CALIFORNIA BUSINESS AND PROFESSIONS CODE
SECTION 805

805.  (a) As used in this section, the following terms have the
following definitions:
   (1) "Peer review body" includes:
   (A) A medical or professional staff of any health care facility or
clinic licensed under Division 2 (commencing with Section 1200) of
the Health and Safety Code or of a facility certified to participate
in the federal Medicare program as an ambulatory surgical center.
   (B) A health care service plan registered under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that contracts with licentiates to
provide services at alternative rates of payment pursuant to Section
10133 of the Insurance Code.
   (C) Any medical, psychological, marriage and family therapy,
social work, dental, or podiatric professional society having as
members at least 25 percent of the eligible licentiates in the area
in which it functions (which must include at least one county), which
is not organized for profit and which has been determined to be
exempt from taxes pursuant to Section 23701 of the Revenue and
Taxation Code.
   (D) A committee organized by any entity consisting of or employing
more than 25 licentiates of the same class that functions for the
purpose of reviewing the quality of professional care provided by
members or employees of that entity.
   (2) "Licentiate" means a physician and surgeon, podiatrist,
clinical psychologist, marriage and family therapist, clinical social
worker, or dentist.  "Licentiate" also includes a person authorized
to practice medicine pursuant to Section 2113.
   (3) "Agency" means the relevant state licensing agency having
regulatory jurisdiction over the licentiates listed in paragraph (2).
   (4) "Staff privileges" means any arrangement under which a
licentiate is allowed to practice in or provide care for patients in
a health facility.  Those arrangements shall include, but are not
limited to, full staff privileges, active staff privileges, limited
staff privileges, auxiliary staff privileges, provisional staff
privileges, temporary staff privileges, courtesy staff privileges,
locum tenens arrangements, and contractual arrangements to provide
professional services, including, but not limited to, arrangements to
provide outpatient services.
   (5) "Denial or termination of staff privileges, membership, or
employment" includes failure or refusal to renew a contract or to
renew, extend, or reestablish any staff privileges, if the action is
based on medical disciplinary cause or reason.
   (6) "Medical disciplinary cause or reason" means that aspect of a
licentiate's competence or professional conduct that is reasonably
likely to be detrimental to patient safety or to the delivery of
patient care.
   (7) "805 report" means the written report required under
subdivision (b).
   (b) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file an 805 report
with the relevant agency within 15 days after the effective date of
any of the following that occur as a result of an action of a peer
review body:
   (1) A licentiate's application for staff privileges or membership
is denied or rejected for a medical disciplinary cause or reason.
   (2) A licentiate's membership, staff privileges, or employment is
terminated or revoked for a medical disciplinary cause or reason.
   (3) Restrictions are imposed, or voluntarily accepted, on staff
privileges, membership, or employment for a cumulative total of 30
days or more for any 12-month period, for a medical disciplinary
cause or reason.
   (c) The chief of staff of a medical or professional staff or other
chief executive officer, medical director, or administrator of any
peer review body and the chief executive officer or administrator of
any licensed health care facility or clinic shall file an 805 report
with the relevant agency within 15 days after any of the following
occur after notice of either an impending investigation or the denial
or rejection of the application for a medical disciplinary cause or
reason:
   (1) Resignation or leave of absence from membership, staff, or
employment.
   (2) The withdrawal or abandonment of a licentiate's application
for staff privileges or membership.
   (3) The request for renewal of those privileges or membership is
withdrawn or abandoned.
   (d) For purposes of filing an 805 report, the signature of at
least one of the individuals indicated in subdivision (b) or (c) on
the completed form shall constitute compliance with the requirement
to file the report.
   (e) An 805 report shall also be filed within 15 days following the
imposition of summary suspension of staff privileges, membership, or
employment, if the summary suspension remains in effect for a period
in excess of 14 days.
   (f) A copy of the 805 report, and a notice advising the licentiate
of his or her right to submit additional statements or other
information pursuant to Section 800, shall be sent by the peer review
body to the licentiate named in the report.
   The information to be reported in an 805 report shall include the
name and license number of the licentiate involved, a description of
the facts and circumstances of the medical disciplinary cause or
reason, and any other relevant information deemed appropriate by the
reporter.
