BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                  SB 1483|
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                                 THIRD READING


          Bill No:  SB 1483
          Author:   Steinberg (D)
          Amended:  5/29/12
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECON. DEVELOP. COM  :  7-0, 04/23/12
          AYES:  Price, Emmerson, Corbett, Correa, Hernandez, 
            Strickland, Wyland
          NO VOTE RECORDED:  Negrete McLeod, Vargas

           SENATE APPROPRIATIONS COMMITTEE  :  5-2, 5/24/12
          AYES:  Kehoe, Alquist, Lieu, Price, Steinberg
          NOES:  Walters, Dutton


           SUBJECT  :    Physicians and surgeons

           SOURCE  :     California Hospital Association
                      California Medical Association
                      California Psychiatric Association
                      California Society of Addiction Medicine


           DIGEST  :    This bill establishes the Physician Health 
          Program (PHP), administered by the Physician Health, 
          Awareness and Monitoring Quality Oversight Committee 
          (Committee), with 14 members to be appointed as specified.  
          The program would promote awareness and education relative 
          to physician and surgeon health issues, including 
          impairment due to alcohol or substance abuse, mental 
          disorders, or other health conditions that could affect the 
          safe practice of medicine.  This bill provides for referral 
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          by the PHP of physicians and surgeons, as defined, to 
          certified monitoring programs on a voluntary basis, 
          governed by a written agreement between the participant and 
          the PHP.  This bill requires the Department of Consumer 
          Affairs (DCA) to select a contractor to implement the 
          program with the Committee serving as the evaluation body 
          for submitted proposals.  This bill requires the Committee 
          to report to the DCA on the outcome of the PHP and requires 
          regular audits of the program. 

           ANALYSIS  :    Existing law:

            1.  Provides for the licensure and regulation of 
              physicians and surgeons by the Medical Board of 
              California (Board) under the DCA pursuant to the 
              Medical Practice Act.

            2.  Required the Board to oversee a diversion program for 
              physicians and surgeons with alcohol and substance 
              abuse problems until June 30, 2008.  (The Board is no 
              longer responsible for a diversion program.)

            3.  As part of the prior diversion program, the Board 
              established diversion evaluation committees to identify 
              and rehabilitate physicians and surgeons with drug, 
              alcohol abuse problems, or mental or physical illness 
              that affected their competency to practice medicine, 
              and provided for procedures and criteria to be followed 
              by the diversion evaluation committees for acceptance, 
              denial or termination of physicians and surgeons in the 
              diversion program.

            4.  Establishes in the DCA the Substance Abuse 
              Coordination Committee, comprised of executive officers 
              of the DCA's healing arts boards as specified below and 
              a designee of the State Department of Alcohol and Drug 
              Programs. 

            5.  Requires the Substance Abuse Coordination Committee 
              to formulate, by January 1, 2010, uniform and specific 
              standards in specified areas that each healing arts 
              board shall use in dealing with substance-abusing 
              licensees, whether or not a board chooses to have a 
              formal diversion program.

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            6.  Establishes the Attorney Diversion and Assistance Act 
              within the State Bar of California to address the 
              substance abuse and mental health problems of attorneys 
              who voluntarily participate in the program.

            7.  Provides for the professional review of specified 
              healing arts licentiates by a peer review body, as 
              defined, including a medical or professional staff of 
              any licensed health care facility or clinic, health 
              care service plan, specified health professional 
              societies, or a committee organized by any entity that 
              functions as a body to review the quality of 
              professional care provided by specified health care 
              practitioners.

          This bill:

            1.  Makes the following findings and declarations: 

             A.   It is in every patient's interest to have 
               physicians and surgeons that are healthy and well.

             B.   Physicians and surgeons may have health conditions 
               that interfere with their ability to practice medicine 
               safely.

             C.   In such cases, the most effective long-term 
               protection for patients is early intervention to 
               address health issues that have the potential to 
               interfere with the safe practice of physicians and 
               surgeons.

            1.  Provides that while the Legislature recognizes that 
              physicians and surgeons have a number of options for 
              obtaining treatment, it is the intent of the 
              Legislature in enacting this act to promote awareness 
              among members of the medical community about health 
              issues that could interfere with safe practice, to 
              promote awareness that private early intervention 
              options are available, to provide resources and 
              referrals to ensure physicians and surgeons are better 
              able to choose high quality private interventions that 
              meet their specific needs, and to provide a separate 

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              mechanism for monitoring treatment.

