Court Opinion

ID: 9791302
Source: CourtListenerOpinion
Date Created: 2023-08-31 02:08:40.255751+00
Date Added: 2024-06-11T07:37:35.277118
License: Public Domain

KENNARD, J.
I dissent.
In granting plaintiff psychologists primary responsibility for the admission, diagnosis, treatment and discharge of hospitalized patients, the majority grants by litigation what could not be achieved by legislation. In doing so, the majority fails to adhere to established standards of judicial review; disregards an eminently reasonable interpretation of the governing statute by the agency charged with its enforcement; and, through a strained interpretation of legislative history, converts legislative rejection into implied legislative acceptance.
Fidelity to established standards of judicial review, a fair reading of statutory language, and an analysis of legislative history, compel the conclusion that the Department of Health Services (Department) did not act in excess of its authority when it promulgated the challenged regulations.
Discussion
A. The Challenged Regulations
This case involves the validity of regulations promulgated by the Department pursuant to a delegation of legislative power to license and regulate hospitals. (Health & Saf. Code, §§ 208, subd. (a), 1253, 1254, 1254.1, 1298.)1 In implementing section 1316.5, the statute at issue here, the Department issued two regulations according psychiatrists primary responsibility for diagnostic formulation and treatment of patients hospitalized for mental problems. (Cal. Code Regs., tit. 22, §§ 70577, subd. (d)(1), 71203, subd. (a)(1)(A).) One regulation applied to general acute care hospitals, the other to acute psychiatric hospitals. (Id., tit. 22, §§ 70005, 71005.)
The standard governing our review of the Department’s regulations in this case is unambiguous. The regulations are not alleged to be arbitrary, *23capricious or wholly lacking in evidentiary support; the only question before this court is whether the regulations “transgress statutory power.” (Morris v. Williams (1967) 67 Cal.2d 733, 749 [63 Cal.Rptr. 689, 433 P.2d 697].) “Courts have long recognized that the Legislature may elect to defer to and rely upon the expertise of administrative agencies [citations].” (Credit Ins. Gen. Agents Assn. v. Payne (1976) 16 Cal.3d 651, 656 [128 Cal.Rptr. 881, 547 P.2d 993].) Judicial interference is warranted only when the agency has “clearly overstepped” its statutory authority. (Ford Dealers Assn. v. Department of Motor Vehicles (1982) 32 Cal.3d 347, 356 [185 Cal.Rptr. 453, 650 P.2d 328].) “Under established principles [an agency’s] construction is to be regarded with deference by a court performing the judicial function of statutory construction, and will generally be followed unless it is clearly erroneous.” (San Mateo City School Dist. v. Public Employment Relations Bd. (1983) 33 Cal.3d 850, 856 [191 Cal.Rptr. 800, 663 P.2d 523].) As we observed in Highland Ranch v. Agricultural Labor Relations Bd. (1981) 29 Cal.3d 848, 859 [176 Cal.Rptr. 753, 633 P.2d 949]: “[B]oth this court and the United States Supreme Court have recognized on numerous occasions that ‘[t]he construction of a statute by the officials charged with its administration must be given great weight ....’” (First brackets added.)
The majority invokes this legal standard but ignores its application. The majority accords no deference whatsoever to the Department’s interpretation of the statutes it is charged with implementing and enforcing. Disregarding the Department’s reasonable interpretation of the law, the majority substitutes its judgment for that of the rulemaking agency, in violation of Government Code section 11340.1.
As demonstrated below, the challenged regulations are (1) consistent with section 1316.5, which contains no language granting clinical psychologists primary responsibility for hospitalized patients, and (2) in conformance with the statute’s legislative history, which establishes the Legislature’s overwhelming rejection—by a vote of 45 to 13—of the very language that the majority claims the Department should have adopted in its regulations.
B. Statutory Analysis
The statutory language itself does not support the majority’s holding. Subdivision (a) of section 1316.5 provides in pertinent part: “The rules of a health facility may enable the appointment of clinical psychologists on such terms and conditions as the facility shall establish. In such health facilities, clinical psychologists may hold membership and serve on committees of the medical staff and carry professional responsibilities consistent with the scope of their licensure and their competence, subject to the rules of the *24health facility . . . . [fl] If a health service is offered by a health facility with both licensed physicians and surgeons and clinical psychologists on the medical staff, which both licensed physicians and surgeons and clinical psychologists are authorized by law to perform, such service may be performed by either, without discrimination.”
