AB 154, as amended, Atkins. 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 Board within the jurisdiction of the Medical Board of California.
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, and to comply with standardized procedures or protocols, 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: yes. State-mandated local program: yes.
The people of the State of California do enact as follows:
Section 2253 of the Business and Professions
2Code is amended to read:
(a) Failure to comply with the Reproductive Privacy
4Act (Article 2.5 (commencing with Section 123460) of Chapter 2
5of Part 2 of Division 106 of the Health and Safety Code) constitutes
6unprofessional conduct.
7(b) (1) Except as provided in paragraph (2), a person is subject
8to Section 2052 if he or she performs an abortion, and at the time
9of so doing, does not have a valid, unrevoked, and unsuspended
10license to practice as a physician and surgeon.
11(2) A person shall not be subject to Section 2052 if he or she
12performs an abortion by medication or aspiration techniques in
13the
first trimester of pregnancy, and at the time of so doing, has a
14valid, unrevoked, and unsuspended license or certificate obtained
15in accordance with the Nursing Practice Act (Chapter 6
16(commencing with Section 2700)) or the Physician Assistant
17Practice Act (Chapter 7.7 (commencing with Section 3500)), that
18authorizes him or her to perform the functions necessary for an
19abortion by medication or aspiration techniques.
20(c) In order to perform an abortion by aspiration techniques
21pursuant to paragraph (2) of subdivision (b), a person shall comply
22with Section 2725.4 or 3502.4.
Section 2725.4 is added to the Business and Professions
24Code, to read:
begin delete(a)end deletebegin delete end deletebegin insertNotwithstanding any other provision of this
26chapter, the following shall apply:end insert
27begin insert(a)end insertbegin insert end insert In order to perform an abortion by aspiration techniques
28pursuant to Section 2253, a person with a
license or certificate to
29practice as a nurse practitioner or a certified nurse-midwife shall
30complete training recognized by the Board of Registered Nursing.
31Beginning January 1, 2014, and until January 1, 2016, the
32competency-based training protocols established by Health
33Workforce Pilot Project (HWPP) No. 171 through the Office of
34Statewide Health Planning and Development shall be used.
35(b) In order to perform an abortion by aspiration techniques
36pursuant to Section 2253, a person with a license or certificate to
37practice as a nurse practitioner or a certified nurse-midwife shall
P4 1adhere to standardized procedures developed in compliance with
2subdivision (c) of Section 2725 that specify all of the following:
3(1) The extent of supervision by a physician and surgeon with
4relevant
training and expertise.
5(2) Procedures for transferring patients to the care of the
6physician and surgeon or a hospital.
7(3) Procedures for obtaining assistance and consultation from
8a physician and surgeon.
9(4) Procedures for providing emergency care until physician
10assistance and consultationbegin delete isend deletebegin insert areend insert available.
11(5) The method of periodic review of the provisions of the
12standardized procedures.
13(c) A nurse practitioner or certified
nurse-midwife who has
14completed training and achieved clinical competency through
15HWPP No. 171 shall be authorized to perform abortions by
16aspiration techniques pursuant to Section 2253, in adherence to
17standardized procedures described in subdivision (b).
18(d) It is unprofessional conduct for any nurse practitioner or
19certified nurse-midwife to perform an abortion by aspiration
20techniques pursuant to Section 2253 without prior completion of
21training and validation of clinical competency.
Section 3502.4 is added to the Business and Professions
23Code, to read:
(a) In order to receive authority from his or her
25supervising physician and surgeon to perform an abortion by
26aspiration techniques pursuant to Section 2253, a physician
27assistant shall complete training either through training programs
28approved by the board pursuant to Section 3513 or by training to
29perform medical services which augment his or her current areas
30of competency pursuant to Section 1399.543 of Title 16 of the
31California Code of Regulations. Beginning January 1, 2014, and
32until January 1, 2016, the training and clinical competency
33protocols established by Health Workforce Pilot Project (HWPP)
34No. 171 through the Office of Statewide Health Planning and
35Development shall be used as training and clinical
competency
36guidelines to meet this requirement.
37(b) In order to receive authority from his or her supervising
38physician and surgeon to perform an abortion by aspiration
39techniques pursuant to Section 2253, a physician assistant shall
P5 1comply with protocols developed in compliance with Section 3502
2that specify:
3(1) The extent of supervision by a physician and surgeon with
4relevant training and expertise.
5(2) Procedures for transferring patients to the care of the
6physician and surgeon or a hospital.
7(3) Procedures for obtaining assistance and consultation from
8a physician and surgeon.
9(4) Procedures for
providing emergency care until physician
10assistance and consultationbegin delete isend deletebegin insert areend insert available.
11(5) The method of periodic review of the provisions of the
12protocols.
13(c) The training protocols established by HWPP No. 171 shall
14be deemed to meet the standards of the
board. A physician assistant
15who has completed training and achieved clinical competency
16through HWPP No. 171 shall be authorized to perform abortions
17by aspiration techniques pursuant to Section 2253, in adherence
18to protocols described in subdivision (b).
19(d) It is unprofessional conduct for any physician assistant to
20perform an abortion by aspiration techniques pursuant to Section
212253 without prior completion of training and validation of clinical
22competency.
Section 123468 of the Health and Safety Code is
24amended to read:
The performance of an abortion is unauthorized if
26either of the following is true:
27(a) The person performing the abortion is not a health care
28provider authorized to perform an abortion pursuant to Section
292253 of the Business and Professions Code.
30(b) The abortion is performed on a viable fetus, and both of the
31following are established:
32(1) In the good faith medical judgment of the physician, the
33fetus was viable.
34(2) In the good faith medical judgment of the physician,
35continuation
of the pregnancy posed no risk to life or health of the
36pregnant woman.
No reimbursement is required by this act pursuant to
38Section 6 of Article XIII B of the California Constitution because
39the only costs that may be incurred by a local agency or school
40district will be incurred because this act creates a new crime or
P6 1infraction, eliminates a crime or infraction, or changes the penalty
2for a crime or infraction, within the meaning of Section 17556 of
3the Government Code, or changes the definition of a crime within
4the meaning of Section 6 of Article XIII B of the California
5Constitution.
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