            2.  Defines "Committee" as the Physician Health, 
              Awareness, and Monitoring Quality Oversight Committee, 
              as specified.

            3.  Defines "Impairment" as the inability to practice 
              medicine with reasonable skill and safety to patients 
              by reason of alcohol or substance abuse, a mental 
              disorder, or another health condition as determined by 
              a clinical evaluation in individual circumstances.

            4.  Defines the "Physician Health Program" (PHP) as the 
              program specified under the Act and includes vendors, 
              providers, or entities that contract with the Committee 
              pursuant to this Act.  The PHP itself shall not offer 
              or provide treatment services to physicians and 
              surgeons.

            5.  Defines "Qualifying illness" as alcohol or substance 
              abuse, a mental disorder, or another health condition 
              that a clinical evaluation determines can be monitored 
              and treated with private clinical and monitoring 
              programs.

            6.  Requires the PHP to do all of the following:

             A.   Be available to all physicians and surgeons, as 
               defined.

             B.   Promote awareness among members of the medical 
               community on the recognition of health issues that 
               could interfere with safe practice.

             C.   Educate the medical community on the benefits of 
               and options available for early intervention to 
               address those health issues.

             D.   Refer physicians and surgeons to monitoring 
               programs certified by the program by executing a 
               written agreement with the participant and monitoring 
               the compliance of the participant with that agreement.

             E.   Provide for the confidential participation by 

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               physicians and surgeons who have a qualifying illness 
               and who are not on probation with the Board.

            1.  Establishes the Committee within DCA and specifies 
              that it shall have the duties and responsibilities as 
              set forth in the Act and to take any reasonable 
              administrative actions necessary including, but not 
              limited to, hiring of staff and entering into 
              contracts.

            2.  Provides that the Committee shall be formed no later 
              than April 1, 2013.

            3.  Provides for a 14 member Committee and that the 
              following 12 members shall be appointed by the Governor 
              and licensed in this state as physicians and surgeons 
              with education, training, and experience in the 
              identification and treatment of substance use or mental 
              disorders, or both:

             A.   Two members recommended by a statewide association 
               representing psychiatrists with at least 3,000 
               members.

             B.   Two members recommended by a statewide association 
               representing addiction medicine specialists with at 
               least 300 members.

             C.   Three members recommended by a statewide 
               association representing physician and surgeons from 
               all specialties, modes of practice, and practice 
               settings with at least 25,000 members.

             D.   One member recommended by a statewide hospital 
               association representing at least 400 hospitals.

             E.   Four members of the public, as specified. 

            1.  Provides that the remaining 2 public members, as 
              specified, shall be chosen by the Legislature; one 
              member appointed by the Speaker of the Assembly and one 
              member appointed by Senate Committee on Rules. 

            2.  Provides that the Committee shall be subject to the 

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              Bagley-Keene Open Meetings Act, the California Public 
              Records Act, and the California Administrative 
              Procedures Act.

            3.  Requires the Committee to also do all of the 
              following:

             A.   Monitor compliance of the PHP with the requirements 
               of the Act and its implementing rules and regulations, 
               if any.

             B.   Report to the DCA statistics received from the PHP 
               and the outcomes of the PHP, including, but not 
               limited to, information as specified, and that the DCA 
               shall report to the Legislature the same information.  
               However, provides that in making these reports, the 
               Committee and the DCA shall not disclose any 
               personally identifiable information relating to any 
               physician and surgeon participating in the PHP 
               pursuant to any agreement, as specified, entered into 
               with the PHP.

             C.   Requires the Committee to biennially contract to 
               perform an audit of the PHP and its vendors, as 
               specified.  Provides that the audit shall be done by 
               an �unspecified date] and shall ascertain, if the PHP 
               is operating in conformance with the rules and 
               regulations established by the Committee.  

            1.  Requires that the rules adopted by the Committee 
              shall be consistent with the Uniform Standards 
              Regarding Substance-Abusing Healing Arts Licensees as 
              adopted by the Substance Abuse Coordination Committee 
              of DCA pursuant to Section 315 of the Business and 
              Professions Code, the guidelines of the Federation of 
              State Physician Health Programs, Inc., as well as 
              community standards of practice, including, but not 
              limited to, criteria for acceptance of participants 
              into the PHP and the refusal to accept a person as a 
              participant into the PHP and the assigning of costs of 
              participation and associated financial responsibilities 
              of participants.  In the event of any conflicts between 
              Section 315 and the guidelines of the Federation of 
              State Physician Health Programs, Inc., and community 

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              standards of practice, Section 315 shall prevail.

