BILL NUMBER: AB 154	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MARCH 19, 2013

INTRODUCED BY   Assembly Member Atkins

                        JANUARY 22, 2013

    An act relating to reproductive health care. 
 An act to amend Section 2253 of, and to add Sections 734,
2725.4, and 3502.4 to, the Business and Professions Code, and to
amend Section 123468 of the Health and Safety Code, relating to
healing arts. 



	LEGISLATIVE COUNSEL'S DIGEST


   AB 154, as amended, Atkins.  Healing arts: reproductive
health care.   Abortion. 
   Existing law makes it a public offense, punishable by a fine not
exceeding $10,000 or imprisonment, or both, for a person to perform
or assist in performing a surgical abortion if the person does not
have a valid license to practice as a physician and surgeon, or to
assist in performing a surgical abortion without a valid license or
certificate obtained in accordance with some other law that
authorizes him or her to perform the functions necessary to assist in
performing a surgical abortion. Existing law also makes it a public
offense, punishable by a fine not exceeding $10,000 or imprisonment,
or both, for a person to perform or assist in performing a
nonsurgical abortion if the person does not have a valid license to
practice as a physician and surgeon or does not have a valid license
or certificate obtained in accordance with some other law authorizing
him or her to perform or assist in performing the functions
necessary for a nonsurgical abortion. Under existing law, nonsurgical
abortion includes termination of pregnancy through the use of
pharmacological agents.
   Existing law, the Nursing Practice Act, provides for the licensure
and regulation of registered nurses, including nurse practitioners
and certified nurse-midwives, by the Board of Registered Nursing.
Existing law, the Physician Assistant Practice Act, provides for the
licensure and regulation of physician assistants by the Physician
Assistant Committee of the Medical Board of California. 
   Existing law authorizes the Office of Statewide Health Planning
and Development to designate experimental health workforce projects
as approved projects that, among other things, teach new skills to
existing categories of health care personnel. The office has
designated a pilot project, known as the Access through Primary Care
Project, relating to the provision of health care services involving
pregnancy.  
   This bill would state that it is the intent of the Legislature to
enact legislation that would expand access to reproductive health
care in California by allowing qualified health care professionals to
perform early abortions.  
   This bill would instead make it a public offense, punishable by a
fine not exceeding $10,000 or imprisonment, or both, for a person to
perform an abortion if the person does not have a valid license to
practice as a physician and surgeon, except that it would not be a
public offense for a person to perform an abortion by medication or
aspiration techniques in the first trimester of pregnancy if he or
she holds a license or certificate authorizing him or her to perform
the functions necessary for an abortion by medication or aspiration
techniques. The bill would also require a nurse practitioner,
certified nurse-midwife, or physician assistant to complete training,
as specified, in order to perform an abortion by aspiration
techniques, and would indefinitely authorize a nurse practitioner,
certified nurse-midwife, or physician assistant who completed a
specified training program and achieved clinical competency to
continue to perform abortions by aspiration techniques. The bill
would delete the references to a nonsurgical abortion and would
delete the restrictions on assisting with abortion procedures. The
bill would also make technical, nonsubstantive changes.  
   Because the bill would change the definition of crimes, the bill
would impose a state-mandated local program.  
    The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.  
   This bill would provide that no reimbursement is required by this
act for a specified reason. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program:  no
  yes  .