The statute contains no express language granting clinical psychologists primary responsibility for hospitalized patients. The majority, however, insists that such a grant is implied in the statute’s references to (1) the performance of services by clinical psychologists within “the scope of their licensure” and “without discrimination,” and (2) their eligibility for membership on a hospital’s medical staff. I disagree.
1. Scope of Licensure
The Psychology Licensing Law is set forth in Business and Professions Code section 2900 et seq. Business and Professions Code section 2903 defines the practice of psychology as follows: “The practice of psychology is defined as rendering or offering to render . . . any psychological service involving the application of psychological principles .... [10 The application of such principles and methods includes, but is not restricted to: diagnosis, prevention, treatment, and amelioration of psychological problems and emotional and mental disorders of individuals and groups.”
As the majority points out, Business and Professions Code section 2903 was drafted to regulate outpatient practice where “no other professional is even involved.” (Maj. opn., ante, at p. 13.) Because its focus is outpatient care, the provision does not apply to hospitalized medical care. Nor does it apply to primary responsibility for the obvious reason that primary responsibility cannot be an issue when there is only one professional involved. Thus, Business and Professions Code section 2903’s history and purpose cannot support the majority’s position of an implied grant to psychologists of primary responsibility over hospitalized patients. Moreover, as explained below, the express terms of the statute preclude such an implied grant.
The key word in the language of Business and Professions Code section 2903 is “psychological.” The majority correctly notes that psychologists have authority to diagnose and treat psychological problems of patients in hospitals. (Maj. opn., ante, at p. 13.) The majority, however, equates such authority with primary responsibility for the admission, diagnosis, and treatment of hospitalized patients.
How can primary responsibility for a hospitalized patient’s care be exercised by one who lacks authority to consider the full range of possible *25causes of an illness and to select the most appropriate combination of methods of treatment?
Patients do not necessarily enter hospitals with psychological conditions neatly divorced from biological, neurological, physiological or genetic disorders. The nature of an illness cannot be ascertained prior to diagnosis by a legally authorized professional. Physicians are legally qualified to provide comprehensive diagnosis and treatment; psychologists are not.
Unlike psychologists, physicians possess the legal authority to consider all possible causes of an illness. The State Medical Practice Act (Bus. & Prof. Code, § 2000 et seq.), which governs physicians, defines diagnosis as including “any undertaking by any method, device, or procedure whatsoever ... to ascertain or establish whether a person is suffering from any physical or mental disorder.” (Bus. & Prof. Code, § 2038.) In contrast, the diagnostic authority granted psychologists is severely limited. The scope of their licensure limits psychologists to the diagnosis of psychological problems. (Bus. & Prof. Code, § 2903.) Unlike physicians, psychologists are not allowed to “use any method, device, or procedure” or determine whether a person is suffering from “any physical or mental disorder.” (Compare Bus. & Prof. Code, § 2903 with Bus. & Prof. Code, § 2038.) Psychologists are limited to the application of psychological principles to psychological disorders. (Bus. & Prof. Code, § 2903.) Thus, they may not diagnose an illness caused or complicated by nonpsychological factors.
Unlike psychologists, physicians are authorized to use “any and all . . . methods,” including drugs and devices, in the treatment of physical and mental conditions. (Bus. & Prof. Code, § 2051.) Psychologists, on the other hand, are statutorily prohibited from prescribing drugs, performing surgery, or administering electroconvulsive therapy. (Bus. & Prof. Code, § 2904.) Nor may they use biofeedback instruments that pierce or cut the skin (Bus. & Prof. Code, § 2903.1); the law restricts them to the use of psychological principles (Bus. & Prof. Code, § 2903). Thus, psychologists may not provide treatment that would require more than the application of psychological principles.
There is no support for the majority’s assertion that the authority to diagnose and treat subsumes the authority to admit patients into hospitals. (Maj. opn., ante, at p. 13, fn. 7.) The assertion cannot be statutorily based; the statutes say nothing about who can admit patients to hospitals. The Department, not this court, has the expertise necessary to resolve this issue.
As demonstrated above, the authority of a physician to diagnose and treat is different and much broader than that granted psychologists. Because *26the concept of primary responsibility includes the ability to evaluate a hospitalized patient’s overall condition and to select the most appropriate methods of treatment, the Legislature’s grant of limited authority to psychologists cannot be equated with primary responsibility. Nothing in the statutory scheme suggests otherwise.
