BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 722
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 722 (Lowenthal)
          As Amended  May 28, 2013
          Majority vote
           
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          |ASSEMBLY:  |77-0 |(April 15,      |SENATE: |33-0 |(July 8, 2013) |
          |           |     |2013)           |        |     |               |
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           Original Committee Reference:    TRANS  .

           SUMMARY  :  Adds chiropractors to the list of eligible persons to  
          perform medical examinations for specified drivers.   
          Specifically,  this bill  :  

          1)Adds chiropractors to the list of eligible health care  
            providers that may perform and report medical examinations for  
            applicants of all ages applying or renewing certification to  
            operate a school bus, school pupil activity bus, youth bus,  
            general public paratransit vehicle, or farm labor vehicle.  

          2)Clarifies that chiropractors that perform physical  
            examinations for commercial license applicants must be in  
            compliance with federal requirements.   

           The Senate amendments  provide additional clarification that a  
          licensed chiropractor as specified in federal regulations may  
          perform medical examinations on applicants identified in this  
          bill.  

           EXISTING LAW  : 

          1)Requires applicants for an original or renewal certificate to  
            drive a school bus, school pupil activity bus, youth bus,  
            general public paratransit vehicle, or farm labor vehicle to  
            submit a report to the Department of Motor Vehicles (DMV) of a  
            medical examination given by a physician licensed to practice  
            medicine, a licensed advance practice registered nurse  
            qualified to perform a medical examination, or a licensed  
            physician assistant.  

          2)Allows chiropractors to conduct physical examinations on  
            drivers for all other categories of commercial vehicles.  









                                                                  AB 722
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          3)Allows chiropractors to conduct physical examinations on  
            school bus drivers 65 years of age or older.  

          4)Requires, at the federal level, all healthcare providers to be  
            certified and listed on the National Registry of Certified  
            Medical Examiners (NRCME) in order to perform physical  
            examinations on applicants for commercial driver's licenses;  
            defines chiropractor as a licensed medical examiner.  

           FISCAL EFFECT  :  Unknown.  This bill is keyed non-fiscal by the  
          Legislative Counsel.   

           COMMENTS  :  In 1992, federal guidelines were modified to allow a  
          licensed physician assistant, nurse practitioner, or  
          chiropractor to perform physical examinations on commercial  
          vehicle drivers.  Several years later, inconsistencies in the  
          vehicle code pertaining to these federal regulations were  
          uncovered which, as a result, prohibited these professions from  
          conducting physical examinations on this category of commercial  
          drivers.  DMV then modified its physical examination forms and  
          examiner guidelines so that only medical doctors could carry out  
          specific driver exams for school buses, school pupil activity  
          buses, youth buses, general public paratransit vehicles, and  
          farm labor vehicles.  

          Over time, state law has been amended to allow chiropractors to  
          perform physical examinations on all other categories of  
          commercial drivers including trucks, public transit vehicles,  
          and ambulances.  State law was further amended to allow  
          chiropractors to perform physical examines on school bus drivers  
          65 years of age or older.  As a result, school bus drivers under  
          65 years of age are the last remaining group of drivers which  
          are prohibited from receiving a physical examine from  
          chiropractors.  

          The sponsors of this bill state "AB 722 would eliminate this gap  
          in the law by allowing chiropractors to similarly perform  
          physical exams to those under 65 of age.  Chiropractors are  
          educated and licensed by the State of California to serve as a  
          portal of entry and as primary care providers.  Chiropractors  
          have rigorous academic and clinical training.  They earn a  
          4-year doctorate degree and undergo extensive clinical  
          education, which includes a year-long internship.  By law,  
          chiropractors are required to refer patients to another health  
          care provider if they detect a condition that is not part of the  








                                                                  AB 722
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          chiropractic scope of practice."  

          Furthermore, on April 20, 2012, the Federal Motor Carrier Safety  
          Administration (FMCSA) issued its final ruling on the creation  
          of the NRCME.  In this final ruling, starting in May 2014, the  
          FMCSA requires health care providers who conduct physical  
          examinations on applicants for a commercial license to be a  
          licensed medical examiner, undergo and pass a certification  
          process, and be listed in the NRCME.  The list of licensed  
          medical examiners includes a variety of health providers  
          including chiropractors.  

          This bill will bring the state into alignment with federal law  
          and ensure consistency amongst providers by requiring all  
          licensed medical examiners that perform physical examinations  
          for commercial license applicants to undergo the same federal  
          certification process.  

          This bill was substantially similar to the version passed by the  
          Assembly.  

           
          Analysis Prepared by  :    Manny Leon / TRANS. / (916) 319-2093 


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