Senate BillNo. 352


Introduced by Senator Pavley

(Principal coauthor: Senator Hernandez)

February 20, 2013


An act to amend Section 2069 of the Business and Professions Code, relating to healing arts.

LEGISLATIVE COUNSEL’S DIGEST

SB 352, as introduced, Pavley. Medical assistants: supervision.

Existing law authorizes a medical assistant to perform specified services relating to the administration of medication and performance of skin tests and simple routine medical tasks and procedures upon specific authorization from and under the supervision of a licensed physician and surgeon or podiatrist, or in a specified clinic upon specific authorization of a physician assistant, nurse practitioner, or nurse-midwife.

This bill would delete the requirement that the services performed by the medical assistant be in a specified clinic when under the specific authorization of a physician assistant, nurse practitioner, or nurse-midwife. The bill would also delete several obsolete references and make other technical, nonsubstantive changes.

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

The people of the State of California do enact as follows:

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SECTION 1.  

Section 2069 of the Business and Professions
2Code
is amended to read:

3

2069.  

(a) (1) Notwithstanding any otherbegin delete provision ofend delete law, a
4medical assistant may administer medication only by intradermal,
P2    1subcutaneous, or intramuscular injections and perform skin tests
2and additional technical supportive services upon the specific
3authorization and supervision of a licensed physician and surgeon
4or a licensed podiatrist. A medical assistant may also perform all
5these tasks and servicesbegin delete in a clinic licensed pursuant to subdivision
6(a) of Section 1204 of the Health and Safety Codeend delete
upon the specific
7authorization of a physician assistant, a nurse practitioner, or a
8nurse-midwife.

9(2) The supervising physician and surgeonbegin delete at a clinic described
10in paragraph (1)end delete
may, at his or her discretion, in consultation with
11the nurse practitioner, nurse-midwife, or physician assistantbegin insert,end insert
12 provide written instructions to be followed by a medical assistant
13in the performance of tasks or supportive services. These written
14instructions may provide that the supervisory function for the
15medical assistant for these tasks or supportive services may be
16delegated to the nurse practitioner, nurse-midwife, or physician
17assistant within the standardized procedures or protocol, and that
18tasks may be performed when the supervising physician and
19surgeon is not onsite,begin delete so long asend deletebegin insert if either ofend insert the following apply:

20(A) The nurse practitioner or nurse-midwife is functioning
21pursuant to standardized procedures, as defined by Section 2725,
22or protocol. The standardized procedures or protocol shall be
23developed and approved by the supervising physician and surgeon,
24the nurse practitioner or nurse-midwife, and the facility
25administrator or his or her designee.

26(B) The physician assistant is functioning pursuant to regulated
27services defined in Section 3502 and is approved to do so by the
28supervising physicianbegin delete orend deletebegin insert andend insert surgeon.

29(b) As used in this section and Sections 2070 and 2071, the
30following definitionsbegin delete shallend delete apply:

31(1) “Medical assistant” means a person who may be unlicensed,
32who performs basic administrative, clerical, and technical
33supportive services in compliance with this section and Section
342070 for a licensed physician and surgeon or a licensed podiatrist,
35or group thereof, for a medical or podiatry corporation, for a
36physician assistant, a nurse practitioner, or a nurse-midwife as
37provided in subdivision (a), or for a health care service plan, who
38is at least 18 years of age, and who has had at least the minimum
39amount of hours of appropriate training pursuant to standards
40established by thebegin delete Division of Licensingend deletebegin insert boardend insert. The medical
P3    1assistant shall be issued a certificate by the training institution or
2instructor indicating satisfactory completion of the required
3 training. A copy of the certificate shall be retained as a record by
4each employer of the medical assistant.

5(2) “Specific authorization” means a specific written order
6prepared by the supervising physician and surgeon or the
7supervising podiatrist, or the physician assistant, the nurse
8practitioner, or the nurse-midwife as provided in subdivision (a),
9authorizing the procedures to be performed on a patient, which
10shall be placed in the patient’s medical record, or a standing order
11prepared by the supervising physician and surgeon or the
12supervising podiatrist, or the physician assistant, the nurse
13practitioner, or the nurse-midwife as provided in subdivision (a),
14authorizing the procedures to be performed, the duration of which
15shall be consistent with accepted medical practice. A notation of
16the standing order shall be placed on the patient’s medical record.

17(3) “Supervision” means the supervision of procedures
18authorized by this section by the following practitioners, within
19the scope of their respective practices, who shall be physically
20present in the treatment facility during the performance of those
21procedures:

22(A) A licensed physician and surgeon.

23(B) A licensed podiatrist.

24(C) A physician assistant, nurse practitioner, or nurse-midwife
25as provided in subdivision (a).

26(4) “Technical supportive services” means simple routine
27medical tasks and procedures that may be safely performed by a
28medical assistant who has limited training and who functions under
29the supervision of a licensed physician and surgeon or a licensed
30podiatrist, or a physician assistant, a nurse practitioner, or a
31nurse-midwife as provided in subdivision (a).

32(c) Nothing in this section shall be construed as authorizingbegin delete theend delete
33begin insert any of the following:end insert

34begin insert(1)end insertbegin insertend insertbegin insertTheend insert licensure of medical assistants.begin delete Nothing in this section
35shall be construed as authorizing theend delete

36begin insert(2)end insertbegin insertend insertbegin insertTheend insert administration of local anesthetic agents by a medical
37assistant.begin delete Nothing in this section shall be construed as authorizing
38the division toend delete

39begin insert(3)end insertbegin insertend insertbegin insertThe boardend insertbegin insert toend insert adopt any regulations that violate the
40prohibitions on diagnosis or treatment in Section 2052.

P4    1(e) Nothing in this section shall be construed as authorizing a
2medical assistant to perform any clinical laboratory test or
3examination for which he or she is not authorized by Chapter 3
4(commencing with Section 1206.5). Nothing in this section shall
5be construed as authorizing a nurse practitioner, nurse-midwife,
6or physician assistant to be a laboratory director of a clinical
7laboratory, as those terms are defined in paragraph (8) of
8subdivision (a) of Section 1206 and subdivision (a) of Section
91209.

10(d) Notwithstanding any otherbegin delete provision ofend delete law, a medical
11assistantbegin delete mayend deletebegin insert shallend insert not be employed for inpatient care in a licensed
12general acute care hospitalbegin insert,end insert as defined in subdivision (a) of Section
131250 of the Health and Safety Code.

begin insert

14(4) A medical assistant to perform any clinical laboratory test
15or examination for which he or she is not authorized by Chapter
163 (commencing with Section 1200).

end insert
begin insert

17(5) A nurse practitioner, nurse-midwife, or physician assistant
18to be a laboratory director of a clinical laboratory, as those terms
19are defined in paragraph (8) of subdivision (a) of Section 1206
20and subdivision (a) of Section 1209.

end insert


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