Healing arts.

(1) Existing law provides for the licensure and regulation of various professions and vocations by boards within the Department of Consumer Affairs. Existing law authorizes an administrative law judge, in an order issued in resolution of a disciplinary proceeding before a board within the Department of Consumer Affairs or before the Osteopathic Medical Board of California, upon request of the entity bringing the proceeding, to direct a licensee found to have committed a violation of the licensing act to pay a sum that does not exceed the reasonable costs of the investigation and enforcement of the case. Under existing law, the Medical Board of California is prohibited from requesting or obtaining from a physician and surgeon investigation and prosecution costs for a disciplinary proceeding against the licensee. This bill would repeal the above-described provision that prohibits the board from requesting or obtaining investigation and prosecution costs for a disciplinary proceeding against a licensee. (2) Existing law, the Medical Practice Act, establishes the Medical Board of California within the Department of Consumer Affairs and sets forth its powers and duties relating to the licensure and regulation of the practice of medicine by physicians and surgeons. Under existing law, the board consists of 15 members, 7 of whom are public members. Existing law requires the Senate Committee on Rules and the Speaker of the Assembly to each appoint one public member. Existing law repeals these provisions on January 1, 2022. The bill would instead repeal these provisions on January 1, 2024. The bill would also require the Director of Consumer Affairs to appoint an independent enforcement monitor that meets specified requirements no later than March 1, 2022. The bill would, among other things, require the independent enforcement monitor to monitor and evaluate the board's enforcement efforts with specific concentration on the handling and processing of complaints and timely application of sanctions or discipline imposed on licensees and persons in order to protect the public and would require the enforcement monitor to report findings and conclusions to the Legislature, as prescribed. Existing law authorizes the board to employ and fix the compensation of an executive director, and other specified staff, as provided. Existing law authorizes the Attorney General to act as legal counsel for the board for any judicial and administrative proceedings. Existing law repeals these provisions on January 1, 2022. This bill would extend that date to January 1, 2024. Existing law authorizes the board to take action against licensees who violate specified provisions, except as provided. Existing law subjects licensees to disciplinary action, as provided. This bill would authorize the board to delegate to its executive director the authority to issue an administrative confidential letter of advice to a licensee to resolve a complaint for an alleged minor violation that is not related to patient care, as provided. Existing law requires a graduate of an approved medical school who is enrolled in a postgraduate training program to obtain a postgraduate training license by submitting an application to the board on a form provided by the board, as provided. Existing law permits a physician and surgeon postgraduate training licensee to engage in the practice of medicine only in connection with their duties as an intern or resident physician in a board-approved program, as specified, including diagnosing and treating patients, prescribing medications, and signing birth and death certificates. Existing law requires an applicant for a physician's and surgeon's license to successfully complete 36 months of board-approved postgraduate training in order to be issued a physician's and surgeon's license. Existing law authorizes a physician's and surgeon's license to be valid for 90 days after the holder has successfully completed 36 months of board-approved postgraduate training. Existing law authorizes the board to grant an extension beyond 39 months to a postgraduate training licensee in order to successfully complete the 36 months of required approved postgraduate training. This bill would require each application for a postgraduate training license to be made upon an online electronic form, or on another form provided by the board. The bill would additionally authorize a postgraduate licensee to engage in the practice of medicine by signing forms a physician and surgeon is authorized to sign. The bill would require a postgraduate licensee to have received 12 months of board-approved postgraduate training for graduates of medical schools in the United States and Canada, or 24 months of board-approved postgraduate training for graduates of foreign medical schools, as provided, before being issued a physician's and surgeon's license pursuant to the attestation of the program director, or other specified individual. By requiring an attestation by the program director, or other specified individual, the bill would expand the scope of the crime of perjury, thereby imposing a state-mandated local program. The bill would authorize the board to grant an extension beyond 15 months to a postgraduate licensee who graduated from a medical school in the United States or Canada, or beyond 27 months to a postgraduate training licensee who graduated from a foreign medical school, as provided, to receive credit for the required training. For individuals issued a physician's and surgeon's license by the board on or after January 1, 2022, the bill would require, at the time of initial renewal, a physician and surgeon to show