPC � 3504)
6. Authorizes the PAC to appoint an executive officer, and
makes that authority inoperative and repealed on January
1, 2013. (BPC � 3512)
7. The PAC is comprised of nine members: four PAs, four
public members and one physician representative of MBC.
Four PAs, the physician members and two public members
are appointed by the Governor. Senate Rules Committee
and the Assembly Speaker each appoint a public member.
(BPC � 3505)
8. Provides that protection of the public shall be the
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highest priority for the PAC in exercising its
licensing, regulatory, and disciplinary functions, and
whenever the protection of the public is inconsistent
with other interests sought to be promoted, the
protection of the public shall be paramount. (BPC �
3504.1)
This bill:
1. Extends the BPM's sunset date four years to January 1,
2017. (BPC � 2460)
2. Amends BPC � 2472 (d) (1) by removing the reference to
"ankle certification after January 1, 1984," thereby
confirming a single scope of licensure for DPMs.
3. Repeals an obsolete provision prohibiting a DPM from
performing an admitting history and physical exam at an
acute care hospital. BPC � 2472)
4. Eliminates the four-year limit for postgraduate
training. (BPC � 2475)
5. Clarifies that anyone may offer special shoes and
inserts without a license to aid comfort and athletic
performance, but that a medical license is needed to
diagnose and prescribe for medical conditions. (BPC �
2477)
6. Removes a requirement that applicants obtain a specific
score on the licensing examination. (BPC � 2493)
7. Authorizes that the vote of only one board member of the
BPM is necessary to defer a decision for consideration
by the entire board. (BPC � 2335)
8. Authorizes BPM to increase costs assessed when a
proposed decision is not adopted by the BPM and the BPM
finds grounds for increasing the assessed costs (BPC �
2497.5)
9. Extends sunset dates for PAC/BPM and executive officer
to January 1, 2013. (BPC �� 3504, 3512)
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10.Changes the name the PAC to Physician Assistant Board
(PAB) and correspondingly changes "Board" to "Medical
Board of California." (BPC multiple sections)
11.Changes the composition of the "Board" to replace the
physician with a PA. (BPC � 3505)
12.Establishes an exemption for active military from
payment of the PA license renewal. (BPC � 3521.3)
13.Establishes a "retired" license status for PA licensees
no longer practicing to retain their license without
payment of renewal fees or completion of continuing
education. (BPC � 3521.4)
14.Clarifies that the reporting requirements in the 800
series apply to PAs. (BPC �� 800-805)
Background
California Board of Podiatric Medicine (BPM) . The BPM is
responsible for licensing and regulating DPMs in
California. Although the BPM functions in an independent
manner, similar to other boards under DCA, the BPM lies
within the jurisdiction of the MBC, and it is the MBC that
officially issues licenses to these practitioners upon the
"recommendation" of the BPM.
The BPM licenses approximately 2,000 DPMs. The BPM issues
some 55 licenses each year, and approximately 1,000
licenses are renewed each year.
The DPM license as defined in the BPC and in the
regulations of the BPM are specialists in the foot and
ankle. Some DPMs specialize in conservative care while
others practice mostly as surgeons. Many DPMs specialize
in care and preservation of the diabetic foot. DPMs also
assist other doctors in non-podiatric surgeries. DPMs are
the only medical specialty limited to its area of expertise
by the license itself, which enhances patient protection.
Currently, the BPM is composed of seven members. It has a
professional majority with three public members, and four
professional members. The Governor appoints five members
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of the BPM. The Senate Rules Committee and the Assembly
Speaker each appoints one public member. The BPM is
required to meet at least three times each calendar year
and meets at various locations throughout the state. Board
meetings are open and give the public the opportunity to
testify on agenda items and on other issues.
The BPM currently has five committees that perform various
functions:
Public Outreach Committee: external communication &
public liaison.
Enforcement Committee: enforcement procedures.
Legislative Committee: legislative liaison.
Licensing & Medical Education Committee: licensing,
exams, approval of schools and residencies.
Professional Practice Committee: guides and advises
staff on practice matters.
As a Special Fund agency, the BPM receives no General Fund
support, relying solely on fees set by statute and
collected from licensees and applicants. The total
revenues anticipated by the BPM for fiscal year (FY)
2011/2012 is $918,000. The total expenditures anticipated
for BPM for FY 2011/2012 are $960,000, and for FY
2012/2013, $979,000. Based upon these figures, the BPM
would have approximately 10 months in reserve in FY
2011/2012, and 9.3 months in reserve in FY 2012/2013. The
BPM spends approximately 70% of its budget on
enforcement-related functions. The BPM has a staff level
of five authorized positions and currently has no
vacancies.
Physician Assistant Committee (PAC) . The PAC was
established in 1975. At the time, the Legislature was
concerned about the existing shortage and geographic
maldistribution of health care services in the state. The
intent was in part to "create a framework for the
development of a new category of health manpower, the
physician assistant," and to encourage their utilization as
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a way of serving California's health care consumers. PAs
are medical practitioners who perform services under the
supervision of physicians.
The PAC's primary role is the licensure of PAs. The PAC
exists within the MBC but has limited ties to that board
and acts independently on many of its mandates. The PAC
continues to rely on MBC for investigative and other
services and generally has a cooperative working
arrangement with the Board.
The scope of practice of the PA is described in the
Physician Assistant Practice Act and in regulations
promulgated by MBC. Pursuant to these laws, each PA may
perform only those services he or she is authorized to
perform pursuant to a written delegation of authority by
the supervising physician.
The PAC is comprised of nine members: four PAs, four
public members and one physician representative of MBC.
Four PA members are appointed by the Governor. Two public
members are also appointed by the Governor. One public
member is appointed by the Senate Committee on Rules and
one member is appointed by the Speaker of the Assembly.
The PAC is a special fund agency, receiving its funding
from the licensing of PAs and biennial renewal fees of PAs.
Currently, the license fee for PAs is $200 while the
renewal fee is $300. These fees provided approximately 60%
of the PAC's revenue therefore to compensate for the loss
of revenue from the supervising physician fees, the PA
application and renewal fees were increased. The PAC
currently licenses 7,589 licensees.
The total revenues anticipated by the PAC for FY 2011/2012,
is $2,002,000 and for FY 2012/2013, $1,948,000. The total
expenditures anticipated for FY 2011/2012, is $1,371,000,
and for FY 2012/2013, 1,469,000. The PAC anticipates it
would have approximately 5.2 months in reserve for FY
2011/2012, and 3.8 months in reserve for FY 2012/2013. The
PAC spends approximately 62% of its budget on its
enforcement program, 20% on its licensing program, 8% on
its diversion program and 10% on administration.
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The PAC's staff is comprised of the Executive Officer and
four additional staff including two Associate Governmental
Program Analysts, one Staff Services Analyst, and a .5
Office Technician.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
According to the Senate Appropriations Committee:
Estimated annual cost of $1.09 million from the Board of
Podiatric Medicine Fund (1110-0295) based on the 2010-11
Budget Act, all costs offset by existing fees.
Estimated annual cost of $1.29 million from the Physician
Assistant Fund (1110-0280) based on the 2010-11 Budget
Act, all costs offset by existing fees.
SUPPORT : (Verified 5/24/12)
Board of Podiatric Medicine
Physician Assistant Committee
OPPOSITION : (Verified 5/24/12)
California Medical Association
JJA:mw 5/24/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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