            2.  Provides that the DCA shall select a contractor for 
              the PHP pursuant to a request for proposals, and the 
              Committee shall contract for a five-year term with that 
              entity.  The process for procuring the services for the 
              PHP shall be administered by the DCA pursuant the 
              Public Contract Code.  However, the Committee shall 
              serve as the evaluation body for the procurement.

            3.  Requires the chief executive officer of the PHP 
              vendor to have expertise in the areas of substance or 
              alcohol abuse, and mental disorders in health care 
              professionals.

            4.  Requires the PHP �vendor] to perform all of the 
              following pursuant to the contract entered into with 
              the Committee:

             A.   Have a medical director to oversee clinical aspects 
               of the PHP's operations.  The medical director shall 
               have expertise in the diagnosis and treatment of 
               alcohol and substance abuse and mental disorders in 
               health care professionals.

             B.   Have established relationships with local medical 
               societies and hospital well-being committees for 
               conducting education, outreach, and referrals for 
               physician and surgeon health.

             C.   Monitor the monitoring entities that participating 
               physicians and surgeons have retained for monitoring 
               the participant's treatment and shall provide ongoing 
               services to physicians and surgeons that resume 
               practice.

             D.   Have a system for immediately reporting physicians 
               and surgeons to the Medical Board of California 
               (Board) who fail to meet the requirements of the PHP.  
               This system shall ensure absolute confidentiality in 
               the communication to the enforcement division of the 
               Board, and shall not provide this information to any 
               other individual or entity unless authorized by the 
               enrolled physician and surgeon.

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             E.   Report annually, beginning October 1, 2014, to the 
               Committee statistics related to the PHP, including, 
               but not limited to, the number of participants 
               currently in the PHP, the number of participants 
               referred by the Board as a condition of probation, the 
               number of participants who have successfully completed 
               their agreement period, the number of participants 
               terminated from the PHP, and the number of 
               participants reported by the PHP for noncompliance and 
               failure to meet the requirements of the PHP.  However, 
               in making that report, the program shall not disclose 
               any personally identifiable information relating to 
               any participant.  Sunsets this requirement on October 
               1, 2018.

             F.   Submit to periodic audits and inspections of all 
               operations, records, and management related to the PHP 
               to ensure compliance with the requirements of this Act 
               and its implementing rules and regulations.  Copies of 
               the audits shall be published and provided to the 
               appropriate policy committees of the Legislature 
               within 10 business days of publication and a copy 
               shall also be made available to the public by Internet 
               Website.

            1.  Requires a physician and surgeon as a condition of 
              participation in the PHP to enter into an individual 
              agreement with the PHP and agrees to pay expenses 
              related to treatment, monitoring, laboratory test, and 
              other activities specified in the participants written 
              agreement with the PHP, consistent with the standards 
              adopted by the Committee, and that the agreement shall 
              include the following:

             A.   A jointly agreed-upon plan and mandatory conditions 
               and procedures to monitor compliance with the program, 
               including, but not limited to, an agreement to cease 
               practice.

             B.   Compliance with terms and conditions of treatment 
               and monitoring.

             C.   Limitations on practice.

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             D.   Conditions and terms for return to practice.

             E.   Criteria for program completion.

             F.   Criteria for termination of the participant from 
               the program.

             G.   A stipulation that expenses related to treatment, 
               monitoring, laboratory tests, and other activities 
               specified in the participant's written agreement with 
               the PHP will be paid by the participant.

            1.  Provides that if the physician and surgeon retains 
              the services of a private monitoring entity, he or she 
              shall agree to authorize the PHP vendor to receive 
              reports from the private monitoring entity and to 
              request information from the private monitoring entity 
              regarding his or her treatment status.  Except as 
              otherwise specified, a physician and surgeon's 
              participation in the PHP pursuant to an agreement shall 
              be confidential unless waived by the physician and 
              surgeon.

            2.  Specifies that any agreement entered into under these 
              provisions shall not be considered a disciplinary 
              action or order by the Board, and shall not be 
              disclosed to the Committee or the Board if both of the 
              following apply:

             A.   The physician and surgeon did not enroll in the 
               program as a condition of probation or as a result of 
               an action of the Board.

