BILL NUMBER: SB 352	INTRODUCED
	BILL TEXT


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:

  SECTION 1.  Section 2069 of the Business and Professions Code is
amended to read:
   2069.  (a) (1) Notwithstanding any other  provision of
 law, a medical assistant may administer medication only by
intradermal, subcutaneous, or intramuscular injections and perform
skin tests and additional technical supportive services upon the
specific authorization and supervision of a licensed physician and
surgeon or a licensed podiatrist. A medical assistant may also
perform all these tasks and services  in a clinic licensed
pursuant to subdivision (a) of Section 1204 of the Health and Safety
Code  upon the specific authorization of a physician
assistant, a nurse practitioner, or a nurse-midwife.
   (2) The supervising physician and surgeon  at a clinic
described in paragraph (1)  may, at his or her discretion,
in consultation with the nurse practitioner, nurse-midwife, or
physician assistant  ,  provide written instructions to be
followed by a medical assistant in the performance of tasks or
supportive services. These written instructions may provide that the
supervisory function for the medical assistant for these tasks or
supportive services may be delegated to the nurse practitioner,
nurse-midwife, or physician assistant within the standardized
procedures or protocol, and that tasks may be performed when the
supervising physician and surgeon is not onsite,  so long as
  if either of  the following apply:
   (A) The nurse practitioner or nurse-midwife is functioning
pursuant to standardized procedures, as defined by Section 2725, or
protocol. The standardized procedures or protocol shall be developed
and approved by the supervising physician and surgeon, the nurse
practitioner or nurse-midwife, and the facility administrator or his
or her designee.
   (B) The physician assistant is functioning pursuant to regulated
services defined in Section 3502 and is approved to do so by the
supervising physician  or   and  surgeon.
   (b) As used in this section and Sections 2070 and 2071, the
following definitions  shall  apply:
   (1) "Medical assistant" means a person who may be unlicensed, who
performs basic administrative, clerical, and technical supportive
services in compliance with this section and Section 2070 for a
licensed physician and surgeon or a licensed podiatrist, or group
thereof, for a medical or podiatry corporation, for a physician
assistant, a nurse practitioner, or a nurse-midwife as provided in
subdivision (a), or for a health care service plan, who is at least
18 years of age, and who has had at least the minimum amount of hours
of appropriate training pursuant to standards established by the
 Division of Licensing   board  . The
medical assistant shall be issued a certificate by the training
institution or instructor indicating satisfactory completion of the
required training. A copy of the certificate shall be retained as a
record by each employer of the medical assistant.
   (2) "Specific authorization" means a specific written order
prepared by the supervising physician and surgeon or the supervising
podiatrist, or the physician assistant, the nurse practitioner, or
the nurse-midwife as provided in subdivision (a), authorizing the
procedures to be performed on a patient, which shall be placed in the
patient's medical record, or a standing order prepared by the
supervising physician and surgeon or the supervising podiatrist, or
the physician assistant, the nurse practitioner, or the nurse-midwife
as provided in subdivision (a), authorizing the procedures to be
performed, the duration of which shall be consistent with accepted
medical practice. A notation of the standing order shall be placed on
the patient's medical record.
   (3) "Supervision" means the supervision of procedures authorized
by this section by the following practitioners, within the scope of
their respective practices, who shall be physically present in the
treatment facility during the performance of those procedures:
   (A) A licensed physician and surgeon.
   (B) A licensed podiatrist.
   (C) A physician assistant, nurse practitioner, or nurse-midwife as
provided in subdivision (a).
   (4) "Technical supportive services" means simple routine medical
tasks and procedures that may be safely performed by a medical
assistant who has limited training and who functions under the
supervision of a licensed physician and surgeon or a licensed
podiatrist, or a physician assistant, a nurse practitioner, or a
nurse-midwife as provided in subdivision (a).
   (c) Nothing in this section shall be construed as authorizing
 the   any of the following: 
    (1)     The  licensure of medical
assistants.  Nothing in this section shall be construed as
authorizing the 
    (2)     The  administration of local
anesthetic agents by a medical assistant.  Nothing in this
section shall be construed as authorizing the division to 
    (3)     The board   to  adopt
any regulations that violate the prohibitions on diagnosis or
treatment in Section 2052.
   (e) Nothing in this section shall be construed as authorizing a
medical assistant to perform any clinical laboratory test or
examination for which he or she is not authorized by Chapter 3
(commencing with Section 1206.5). Nothing in this section shall be
construed as authorizing a nurse practitioner, nurse-midwife, or
physician assistant to be a laboratory director of a clinical
laboratory, as those terms are defined in paragraph (8) of
subdivision (a) of Section 1206 and subdivision (a) of Section 1209.
   (d) Notwithstanding any other  provision of  law,
a medical assistant  may  shall  not be
employed for inpatient care in a licensed general acute care hospital
 ,  as defined in subdivision (a) of Section 1250 of the
Health and Safety Code. 
   (4) A medical assistant to perform any clinical laboratory test or
examination for which he or she is not authorized by Chapter 3
(commencing with Section 1200).  
   (5) A nurse practitioner, nurse-midwife, or physician assistant to
be a laboratory director of a clinical laboratory, as those terms
are defined in paragraph (8) of subdivision (a) of Section 1206 and
subdivision (a) of Section 1209.