Amended IN Assembly March 23, 2018 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 2904Introduced by Assembly Member CarrilloFebruary 16, 2018 An act to amend Section 22900 2290.5 of the Business and Professions Code, relating to business. healing arts.LEGISLATIVE COUNSEL'S DIGESTAB 2904, as amended, Carrillo. Equipment dealers. Healing arts: telehealth.Under existing law, telehealth is defined as the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site, and health care provider is defined as a person who is licensed under specified provisions of law relating to healing arts. Existing law requires a health care provider, prior to the delivery of health care via telehealth, to inform the patient about the use of telehealth, obtain verbal or written consent from the patient for the use of telehealth, and document that consent. Under existing law, the failure of a health care provider to comply with these provisions constitutes unprofessional conduct.This bill would require a health care provider to document the consent of the patient to use telehealth in either printed or electronic form.Existing law provides for the regulation of equipment dealers and makes related findings and declarations.This bill would make a nonsubstantive change to those findings and declarations.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NOYES Local Program: NO Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 2290.5 of the Business and Professions Code is amended to read:2290.5. (a) For purposes of this division, the following definitions shall apply:(1) Asynchronous store and forward means the transmission of a patients medical information from an originating site to the health care provider at a distant site without the presence of the patient.(2) Distant site means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system.(3) Health care provider means either of the following:(A) A person who is licensed under this division.(B) A marriage and family therapist intern or trainee functioning pursuant to Section 4980.43.(4) Originating site means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates.(5) Synchronous interaction means a real-time interaction between a patient and a health care provider located at a distant site.(6) Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.(b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented. documented by the health care provider in either printed or electronic form.(c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth.(d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section.(e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law.(f) All laws regarding the confidentiality of health care information and a patients rights to his or her medical information shall apply to telehealth interactions.(g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility.(h) (1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.(2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1).(3) For the purposes of this subdivision, telehealth shall include telemedicine as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.SECTION 1.Section 22900 of the Business and Professions Code is amended to read:22900.The Legislature finds and declares that the retail distribution, sales, and rental of agricultural, construction, utility, industrial, mining, outdoor power, forestry, and lawn and garden equipment, utilizing independent dealers operating under contract with the supplier vitally affects the general economy of the state, the public interest, and the public welfare. Therefore, the Legislature has determined that it is necessary to regulate the business relations between the dealers and suppliers as described by this chapter. Amended IN Assembly March 23, 2018 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 2904Introduced by Assembly Member CarrilloFebruary 16, 2018 An act to amend Section 22900 2290.5 of the Business and Professions Code, relating to business. healing arts.LEGISLATIVE COUNSEL'S DIGESTAB 2904, as amended, Carrillo. Equipment dealers. Healing arts: telehealth.Under existing law, telehealth is defined as the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site, and health care provider is defined as a person who is licensed under specified provisions of law relating to healing arts. Existing law requires a health care provider, prior to the delivery of health care via telehealth, to inform the patient about the use of telehealth, obtain verbal or written consent from the patient for the use of telehealth, and document that consent. Under existing law, the failure of a health care provider to comply with these provisions constitutes unprofessional conduct.This bill would require a health care provider to document the consent of the patient to use telehealth in either printed or electronic form.Existing law provides for the regulation of equipment dealers and makes related findings and declarations.This bill would make a nonsubstantive change to those findings and declarations.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: NOYES Local Program: NO Amended IN Assembly March 23, 2018 Amended IN Assembly March 23, 2018 CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Bill No. 2904 Introduced by Assembly Member CarrilloFebruary 16, 2018 Introduced by Assembly Member Carrillo February 16, 2018 An act to amend Section 22900 2290.5 of the Business and Professions Code, relating to business. healing arts. LEGISLATIVE COUNSEL'S DIGEST ## LEGISLATIVE COUNSEL'S DIGEST AB 2904, as amended, Carrillo. Equipment dealers. Healing arts: telehealth. Under existing law, telehealth is defined as the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site, and health care provider is defined as a person who is licensed under specified provisions of law relating to healing arts. Existing law requires a health care provider, prior to the delivery of health care via telehealth, to inform the patient about the use of telehealth, obtain verbal or written consent from the patient for the use of telehealth, and document that consent. Under existing law, the failure of a health care provider to comply with these provisions constitutes unprofessional conduct.This bill would require a health care provider to document the consent of the patient to use telehealth in either printed or electronic form.Existing law provides for the regulation of equipment dealers and makes related findings and declarations.This bill would make a nonsubstantive change to those findings and declarations. Under existing law, telehealth is defined as the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site, and health care provider is defined as a person who is licensed under specified provisions of law relating to healing arts. Existing law requires a health care