Amended in Senate April 30, 2013

Senate Bill No. 410

Introduced by Senator Yee

February 20, 2013

An act to begin delete amend Section 2241.5 end delete begin insert add Chapter 7.75 (commencing with Section 3550) to Division 2 end insert of the Business and Professions Code, relating to begin delete medicine end delete begin insert healing arts end insert .

LEGISLATIVE COUNSEL’S DIGEST

SB 410, as amended, Yee. begin delete Health care: controlled substances and dangerous drugs. end delete begin insert Anesthesiologist assistants. end insert

begin insert

Existing law, the Medical Practice Act, provides for the licensure and regulation of physicians and surgeons by the Medical Board of California.

end insert begin insert

This bill would enact the Anesthesiologist Assistant Practice Act, which would require the licensure and regulation of anesthesiologist assistants by the Medical Board of California and would prescribe the services that may be performed by a radiologist assistant under the supervision of a qualified physician and surgeon. The bill would make it a crime for a person to practice as an anesthesiologist assistant without a license or for an anesthesiologist assistant to practice outside the scope of his or her practice, as specified, thereby imposing a state-mandated local program. The bill would require the board to adopt regulations relating to the licensure of radiologist assistants and certification of approved programs by July 1, 2014, and would require the board to commence licensure and certification on that date.

end insert begin insert

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

end insert begin insert

This bill would provide that no reimbursement is required by this act for a specified reason.

end insert begin delete

Existing law authorizes a physician and surgeon to prescribe for, or dispense or administer to, a person under his or her treatment for a medical condition, drugs or prescription controlled substances for the treatment of pain or a condition causing pain, including intractable pain. Existing law requires the physician and surgeon to exercise reasonable care in determining whether a particular patient or condition, or complexity of the patient’s treatment, including, but not limited to, a current or recent pattern of drug abuse, requires consultation with, or referral to, a more qualified specialist.

end delete begin delete

This bill would specify that chronic pain is included among the types of pain for which these drugs or substances may be prescribed.

end delete

Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program:  begin delete no end delete begin insert yes end insert .

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

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert Chapter 7.75 (commencing with Section 3550)
is added to Division 2 of the end insert begin insert Business and Professions Code end insert begin insert , to
read: end insert

begin insert

 

Chapter   begin insert 7.75. end insert Anesthesiologist Assistants

 

Article begin insert 1. end insert   General Provisions

 

begin insert 3550. end insert   

This chapter shall be known and cited as the
Anesthesiologist Assistant Practice Act.

begin insert 3550.5. end insert   

For the purposes of this chapter, the following
definitions shall apply:

(a) “Anesthesiologist” means a physician and surgeon who has
completed a residency in anesthesiology approved by the American
Board of Anesthesiology or the American Osteopathic Board of
Anesthesiology.

(b) “Anesthesiologist assistant” means a person who meets the
requirements of Section 3553 and provides health care services
delegated by a licensed anesthesiologist.

(c) “Board” means the Medical Board of California.

begin insert 3551. end insert   

Notwithstanding any other law, a licensed
anesthesiologist assistant may assist the supervising
anesthesiologist in developing and implementing an anesthesia
care plan for a patient. In providing assistance to the supervising
anesthesiologist, an anesthesiologist assistant may do all of the
following:

(a) Obtain a comprehensive patient history, perform relevant
elements of a physical examination, and present the patient history
to the supervising anesthesiologist.

(b) Pretest and calibrate anesthesia delivery systems and obtain
and interpret information from the systems and monitors, in
consultation with an anesthesiologist.

(c) Assist the supervising anesthesiologist with the
implementation of medically accepted monitoring techniques.

(d) Establish basic and advanced airway interventions, including
intubation of the trachea and performing ventilatory support.

(e) Administer intermittent vasoactive drugs and start and adjust
vasoactive infusions.

(f) Administer anesthetic drugs, adjuvant drugs, and accessory
drugs.

(g) Assist the supervising anesthesiologist with the performance
of epidural anesthetic procedures, spinal anesthetic procedures,
and other regional anesthetic techniques.

(h) Administer blood, blood products, and supportive fluids.

(i) Provide assistance to a cardiopulmonary resuscitation team
in response to a life threatening situation.

(j) Participate in administrative, research, and clinical teaching
activities as authorized by the supervising anesthesiologist.

