BILL ANALYSIS ------------------------------------------------------------ |SENATE RULES COMMITTEE | SB 1069| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ THIRD READING Bill No: SB 1069 Author: Pavley (D), et al Amended: 5/5/10 Vote: 21 SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE : 8-0, 4/12/10 AYES: Negrete McLeod, Wyland, Aanestad, Calderon, Correa, Oropeza, Walters, Yee NO VOTE RECORDED: Florez SENATE JUDICIARY COMMITTEE : 4-0, 4/20/10 AYES: Corbett, Harman, Hancock, Leno NO VOTE RECORDED: Walters SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8 SUBJECT : Physician assistants SOURCE : California Academy of Physician Assistants DIGEST : This bill authorizes a physician assistant, pursuant to a delegation of services agreement, to order durable medical equipment, certify unemployment insurance disability, and for individuals receiving home health services or personal care services, after consultation with the supervising physician, approve, sign, modify, or add to a plan of treatment or plan of care. Also, authorizes physician assistants to conduct specified medical examinations and sign corresponding medical certificates CONTINUED SB 1069 Page 2 for various individuals, and specifies certain statutes of limitations for the filing of an accusation against a licensee by the Physician Assistant Committee similar to other health care licensing acts. Senate Floor Amendments of 5/5/10 correct a grammatical error an add co-authors. ANALYSIS : Existing law: 1. Establishes the Physician Assistant Practice Act administered by the Physician Assistant Committee (Committee) of the Medical Board of California (MBC) to regulate physician assistants. 2. Provides that a physician assistant (PA) may perform those medical services as set forth by the regulations of MBC when the services are rendered under the supervision of a licensed physician and surgeon approved by MBC, except as otherwise provided. 3. States that an accusation filed against a licensee shall be filed within three years from the date the board discovers the alleged act or omission that is the basis for the disciplinary action or within seven years from the date the alleged act or omission that is the basis for the disciplinary action occurred, whichever occurs first. This statute of limitations provision is included in the practice act of the following health care practitioners: dentists, physicians and surgeons, psychologists, respiratory care therapists, marriage and family therapists, social workers, and educational psychologists. Defines "discovers" for purposes of this provision, but only for the practice act that applies to marriage and family therapists, social workers, and educational psychologists. 4. Exempts an accusation alleging the procurement of a license by fraud or misrepresentation from the statute of limitations specified in #3 above. 5. States that an accusation alleging sexual misconduct SB 1069 Page 3 shall be filed within three years after the boards discover the act or omission or within 10 years after the act or omission. 6. States that if an alleged act or omission involves a minor, the seven-year limitations specified in #3 above and the 10-year limitations specified in #5 above shall be tolled until the minor reaches the age of majority. Further states that for marriage and family therapists, social workers, and educational therapists, if specified acts are committed against a minor, the Board of Behavioral Sciences (BBS), which regulates these health care licensees, is authorized to take action regardless of whether or not the act occurred prior to or after the time the license was issued by BBS. 7. States that the limitations specified in #3 above shall be tolled during any period if material evidence necessary for prosecuting or determining whether a disciplinary action would be appropriate is unavailable to the boards due to an ongoing criminal investigation. 8. States that an accusation is a written statement of charges against a healing arts licensee which shall set forth in ordinary and concise language the acts or omissions with which a licensee is charged. This bill: 1. Defines delegation of services agreement as the writing that delegates to a PA from a supervising physician the medical services the PA is authorized to perform, as specified. 2. Defines other specified medical services as tests or exams performed by or ordered by a PA practicing in compliance with the Physician Assistant Practice Act. 3. Specifies that a delegation of services agreement may authorize a PA to do any of the following: A. Order durable medical equipment, as specified. States that this does not limit the ability of a third-party payer to require prior approval for the SB 1069 Page 4 medical equipment. B. Certify unemployment insurance disability, as specified, after performance of a physical examination by the PA under the supervision of a physician and surgeon, as specified. C. For individuals receiving home health services or personal care services, after consultation with the supervising physician, approve, sign, modify, or add to a plan of treatment or plan of care. 4. States that nothing in #3 above shall be construed to affect the validity of any delegation of services agreement in effect prior to the enactment of this bill, as specified. 5. Requires any accusation filed against a licensee, except as provided in #6 below, to be filed within three years after the Committee discovers the act or omission alleged as the grounds for disciplinary action or within seven years after the act or omission alleged as the grounds for disciplinary action occurs, whichever occurs first. 6. Exempts the following from the statutes of limitations specified in #5 above: A. An accusation alleging the procurement of a license by fraud or misrepresentation. B. An accusation alleging unprofessional conduct based on incompetence, gross negligence, or repeated negligent acts, as specified. 