   A supplemental report shall also be made within 30 days following
the date the licentiate is deemed to have satisfied any terms,
conditions, or sanctions imposed as disciplinary action by the
reporting peer review body.  In performing its dissemination
functions required by Section 805.5, the agency shall include a copy
of a supplemental report, if any, whenever it furnishes a copy of the
original 805 report.
   If another peer review body is required to file an 805 report, a
health care service plan is not required to file a separate report
with respect to action attributable to the same medical disciplinary
cause or reason.  If the Medical Board of California or a licensing
agency of another state revokes or suspends, without a stay, the
license of a physician, a peer review body is not required to file an
805 report when it takes an action as a result of the revocation or
suspension.
   (g) The reporting required by this section shall not act as a
waiver of confidentiality of medical records and committee reports.
The information reported or disclosed shall be kept confidential
except as provided in subdivision (c) of Section 800 and Sections
803.1 and 2027, provided that a copy of the report containing the
information required by this section may be disclosed as required by
Section 805.5 with respect to reports received on or after January 1,
1976.
   (h) The Medical Board of California, the Osteopathic Medical Board
of California, and the Dental Board of California shall disclose
reports as required by Section 805.5.
   (i) An 805 report shall be maintained by an agency for
dissemination purposes for a period of three years after receipt.
   (j) No person shall incur any civil or criminal liability as the
result of making any report required by this section.
   (k) A willful failure to file an 805 report by any person who is
designated or otherwise required by law to file an 805 report is
punishable by a fine not to exceed one hundred thousand dollars
($100,000) per violation.  The fine may be imposed in any civil or
administrative action or proceeding brought by or on behalf of any
agency having regulatory jurisdiction over the person regarding whom
the report was or should have been filed.  If the person who is
designated or otherwise required to file an 805 report is a licensed
physician and surgeon, the action or proceeding shall be brought by
the Medical Board of California.  The fine shall be paid to that
agency but not expended until appropriated by the Legislature.  A
violation of this subdivision may constitute unprofessional conduct
by the licentiate.  A person who is alleged to have violated this
subdivision may assert any defense available at law.  As used in this
subdivision, "willful" means a voluntary and intentional violation
of a known legal duty.
   (l) Except as otherwise provided in subdivision (k), any failure
by the administrator of any peer review body, the chief executive
officer or administrator of any health care facility, or any person
who is designated or otherwise required by law to file an 805 report,
shall be punishable by a fine that under no circumstances shall
exceed fifty thousand dollars ($50,000) per violation.  The fine may
be imposed in any civil or administrative action or proceeding
brought by or on behalf of any agency having regulatory jurisdiction
over the person regarding whom the report was or should have been
filed.  If the person who is designated or otherwise required to file
an 805 report is a licensed physician and surgeon, the action or
proceeding shall be brought by the Medical Board of California.  The
fine shall be paid to that agency but not expended until appropriated
by the Legislature.  The amount of the fine imposed, not exceeding
fifty thousand dollars ($50,000) per violation, shall be proportional
to the severity of the failure to report and shall differ based upon
written findings, including whether the failure to file caused harm
to a patient or created a risk to patient safety; whether the
administrator of any peer review body, the chief executive officer or
administrator of any health care facility, or any person who is
designated or otherwise required by law to file an 805 report
exercised due diligence despite the failure to file or whether they
knew or should have known that an 805 report would not be filed; and
whether there has been a prior failure to file an 805 report.  The
amount of the fine imposed may also differ based on whether a health
care facility is a small or rural hospital as defined in Section
124840 of the Health and Safety Code.
   (m) A health care service plan registered under Chapter 2.2
(commencing with Section 1340) of Division 2 of the Health and Safety
Code or a disability insurer that negotiates and enters into a
contract with licentiates to provide services at alternative rates of
payment pursuant to Section 10133 of the Insurance Code, when
determining participation with the plan or insurer, shall evaluate,
on a case-by-case basis, licentiates who are the subject of an 805
report, and not automatically exclude or deselect these licentiates.
805.1.  (a) The Medical Board of California, the Osteopathic Medical
Board of California, and the Dental Board of California shall be
entitled to inspect and copy the following documents in the record of
any disciplinary proceeding resulting in action that is required to
be reported pursuant to Section 805:
   (1) Any statement of charges.
