BILL ANALYSIS ------------------------------------------------------------ |SENATE RULES COMMITTEE | SB 1069| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ UNFINISHED BUSINESS Bill No: SB 1069 Author: Pavley (D), et al Amended: 8/16/10 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 SENATE FLOOR : 30-0, 5/10/10 AYES: Aanestad, Alquist, Ashburn, Calderon, Cedillo, Cogdill, Correa, Cox, DeSaulnier, Ducheny, Florez, Hancock, Hollingsworth, Huff, Kehoe, Leno, Lowenthal, Negrete McLeod, Padilla, Pavley, Price, Romero, Runner, Simitian, Steinberg, Walters, Wolk, Wright, Wyland, Yee NO VOTE RECORDED: Corbett, Denham, Dutton, Harman, Liu, Oropeza, Strickland, Wiggins, Vacancy, Vacancy ASSEMBLY FLOOR : 75-0, 8/18/10 - See last page for vote SUBJECT : Physician assistants SOURCE : California Academy of Physician Assistants CONTINUED SB 1069 Page 2 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 for various individuals. Assembly Amendments prohibit a physician assistant from certifying disability after performing a physical examination under the supervision of a physician and surgeon, as specified, delete provisions relating to the timing of accusation filings, and delete "physician assistant" from the definition of "practitioner" in the Unemployment Insurance Code. 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 (PAs). 2. Provides that a 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 SB 1069 Page 3 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 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. 6. 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 either 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 medical equipment. B. For individuals receiving home health services or personal care services, after consultation with the SB 1069 Page 4 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. 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 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 SB 1069 Page 5 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. 6. 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 8/18/10) California Academy of Physician Assistants (source) American Congress of Obstetricians and Gynecologists American Federation of State, County and Municipal Employees California Academy of Family Physicians California Assisted Living Association California Chapter of the American College of Emergency Physicians California Medical Association California Psychiatric Association California Radiological Society Medical Board of California Osteopathic Physicians and Surgeons of California 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 SB 1069 Page 6 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 the prosecuting agencies can devote their resources to more recent misdeeds. ASSEMBLY FLOOR : AYES: Adams, Ammiano, Anderson, Arambula, Bass, Beall, Bill Berryhill, Tom Berryhill, Block, Blumenfield, Bradford, Brownley, Buchanan, Caballero, Carter, Chesbro, Conway, Cook, Coto, Davis, De La Torre, De Leon, DeVore, Eng, Feuer, Fletcher, Fong, Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick, Gatto, Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill, Huber, Huffman, Jeffries, Jones, Knight, Lieu, Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello, Nielsen, Norby, V. Manuel Perez, Portantino, Ruskin, Salas, Saldana, Silva, Skinner, Smyth, Solorio, Audra Strickland, Swanson, Torlakson, Torres, Torrico, Tran, Villines, Yamada, John A. Perez NO VOTE RECORDED: Blakeslee, Charles Calderon, Evans, Logue, Vacancy JJA:mw 8/18/10 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE SB 1069 Page 7 **** END ****