BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 356
                                                                  Page  1

          Date of Hearing:   May 13, 2009 

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                  AB 356 (Fletcher) - As Amended:  April 23, 2009  

          Policy Committee:                              HealthVote:  16-0
                       Business & Professions                10-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill authorizes a physician and surgeon to delegate  
          procedures using fluoroscopy to a licensed physician assistant  
          (PA) if the PA completes 40 hours of total coursework, including  
          radiation safety and protection approved by the California  
          Department of Public Health (DPH). 

           FISCAL EFFECT  

          Absorbable workload to DPH to continue oversight of diagnostic  
          imaging professional proficiency. 

           COMMENTS  

           1)Rationale . This bill is sponsored by the California  
            Association of Physician Assistants (CAPA) to allow PAs to  
            conduct fluoroscopy procedures under the supervision of a  
            physician and after completing training. Fluoroscopy imaging  
            obtains real-time moving images of the internal structures of  
            a patient via an x-ray and fluorescent screens between which a  
            patient is placed. Computers and video equipment allow images  
            to be displayed. Under current law, PAs are allowed to provide  
            medical services they are deemed competent to perform, as  
            determined by a supervising physician and consistent with  
            their education, training, and experience. This bill adds  
            fluoroscopy to the services which a supervising physician may  
            authorize for a PA.  

           2)Background  . The DPH enforces laws and regulations related to  
            radiological equipment to protect the public, radiation  
            workers, and the environment. The DPH is responsible for  








                                                                  AB 356
                                                                  Page  2

            administering a radiation control program, including licensing  
            of radioactive materials, registration of x-ray-producing  
            machines, certification of medical and industrial x-ray and  
            radioactive material users, inspection of facilities using  
            radiation, investigation of radiation incidents, and  
            surveillance of radioactive contamination in the environment. 
           

           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081