   (2) Any document, medical chart, or exhibits in evidence.
   (3) Any opinion, findings, or conclusions.
   (b) The information so disclosed shall be kept confidential and
not subject to discovery, in accordance with Section 800, except that
it may be reviewed, as provided in subdivision (c) of Section 800,
and may be disclosed in any subsequent disciplinary hearing conducted
pursuant to the Administrative Procedure Act (Chapter 5 (commencing
with Section 11500) of Part 1 of Division 3 of Title 2 of the
Government Code).
805.2.  (a) It is the intent of the Legislature to provide for a
comprehensive study of the peer review process as it is conducted by
peer review bodies defined in paragraph (1) of subdivision (a) of
Section 805, in order to evaluate the continuing validity of Section
805 and Sections 809 to 809.8, inclusive, and their relevance to the
conduct of peer review in California.  The Medical Board of
California shall contract with the Institute for Medical Quality to
conduct this study, which shall include, but not be limited to, the
following components:
   (1) A comprehensive description of the various steps of and
decisionmakers in the peer review process as it is conducted by peer
review bodies throughout the state, including the role of other
related committees of acute care health facilities and clinics
involved in the peer review process.
   (2) A survey of peer review cases to determine the incidence of
peer review by peer review bodies, and whether they are complying
with the reporting requirement in Section 805.
   (3) A description and evaluation of the roles and performance of
various state agencies, including the State Department of Health
Services and occupational licensing agencies that regulate healing
arts professionals, in receiving, reviewing, investigating, and
disclosing peer review actions, and in sanctioning peer review bodies
for failure to comply with Section 805.
   (4) An assessment of the cost of peer review to licentiates and
the facilities which employ them.
   (5) An assessment of the time consumed by the average peer review
proceeding, including the hearing provided pursuant to Section 809.2,
and a description of any difficulties encountered by either
licentiates or facilities in assembling peer review bodies or panels
to participate in peer review decisionmaking.
   (6) An assessment of the need to amend Section 805 and Sections
809 to 809.8, inclusive, to ensure that they continue to be relevant
to the actual conduct of peer review as described in paragraph (1),
and to evaluate whether the current reporting requirement is yielding
timely and accurate information to aid licensing boards in their
responsibility to regulate and discipline healing arts practitioners
when necessary, and to assure that peer review bodies function in the
best interest of patient care.
   (7) Recommendations of additional mechanisms to stimulate the
appropriate reporting of peer review actions under Section 805.
   (8) Recommendations regarding the Section 809 hearing process to
improve its overall effectiveness and efficiency.
   (b) The Institute of Medical Quality shall exercise no authority
over the peer review processes of peer review bodies.  However, peer
review bodies, health care facilities, health care clinics, and
health care service plans shall cooperate with the institute and
provide data, information, and case files as requested in the
timeframes specified by the institute.
   (c) The institute shall work in cooperation with and under the
general oversight of the Medical Director of the Medical Board of
California and shall submit a written report with its findings and
recommendations to the board and the Legislature no later than
November 1, 2003.
805.5.  (a) Prior to granting or renewing staff privileges for any
physician and surgeon, psychologist, podiatrist, or dentist, any
health facility licensed pursuant to Division 2 (commencing with
Section 1200) of the Health and Safety Code, or any health care
service plan or medical care foundation, or the medical staff of the
institution shall request a report from the Medical Board of
California, the Board of Psychology, the Osteopathic Medical Board of
California, or the Dental Board of California to determine if any
report has been made pursuant to Section 805 indicating that the
applying physician and surgeon, psychologist, podiatrist, or dentist
has been denied staff privileges, been removed from a medical staff,
or had his or her staff privileges restricted as provided in Section
805.  The request shall include the name and California license
number of the physician and surgeon, psychologist, podiatrist, or
dentist.  Furnishing of a copy of the 805 report shall not cause the
805 report to be a public record.
   (b) Upon a request made by, or on behalf of, an institution
described in subdivision (a) or its medical staff, which is received
on or after January 1, 1980, the board shall furnish a copy of any
report made pursuant to Section 805.  However, the board shall not
send a copy of a report (1) if the denial, removal, or restriction
was imposed solely because of the failure to complete medical
records, (2) if the board has found the information reported is
without merit, or (3) if a period of three years has elapsed since
the report was submitted.  This three-year period shall be tolled
during any period the licentiate has obtained a judicial order
precluding disclosure of the report, unless the board is finally and
permanently precluded by judicial order from disclosing the report.
