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AB-1156 Healing arts: medical school graduates: postgraduate training license.(2021-2022)

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Date Published: 06/22/2021 09:00 PM
AB1156:v97#DOCUMENT

Amended  IN  Senate  June 22, 2021
Amended  IN  Assembly  March 11, 2021

CALIFORNIA LEGISLATURE— 2021–2022 REGULAR SESSION

Assembly Bill
No. 1156

Introduced by Assembly Member Holden Akilah Weber

February 18, 2021

An act to amend Section 8389 Sections 2064.5, 2065, and 2096 of the Public Utilities Business and Professions Code, relating to electricity. healing arts, and declaring the urgency thereof, to take effect immediately.


LEGISLATIVE COUNSEL'S DIGEST


AB 1156, as amended, Holden Akilah Weber. Electrical corporations: safety certification: executive incentive compensation structures. Healing arts: medical school graduates: postgraduate training license.
Existing law requires a graduate of an approved medical school who is enrolled in a postgraduate training program to obtain a postgraduate training license. 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.
This bill would reduce the required months of board-approved postgraduate training required to be issued a physician’s and surgeon’s license to 12 months for graduates of medical schools in the United States and Canada or 24 months for graduates of foreign medical schools other than Canadian medical schools, and make conforming changes.
Existing law requires a program director for an approved postgraduate training program in California to report to the board, as specified, certain actions within 30 days of the action, including, among others, when a postgraduate trainee takes a leave of absence or any break from their postgraduate training, and they are notified that their postgraduate training period is extended.
This bill would require that the program director also specify in the report that the program director had made a determination that the extension was necessary.
This bill would declare that it is to take effect immediately as an urgency statute.

Under existing law, the Public Utilities Commission has regulatory authority over electrical corporations. Existing law requires the executive director of the commission to issue a safety certification to an electrical corporation if the electrical corporation provides documentation that it has an approved wildfire mitigation plan, is in good standing, has established a safety committee of its board of directors, has established board-of-director-level reporting to the commission on safety issues, has established a compensation structure for any new or amended contracts for executive officers, and has established an executive incentive compensation structure approved by the commission’s Wildfire Safety Division, as specified. Existing law requires the division to approve an electrical corporation’s executive incentive compensation structure if the division determines the structure meets specified principles.

Existing law requires the commission to award reasonable advocate’s fees, reasonable expert witness fees, and other reasonable costs of preparation for, and participation in, a hearing or proceeding, as defined, to any customer who complies with specified procedural requirements, makes a substantial contribution to the adoption of the commission’s order or decision, and would otherwise experience a significant financial hardship as a result of that participation or intervention.

This bill would require the commission, rather than the division, to approve an electrical corporation’s executive incentive compensation structure if the commission determines the structure meets those principles, and would expressly authorize the commission to reject or modify the structure if it determines those principles are not met. The bill would expressly authorize a public utility customer to be compensated for the costs of participating or intervening in the commission’s review of the structure, as specified.

Vote: MAJORITY2/3   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 2064.5 of the Business and Professions Code is amended to read:

2064.5.
 (a) Within 180 days after enrollment in a board-approved postgraduate training program pursuant to Section 2065, medical school graduates shall obtain a physician’s and surgeon’s postgraduate training license. To be considered for a postgraduate training license, the applicant shall submit the application forms and primary source documents required by the board, shall successfully pass all required licensing examinations, shall pay a nonrefundable application and processing fee, and shall not have committed any act that would be grounds for denial.
(1) Each application submitted pursuant to this section shall be made upon a form provided by the board, and each application form shall contain a legal verification to be signed by the applicant verifying under penalty of perjury that the information provided by the applicant is true and correct and that any information in supporting documents provided by the applicant is true and correct.
(2) Each application shall include the following:
(A) A diploma issued by a board-approved medical school. The requirements of the school shall not have been less than those required under this chapter at the time the diploma was granted or by any preceding medical practice act at the time that the diploma was granted. In lieu of a diploma, the applicant may submit evidence satisfactory to the board of having possessed the same.
(B) An official transcript or other official evidence satisfactory to the board showing each approved medical school in which a resident course of professional instruction was pursued covering the minimum requirements for certification as a physician and surgeon, and that a diploma and degree were granted by the school.
(C) Other information concerning the professional instruction and preliminary education of the applicant as the board may require.
(D) An affidavit showing to the satisfaction of the board that the applicant is the person named in each diploma and transcript that he or she the applicant submits, that he or she the applicant is the lawful holder thereof, and that the diploma or transcript was procured in the regular course of professional instruction and examination without fraud or misrepresentation.
(E) Either fingerprint cards or a copy of a completed Live Scan form from the applicant in order to establish the identity of the applicant and in order to determine whether the applicant has a record of any criminal convictions in this state or in any other jurisdiction, including foreign countries. The information obtained as a result of the fingerprinting of the applicant shall be used in accordance with Section 11105 of the Penal Code, and to determine whether the applicant is subject to denial of licensure under the provisions of Division 1.5 (commencing with Section 475) and Section 2221 of this code.
(F) If the medical school graduate graduated from a foreign medical school approved by the board pursuant to Section 2084, an official Educational Commission for Foreign Medical Graduates (ECFMG) Certification Status Report confirming the graduate is ECFMG certified.
(b) The physician’s and surgeon’s postgraduate training license shall be valid until 90 days after the holder has successfully completed 36 12 months of board-approved postgraduate training. 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 approved by the board pursuant to Section 2084 other than Canadian medical schools. The physician’s and surgeon’s postgraduate training licensee may engage in the practice of medicine only in connection with his or her the postgraduate training licensee’s duties as an intern or resident physician in a board-approved program, including its affiliated sites, or under those conditions as are approved in writing and maintained in the postgraduate training licensee’s file by the director of his or her the postgraduate training licensee’s program.
(c) The postgraduate training licensee may engage in the practice of medicine in locations authorized by subdivision (b), and as permitted by the Medical Practice Act and other applicable statutes and regulations, including, but not limited to, the following:
(1) Diagnose and treat patients.
(2) Prescribe medications without a cosigner, including prescriptions for controlled substances, if the training licensee has the appropriate Drug Enforcement Agency registration or permit and is registered with the Department of Justice CURES program.
(3) Sign birth certificates without a cosigner.
(4) Sign death certificates without a cosigner.
(d) The postgraduate training licensee may be disciplined by the board at any time for any of the grounds that would subject the holder of a physician’s and surgeon’s certificate to discipline.
(e) If the medical school graduate fails to obtain a postgraduate training license within 180 days after enrollment in a board-approved postgraduate training program or if the board denies his or her the medical school graduate’s application for a postgraduate training license, all privileges and exemptions under this section shall automatically cease.
(f) Each medical school graduate enrolled in a board-approved postgraduate training program on January 1, 2020, shall apply for and obtain a postgraduate training license by June 30, 2020, in order to continue in postgraduate training pursuant to Section 2065.
(g) Each medical school graduate who was issued a postgraduate training authorization letter by the board prior to January 1, 2020, and is enrolled in a board-approved postgraduate training program by April 30, 2025, will be issued a postgraduate training license automatically by June 30, 2020, or by June 30 of the year following initial enrollment into a board-approved postgraduate training program, whichever is earlier, upon proof of enrollment in the postgraduate training program.
(h) The board shall confidentially destroy the file of each medical school graduate who was issued a postgraduate training authorization letter by the board prior to January 1, 2020, who did not enroll in a postgraduate training program by April 30, 2025.

(i)This section shall become operative on January 1, 2020.

SEC. 2.

 Section 2065 of the Business and Professions Code is amended to read:

2065.
 (a) Unless otherwise provided by law, no postgraduate trainee, intern, resident, postdoctoral fellow, or instructor may engage in the practice of medicine, or receive compensation therefor, or offer to engage in the practice of medicine unless they hold a valid, unrevoked, and unsuspended physician’s and surgeon’s certificate issued by the board. However, a graduate of an approved medical school may engage in the practice of medicine whenever and wherever required as a part of a postgraduate training program under the following conditions:
(1) The medical school graduate has taken and passed the board-approved medical licensing examinations required to qualify the applicant to participate in an approved postgraduate training program.
(2) If the medical school graduate graduated from a foreign medical school approved by the board pursuant to Section 2084, the Educational Commission for Foreign Medical Graduates (ECFMG) has submitted an official ECFMG Certification Status Report directly to the board confirming the graduate is ECFMG certified.
(3) The medical school graduate is enrolled in a postgraduate training program approved by the board.
(4) The board-approved postgraduate training program has submitted the required board-approved form to the board documenting the medical school graduate is enrolled in an approved postgraduate training program.
(5) The medical school graduate obtains a physician’s and surgeon’s postgraduate training license in accordance with Section 2064.5.
(b) A medical school graduate enrolled in an approved first-year postgraduate training program in accordance with this section may engage in the practice of medicine whenever and wherever required as a part of the training program, and may receive compensation for that practice.
(c) A graduate who has completed the first year of postgraduate training may, in an approved residency or fellowship, engage in the practice of medicine whenever and wherever required as part of that residency or fellowship, and may receive compensation for that practice. The resident or fellow shall qualify for, take, and pass the next succeeding written examination for licensure. If the resident or fellow fails to receive a license to practice medicine under this chapter within 27 months from the commencement of the residency or fellowship, except as otherwise allowed under subdivision (g) or (h), or if the board denies their application for licensure, all privileges and exemptions under this section shall automatically cease.
(d) All approved postgraduate training the medical school graduate has successfully completed in the United States or Canada shall count toward the 39-month 15-month license exemption, exemption for graduates of medical schools in the United States and Canada or 27-month license exemption for graduates of foreign medical schools approved by the board pursuant to Section 2084 other than Canadian medical schools, except as otherwise allowed under subdivision (h).
(e) A medical school graduate from a medical school approved by the board shall have successfully completed a minimum of 36 12 months of approved postgraduate training, 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 approved by the board pursuant to Section 2084 other than Canadian medical schools, which includes successful progression through 24 12 months in the same program, to be eligible for a California physician’s and surgeon’s certificate.
(f) The program director for an approved postgraduate training program in California shall report to the board, on a form approved by the board, and provide any supporting documents as required by the board, the following actions within 30 days of the action:
(1) A postgraduate trainee is notified that they have received partial or no credit for a period of postgraduate training, and their postgraduate training period is extended.
(2) A postgraduate trainee takes a leave of absence or any break from their postgraduate training, and they are notified that their postgraduate training period is extended. extended, because the program director made a determination that an extension was necessary.
(3) A postgraduate trainee is terminated from the postgraduate training program.
(4) A postgraduate trainee resigns, dies, or otherwise leaves the postgraduate training program.
(5) A postgraduate trainee has completed a one-year contract approved by the postgraduate training program.
(g) Upon review of supporting documentation, the board, in its discretion, may grant an extension beyond 39 15 months to a postgraduate training 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 approved by the board pursuant to Section 2084 other than a Canadian medical school, to successfully complete the 36 12 months of required approved postgraduate training. training for graduates of medical schools in the United States and Canada and 24 months of required approved postgraduate training for graduates of foreign medical schools other than Canadian medical schools.
(h) An applicant for a physician’s and surgeon’s license who has successfully completed 36 the required number of months of approved postgraduate training required by subdivision (e) in another state or in Canada and who is accepted into an approved postgraduate training program in California shall obtain their physician’s and surgeon’s license within 90 days after beginning that postgraduate training program or all privileges and exemptions under this section shall automatically cease.

(i)This section shall become operative on January 1, 2020.

SEC. 3.

 Section 2096 of the Business and Professions Code is amended to read:

2096.
 (a) In addition to other requirements of this chapter, before a physician’s and surgeon’s license may be issued, each applicant, including an applicant applying pursuant to Article 5 (commencing with Section 2100), 2105), shall show by evidence satisfactory to the board that the applicant has successfully completed at least 36 12 months of board-approved postgraduate training. 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 approved by the board pursuant to Section 2084 other than Canadian medical schools.
(b) The postgraduate training required by this section shall include at least four months of general medicine and shall be obtained in a postgraduate training program approved by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada (RCPSC), or the College of Family Physicians of Canada (CFPC).
(c) An applicant who has completed at least 36 12 months of board-approved postgraduate training, 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 approved by the board pursuant to Section 2084 other than Canadian medical schools, not less than 24 12 months of which was completed as part of an oral and maxillofacial surgery postgraduate training program as a resident after receiving a medical degree from a combined dental and medical degree program accredited by the Commission on Dental Accreditation (CODA) or approved by the board, shall be eligible for licensure. Oral and maxillofacial surgery residency programs accredited by CODA shall be approved as postgraduate training required by this section if the applicant attended the program as part of a combined dental and medical degree program accredited by CODA. These applicants shall not have to comply with subdivision (b).

(d)This section shall become operative on January 1, 2020.

SEC. 4.

 This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to address the growing need for healthcare professionals during the COVID-19 public health emergency, it is necessary that this act go into effect immediately.
SECTION 1.Section 8389 of the Public Utilities Code is amended to read:
8389.

(a)For purposes of this section, the following definitions apply:

(1)“Board” means the California Wildfire Safety Advisory Board established pursuant to Section 326.1.

(2)“Division” means the Wildfire Safety Division established pursuant to Section 326.

(3)“Proceeding” has the same meaning as defined in Section 1802.

(b)By June 30, 2020, and annually thereafter, the board shall make recommendations to the division on all of the following:

(1)Appropriate performance metrics and processes for determining an electrical corporation’s compliance with its approved wildfire mitigation plan.

(2)Appropriate requirements in addition to the requirements set forth in Section 8386 for the wildfire mitigation plan.

