Physician Health Program for California

Physician Health Program for California

Ongoing Legislation for PHP

Status 2022: California’s MBC Physician Health and Wellness Program
Proposed regulations that will govern this new program were distributed with the agenda materials for the May 20 meeting of the Medical Board of California. You can see them on pages 32-46 of the attachment HERE. The proposed regulations will be discussed at the Board’s next quarterly meeting on August 25-26, 2022. Once this language is approved by the Board, the Department of Consumer Affairs, and the Business, Consumer Services, and Housing Agency, it will be submitted to the Office of Administrative Law to be published with a 45-day comment period.

Who will run the program?
If no substantive adverse comments are received during the 45-day comment period, the MBC will put out a request for proposal for a vendor that will contract with the MBC to administer the program. The vendor may engage contractors to staff the program and to provide the services of the program, and those contractors must meet the requirements specified in Section 1357.10 (i), (j), and (k) of the proposed regulations.
There is no estimated time or target date for when that RFP might be issued.

How much will it cost each participant?
After the vendor is chosen and a contract between the vendor and the MBC is in place, the MBC staff will draft regulations to set the fees for participants.

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 Program 

CPPPH has published its vision of an ideal physician health program for California. We envision a program designed to encourage and assist all organizations, institutions and entities where physicians practice or affiliate in their efforts to maintain the health of their physician population. Its services should be available to assist the citizens of California, the regulatory board, associations, hospitals, clinics and individual physicians. California’s ideal physician health program (PHP) should identify, provide, or 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.

Program Components — A well designed PHP would include elements shown to be effective.

  • Education throughout the medical community
  • Orientation to the role and function of physician health committees
  • Consultation to physician health committees and all with the responsibility for physician health, public safety and the maintenance of quality of care Advocacy for activities that promote wellness
  • Activities designed to support case finding Intervention Evaluation, both initial assessment and continuing evaluation as needed, including evaluation for the resumption of patient care responsibilities
  • Design of treatment and monitoring plan Referral to initial treatment
  • Referral to on-going treatment Monitoring Case management Quality assurance activities
  • Guidelines for what criteria the different physician health services should meet
  • A process for determining if an organization’s or group’s services meet the guidelines

Policies and procedures for the operation of a physician health program
A PHP would provide consistency and continuity in approaching and managing physician health across the state. 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 length of time a person is required to be in the program would be in the range of 3-5 years, based on the severity of illness and clinical recommendation.

The program would not report information about a participant to any person or organization other than the referring person or entity unless there has been failure to comply with the agreement and it was determined that the physician was a danger to the public. The program would have the resources necessary for appropriate quality assurance activities. The administering entity and the program it operates 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 consulted in the development of the CPPPH model adopted by the Board of Directors of CPPPH, Inc. on April 25, 2011:

  • 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
  • Policy on Physician Impairment, April 1995 Federation of State Medical Boards
  • Guidelines for Physician Health Programs, 2008 Federation of State Physician Health Programs
  • Guidelines for Hospital Medical Staff Committees on the Well-being of Physicians, 2009 California Medical Association