The majority, albeit obliquely, concedes the difference. In a footnote at the very end of its opinion, the majority, without discussion, prior explanation, or citation of relevant authority, says: “Under the trial court’s order, a physician must be available to examine the patient upon admission and provide medical treatment as needed.” (Maj. opn., ante, at p. 21, fn. 14.) This concession by the majority is inconsistent with the position it has maintained throughout its opinion that psychologists can take primary responsibility for the admission, diagnosis, and treatment of hospitalized patients.
2. Prohibition Against Discrimination
Section 1316.5 prohibits discrimination between physicians and clinical psychologists with respect to the health services both are authorized to perform. As shown above, the health services psychologists are authorized to provide and the health services physicians are authorized to provide are not coextensive. (See California State Psychological Assn. v. County of San Diego (1983) 148 Cal.App.3d 849, 853 [198 Cal.Rptr. 1].)
The antidiscrimination clause does not address the issue of who has primary responsibility for a patient. It simply requires that when psychologists and physicians are both authorized to provide the health service, one may not be preferred over the other. Thus, if psychological services are required as part of the treatment of a patient, a physician may not be selected to perform the services over a psychologist. The clause neither says nor implies that psychologists are to be given overall primary responsibility for the admission, diagnosis, treatment and discharge of hospitalized patients.
The majority asserts that the regulations violated the antidiscrimination language because a psychologist performing psychological services would be subject to the supervision of a psychiatrist. (Maj. opn., ante, at pp. 13-14.) The majority’s unarticulated assumption is that primary responsibility for a patient necessarily entails physician control over a psychologist’s performance of psychological services. It does not. Primary responsibility may encompass a physician’s decision to refer a patient for psychological evaluation; it does not follow, however, that the reference therefore includes control over the psychologist’s performance. A physician may also decide, *27for example, to refer a patient to a radiologist. The physician does not thereby assume control over the radiologist’s performance of the radiology services. The regulations challenged in this case did not provide otherwise. (Ante, at p. 22; maj. opn., ante, at p. 6, fn. 1.)
Although the medical needs of a patient may require the psychiatrist to change the treatment plan, this court should not assume, as the majority does, that “when a psychiatrist refers a patient to a psychologist for psychotherapy,” the psychiatrist would exercise his or her authority to control the psychologist’s performance. (Maj. opn., ante, at pp. 13-14, fn. 8.) Inherent in the concept of referral is a recognition of the particular competence and expertise of the health provider to whom the patient is referred. Heavy-handed supervision would be inconsistent with this recognition, whether the referral be to a radiologist or a psychologist.
3. Membership on Medical Staff
Section 1316.5 provides for health facilities to allow clinical psychologists to be members of the medical staff. Such membership encompasses responsibility to the hospital governing body for the quality of in-hospital medical care; evaluation of the qualifications of applicants and holders of staff privileges; recommendations for appointment, reappointment, curtailment and exclusion from staff privileges; and provisions for peer group methods for reviewing basic medical, surgical and obstetrical functions. (West Covina Hospital v. Superior Court (1986) 41 Cal.3d 846, 852-853 [226 Cal.Rptr. 132, 718 P.2d 119, 60 A.L.R.4th 1257]; Matchett v. Superior Court (1974) 40 Cal.App.3d 623, 628 [115 Cal.Rptr. 317].)
This provision does nothing more than afford a clinical psychologist on a hospital’s medical staff a voice in the policymaking body of the hospital; it does not grant the psychologist primary responsibility for patients.
The analysis above mirrors the interpretation of the statute by the Department.
C. Legislative History
The legislative history of section 1316.5 reveals that the Legislature specifically considered and rejected giving clinical psychologists the very expansion of authority that the majority grants them.
1. Senate Bill No. 259
In 1978, Senator Carpenter introduced Senate Bill No. 259, which formed the basis for section 1316.5. Originally, the bill contained this provi*28sion under subdivision (c): “When a patient is admitted to a health facility upon referral of a licensed clinical psychologist. . . the health facility shall require that a licensed physician and surgeon be designated to provide for any anticipated or potential medical needs of the patient. However, nothing in this subdivision shall require or authorize such physician to supervise or prescribe psychological care to be provided by the licensed clinical psychologist within the scope of his licensure, and the patient’s care, other than medical care, shall be the responsibility and subject to the direction of the psychologist.” (Sen. Bill No. 259 (1977-1978 Reg. Sess.) § 2.)