             B.   The physician and surgeon is in compliance with the 
               conditions and procedures in the agreement.

            1.  Requires the PHP to immediately report the name of a 
              participant to the Board and the Committee when it 
              learns of the participant's failure to meet the 
              requirements of the PHP including failure to cease 
              practice when required, failure to submit to 
              evaluation, treatment, or biological testing when 
              required, or a violation of the rules adopted the 

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              Committee.  The PHP shall also immediately report the 
              name of a participant to the Committee when it learns 
              that the participant's impairment is not substantially 
              alleviated through treatment, or if the participant 
              withdraws or is terminated from the PHP prior to 
              completion, or if, in the opinion of the PHP after a 
              risk assessment is conducted, the participant is unable 
              to practice medicine with reasonable skill and safety.

            2.  Requires the report provide sufficient information to 
              permit the Board to assess whether discipline or other 
              action is required to protect the public. 

            3.  Provides that except as specified, any oral or 
              written information reported to the Board, including, 
              but not limited to, any physician and surgeon's 
              participation in the PHP and any agreement entered 
              pursuant to the provisions of this Act, shall remain 
              confidential as specified, and shall not constitute a 
              waiver of any existing evidentiary privileges under any 
              other provision or rule of law.  However, 
              confidentiality regarding the physician and surgeon's 
              participation in the PHP and of all information and 
              records created by the PHP related to that 
              participation shall not apply if the Board has referred 
              a participant as a condition of probation.

            4.  Provides that nothing in the Act prohibits, requires, 
              or otherwise affects the discovery or admissibility of 
              evidence in an action by the Board against a physician 
              and surgeon based on acts or omissions within the 
              course and scope of his or her practice.

            5.  Specifies that any information received, developed, 
              or maintained by the Committee regarding a physician 
              and surgeon in the PHP shall not be used for any other 
              purposes.

            6.  Increases the biennial license renewal fee by $39.50, 
              and requires MBC transfer the increase to the Physician 
              Health, Awareness, and Monitoring Quality Trust Fund, 
              which is created in the State Treasury.  Specifies 
              nothing in the bill shall be construed to prohibit 
              additional funding from private sources from being used 

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              to support operations of the PHP or to support the 
              establishment of the Committee and PHP.

           Background
           
           Physician Diversion Program of the Medical Board.   The 
          Board's PDP was created in 1980 to rehabilitate doctors 
          with mental illness and substance abuse problems without 
          endangering public health and safety.  Under this concept, 
          physicians who abuse drugs and/or alcohol or who are 
          mentally or physically ill may be "diverted" from the 
          disciplinary track into a program that monitors their 
          compliance with terms and conditions of a contract that is 
          aimed at ensuring their recovery.

          The PDP was a voluntary program and only those physicians 
          and surgeons who voluntarily requested diversion treatment 
          and supervision could participate in the program.  A 
          physician could enter the diversion program in any of the 
          following ways:  a) self-referral; b) referral by the 
          Enforcement Unit of the Board in lieu of discipline; or c) 
          directed as part of a disciplinary order.  Confidentiality 
          was required for physicians and doctors that self-refer and 
          could be granted to those who were referred by the Board 
          (doctors could avoid public discipline if there was no 
          evidence of patient harm and they successfully completed 
          the program).  For those who were directed to the program 
                                                                 as part of a disciplinary order, disciplinary actions are 
          public records and the practice violation that triggered 
          the Board's involvement would be reflected in the doctor's 
          public file.  Any physician and surgeon terminated from the 
          PDP for failure to comply with program requirements was 
          subject to a disciplinary action for acts committed before, 
          after or during participation in the PDP, and a physician 
          that successfully completed the PDP was not subject to any 
          disciplinary action for any alleged violation that resulted 
          in referral to the PDP.  The PDP monitored participants' 
          attendance at group meetings, facilitated random drug 
          testing, and required reports from work-site monitors and 
          treatment providers.  The PDP was allowed to on 
          June 30, 2008.