provider, prior to the delivery of health care via telehealth, to inform the patient about the use of telehealth, obtain verbal or written consent from the patient for the use of telehealth, and document that consent. Under existing law, the failure of a health care provider to comply with these provisions constitutes unprofessional conduct. This bill would require a health care provider to document the consent of the patient to use telehealth in either printed or electronic form. Existing law provides for the regulation of equipment dealers and makes related findings and declarations. This bill would make a nonsubstantive change to those findings and declarations. ## Digest Key ## Bill Text The people of the State of California do enact as follows:SECTION 1. Section 2290.5 of the Business and Professions Code is amended to read:2290.5. (a) For purposes of this division, the following definitions shall apply:(1) Asynchronous store and forward means the transmission of a patients medical information from an originating site to the health care provider at a distant site without the presence of the patient.(2) Distant site means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system.(3) Health care provider means either of the following:(A) A person who is licensed under this division.(B) A marriage and family therapist intern or trainee functioning pursuant to Section 4980.43.(4) Originating site means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates.(5) Synchronous interaction means a real-time interaction between a patient and a health care provider located at a distant site.(6) Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.(b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented. documented by the health care provider in either printed or electronic form.(c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth.(d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section.(e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law.(f) All laws regarding the confidentiality of health care information and a patients rights to his or her medical information shall apply to telehealth interactions.(g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility.(h) (1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.(2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1).(3) For the purposes of this subdivision, telehealth shall include telemedicine as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.SECTION 1.Section 22900 of the Business and Professions Code is amended to read:22900.The Legislature finds and declares that the retail distribution, sales, and rental of agricultural, construction, utility, industrial, mining, outdoor power, forestry, and lawn and garden equipment, utilizing independent dealers operating under contract with the supplier vitally affects the general economy of the state, the public interest, and the public welfare. Therefore, the Legislature has determined that it is necessary to regulate the business relations between the dealers and suppliers as described by this chapter. The people of the State of California do enact as follows: ## The people of the State of California do enact as follows: SECTION 1. Section 2290.5 of the Business and Professions Code is amended to read:2290.5. (a) For purposes of this division, the following definitions shall apply:(1) Asynchronous store and forward means the transmission of a patients medical information from an originating site to the health care provider at a distant site without the presence of the patient.(2) Distant site means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system.(3) Health care provider means either of the following:(A) A person who is licensed under this division.(B) A marriage and family therapist intern or trainee functioning pursuant to Section 4980.43.(4) Originating site means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates.(5) Synchronous interaction means a real-time interaction between a patient and a health care provider located at a distant site.(6) Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.(b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented. documented by the health care provider in either printed or electronic form.(c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth.(d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section.(e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law.(f) All laws regarding the confidentiality of health care information and a patients rights to his or her medical information shall apply to telehealth interactions.(g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility.(h) (1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.(2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1).(3) For the purposes of this subdivision, telehealth shall include telemedicine as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations. SECTION 1. Section 2290.5 of the Business and Professions Code is amended to read: ### SECTION 1. 2290.5. (a) For purposes of this division, the following definitions shall apply:(1) Asynchronous store and forward means the transmission of a patients medical information from an originating site to the health care provider at a distant site without the presence of the patient.(2) Distant site means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system.(3) Health care provider means either of the following:(A) A person who is licensed under this division.(B) A marriage and family therapist intern or trainee functioning pursuant to Section 4980.43.(4) Originating site means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates.(5) Synchronous interaction means a real-time interaction between a patient and a health care provider located at a distant site.(6) Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.(b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented. documented by the health care provider in either printed or electronic form.(c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth.(d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section.(e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law.(f) All laws regarding the confidentiality of health care information and a patients rights to his or her medical information shall apply to telehealth interactions.(g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility.(h) (1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.(2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1).(3) For the purposes of this subdivision, telehealth shall include telemedicine as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations. 2290.5. (a) For purposes of this division, the following definitions shall apply:(1) Asynchronous store and forward means the transmission of a patients medical information from an originating site to the health care provider at a distant site without the presence of the patient.