evidence satisfactory to the board that the applicant has received credit for at least 36 months of board-approved postgraduate training, as specified. The bill would require that the physician's and surgeon's certificate be automatically placed in delinquent status by the board if the holder does not show satisfactory evidence of credit. The bill would authorize the board to renew a physician's and surgeon's license if the applicant has demonstrated substantial compliance, as provided. The bill would require those postgraduate trainees with a physician's and surgeon's license to provide documentation to the board that they have received credit for the postgraduate training, pursuant to attestation by their program director, or other specified individual. By requiring an attestation by the program director, or other specified individual, the bill would expand the scope of the crime of perjury, thereby imposing a state-mandated local program. Existing law authorizes physicians who are not citizens but who meet certain requirements and who seek postgraduate study in an approved medical school or academic medical center to be permitted to participate in the professional activities of the department or division in the medical school or academic medical center to which they are appointed, as provided. Existing law authorizes physicians who are not citizens and who seek postgraduate study to participate in a fellowship program in a specialty or subspecialty field, as provided. Existing law authorizes any person who does not immediately qualify for a physician's and surgeon's certificate and who is offered a full-time faculty position by an approved medical school, to be granted a certificate of registration to engage in the practice of medicine, as provided. This bill would allow for cancellation of these permits or certificates under certain conditions. Existing law requires an applicant for a special faculty permit to practice medicine in the medical school, any affiliated institution of the medical school, or an academic medical center, as defined. Existing law requires an academic medical center to meet certain criteria, including the facility has an intern and resident-to-bed ratio meeting the federal Centers for Medicare and Medicaid Services definition as a major teaching hospital and conducts research in an amount of $100,000,000 or more annually. This bill would remove that requirement. The bill would additionally require a facility to be accredited by the Western Association of Schools and Colleges and the Accreditation Council for Graduate Medical Education to be an academic medical center. Under existing law, all moneys paid to and received by the board are required to be paid into the State Treasury and credited to the Contingent Fund of the Medical Board of California. Under existing law, moneys in the contingent fund shall be available, upon appropriation by the Legislature, as provided. Existing law, applicable to the licensure of physicians and surgeons, requires an applicant for a certificate based upon a national board diplomate certificate, an applicant for a certificate based on reciprocity, and an applicant for a certificate based upon written examination to pay a nonrefundable application and processing fee at the time the application is filed. Existing law requires the board to fix the application and processing fee, as specified, at an amount necessary to recover the actual costs of the licensing program as projected for the fiscal year commencing on the date the fees become effective. Existing law requires an applicant who qualifies for a certificate, as a condition precedent to its issuance, in addition to other required fees, to pay an initial license fee in an amount not to exceed $790. Existing law requires the board to fix the biennial renewal fee not to exceed $790. This bill would instead require the application and processing fee to be $625, the initial license fee to be $863, and for licenses that expire on or after January 1, 2022, the biennial renewal fee to be $863. The bill would require the Legislature to review the amount of fees in 2022 to determine the necessity of increasing fees, as provided. Under existing law, the use of any fictitious, false, or assumed name, or any name other than their own by a physician and surgeon or any doctor of podiatric medicine, as specified, in any public communication, advertisement, sign, or announcement of their practice constitutes unprofessional conduct unless the proprietor, partnership, group, or professional corporation obtains and maintains in current status a fictitious name permit, as specified. Existing law requires the initial permit fee to be $50 and the biennial renewal fee to be $40, and requires the duplicate permit fee to not exceed the cost of processing up to a maximum of $50. This bill would require the initial permit fee to be $70, for permits that expire on or after January 1, 2022, the biennial renewal fee to be $50, and the duplicate permit fee to be $40. Existing law creates, until January 1, 2022, the Podiatric Medical Board of California. Existing law also creates the Osteopathic Medical Board of California and requires it to require each licensed osteopathic physician and surgeon to complete a minimum of 100 hours of American Osteopathic Association continuing education hours during each 2-year cycle, of which 40 hours shall be completed in American Osteopathic Association Category 1 continuing education hours and the remaining 60 hours shall be either American Osteopathic Association or American Medical Association accredited as a condition for renewal of an active license. This bill would