           Audits of the Physician Diversion Program.   The BSA audited 
          the PDP four times between 1982 and 2007.  In 2005, a 

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          legislatively created enforcement monitor also audited the 
          PDP.  The enforcement monitor's audit indicated that "the 
          Board's PDP is significantly flawed; its most important 
          monitoring mechanisms are failing, it is chronically 
          understaffed, and it exposes patients to unacceptable risks 
          posed by physicians who abuse drugs and alcohol."  The 2007 
          BSA audit concluded, "Although the PDP has made many 
          improvements since the release of the November 2005 report 
          of the enforcement monitor, there are still some areas in 
          which the program must improve in order to adequately 
          protect the public."  BSA points out the following:  
          Although case managers appear to be contacting participants 
          on a regular basis and participants appear to be attending 
          group meetings and completing the required amount of drug 
          tests, the PDP does not adequately ensure that it receives 
          required monitoring reports from its participants' 
          treatment providers and work-site monitors.  In addition, 
          although the PDP has reduced the amount of time it takes to 
          admit new participants into the program and begin drug 
          testing, it does not always respond to potential relapses 
          in a timely and adequate manner.  Specifically, the PDP has 
          not always required a physician to immediately stop 
          practicing medicine after testing positive for alcohol or a 
          non-prescribed or prohibited drug.  Further, of the drug 
          tests scheduled in June and October 2006, 26% were not 
          performed as randomly scheduled.  Additionally, the PDP 
          currently does not have an effective process for 
          reconciling its scheduled drug tests with the actual drug 
          tests performed and does not formally evaluate its 
          collectors, group facilitators, and diversion evaluation 
          committee members to determine whether they are meeting 
          program standards.  Finally, the BSA indicates that MBC has 
          not provided consistently effective oversight.

          In recognition that patient safety cannot continue to be 
          compromised, the Board voted unanimously on July 26, 2007 
          to end the PDP, declaring in its motion that "in light of 
          Board's primary mission of consumer protection and as the 
          regulatory agency charged with the licensing of physicians 
          and surgeons and enforcement of the Medical Practice Act, 
          The Board hereby determines it is inconsistent with Board's 
          public protection mission and policies to operate a 
          diversion program."  This declaration prompted the Board to 
          approve a Diversion Transition Plan (DTP) on November 2, 

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          2007 to accommodate the 203 physicians already in the 
          program.  

           Other Health Provider Diversion Programs  .  While the Board 
          houses its diversion program, other boards outsource these 
          functions.  The DCA currently manages a master contract 
          with MAXIMUS, Inc. (MAXIMUS), a publicly traded corporation 
          for six boards' and one committee's diversion programs: the 
          Board of Registered Nursing, the Dental Board of 
          California, the Board of Pharmacy, the Physical Therapy 
          Board of California, the Veterinary Medical Board of 
          California, the Osteopathic Medical Board of California, 
          and the Physician Assistant Committee.  The individual 
          Boards oversee the programs, but services are provided by 
          MAXIMUS.  The Boards' diversion programs follow the same 
          general principles of the Medical Board's PDP.  Health 
          practitioners with mental illnesses or substance abuse 
          issues may be referred in lieu of discipline or self-refer 
          into the programs and receive help with rehabilitation.  
          After an initial evaluation, individuals accept a 
          participation agreement and are regularly monitored in 
          various ways, including random drug testing, to ensure 
          compliance.  MAXIMUS provides the following services that 
          the Medical Board kept in-house:  Medical advisors, 
          compliance monitors, case managers, urine testing system, 
          reporting, and record maintenance.  The DCA's master 
          contract standardizes certain tasks, such as designing and 
          implementing a case management system, maintaining a 
          24-hour access line, and providing initial intake and 
          in-person assessments, but the planning and execution of 
          the programs are tailored to each board according to their 
          needs and mandates.  Each board specifies its own policies 
          and procedures.  MAXIMUS generally has a less hands-on 
          approach to managing the diversion programs than the 
          Medical Board attempted.  MAXIMUS reports that caseloads 
          range from 100 to 200 per clinical case management team.  
          MAXIMUS also limits its in-person resources; for example, 
          in the program design for the Board of Registered Nursing, 
          MAXIMUS specifies that they will conduct in-person 
          reassessments by telephone unless otherwise requested by 
          the Nursing Board.  Also, the contractor performs 
          unobserved, as well as observed, drug screening.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   

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          Local:  No

          According to the Senate Appropriations Committee, unknown, 
          major program costs likely in the range of $1.5 million to 
          $2 million annually to the Department of Consumer Affairs.

           SUPPORT  :   (Verified  4/24/12) (per Senate Business, 
          Professions & Economic Developmental Committee analysis - 
          unable to reverify at time of writing)

          California Hospital Association (co-source)
          California Medical Association (co-source) 
          California Psychiatric Association (co-source) 
          California Society of Addiction Medicine (co-source) 


          JJA:nl  5/29/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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