This entire provision, however, was deleted before the Legislature’s passage of the bill. (Sen. Amend, to Sen. Bill No. 259 (1977-1978 Reg. Sess.) Jan. 19, 1978.) As enacted in 1978, section 1316.5 contained no language whatsoever granting clinical psychologists independent admission and treatment rights. It merely provided in relevant part: “(a) The rules of a health facility may enable the appointment of clinical psychologists on such terms and conditions as the facility shall establish. Psychologists may hold membership and serve on committees of the professional staff and may possess clinical privileges and carry professional responsibilities consistent with the scope of their licensure and their competence, subject to the rules of the health facility.” (Stats. 1978, ch. 116, § 2, p. 286.) The deletion of an express provision is evidence that it was not intended by the Legislature. (United States v. Security Industrial Bank (1982) 459 U.S. 70, 81-82 [74 L.Ed.2d 235, 245, 103 S.Ct. 407].)
It was not long before Senator Carpenter sought to amend section 1316.5 through Senate Bill No. 1443, which proposed to expand the authority of clinical psychologists.
2. Senate Bill No. 1443
In 1980, Senator Carpenter introduced Senate Bill No. 1443, which proposed amending section 1316.5 to give clinical psychologists certain independent admission and treatment rights over hospitalized patients. The proposed language read: “The rules of an acute psychiatric hospital . . . shall allow [clinical] psychologists to admit and treat patients within the scope of their licensure, without a physician and surgeon ordering care. However, a physician and surgeon shall be responsible for all those acts of diagnosis, treatment, or prescribing or ordering drugs for the patient which may only be performed by licensed physicians.” (Sen. Bill No. 1443 (1979-1980 Reg. Sess.) § 1.)
Not only did this language resemble that contained in Senator Carpenter’s original version of Senate Bill No. 259, which I discussed earlier, but it *29also met a similar fate: it too was deleted prior to the Legislature’s amendment of section 1316.5. As noted above, the deletion of a provision is evidence that it was not intended by the Legislature. (United States v. Security Industrial Bank, supra, 459 U.S. at pp. 81-82 [74 L.Ed.2d at p. 245].)
As relevant here, the amendment added the following language to the statute: “If a health service is offered by a health facility with both licensed physicians and surgeons and clinical psychologists on the medical staff, which both licensed physicians and surgeons and clinical psychologists are authorized by law to perform, such service may be performed by either, without discrimination.” (Sen. Amend, to Sen. Bill No. 1443 (1979-1980 Reg. Sess.) May 7, 1980; Stats. 1980, ch. 730, § 1, p.2178.)
Almost three years later, Senator Carpenter again attempted, through Senate Bill No. 181, to expand the responsibility of psychologists over hospitalized patients.
3. Senate Bill No. 181
Senate Bill No. 181, which Senator Carpenter introduced in January 1983, proposed adding a section 1316.7 to the Health and Safety Code to grant clinical psychologists primary responsibility for the diagnosis and treatment of hospitalized patients.
In April 1983, Senator Carpenter amended his bill by proposing that, instead of creating a new section, the bill’s language be used to modify section 1316.5 as follows: “Clinical psychologists, who are members of the medical staff. . . shall, subject to the rules of the health facility . . . also be responsible, in accordance with the scope of their licensure, for diagnostic formulations and the development and implementation of individual treatment plans for their patients or for those referred to them, as appropriate.” (Sen. Amend, to Sen. Bill No. 181 (1983-1984 Reg. Sess.) Apr. 13, 1983.) This version did pass the Senate. But the bill was overwhelmingly rejected by the Assembly on September 14, 1983, by a vote of 45 to 13.2(5 Assem. J. (1983-1984 Reg. Sess.) pp. 9356-9357.) Nine months later, on June 20, 1984, plaintiffs filed this lawsuit; they prevailed in the trial court but lost in the Court of Appeal.
There is a marked similarity between the language that the trial court ordered the Department to adopt and the language of Senate Bill No. 181 *30that had earlier been soundly rejected by the Legislature, as this side-by-side comparison illustrates:
Trial Court Order ^[8 “The Department of Health Services is ordered to amend Title 22 Cal. Admin. Code §§ 70577(d)(1) and 71203(a)(1)(A) to provide as follows:
‘Psychiatrists or clinical psychologists within the scope of their licensure and subject to the rules of the facility shall be responsible for the diagnostic formulation for their patients and the development and implementation of each patient’s treatment plan.’ ”
Senate Bill No. 181 “[Cjlinical psychologists as defined in Section 1316.5, who are members of the medical staff of a health facility, or who are privileged to practice or consult therein, shall be responsible, within the scope of their licensure, for diagnostic formulations and the development and implementation of individual treatment plans, as appropriate.”
