BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1841
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          ASSEMBLY THIRD READING
          AB 1841 (Mullin)
          As Amended  April 21, 2014
          Majority vote 

           BUSINESS & PROFESSIONS     14-0                                 
           
           ----------------------------------------------------------------- 
          |Ayes:|Bonilla, Jones,           |     |                          |
          |     |Bocanegra, Campos,        |     |                          |
          |     |Dickinson, Eggman,        |     |                          |
          |     |Gordon, Hagman, Holden,   |     |                          |
          |     |Maienschein, Mullin,      |     |                          |
          |     |Skinner, Ting, Wilk       |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Clarifies that medical assistants (MAs) may hand out  
          properly labeled and prepackaged prescription drugs to patients  
          as part of their existing authorization to provide "technical  
          supportive services."  Specifically,  this bill  :  

          1)States that, notwithstanding any other law, "technical  
            supportive services" includes the ability for an MA to hand a  
            patient a properly labeled and prepackaged prescription drug,  
            excluding a controlled substance, ordered by a licensed  
            physician and surgeon, a licensed podiatrist, a physician  
            assistant, a nurse practitioner, or a certified nurse-midwife,  
            as specified.  

          2)Requires a licensed physician and surgeon, a licensed  
            podiatrist, a physician assistant, a nurse practitioner, or a  
            certified nurse-midwife to verify that the medication and  
            dosage for that specific patient is correct, and that the  
            patient's name is affixed to the package prior to an MA  
            handing the medication to a patient.

           FISCAL EFFECT  :  None.  This bill is keyed non-fiscal by the  
          Legislative Counsel.

           COMMENTS  :   

          1)This bill clarifies that MAs may hand out properly labeled and  
            prepackaged prescription drugs to patients as part of their  








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            existing scope of practice under "technical supportive  
            services."  This bill is sponsored by Planned Parenthood.  

           2)According to the author's office, "Providing MAs this  
            authority will help reduce waiting times, expand access, and  
            improve patient care and satisfaction in community clinics,  
            including Planned Parenthoods.  Allowing an MA to hand over  
            medication and provide follow up instruction will ensure that  
            a patient has received counseling on their medication twice  
            and will provide them an additional opportunity to ask  
            questions.  This will also free up the clinician, allowing  
            them to spend more time with the patient answering questions  
            because they are not rushing to perform additional duties." 

          3)MAs are unlicensed, but certificated, individuals.  An MA must  
            have a high school diploma or GED equivalent and take a  
            certificate course at an approved school.  The exact duration  
            of these programs vary, but San Francisco State University,  
            for example, requires 140 classroom hours and a clinical  
            externship.  MAs also must complete a minimum of 60 hours of  
            continuing education over five years. 
            An MA may perform the following specific functions as part of  
            "technical supportive" services in addition to administrative  
            functions:

             a)   Administer medication orally, sublingually, topically,  
               vaginally or rectally, or by providing a single dose to a  
               patient for immediate self-administration; 

             b)   Administer medication by inhalation if the medications  
               are patient-specific and have been or will be routinely and  
               repetitively administered to that patient; 

             c)   Perform electrocardiogram, electroencephalogram, or  
               plethysmography tests (used to measure changes in volume in  
               different parts of the body); 

             d)   Apply and remove bandages and dressings;

             e)   Remove sutures or staples from superficial incisions or  
               lacerations; 

             f)   Collect by non-invasive techniques and preserve  
               specimens for testing, including urine, sputum, semen and  








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               stool;

             g)   Prepare patients for and assist the physician,  
               podiatrist, physician assistant or registered nurse in  
               examinations or procedures including positioning, draping,  
               shaving and disinfecting treatment sites; and prepare a  
               patient for gait analysis testing;

             h)   As authorized by the physician or podiatrist, provide  
               patient information and instructions;

             i)   Collect and record patient data including height,  
               weight, temperature, pulse, respiration rate and blood  
               pressure; and,

             j)   Perform simple laboratory and screening tests  
               customarily performed in a medical office.

            This bill simply clarifies that MAs may hand out properly  
            labeled and prepackaged prescription drugs to patients as part  
            of "technical supportive services."  Based on their current  
            abilities, this appears to be well within their scope of  
            practice.  

            This clarification is consistent with the work of similarly  
            unlicensed "pharmacy clerks" or "pharmacy assistants."  This  
            is a traditional title used in the pharmacy industry and is  
            included under regulations for "ancillary personnel" in  
            pharmacy regulations.  A pharmacy clerk may also perform  
            various "non-discretionary" tasks that do not require the  
            abilities and authorities of either a pharmacist or a Licensed  
            Pharmacy Technician.
              
            These unlicensed individuals work in a pharmacy under the  
            supervision of a pharmacist and cannot "dispense"  
            prescriptions as that term is understood in current law, but  
            they can "hand" the patient filled prescriptions that have  
            been approved by a pharmacist for dispensing.  
           

          Analysis Prepared by  :    Sarah Huchel / B., P. & C.P. / (916)  
          319-3301










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