7. States that if an alleged act or omission involves a minor, the seven-year limitations period provided for in #5 above and the 10-year limitations provided in #8 below shall be tolled until the minor reaches the age of majority. However, if the Committee discovers an alleged act of sexual contact with a minor under specified sections of the Penal Code after the limitations periods have otherwise expired, and there is independent evidence that corroborates the allegation, SB 1069 Page 5 an accusation shall be filed within three years from the date the Committee discovers that alleged act. 8. An accusation alleging sexual misconduct shall be filed within three years after the Committee discovers the act or omission alleged as the grounds for disciplinary action, or within 10 years after the act or omission alleged as the grounds for disciplinary action occurs, whichever occurs first. Specifies that this provision applies to complaints alleging sexual misconduct received by the Committee on or after January 1, 2011. 9. States that the statute of limitations provided for in #5 above shall be tolled during any period if material evidence necessary for prosecuting or determining whether a disciplinary action would be appropriate is unavailable to the Committee due to an ongoing criminal investigation. 10.Defines "discovers" as the latest of the occurrence of any of the following with respect to each act or omission alleged as the basis for disciplinary action: A. The date the committee receives a complaint or report describing the act or omission. B. The date, subsequent to the original complaint or report, on which the committee becomes aware of any additional acts or omissions alleged as the basis for disciplinary action against the same individual. C. The date the committee receives from the complainant a written release of information pertaining to the complainant's diagnosis and treatment. 11.Authorizes a PA to do the following: A. Certify that an applicant for a teacher certification or renewal of certification is free from any contagious or communicable disease or other disabling disease or defect, as specified. B. Conduct medical examinations and certify that an SB 1069 Page 6 individual that is initially employed by a school district in a certificated or classified position, is free from tuberculosis, as specified. C. Order medications for any pupil to take during the regular school day, as specified, and provide written statements to the school district detailing information about the medication. D. Certify the results of a determination of a child's vision to be presented by a parent to the school district for waiving a required vision assessment of school-aged children. E. Perform a physical examination of a student participating in an interscholastic athletic program, as specified. F. Conduct medical examination and certify that an applicant for an academic position at a community college district is free from any communicable disease, including tuberculosis. G. Conduct medical examination and certify that a retirant applicant of a community college district is free from any disabling disease. H. Conduct medical examination and certify that anyone who wishes to be employed in an academic or classified position at a community college is free of active tuberculosis, as specified. I. Certify the need for an individual who has been diagnosed by a licensed physician and surgeon as being deaf or hearing impaired to participate in a program implemented by the Public Utilities Commission (PUC) to provide telecommunications devices for deaf or hearing impaired, as specified. J. Certify an individual's disability, thereby qualifying an individual to participate in the state's specialized or supplemental telephone communications equipment program, as specified. SB 1069 Page 7 12.Includes PAs in the definition of practitioner who could certify medical eligibility for unemployment disability benefits. 13.Authorizes a physician and surgeon to perform a required physical examination of a student as a condition of participation in an interscholastic athletic program. FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes Local: No SUPPORT : (Verified 5/5/10) California Academy of Physician Assistants (source) American Congress of Obstetricians and Gynecologists American Federation of State, County and Municipal Employees California Assisted Living Association California Medical Association California Radiological Society United Nurses Association of California/Union of Health Care Professionals ARGUMENTS IN SUPPORT : The California Academy of Physician Assistants (CAPA) is the sponsor of this bill. CAPA states that this bill clarifies various inconsistencies and omissions in existing law by allowing PAs to order durable medical equipment, certify disability for purposes of unemployment insurance eligibility, approve, sign, modify or add to a treatment plan for home health or personal care services, and conduct specified physical examinations and sign corresponding certificates or forms. CAPA points out that all of these functions would be performed under physician supervision and consistent with existing PA scope of practice. Additionally, CAPA points out that there is a need to establish statute of limitations provisions for PAs. CAPA states that the primary purpose for statute of limitation provisions is to assure fairness to defendants. The ability to prepare a defense is clearly undermined in cases where a claim is not pursued for a long period of time because evidence is lost, memories fade and witnesses disappear. Statute of limitation provisions also assures SB 1069 Page 8 the prosecuting agencies can devote their resources to more recent misdeeds. JJA:mw 5/5/10 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END ****