The legislative history of section 1316.5 thus compels the same conclusion as the analysis of the statutory language itself: the Legislature has not granted clinical psychologists primary responsibility over hospitalized patients.
Nevertheless, the majority maintains the contrary. It claims that the 1978 statute’s legislative declaration evidences an intent by the Legislature to expand the authority of clinical psychologists. (Maj. opn., ante, at pp. 15-16.) The majority has misread and mischaracterized the declaration, as I shall demonstrate.
Prior to 1978, the status of clinical psychologists on a hospital’s staff was highly uncertain. Often, they were excluded from hospital privileges. Department regulations that were then in effect provided that the composition of the organized professional staff of a health facility would consist of physicians, dentists, and podiatrists.3 As the Department’s Enrolled Bill Report to the Governor explained: “Existing law is silent on whether a health facility may grant staff privileges to a licensed clinical psychologist. While a number of hospitals in California have granted prescribed privileges to clinical psychologists, supporters of SB 259 maintain that the bill is necessary to make it explicit that clinical psychologists may be given such *31privileges.” (Cal. Dept. Health, Enrolled Bill Rep., Sen. Bill No. 259 (1978) p. 2.) Against this backdrop, the Legislature enacted section 1316.5 in 1978. In its declaration of purpose, the Legislature stated that “under present law” psychologists were unduly restricted in their access to and utilization of health facilities, thus preventing hospitalized patients from continuing to receive care from the psychologist of their choice.
Therefore, as set forth plainly in the legislative declaration to the 1978 statute and in the bill report to the Governor, the purpose of the statute simply was to ensure that clinical psychologists could become staff members of a hospital.
Equally misplaced is the majority’s reliance on an opinion of the Legislative Counsel dated January 4, 1979, and an unpublished letter by the Attorney General of March 15, 1979. Both were in response to a request from Senator Carpenter for an interpretation of the 1978 statute, and both concluded that under the statute clinical psychologists were authorized to take primary responsibility for hospitalized patients. The majority argues that, because these opinions were rendered before the Legislature considered amending the statute in 1980, the Legislature had “the opportunity to correct matters” if the opinions were incorrect in their interpretation of the 1978 statute. The Legislature’s failure to state to the contrary in its amendment of the statute, the majority reasons, indicates its acceptance of the statute’s construction by the Legislative Counsel and the Attorney General before the statute’s amendment. (Maj. opn., ante, at pp. 16-17.)
As a general principle of statutory construction, the rule of legislative acquiescence or inaction relied on by the majority is “a slim reed upon which to lean” when applied to precedential judicial decisions. (Quinn v. State of California (1975) 15 Cal.3d 162, 175 [124 Cal.Rptr. 1, 539 P.2d 761]; see also United States v. Price (1960) 361 U.S. 304, 310-311 [4 L.Ed.2d 334, 339, 80 S.Ct. 326].) In this case, the majority’s reliance on the rule is wholly unjustified. When a court has interpreted a statute and that construction is not altered by subsequent legislation, there is, in appropriate circumstances, a reasoned basis to presume that the Legislature may be aware of the judicial construction and approves of it. (See, e.g., Quinn v. State of California, supra, at p. 175; People v. Hallner (1954) 43 Cal.2d 715, 720 [277 P.2d 393].)
Although the Legislature is presumed to know of existing judicial decisions, its awareness of a statutory analysis by the Attorney General or the Legislative Counsel is more doubtful, and the relevant circumstances should be carefully evaluated. In this case, the majority relies on documents that were never published and were issued some four years before the Legisla*32ture’s vote that is supposed to demonstrate acquiescence. The majority offers no evidence that the Legislature was actually aware of either document when it voted in 1983 to reject Senate Bill No. 181,4 nor does it provide any authority for the proposition that legislative awareness of such unpublished interpretations should be presumed.