(k) Perform other tasks not prohibited by law under the
supervision of a licensed anesthesiologist that an anesthesiologist
assistant has been trained and is proficient to perform.

begin insert 3551.5. end insert   

The board may adopt, amend, and repeal regulations
as may be necessary to enable it to carry into effect this chapter.
All regulations shall be in accordance with, and not inconsistent
with, this chapter. All regulations shall be adopted, amended, or
repealed in accordance with Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code.

begin insert 3551.7. end insert   

No person other than one licensed to practice as an
anesthesiologist assistant shall practice as an anesthesiologist
assistant or in a similar capacity to an anesthesiologist or hold
himself or herself out as an “anesthesiologist assistant.”

 

Article begin insert 2. end insert   Licensure

 

begin insert 3552. end insert   

The board shall adopt regulations consistent with this
chapter for the consideration of applications for licensure as an
anesthesiologist assistant no later than July 1, 2014.

begin insert 3553. end insert   

Commencing July 1, 2014, the board shall issue a license
to each anesthesiologist assistant applicant who meets each of the
following requirements:

(a) Has graduated from an anesthesiologist assistant program
accredited by the American Medical Association’s Committee on
Allied Health Education and Accreditation or by its successor
agency.

(b) Has passed the certifying examination administered by the
National Commission on Certification of Anesthesiologist
Assistants.

(c) Has active certification by the National Commission on
Certification of Anesthesiologist Assistants.

 

Article begin insert 3. end insert   Penalties

 

begin insert 3554. end insert   

Any person who violates Section 3551.7 shall be guilty
of a misdemeanor punishable by imprisonment in a county jail not
exceeding six months, or by a fine not exceeding one thousand
dollars ($1,000), or by both.

end insert

begin insert

begin insert SEC. 2. end insert   

end insert begin insert

No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of
the Government Code, or changes the definition of a crime within
the meaning of Section 6 of Article XIII B of the California
Constitution.

end insert

begin delete

SECTION 1.  

Section 2241.5 of the Business and Professions
Code is amended to read:

2241.5.  

(a) A physician and surgeon may prescribe for, or
dispense or administer to, a person under his or her treatment for
a medical condition dangerous drugs or prescription controlled
substances for the treatment of pain or a condition causing pain,
including, but not limited to, chronic pain or intractable pain.

(b) No physician and surgeon shall be subject to disciplinary
action for prescribing, dispensing, or administering dangerous
drugs or prescription controlled substances in accordance with this
section.

(c) This section shall not affect the power of the board to take
any action described in Section 2227 against a physician and
surgeon who does any of the following:

(1) Violates subdivision (b), (c), or (d) of Section 2234 regarding
gross negligence, repeated negligent acts, or incompetence.

(2) Violates Section 2241 regarding treatment of an addict.

(3) Violates Section 2242 regarding performing an appropriate
prior examination and the existence of a medical indication for
prescribing, dispensing, or furnishing dangerous drugs.

(4) Violates Section 2242.1 regarding prescribing on the Internet.

(5) Fails to keep complete and accurate records of purchases
and disposals of substances listed in the California Uniform
Controlled Substances Act (Division 10 (commencing with Section
11000) of the Health and Safety Code) or controlled substances
scheduled in the federal Comprehensive Drug Abuse Prevention
and Control Act of 1970 (21 U.S.C. Sec. 801 et seq.), or pursuant
to the federal Comprehensive Drug Abuse Prevention and Control
Act of 1970. A physician and surgeon shall keep records of his or
her purchases and disposals of these controlled substances or
dangerous drugs, including the date of purchase, the date and
records of the sale or disposal of the drugs by the physician and
surgeon, the name and address of the person receiving the drugs,
and the reason for the disposal or the dispensing of the drugs to
the person, and shall otherwise comply with all state recordkeeping
requirements for controlled substances.

(6) Writes false or fictitious prescriptions for controlled
substances listed in the California Uniform Controlled Substances
Act or scheduled in the federal Comprehensive Drug Abuse
Prevention and Control Act of 1970.

(7) Prescribes, administers, or dispenses in violation of this
chapter, or in violation of Chapter 4 (commencing with Section
11150) or Chapter 5 (commencing with Section 11210) of Division
10 of the Health and Safety Code.

(d) A physician and surgeon shall exercise reasonable care in
determining whether a particular patient or condition, or the
complexity of a patient’s treatment, including, but not limited to,
a current or recent pattern of drug abuse, requires consultation
with, or referral to, a more qualified specialist.

(e) Nothing in this section shall prohibit the governing body of
a hospital from taking disciplinary actions against a physician and
surgeon pursuant to Sections 809.05, 809.4, and 809.5.

end delete