In the event a request is received by the board while the board is
subject to a judicial order limiting or precluding disclosure, the
board shall provide a disclosure to any qualified requesting party as
soon as practicable after the judicial order is no longer in force.
   In the event that the board fails to advise the institution within
30 working days following its request for a report required by this
section, the institution may grant or renew staff privileges for the
physician and surgeon, psychologist, podiatrist, or dentist.
   (c) Any institution described in subdivision (a) or its medical
staff that violates subdivision (a) is guilty of a misdemeanor and
shall be punished by a fine of not less than two hundred dollars
($200) nor more than one thousand two hundred dollars ($1,200).
805.6.  (a) The Medical Board of California, the Osteopathic Medical
Board, and the Dental Board of California shall establish a system
of electronic notification that is either initiated by the board or
can be accessed by qualified subscribers, and that is designed to
achieve early notification to qualified recipients of the existence
of new reports that are filed pursuant to Section 805.
   (b) The State Department of Health Services shall notify the
appropriate licensing agency of any reporting violations pursuant to
Section 805.
   (c) The Department of Managed Health Care shall notify the
appropriate licensing agency of any reporting violations pursuant to
Section 805.
805.7.  (a) The Medical Board of California shall work with
interested parties in the pursuit and establishment of a pilot
program, similar to those proposed by the Citizens Advocacy Center,
of early detection of potential quality problems and resolutions
through informal educational interventions.
   (b) The Medical Board of California shall report to the
Legislature its evaluation and findings and shall include
recommendations regarding the statewide implementation of this pilot
program before April 1, 2004.
806.  Each agency in the department receiving reports pursuant to
the preceding sections shall prepare a statistical report based upon
these records for presentation to the Legislature not later than 30
days after the commencement of each regular session of the
Legislature, including by the type of peer review body, and, where
applicable, type of health care facility, the number of reports
received and a summary of administrative and disciplinary action
taken with respect to these reports and any recommendations for
corrective legislation if the agency considers legislation to be
necessary.
807.  Each agency in the department shall notify every person
licensed, certified or holding similar authority issued by it, and
the department shall notify every insurance company doing business in
this state and every institution mentioned in Section 805 of the
provisions of this article.
808.  For purposes of this article, reports affecting respiratory
care practitioners required to be filed under Sections 801, 802, and
803 shall be filed with the Respiratory Care Board of California.
808.5.  For purposes of this article, reports affecting
psychologists required to be filed under Sections 801, 801.1, 802,
803, 803.5, and 803.6 shall be filed with the Board of Psychology of
the Department of Consumer Affairs.
809.  (a) The Legislature hereby finds and declares the following:
   (1) In 1986, Congress enacted the Health Care Quality Improvement
Act of 1986 (Chapter 117 (commencing with Section 11101) Title 42,
United States Code), to encourage physicians to engage in effective
professional peer review, but giving each state the opporunity to
"opt-out" of some of the provisions of the federal act.
   (2) Because of deficiencies in the federal act and the possible
adverse interpretations by the courts of the federal act, it is
preferable for California to "opt-out" of the federal act and design
its own peer review system.
   (3) Peer review, fairly conducted, is essential to preserving the
highest standards of medical practice.
   (4) Peer review which is not conducted fairly results in harm both
to patients and healing arts practitioners by limiting access to
care.
   (5) Peer review, fairly conducted, will aid the appropriate state
licensing boards in their responsibility to regulate and discipline
errant healing arts practitioners.
   (6) To protect the health and welfare of the people of California,
it is the policy of the State of California to exclude, through the
peer review mechanism as provided for by California law, those
healing arts practitioners who provide substandard care or who engage
in professional misconduct, regardless of the effect of that
exclusion on competition.
   (7) It is the intent of the Legislature that peer review of
professional health care services be done efficiently, on an ongoing
basis, with an emphasis on early detection of potential quality
problems and resolutions through informal educational interventions.
