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.begin insert The bill would prohibit a nurse practitioner, certified nurse-midwife, or physician assistant from authorizing a medical assistant to perform any clinical laboratory test or examination for which the medical assistant is not authorized, as specified, a violation of which would constitute unprofessional conduct.end insert The bill would also delete several obsolete references and make otherbegin insert clarifying,end insert 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 2069 of the Business and Professions
2Code is amended to read:
(a) (1) Notwithstanding any other law, a medical
4assistant may administer medication only by intradermal,
5subcutaneous, or intramuscular injections and perform skin tests
6and additional technical supportive services upon the specific
7authorization and supervision of a licensed physician and surgeon
8or a licensed podiatrist. A medical assistant may also perform all
9these tasks and services upon the specific authorization of a
10physician assistant, a nurse practitioner, or a
certified
11nurse-midwife.
12(2) The supervising physician and surgeon
may, at his or her
13discretion, in consultation with the nurse practitioner, certified
14nurse-midwife, or physician assistant, provide written instructions
15to be followed by a medical assistant in the performance of tasks
16or supportive services. These written instructions may provide that
17the supervisory function for the medical assistant for these tasks
18or supportive services may be delegated to the nurse practitioner,
19certified nurse-midwife, or physician assistant within the
20standardized procedures or protocol, and that tasks may be
21performed when the supervising physician and surgeon is not
22onsite, if either of the following apply:
23(A) The nurse practitioner or certified nurse-midwife is
24functioning pursuant to standardized procedures, as defined by
25Section 2725, or protocol. The standardized procedures or protocolbegin insert,
26
including instructions for specific authorizations, end insert shall be
27developed and approved by the supervising physician and surgeon
28and the nurse practitioner or certified nurse-midwife.
29(B) The physician assistant is functioning pursuant to regulated
30services defined in Section 3502begin insert, including instructions for specific
31authorizations,end insert and is approved to do so by the supervising
32physician and surgeon.
P3 1(b) As used in this section and Sections 2070 and 2071, the
2following definitions apply:
3(1) “Medical assistant” means a person who may be unlicensed,
4who performs basic administrative, clerical, and technical
5supportive
services in compliance with this section and Section
62070 for a licensed physician and surgeon or a licensed podiatrist,
7or group thereof, for a medical or podiatry corporation, for a
8physician assistant, a nurse practitioner, or a certified
9nurse-midwife as provided in subdivision (a), or for a health care
10service plan, who is at least 18 years of age, and who has had at
11least the minimum amount of hours of appropriate training pursuant
12to standards established by the board. The medical assistant shall
13be issued a certificate by the training institution or instructor
14indicating satisfactory completion of the required training. A copy
15of the certificate shall be retained as a record by each employer of
16the medical assistant.
17(2) “Specific authorization” means a specific written order
18prepared by the supervising physician and surgeon or the
19supervising
podiatrist, or the physician assistant, the nurse
20practitioner, or the certified nurse-midwife as provided in
21subdivision (a), authorizing the procedures to be performed on a
22patient, which shall be placed in the patient’s medical record, or
23a standing order prepared by the supervising physician and surgeon
24or the supervising podiatrist, or the physician assistant, the nurse
25practitioner, or the certified nurse-midwife as provided in
26subdivision (a), authorizing the procedures to be performed, the
27duration of which shall be consistent with accepted medical
28practice. A notation of the standing order shall be placed on the
29patient’s medical record.
30(3) “Supervision” means the supervision of procedures
31authorized by this section by the following practitioners, within
32the scope of their respective practices, who shall be physically
33present
in the treatment facility during the performance of those
34procedures:
35(A) A licensed physician and surgeon.
36(B) A licensed podiatrist.
37(C) A physician assistant, nurse practitioner, or certified
38nurse-midwife as provided in subdivision (a).
39(4) “Technical supportive services” means simple routine
40medical tasks and procedures that may be safely performed by a
P4 1medical assistant who has limited training and who functions under
2the supervision of a licensed physician and surgeon or a licensed
3podiatrist, or a physician assistant, a nurse practitioner, or a
4certified nurse-midwife as provided in subdivision (a).
5(c) Nothing in this section shall be construed as authorizing any
6of the following:
7(1) The licensure of medical assistants.
8(2) The administration of local anesthetic agents by a medical
9assistant.
10(3) The board to adopt any regulations that violate the
11prohibitions on diagnosis or treatment in Section 2052.
12(4) A medical assistant to perform any clinical laboratory test
13or examination for which he or she is not authorized by Chapter
143 (commencing with Section 1200).
15(5) A nurse practitioner, certified nurse-midwife, or physician
16assistant to be a laboratory director of a clinical
laboratory, as those
17terms are defined in paragraph (8) of subdivision (a) of Section
181206 and subdivision (a) of Section 1209.
19(d) A nurse practitioner, certified nurse-midwife, or physician
20assistant shall not authorize a medical assistant to perform any
21clinical laboratory test or examination for which the medical
22assistant is not authorized by Chapter 3 (commencing with Section
231200). A violation of this subdivision constitutes unprofessional
24conduct.
25(d)
end delete
26begin insert(e)end insert Notwithstanding any other law, a medical assistant shall not
27be employed for inpatient care in a licensed general acute care
28hospital, as defined in subdivision (a) of Section 1250 of the Health
29and Safety Code.
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