BILL ANALYSIS
SB 132
Page 1
Date of Hearing: June 30, 2009
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
SB 132 (Denham) - As Amended: June 24, 2009
SENATE VOTE : 34-0
SUBJECT : Polysomnographic technologists: sleep and wake
disorders.
SUMMARY : Establishes educational and registration requirements
for certified polysomnographic technologists (CPT), technicians
and trainees, and requires the Medical Board of California (MBC)
to develop regulations for the employment and designation of
CPTs, technicians, and trainees. Specifically, this bill :
1)Requires MBC to adopt regulations within one year after the
effective date of this bill determining the qualifications
necessary for the registration of individuals as certified
CPTs, polysomnographic technicians, and polysomnographic
trainees.
2)Requires individuals seeking to become a CPT to have the
following minimum qualifications:
a) Valid, current credentials as a polysomnographic
technologist by a national accrediting agency approved by
MBC;
b) Graduated from a polysomnographic educational program
approved by MBC; and,
c) Passed a national certifying examination approved by
MBC, or can submit proof to MBC that they have been
practicing for at least five years in a manner acceptable
to MBC. Beginning three years after the effective date of
this bill, all individuals seeking certification as a CPT
must pass a national certifying examination.
3)Requires the MBC to submit necessary information on all CPTs,
technicians, or trainee certification candidates to the
Department of Justice (DOJ) for the purpose of obtaining
information on state or federal convictions and arrests.
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4)Requires the DOJ to provide information on CPT candidates, as
specified, and any subsequent arrest notifications.
5)Permits an individual to use the title CPT and engage in the
practice of polysomnography under the following circumstances:
a) The individual is registered with MBC;
b) The individual works under the supervision and direction
of a licensed physician and surgeon;
c) The individual has successfully undergone a state and
federal level criminal record check; and,
d) The individual meets the requirements of this bill.
6)Requires MBC to adopt regulations within one year after the
effective date of this bill that establish the means and
circumstances in which a licensed physician and surgeon may
employ polysomnographic technicians and trainees.
7)Permits MBC to adopt regulations specifying the scope of
services that may be provided by a polysomnographic technician
or trainee and the level of supervision necessary for
polysomnographic technicians and trainees when working under
the supervision of a CPT or licensed healthcare professional.
8)Exempts from these requirements California licensed allied
health professionals working within the scope of practice of
their license including respiratory care practitioners.
9)States that this bill shall not be interpreted to authorize a
CPT, technician, or trainee to treat, manage, control,
educate, or care for patients other than those with sleep
disorders or to provide diagnostic testing for patients other
than those with suspected sleep disorders.
10)States that a registration may be denied, suspended, revoked,
or otherwise subjected to discipline for any of the following:
a) Incompetence, gross negligence, or repeated similar
negligent acts performed by the registrant;
b) An act of dishonesty or fraud;
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c) Committing any act or being convicted of a crime
constituting grounds for denial of licensure or
registration, as specified; or,
d) Violating or attempting to violate any provision of this
bill.
11)Requires each registrant to pay a registration fee, not to
exceed $100, into MBC's Contingent Fund. Specifies that:
a) Each person to whom registration is granted must pay a
fee not to exceed $100;
b) The registration shall expire after two years, and may
be renewed biennially for a fee not to exceed $100; and,
c) The money in MBC's Contingent Fund collected pursuant to
this bill shall be used for the administration of this
bill.
12)States that nothing in this bill shall prohibit a clinic or
health facility from employing a CPT, as specified.
13)States that nothing in this bill shall apply to diagnostic
electroencephalograms, as specified.
14)Defines the following:
a) "Polysomnography" means the treatment, management,
diagnostic testing, control, education, and care of
patients with sleep and wake disorders. Polysomnography
includes the process of analysis, monitoring, and recording
of physiologic data during sleep and wakefulness to assist
in the treatment of disorders, syndromes, and dysfunctions
that are sleep-related, manifest during sleep, or disrupt
normal sleep activities. Polysomnography also includes the
therapeutic and diagnostic use of oxygen, the use of
positive airway pressure including continuous positive
airway pressure and bilevel modalities, adaptive
servo-ventilation and maintenance of nasal and oral airways
that do not extend into the trachea; and,
b) "Supervision" means that the supervising physician and
surgeon shall remain available, either in person or through
telephonic or electronic means, at the time that the
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polysomnographic services are provided.
