BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 132
                                                                  Page  1


          SENATE THIRD READING
          SB 132 (Denham)
          As Amended  August 31, 2009
          2/3 vote.  Urgency 

           SENATE VOTE  :   34-0

           BUSINESS & PROFESSIONS   10-0   APPROPRIATIONS      16-0        
           
           ----------------------------------------------------------------- 
          |Ayes:|Hayashi, Emmerson,        |Ayes:|De Leon, Conway, Ammiano, |
          |     |Conway, Eng,              |     |                          |
          |     |Hernandez, Nava, Niello,  |     |Charles Calderon, Coto,   |
          |     |John A. Perez, Ruskin,    |     |Davis,                    |
          |     |Smyth                     |     |Fuentes, Hall, Harkey,    |
          |     |                          |     |Nielsen,                  |
          |     |                          |     |John A. Perez, Skinner,   |
          |     |                          |     |Solorio, Audra            |
          |     |                          |     |Strickland, Torlakson,    |
          |     |                          |     |Hill                      |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           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,  







                                                                  SB 132
                                                                  Page  2


               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.  

          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  







                                                                  SB 132
                                                                  Page  3


            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; 

             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 $150; 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  







                                                                  SB 132
                                                                  Page  4


               activities.  Polysomnography also includes the therapeutic  
               and diagnostic use of oxygen, the use of positive airway  
               pressure including continuous positive airway pressure and  
               bi-level 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  
               polysomnographic services are provided.

           FISCAL EFFECT  :  According to Assembly Appropriations Committee,  
          one-time fee-supported, special fund costs of $193,000 to the MBC  
          to promulgate regulations.  On-going fee-supported special fund  
          costs of $47,000 to continue oversight of sleep specialists.  
          Recent amendments increase the registration fee from $100 to $150  
          to ensure the program is fully supported.

           COMMENTS  :  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. 

          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.







                                                                 SB 132
                                                                  Page  5




           Analysis Prepared by  :    Sarah Huchel / B. & P. / (916) 319-3301  
          FN: 0002601