(3)The appropriate scope and process for assessing the safety culture of an electrical corporation.

(c)By October 31, 2020, and annually thereafter, the division shall issue an analysis and recommendation to the commission on the recommendations provided by the board pursuant to subdivision (b).

(d)By December 1, 2020, and annually thereafter, the commission, after consultation with the division, shall adopt and approve all of the following:

(1)Performance metrics for electrical corporations.

(2)Additional requirements for wildfire mitigation plans.

(3)A wildfire mitigation plan compliance process.

(4)A process for the division to conduct annual safety culture assessments for each electrical corporation.

(e)The executive director of the commission shall issue a safety certification to an electrical corporation if the electrical corporation provides documentation of all of the following:

(1)The electrical corporation has an approved wildfire mitigation plan.

(2)The electrical corporation is in good standing, which can be satisfied by the electrical corporation having agreed to implement the findings of its most recent safety culture assessment, if applicable.

(3)The electrical corporation has established a safety committee of its board of directors composed of members with relevant safety experience.

(4)The electrical corporation has established an executive incentive compensation structure approved by the commission pursuant to subparagraph (B) of paragraph (6) and structured to promote safety as a priority and to ensure public safety and utility financial stability with performance metrics, including incentive compensation based on meeting performance metrics that are measurable and enforceable, for all executive officers, as defined in Section 451.5. This may include tying 100 percent of incentive compensation to safety performance and denying all incentive compensation in the event the electrical corporation causes a catastrophic wildfire that results in one or more fatalities.

(5)The electrical corporation has established board-of-director-level reporting to the commission on safety issues.

(6)(A)The electrical corporation has established a compensation structure for any new or amended contracts for executive officers, as defined in Section 451.5, that is based on the following principles:

(i)(I)Strict limits on guaranteed cash compensation, with the primary portion of the executive officers’ compensation based on achievement of objective performance metrics.

(II)No guaranteed monetary incentives in the compensation structure.

(ii)It satisfies the compensation principles identified in paragraph (4).

(iii)A long-term structure that provides a significant portion of compensation, which may take the form of grants of the electrical corporation’s stock, based on the electrical corporation’s long-term performance and value. This compensation shall be held or deferred for a period of at least three years.

(iv)Minimization or elimination of indirect or ancillary compensation that is not aligned with shareholder and taxpayer interest in the electrical corporation.

(B)The commission, as part of a proceeding, shall approve the compensation structure of an electrical corporation if it determines the compensation structure meets the principles set forth in subparagraph (A) and paragraph (4). If the commission determines the compensation structure of an electrical corporation fails to meet the principles set forth in subparagraph (A) and paragraph (4), the commission may reject or modify the compensation structure. Costs to public utility customers of participation or intervention in the proceeding shall be eligible for compensation pursuant to Article 5 (commencing with Section 1801) of Chapter 9 of Part 1 of Division 1.

(C)It is the intent of the Legislature, in enacting this paragraph and paragraph (4), that any approved bankruptcy reorganization plan of an electrical corporation should, in regards to compensation for executive officers of the electrical corporation, comply with the requirements of those paragraphs.

(7)The electrical corporation is implementing its approved wildfire mitigation plan. The electrical corporation shall file a tier 1 advice letter on a quarterly basis that details the implementation of both its approved wildfire mitigation plan and recommendations of the most recent safety culture assessment, and a statement of the recommendations of the board of directors safety committee meetings that occurred during the quarter. The advice letter shall also summarize the implementation of the safety committee recommendations from the electrical corporation’s previous advice letter filing. If the division has reason to doubt the veracity of the statements contained in the advice letter filing, it shall perform an audit of the issue of concern.

(f)(1)The executive director shall issue an initial safety certification within 30 days of receipt of a request for that certification by an electrical corporation if the electrical corporation provides documentation that it is meeting the requirements set forth in paragraphs (1), (2), (3), and (5) of subdivision (e). A safety certification shall be valid for the 12 consecutive months following the issuance of the certification.

(2)Before the expiration of a certification, an electrical corporation shall submit to the division a request for certification for the following 12 months. The division shall issue a safety certification within 90 days of a request if the electrical corporation has provided documentation that it has satisfied the requirements in subdivision (e).

(3)All documents submitted pursuant to this section shall be publicly available on the commission’s internet website.

(4)Notwithstanding paragraph (1), a safety certification shall remain valid until the division acts on the electrical corporation’s pending request for safety certification.

(g)If the division determines an electrical corporation is not in compliance with its approved wildfire mitigation plan, it may recommend that the commission pursue an enforcement action against the electrical corporation for noncompliance with its approved plan.