EXISTING LAW :
1)Provides for the licensing and regulation of physician
assistants (PAs) by the PA Committee of MBC, within the
Department of Consumer Affairs (DCA), and prescribes the
medical services as set forth by the regulations of the MBC
that may be performed by a PA under the supervision of a
licensed physician and surgeon.
2)Provides for the licensure and regulation of respiratory care
practitioners by the Respiratory Care Board of California
(RCB) within DCA.
3)Defines the practice of respiratory care, and prohibits its
practice without a license issued by the RCB, subject to
certain exceptions.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author, "This bill
establishes criteria for individuals assisting licensed
physicians in the practice of sleep medicine. A
well-established medical discipline, polysomnography involves
the monitoring and recording of individuals while they sleep, to
aid with sleep disorders. This bill establishes educational
requirements, background checks, and other consumer protections,
for the technicians aiding the licensed physicians doing the
study. This bill will also help ensure that patients are able
to continue to seek and receive valuable and needed medical
services in the area of sleep medicine."
Background . The National Sleep Foundation reports that "Nearly
50 million Americans chronically suffer from sleep problems and
disorders that affect their careers, their personal
relationships and safety on our roads." Sleep loss and sleep
disorders have been associated with an increased risk of other
health problems such as high blood pressure, diabetes, obesity,
depression, heart attack and stroke. It is believed that the
majority of people with sleep disorders have not yet been
diagnosed, although most disorders can be successfully treated
or controlled once properly identified.
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Many people seek help with their sleep problems at sleep
disorders centers, medical centers staffed by physicians and
other medical professionals, including polysomnographic
technologists, with specialized training in sleep medicine.
Sleep disorders are evaluated using polysomnography, a complex
assessment of the body during sleep. The results are called a
polysomnographic (PSG) measurement.
Technologists who perform PSG-related procedures must use the
instrumentation in a sleep laboratory and have a knowledge of
the sleep-induced physiological changes in various body systems,
including the neurological, musculoskeletal, cardiac, and
respiratory systems; have a working knowledge of the
physiological and behavioral alterations associated with
sleep/wake pathology; and be capable of interpreting various
reports so as to be able to intervene appropriately during a
study.
Physicians utilize the observations of technologists to assist
in the identification of dysfunction in sleep/wake cycles, to
diagnose breathing disorders during sleep, and to evaluate
treatment of these disorders.
Suggested amendments . The committee may wish to omit the
following phrases from this bill because it is unnecessary to
preempt all other provisions of law to achieve the bill's
purposes: "Notwithstanding any other provision of law,"
Previous legislation . SB 1526 (Perata) of 2008 was an
essentially identical bill that the Governor vetoed. The
Governor vetoed a substantial number of bills that year with the
same message that, due to the delay in passing the 2008-09 State
Budget, he would only sign bills that were "the highest priority
for California." SB 1526 was vetoed for this reason.
SB 1125 (Denham) of 2008 would have provided for the licensing
and regulation of polysomnographic technologists by the RCB.
The bill failed passage in the Senate Business, Professions, and
Economic Development Committee.
Arguments in support . The MBC's Executive Committee writes in
support, "The Board feels that this bill will further its
mission of consumer protection by regulating the health care
providers who work under physician supervision to treat patients
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with sleep disorders. Currently, there is no accountability for
those involved in assisting with the practice of sleep medicine.
These registration requirements would provide consumer
protections to patients seeking sleep disorder treatment, and
help clarify existing law as it relates to polysomnography."
REGISTERED SUPPORT / OPPOSITION :
Support
California Sleep Society (sponsor)
California Hospital Association
California Medical Association
California Society for Respiratory Care
Medical Board of California
Respiratory Care Board
Various individuals
Opposition
None on file.
Analysis Prepared by : Trinh Phan / B. & P. / (916) 319-3301