   (8) Sections 809 to 809.8, inclusive, shall not affect the
respective responsibilities of the organized medical staff or the
governing body of an acute care hospital with respect to peer review
in the acute care hospital setting.  It is the intent of the
Legislature that written provisions implementing Sections 809 to
809.8, inclusive, in the acute care hospital setting shall be
included in medical staff bylaws which shall be adopted by a vote of
the members of the organized medical staff and which shall be subject
to governing body approval, which approval shall not be withheld
unreasonably.
   (9) (A) The Legislature thus finds and declares that the laws of
this state pertaining to the peer review of healing arts
practitioners shall apply in lieu of Chapter 117 (commencing with
Section 11101) of Title 42 of the United States Code, because the
laws of this state provide a more careful articulation of the
protections for both those undertaking peer review activity and those
subject to review, and better integrates public and private systems
of peer review.  Therefore, California exercises its right to opt out
of specified provisions of the Health Care Quality Improvement Act
relating to professional review actions, pursuant to subparagraph (B)
of paragraph (2) of subdivision (c) of Section 11111 of Chapter 117
of Title 42 of the United States Code.  This election shall not
affect the availability of any immunity under California law.
   (B) The Legislature further declares that it is not the intent or
purposes of Sections 809 to 809.8, inclusive, to opt out of any
mandatory national data bank established pursuant to Subchapter II
(commencing with Section 11131) of Chapter 117 of Title 42 of the
United States Code.
   (b) For the purpose of this section and Sections 809.1 to 809.8,
inclusive, "healing arts practitioner" or "licentiate" means a
physician and surgeon, podiatrist, clinical psychologist, or dentist;
  and "peer review body" means a peer review body as specified in
paragraph (1) of subdivision (a) of Section 805, and includes any
designee of the peer review body.
809.05.  It is the policy of this state that peer review be
performed by licentiates.  This policy is subject to the following
limitations:
   (a) The governing bodies of acute care hospitals have a legitimate
function in the peer review process.  In all peer review matters,
the governing body shall give great weight to the actions of peer
review bodies and, in no event, shall act in an arbitrary or
capricious manner.
   (b) In those instances in which the peer review body's failure to
investigate, or initiate disciplinary action, is contrary to the
weight of the evidence, the governing body shall have the authority
to direct the peer review body to initiate an investigation or a
disciplinary action, but only after consultation with the peer review
body.  No such action shall be taken in an unreasonable manner.
   (c) In the event the peer review body fails to take action in
response to a direction from the governing body, the governing body
shall have the authority to take action against a licentiate.  Such
action shall only be taken after written notice to the peer review
body and shall fully comply with the procedures and rules applicable
to peer review proceedings established by Sections 809.1 to 809.6,
inclusive.
   (d) A governing body and the medical staff shall act exclusively
in the interest of maintaining and enhancing quality patient care.
   (e) It is not the intent or purpose of this section to prohibit or
discourage public members on state licensing boards and medical
quality review committees from participating in disciplinary actions
as authorized by law.
809.1.  (a) A licentiate who is the subject of a final proposed
action of a peer review body for which a report is required to be
filed under Section 805 shall be entitled to written notice as set
forth in subdivisions (b) and (c).  For the purposes of this section,
the "final proposed action" shall be the final decision or
recommendation of the peer review body after informal investigatory
activity or prehearing meetings, if any.
   (b) The peer review body shall give the licentiate written notice
of the final proposed action.  This notice shall include all the
following information:
   (1) That an action against the licentiate has been proposed by the
peer review body which, if adopted, shall be taken and reported
pursuant to Section 805.
   (2) The final proposed action.
   (3) That the licentiate has the right to request a hearing on the
final proposed action.
   (4) The time limit, within which to request such a hearing.
   (c) If a hearing is requested on a timely basis, the peer review
body shall give the licentiate a written notice stating all of the
following:
   (1) The reasons for the final proposed action taken or
recommended, including the acts or omissions with which the
licentiate is charged.
   (2) The place, time, and date of the hearing.
809.2.  If a licentiate timely requests a hearing concerning a final
proposed action for which a report is required to be filed under
Section 805, the following shall apply:
   (a) The hearing shall be held, as determined by the peer review
body, before a trier of fact, which shall be an arbitrator or
arbitrators selected by a process mutually acceptable to the
licentiate and the peer review body, or before a panel of unbiased
individuals who shall gain no direct financial benefit from the
outcome, who have not acted as an accuser, investigator, factfinder,
or initial decisionmaker in the same matter, and which shall include,
where feasible, an individual practicing the same specialty as the
licentiate.
