BILL ANALYSIS Ó AB 1841 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 1841 (Mullin) As Amended June 2, 2014 Majority vote ----------------------------------------------------------------- |ASSEMBLY: |76-0 |(May 19, 2014) |SENATE: |35-0 |(August 11, | | | | | | |2014) | ----------------------------------------------------------------- Original Committee Reference: B., P. & C.P. 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." The Senate amendments : 1)Permit MAs to hand out prescription drugs in the following non-state operated facilities licensed by the Board of Pharmacy: a) A nonprofit community clinic or free clinic as specified, b) A primary care clinic owned or operated by a county; c) A clinic operated by a federally recognized Indian tribe or tribal organization; d) A clinic operated by a primary care community or free clinic, operated on separate premises from a licensed clinic, and that is open no more than 20 hours per week; e) A student health center clinic operated by a public institution of higher education; f) A nonprofit multispecialty clinic; or, g) A surgical clinic. 2)Require that a licensed physician and surgeon, a licensed podiatrist, a physician assistant, a nurse practitioner, or a certified nurse-midwife provide the appropriate patient AB 1841 Page 2 consultation regarding use of the drug. 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 existing scope of practice under "technical supportive services" in certain non-state operated clinics. 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 general educational development (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; AB 1841 Page 3 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 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 bill limits the practice settings in which MAs may do this to non-state operated clinics. 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. AB 1841 Page 4 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 FN: 0004294