(2) Distant site means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system.(3) Health care provider means either of the following:(A) A person who is licensed under this division.(B) A marriage and family therapist intern or trainee functioning pursuant to Section 4980.43.(4) Originating site means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates.(5) Synchronous interaction means a real-time interaction between a patient and a health care provider located at a distant site.(6) Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.(b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented. documented by the health care provider in either printed or electronic form.(c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth.(d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section.(e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law.(f) All laws regarding the confidentiality of health care information and a patients rights to his or her medical information shall apply to telehealth interactions.(g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility.(h) (1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.(2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1).(3) For the purposes of this subdivision, telehealth shall include telemedicine as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations. 2290.5. (a) For purposes of this division, the following definitions shall apply:(1) Asynchronous store and forward means the transmission of a patients medical information from an originating site to the health care provider at a distant site without the presence of the patient.(2) Distant site means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system.(3) Health care provider means either of the following:(A) A person who is licensed under this division.(B) A marriage and family therapist intern or trainee functioning pursuant to Section 4980.43.(4) Originating site means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates.(5) Synchronous interaction means a real-time interaction between a patient and a health care provider located at a distant site.(6) Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.(b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented. documented by the health care provider in either printed or electronic form.(c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth.(d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section.(e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law.(f) All laws regarding the confidentiality of health care information and a patients rights to his or her medical information shall apply to telehealth interactions.(g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility.(h) (1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations.(2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1).(3) For the purposes of this subdivision, telehealth shall include telemedicine as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations. 2290.5. (a) For purposes of this division, the following definitions shall apply: (1) Asynchronous store and forward means the transmission of a patients medical information from an originating site to the health care provider at a distant site without the presence of the patient. (2) Distant site means a site where a health care provider who provides health care services is located while providing these services via a telecommunications system. (3) Health care provider means either of the following: (A) A person who is licensed under this division. (B) A marriage and family therapist intern or trainee functioning pursuant to Section 4980.43. (4) Originating site means a site where a patient is located at the time health care services are provided via a telecommunications system or where the asynchronous store and forward service originates. (5) Synchronous interaction means a real-time interaction between a patient and a health care provider located at a distant site. (6) Telehealth means the mode of delivering health care services and public health via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patients health care while the patient is at the originating site and the health care provider is at a distant site. Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers. (b) Prior to the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented. documented by the health care provider in either printed or electronic form. (c) Nothing in this section shall preclude a patient from receiving in-person health care delivery services during a specified course of health care and treatment after agreeing to receive services via telehealth. (d) The failure of a health care provider to comply with this section shall constitute unprofessional conduct. Section 2314 shall not apply to this section. (e) This section shall not be construed to alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting, or in a manner, not otherwise authorized by law. (f) All laws regarding the confidentiality of health care information and a patients rights to his or her medical information shall apply to telehealth interactions. (g) This section shall not apply to a patient under the jurisdiction of the Department of Corrections and Rehabilitation or any other correctional facility. (h) (1) Notwithstanding any other provision of law and for purposes of this section, the governing body of the hospital whose patients are receiving the telehealth services may grant privileges to, and verify and approve credentials for, providers of telehealth services based on its medical staff recommendations that rely on information provided by the distant-site hospital or telehealth entity, as described in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations. (2) By enacting this subdivision, it is the intent of the Legislature to authorize a hospital to grant privileges to, and verify and approve credentials for, providers of telehealth services as described in paragraph (1). (3) For the purposes of this subdivision, telehealth shall include telemedicine as the term is referenced in Sections 482.12, 482.22, and 485.616 of Title 42 of the Code of Federal Regulations. The Legislature finds and declares that the retail distribution, sales, and rental of agricultural, construction, utility, industrial, mining, outdoor power, forestry, and lawn and garden equipment, utilizing independent dealers operating under contract with the supplier vitally affects the general economy of the state, the public interest, and the public welfare. Therefore, the Legislature has determined that it is necessary to regulate the business relations between the dealers and suppliers as described by this chapter.