BILL NUMBER: SB 352 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 10, 2013
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 amended, 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. Existing law requires the Board of Registered
Nursing to issue a certificate to practice nurse-midwifery to a
qualifying applicant who is licensed pursuant to the Nursing Practice
Act.
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 certified nurse-midwife. The bill would also delete
several obsolete references and make other conforming,
technical, and 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 certified
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, certified
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, certified 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 certified 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, surgeon and the nurse
practitioner or certified 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 certified
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 certified 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 certified 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 certified
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
certified 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.
(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, certified 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.
(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.
SECTION 1. Section 2069 of the Business and
Professions Code is amended to read:
2069. (a) (1) Notwithstanding any other 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 upon the specific authorization of a physician assistant, a
nurse practitioner, or a nurse-midwife.
(2) The supervising physician and surgeon 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, 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 and surgeon.
(b) As used in this section and Sections 2070 and 2071, the
following definitions 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
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 any
of the following:
(1) The licensure of medical assistants.
(2) The administration of local anesthetic agents by a medical
assistant.
(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 law, a medical assistant 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.