   (b) If a hearing officer is selected to preside at a hearing held
before a panel, the hearing officer shall gain no direct financial
benefit from the outcome, shall not act as a prosecuting officer or
advocate, and shall not be entitled to vote.
   (c) The licentiate shall have the right to a reasonable
opportunity to voir dire the panel members and any hearing officer,
and the right to challenge the impartiality of any member or hearing
officer.  Challenges to the impartiality of any member or hearing
officer shall be ruled on by the presiding officer, who shall be the
hearing officer if one has been selected.
   (d) The licentiate shall have the right to inspect and copy at the
licentiate's expense any documentary information relevant to the
charges which the peer review body has in its possession or under its
control, as soon as practicable after the receipt of the licentiate'
s request for a hearing.  The peer review body shall have the right
to inspect and copy at the peer review body's expense any documentary
information relevant to the charges which the licentiate has in his
or her possession or control as soon as practicable after receipt of
the peer review body's request.  The failure by either party to
provide access to this information at least 30 days before the
hearing shall constitute good cause for a continuance.  The right to
inspect and copy by either party does not extend to confidential
information referring solely to individually identifiable
licentiates, other than the licentiate under review.  The arbitrator
or presiding officer shall consider and rule upon any request for
access to information, and may impose any safeguards the protection
of the peer review process and justice requires.
   (e) When ruling upon requests for access to information and
determining the relevancy thereof, the arbitrator or presiding
officer shall, among other factors, consider the following:
   (1) Whether the information sought may be introduced to support or
defend the charges.
   (2) The exculpatory or inculpatory nature of the information
sought, if any.
   (3) The burden imposed on the party in possession of the
information sought, if access is granted.
   (4) Any previous requests for access to information submitted or
resisted by the parties to the same proceeding.
   (f) At the request of either side, the parties shall exchange
lists of witnesses expected to testify and copies of all documents
expected to be introduced at the hearing.  Failure to disclose the
identity of a witness or produce copies of all documents expected to
be produced at least 10 days before the commencement  of the hearing
shall constitute good cause for a continuance.
   (g) Continuances shall be granted upon agreement of the parties or
by the arbitrator or presiding officer on a showing of good cause.
   (h) A hearing under this section shall be commenced within 60 days
after receipt of the request for hearing, and the peer review
process shall be completed within a reasonable time, after a
licentiate receives notice of a final proposed action or an immediate
suspension or restriction of clinical privileges, unless the
arbitrator or presiding officer issues a written decision finding
that the licentiate failed to comply with subdivisions (d) and (e) in
a timely manner, or consented to the delay.
809.3.  (a) During a hearing concerning a final proposed action for
which reporting is required to be filed under Section 805, both
parties shall have all of the following rights:
   (1) To be provided with all of the information made available to
the trier of fact.
   (2) To have a record made of the proceedings, copies of which may
be obtained  by the licentiate upon payment of any reasonable charges
associated with the preparation thereof.
   (3) To call, examine, and cross-examine witnesses.
   (4) To present and rebut evidence determined by the arbitrator or
presiding officer to be relevant.
   (5) To submit a written statement at the close of the hearing.
   (b) The burden of presenting evidence and proof during the hearing
shall be as follows:
   (1) The peer review body shall have the initial duty to present
evidence which supports the charge or recommended action.
   (2) Initial applicants shall bear the burden of persuading the
trier of fact by a preponderance of the evidence of their
qualifications by producing information which allows for adequate
evaluation and resolution of reasonable doubts concerning their
current qualifications for staff privileges, membership, or
employment.  Initial applicants shall not be permitted to introduce
information not produced upon request of the peer review body during
the application process, unless the initial applicant establishes
that the information could not have been produced previously in the
exercise of reasonable diligence.
   (3) Except as provided above for initial applicants, the peer
review body shall bear the burden of persuading the trier of fact by
a preponderance of the evidence that the action or recommendation is
reasonable and warranted.