extend the provisions establishing the Podiatric Medical Board of California until January 1, 2026. The bill would also reduce by 12 each of the education hours requirements described above. (3) Existing law, the Licensed Midwifery Practice Act of 1993, provides for the licensure and regulation of midwives by the Medical Board of California and prescribes various fees relating to, among others, an application, licensure, and renewal. Existing law establishes the Licensed Midwifery Fund and requires the fees prescribed by the act to be deposited in the fund and to be available, upon appropriation, to the board for the purposes of the act. Existing law requires the board to fix the fee to be paid upon the filing of a license application at not less than $75 nor more than $300. Existing law requires the board to fix the fee for renewal of the midwife license at not less than $50 nor more than $200. This bill would require the fee to be paid upon the filing of a license application to be $450 and would require the fee for renewal for licenses that expire on or after January 1, 2022, to be $300. The bill would require each application for licensure as a licensed midwife to be made upon a specified online electronic form and would require the applicant to certify under penalty of perjury that the information provided by the applicant is true and correct. By expanding the crime of perjury, the bill would impose a state-mandated local program. (4) Existing law authorizes graduates of specified institutes who have completed clinical training in psychoanalysis to engage in psychoanalysis as an adjunct to teaching, training, or research and hold themselves out to the public as psychoanalysts, and authorizes students in those institutes to engage in psychoanalysis under supervision, if the students and graduates do not hold themselves out to the public by any title or description of services incorporating specified words or that they do not state or imply that they are licensed to practice psychology. Existing law requires those students and graduates seeking to engage in psychoanalysis to register with the Medical Board of California, presenting evidence of their student or graduate status. Existing law requires each person to whom registration is granted under those provisions to pay into the Contingent Fund of the Medical Board of California a fee to be fixed by the Medical Board of California at a sum not in excess of $100. Existing law authorizes the registration to be renewed biennially at a fee to be fixed by the board at a sum not in excess of $50. This bill would instead require the Medical Board of California to fix the registration fee at a sum of $150 and, for registrations that expire on or after January 1, 2022, the renewal fee shall be $75. The bill would require each application for registration as a research psychoanalyst or student research psychoanalyst to be made upon a specified online electronic form and would require the applicant to certify under penalty of perjury that the information provided by the applicant is true and correct. By expanding the crime of perjury, the bill would impose a state-mandated local program. (5) Existing law prohibits a person from using the title "certified polysomnographic technologist" or engaging in the practice of polysomnography unless they are registered as a certified polysomnographic technologist, is supervised and directed by a licensed physician and surgeon, and meets certain other requirements. Existing law requires polysomnographic technologists to apply to and register with the Medical Board of California and to pay specified fees to be fixed by the board at no more than $100 each, and to renew their registration biennially for a fee of no more than $150. Existing law requires the deposit of those fees in the Contingent Fund of the Medical Board of California. This bill would instead require the board to fix the application and registration fees at $120 each and, for registrations that expire on or after January 1, 2022, the renewal fee shall be $220. The bill would require each application for registration as a polysomnographic technologist, technician, or trainee to be made upon a specified online electronic form and would require the applicant to certify under penalty of perjury that the information provided by the applicant is true and correct. By expanding the crime of perjury, the bill would impose a state-mandated local program. (6) Existing law, the Physician Assistant Practice Act, creates, until January 2, 2022, the Physician Assistant Board and provides for the licensure and regulation of physician assistants by the Physician Assistant Board, which is within the jurisdiction of the Medical Board of California. Existing law, until January 1, 2022, also requires the board to employ an executive officer. The act provides that the board shall require physician assistants to take and pass a written examination for licensure. The act provides that the board may make arrangements for the examination to be administered under a uniform examination system. The act, however, requires the board to establish a passing score and time and place for each examination. This bill would, among other things, remove the requirement that the board establish a passing score and time and place for each examination and the provision that the Physician Assistant Board is within the jurisdiction of the Medical Board of California. The bill would also extend the provisions establishing the Physician Assistant Board and requiring the board to employ an executive officer until January 1, 2026. (7) 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.