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 734 is added to the  
Business and Professions Code   , to read:  
   734.  It is unprofessional conduct for any nurse practitioner,
certified nurse midwife, or physician assistant to perform an
abortion pursuant to Section 2253, without prior completion of
training and validation of clinical competency. 
   SEC. 2.    Section 2253 of the   Business
and Professions Code   is amended to read:
   2253.  (a) Failure to comply with the Reproductive Privacy Act
(Article 2.5 (commencing with Section 123460) of Chapter 2 of Part 2
of Division 106 of the Health and Safety Code)  in
performing, assisting, procuring or aiding, abetting, attempting,
agreeing, or offering to procure an illegal abortion 
constitutes unprofessional conduct.
   (b) (1)  A   Except as provided in paragraph
(2), a  person is subject to  Sections  
Section  2052  and 2053  if he or she performs
 or assists in performing a surgical   an 
abortion, and at the time of so doing, does not have a valid,
unrevoked, and unsuspended license to practice as a physician and
surgeon  as provided in this chapter, or if he or she assists
in performing a surgical abortion and does not have a valid,
unrevoked, and unsuspended license or certificate obtained in
accordance with some other provision of law that authorizes him or
her to perform the functions necessary to assist in performing a
surgical abortion  .
   (2) A person  is   shall not be  subject
to  Sections   Section  2052  and
2053  if he or she performs  or assists in
performing a nonsurgical abortion,   an abortion by
medication or aspiration techniques in the first trimester of
pregnancy,  and at the time of so doing,  does not have
a valid, unrevoked, and unsuspended license to practice as a
physician and surgeon as provided in this chapter, or does not have
  has  a valid, unrevoked, and unsuspended license
or certificate obtained in accordance with some other provision of
law  , including, but not limited to, the Nursing Practice Act
(Chapter 6 (commencing with Section 2700)) or the Physician Assistant
Practice Act (Chapter 7.7   (commencing with Section
3500)),  that authorizes him or her to perform  or
assist in performing  the functions necessary for  a
nonsurgical abortion.   an abortion by medication or
aspiration techniques   .  
   (c) For purposes of this section, "nonsurgical abortion" includes
termination of the use of pharmacological agents.  
   (c) In order to perform an abortion by aspiration techniques
pursuant to paragraph (2) of subdivision (b), a person shall comply
with Section 2725.4 or 3502.4. 
   SEC. 3.    Section 2725.4 is added to the  
Business and Professions Code   , to read:  
   2725.4.  (a) In order to perform an abortion by aspiration
techniques, a person with a license or certificate to practice as a
nurse practitioner or a certified nurse-midwife shall complete
training recognized by the Board of Registered Nursing. Beginning
January 1, 2014, and until January 1, 2016, the competency-based
training protocols established by Health Workforce Pilot Project
(HWPP) No. 171 through the Office of Statewide Health Planning and
Development shall be used.
   (b) A nurse practitioner or certified nurse-midwife who has
completed training and achieved clinical competency through HWPP No.
171 shall be authorized to perform abortions by aspiration
techniques. 
   SEC. 4.    Section 3502.4 is added to the  
Business and Professions Code   , to read:  
   3502.4.  (a) In order to receive authority from his or her
supervising physician and surgeon to perform an abortion by
aspiration techniques, a physician assistant shall complete training
either through training programs approved by the Physician Assistant
Board pursuant to Section 3513 or by training to perform medical
services which augment his or her current areas of competency
pursuant to Section 1399.543 of Title 16 of the California Code of
Regulations. Beginning January 1, 2014, and until January 1, 2016,
the training and clinical competency protocols established by Health
Workforce Pilot Project (HWPP) No. 171 through the Office of
Statewide Health Planning and Development shall be used as training
and clinical competency guidelines to meet this requirement.
   (b) The training protocols established by HWPP No. 171 shall be
deemed to meet the standards of the Physician Assistant Board. A
physician assistant who has completed training and achieved clinical
competency through HWPP No. 171 shall be authorized to perform
abortions by aspiration techniques. 
   SEC. 5.    Section 123468 of the   Health
and Safety Code  is amended to read: 
   123468.  The performance of an abortion is unauthorized if either
of the following is true:
   (a)  The person performing  or assisting in performing
 the abortion is not a health care provider authorized to
perform  or assist in performing  an abortion
pursuant to Section 2253 of the Business and Professions Code.
   (b)  The abortion is performed on a viable fetus, and both of the
following are established:
   (1)  In the good faith medical judgment of the physician, the
fetus was viable.
   (2)  In the good faith medical judgment of the physician,
continuation of the pregnancy posed no risk to life or health of the
pregnant woman.
   SEC. 6.    No reimbursement is required by this act
pursuant to Section 6 of Article XIII B of the California
Constitution because the only costs that may be incurred by a local
agency or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction, or
changes the penalty for a crime or infraction, within the meaning of
Section 17556 of the Government Code, or changes the definition of a
crime within the meaning of Section 6 of Article XIII B of the
California Constitution.  
  SECTION 1.    It is the intent of the Legislature
to enact legislation that would expand access to reproductive health
care in California by allowing qualified health care professionals to
perform early abortions, provided that the functions are within the
scope of their licenses.