   (c) The peer review body shall adopt written provisions governing
whether a licentiate shall have the option of being represented by an
attorney at the licentiate's  expense.  No peer review body shall be
represented by an attorney if the licentiate is not so represented,
except dental professional society peer review bodies may be
represented by an attorney provided that the peer review body grants
each licentiate the option of being represented by an attorney at the
licentiate's expense, even if the licentiate declines to be
represented by an attorney.
809.4.  (a) Upon the completion of a hearing concerning a final
proposed action for which a report is required to be filed under
Section 805, the licentiate and the peer review body involved have
the right to receive all of the following:
   (1) A written decision of the trier of fact, including findings of
fact and a conclusion articulating the connection between the
evidence produced at the hearing and the decision reached.
   (2) A written explanation of the procedure for appealing the
decision, if any appellate mechanism exists.
   (b) If an appellate mechanism is provided, it need not provide for
de novo review, but it shall include the following mimimum rights
for both parties:
   (1) The right to appear and respond.
   (2) The right to be represented by an attorney or any other
representative designated by the party.
   (3) The right to receive the written decision of the appellate
body.
809.5.  (a) Notwithstanding Sections 809 to 809.4, inclusive, a peer
review body may immediately suspend or restrict clinical privileges
of a licentiate where the failure to take that action may result in
an imminent danger to the health of any individual, provided that the
licentiate is subsequently provided with the notice and hearing
rights set forth in Sections 809.1 to 809.4, inclusive, or, with
respect to organizations specified in Section 809.7, with the rights
specified in that section.
   (b) When no person authorized by the peer review body is available
to summarily suspend or restrict clinical privileges under
circumstances specified in subdivision (a), the governing body of an
acute care hospital, or its designee, may immediately suspend a
licentiate's clinical privileges if a failure to summarily suspend
those privileges is likely to result in an imminent danger to the
health of any individual, provided the governing body of the acute
care hospital has, before the suspension, made reasonable attempts to
contact the peer review body.  A suspension by the governing body of
an acute care hospital which has not been ratified by the peer
review body within two working days, excluding weekends and holidays,
after the suspension shall terminate automatically.
809.6.  (a) The parties are bound by any additional notice and
hearing provisions contained in any applicable professional society
or medical staff bylaws which are not inconsistent with Sections
809.1 to 809.4, inclusive.
   (b) The parties are bound by any additional notice and hearing
provisions contained in any applicable agreement or contract between
the licentiate and peer review body or health care entity which are
not inconsistent with Sections 809.1 to 809.4, inclusive.
   (c) The provisions of Sections 809.1 to 809.4, inclusive, may not
be waived in any instrument specified in subdivision (a) or (b) for a
final proposed action for which a report is required to be filed
under Section 805.
809.7.  Sections 809.1 to 809.4, inclusive, shall not apply to peer
review proceedings conducted in state or county  hospitals, in
hospitals owned by, operated by, or licensed to the Regents of the
University of California or any of its subsidiary corporations which
serve as a primary teaching facility, or in health facilities which
serve as the primary teaching facility for medical schools approved
pursuant to Section 2084.  In addition, Sections 809.1 to 809.4,
inclusive, shall not apply to licentiates engaged in postgraduate
medical education under the auspices of a medical school approved
pursuant to Section 2084. This section shall not affect the
obligation to afford due process of law to licentiates involved in
peer review proceedings in these hospitals.
809.8.  Nothing in Sections 809 to 809.7, inclusive, shall affect
the availability of judicial review under Section 1094.5 of the Code
of Civil Procedure nor  the provisions relating to discovery and
testimony in Section 1157 of the Evidence Code or Sections 1370 and
1370.1 of the Health and Safety Code.
809.9.  In any suit brought to challenge an action taken or a
restriction imposed which is required to be reported pursuant to
Section 805, the court shall, at the conclusion of the action, award
to a substantially prevailing party the cost of the suit, including a
reasonable attorney's fee, if the other party's conduct in bringing,
defending, or litigating the suit was frivolous, unreasonable,
without foundation, or in bad faith.  For the purposes of this
section, a defendant shall not be considered to have substantially
prevailed when the plaintiff obtains an award for damages or
permanent injunctive or declaratory relief.  For the purpose of this
section, a plaintiff shall not be considered to have substantially
prevailed when the plaintiff does not obtain an award of damages or
permanent injunctive or declaratory relief.