Moreover, even if the documents had been brought to the Legislature’s attention, the Legislature was free to disregard them. A published decision of an appellate court construing a statute must be considered by the Legislature because it is binding on all of the trial courts in the state. (Auto Equity Sales, Inc. v. Superior Court (1962) 57 Cal.2d 450, 455 [20 Cal.Rptr. 321, 369 P.2d 937].) Unless abrogated by the Legislature or contradicted by another appellate court opinion, statutory construction by an appellate court is authoritative and “ ‘becomes as much a part of the statute as if it had been written into it originally.’ ” (People v. Hallner, supra, 43 Cal.2d 715, 720.) By contrast, an analysis of a statute by the Attorney General, or by the Legislative Counsel, binds no one. (See, e.g., Napa Valley Educator’s Assn. v. Napa Valley Unified School Dist. (1987) 194 Cal.App.3d 243, 251 [239 Cal.Rptr. 395]; People v. Vallerga (1977) 67 Cal.App.3d 847, 870 [136 Cal.Rptr. 429].) If the theory of legislative acquiesence in a judicial construction is a “slim reed” (Quinn v. State of California, supra, 15 Cal.3d 162, 175), how are we to characterize the majority’s reliance on interpretations by the Attorney General and the Legislative Counsel that the Legislature may not have known of and was in any event free to disregard?
Finally, the pertinent statutes were given another and different interpretation, which was published, that the majority ignores in its discussion of legislative acquiescence. The Department’s construction of those statutes, which is entitled to great weight (Highland Ranch v. Agricultural Labor Relations Bd., supra, 29 Cal.3d at p. 859; Meyer v. Board of Trustees (1961) 195 Cal.App.2d 420, 431 [15 Cal.Rptr. 717]), was embodied in the regulations it adopted on January 6, 1983. Senate Bill No. 181 was introduced the same month, amended in April 1983, and overwhelmingly rejected on September 14, 1983. If we are to assume anything about the Legislature’s awareness of existing interpretations, we should assume that the Legislature was aware of, and acquiesced in, the interpretation of the Department.
In sum, to construe section 1316.5 as according clinical psychologists independent admission and treatment authority over hospitalized patients, as the majority does, is to read into the statute the very language that the Legislature has expressly rejected. “The rejection by the Legislature of a *33specific provision contained in an act as originally introduced is most persuasive to the conclusion that the act should not be construed to include the omitted provision.” (.Rich v. State Board of Optometry (1965) 235 Cal.App.2d 591, 607 [45 Cal.Rptr. 512]; see also California Mfrs. Assn. v. Public Utilities Com. (1979) 24 Cal.3d 836, 845-846 [157 Cal.Rptr. 676, 598 P.2d 836]; Stroh v. Midway Restaurant Systems, Inc. (1986) 180 Cal.App.3d 1040, 1055 [226 Cal.Rptr. 153].) This court should not grant through litigation what could not be achieved through legislation
Conclusion
Section 1316.5 does not expressly give clinical psychologists authority to assume primary responsibility for hospitalized patients. The statute is, at best, ambiguous and its legislative history strongly suggests that the Legislature had no intention to confer such authority. The regulations the Department enacted were within the scope of its statutory authority and consistent with the language and legislative history of section 1316.5. In disregarding the reasonable interpretation of the administrative agency charged with responsibility for enforcing the statute, and possessed of the expertise necessary to assess the practical impact of alternative interpretations, the majority has succumbed to the temptation to substitute its judgment for that of the Legislature and the Department.
Lucas, C. J., and Panelli, J., concurred.
Appellants’ petition for a rehearing was denied September 20, 1990, and the opinion was modified to read as printed above. Arabian, J., did not participate therein.

 All further statutory references are to the Health and Safety Code, unless indicated otherwise.

The majority mistakenly asserts that the Legislature rejected Assembly Bill No. 3592. (Maj. opn., ante, at p. 15.) That bill, however, was never addressed by the Legislature or even by a legislative committee. (2 Assem. Final Hist. (1985-1986 Reg. Sess.) p. 2273.) The Legislature adjourned before taking action on the bill. (6 Assem. J. (1985-1986 First Ex. Sess.) p. 161; see Cal. Const., art. IV, § 10, subd. (a).)

 In 1978, California Administrative Code (now the Cal. Code Regs.), title 22, section 70703, subdivison (b) provided as follows: “The medical staff shall be composed of physicians and, where dental or podiatric services are provided, dentists or podiatrists.” There was no provision permitting clinical psychologists to be members of a medical staff.

 The one member of the Legislature we can be sure was aware of these interpretations was Senator Carpenter, who had requested them. His sponsorship of Senate Bill No. 181 demonstrates how little he relied upon them.