Getting A Physician Health Program for California

The Medical Board of California's
Physician Health and Wellness Program

Current Efforts

CPPPH joins all who work toward getting the kind of physician health program that other states rely upon. Current efforts began with the May 24, 2024 decision of the Medical Board of California to seek legislation authorizing a PHP based on the evidence and experience of PHPs as espoused by the Federation of State Physician Health Programs.

A New Plan Emerges for Getting a Physician Health Program for California

At its May 24th meeting, the Medical Board of California voted to withdraw the proposed regulations that were based on the Uniform Standards and prepare a proposal for new legislation that would allow a program in line with national best practices. For the full report of this MBC meeting and decision, see the June issue of the CPPPH Newsletter.

2023-2024: Proposed Regulations for the MBC Physician Health and Wellness Program

The next step toward getting a physician health program for California will come at the May 23-24, 2024 meeting of the Medical Board of California when the Board is expected to invite subject matter experts to help them reach agreement on whether to accept the proposed regulations or seek changes in the legislation that governs the Board's new Physician Health and Wellness Program.

There was a 45-day comment period on the proposed regulations that ended on November 14, 2023. Click on the items below for copies of the different documents that provide the specifics:

This action has been a long time coming. The authorizing legislation, SB 1177 (Galgiani), enacted in 2016, required the MBC to prepare regulations for how a new program would operate. Getting regulations prepared and through the multi-step review process has been delayed by several factors.

While this 45-day comment period is a significant step forward, many steps remain. When the comment period closes and comments are reviewed, the Medical Board will first determine if changes should be made to the language of the proposed regulations. If so, that determination would be evaluated by all the reviewers to see if they agree as to whether the change made was non-substantive versus substantive. If the Board had determined that a substantive change should be made, then the modified text will be available for public comment for 15 days.

When those steps are completed, the Medical Board will prepare the final statement of reasons and submit the rulemaking package to its umbrella agencies – the Department of Consumer Affairs and its parent, the California Business, Consumer Services, and Housing Agency. Once approved by those agencies, the rulemaking package will be submitted to the Office of Administrative Law (OAL) for review and approval. Upon approval by OAL, the regulations are filed with the Secretary of State (SOS) and added to the California Code of Regulations to become effective on a date specified by the Secretary of State.

Only then can the Medical Board begin the process it will use to select a vendor to implement the program. After the vendor is selected, The Medical Board will issue another set of regulations to set the fees for what participants will pay.

Inquiries or comments may be addressed to Alexandria Schembra or Kerrie Webb of the Medical Board of California by email to regulations@mbc.ca.gov. Their phone number is (916) 263-2389.

Status 2019

The 2019 issues of CPPPH eNews give the details of where things stand in the Fall of 2019.
(To read the July, August and September issues Click Here).

2016 Legislation

In September, Governor Jerry Brown signed SB1177 authorizing the Medical Board of California (MBC) to establish the Physician and Surgeon Health and Wellness Program "for the early identification of, and appropriate interventions to support a physician and surgeon in his or her rehabilitation from, substance abuse." (See a full copy of the legislation HERE.)

The law requires that the program comply with the 1441 Uniform Standards Regarding Substance-Abusing Healing Arts Licensees.  (See the full text of the Uniform Standards HERE.)

The next step is for the MBC to prepare regulations, then issue a Request for Proposal seeking an entity to administer the program in line with the regulations.  

On January 11, 2017, the Medical Board convened a meeting of interested parties to hear comments on what the Board plans to put in the regulations that will govern the new program.  MBC staff distributed their notes showing what they plan to put into the regulations.  HERE.

According to the schedule announced at that meeting, the Medical Board must complete three separate steps in order to open a program: 1) regulations adopted for operations of the program, 2) an RFP issued and an administering agency selected, 3) a second set of regulations adopted to set the fee that will be charged to each participant.

CPPPH Model Physician Health Programs

CPPPH envisions a program of early intervention to protect patients and to maintain physician health.

In 2011, CPPPH published its vision for California's ideal Physician Health Program (PHP) - one that will support clinically-based health services for physicians with physical, mental health or addiction issues which, if undetected or not appropriately treated and monitored, could compromise the physician's ability to practice medicine safely.

A well designed PHP would include elements shown to be effective:

    • Education throughout the medical community encouraging early intervention and referral
    • Referral to appropriate qualified evaluation and/or treatment providers
    • Comprehensive monitoring programs
    • Confidential participation in the program while complying with all requirements
    • Advocacy for physicians by documenting their health and wellbeing and compliance with monitoring requirements

Referrals into the program would be accepted from all sources. Eligibility for the program would be for persons with substance use, mental health disorders or physical illness when a clinical evaluation determines that the condition can be monitored and treated with the resources available to the program.

The program would have the resources necessary to carry out its responsibilities effectively and would include appropriate quality assurance activities. The administering entity and the program would be subject to periodic audit. The results of the audit would be reported to all funding sources, all program participants, the full medical community, an oversight body, and the legislature.

References:

    • Guidelines for Physician Health Programs, 2020 Federation of State Physician Health Programs
    • Guidelines for Hospital Medical Staff Committees on the Well-being of Physicians, 2022 California Medical Association
    • Model Physician Health Program Act, March 2009 American Medical Association
    • Public Policy Statement of the American Society of Addiction Medicine on Healthcare and Other Licensed Professionals with Addictive Illness, April 2011