BILL ANALYSIS                                                                                                                                                                                                    Ó



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          SENATE THIRD READING
          SB 1083 (Pavley)
          As Amended  August 18, 2014
          Majority vote 

           SENATE VOTE  :36-0  
          
           BUSINESS & PROFESSIONS           14-0                
          APPROPRIATIONS      17-0        
           
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          |Ayes:|Bonilla, Jones,           |Ayes:|Gatto, Bigelow,           |
          |     |Bocanegra, Campos,        |     |Bocanegra, Bradford, Ian  |
          |     |Dickinson, Eggman,        |     |Calderon, Campos,         |
          |     |Gordon, Hagman, Holden,   |     |Donnelly, Eggman, Gomez,  |
          |     |Maienschein, Mullin,      |     |Holden, Jones, Linder,    |
          |     |Skinner, Ting, Wilk       |     |Pan, Quirk,               |
          |     |                          |     |Ridley-Thomas, Wagner,    |
          |     |                          |     |Weber                     |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Authorizes a physician assistant (PA) to certify  
          disability for purposes of disability insurance (DI).   
          Specifically,  this bill  :   

          1) Permits a PA to certify disability after performing a  
             physical examination under the supervision of a physician.

          2) Expands the definition of a practitioner in the Unemployment  
             Insurance Code (UIC) to include a physician assistant who has  
             performed a physical examination under the supervision of a  
             physician and surgeon.    

          3) Requires the Employment Development Department (EDD) to  
             implement the provisions permitting a PA to certify  
             disability, as specified, by January 1, 2017.

          4) Requires funds appropriated to cover costs of this bill to  
             come from the Unemployment Compensation Disability Fund. 

           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee: 









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          1)One-time contract costs to EDD of approximately $4 million to  
            modify and test existing Information Technology (IT) systems  
            (Unemployment Compensation Disability Fund). Ongoing costs are  
            likely minor.  EDD indicates in order to comply with this  
            bill, it would need to reprogram several systems, and that  
            programming also requires testing to ensure all interfaces  
            work properly.  

          2)Minor costs, likely under $100,000 annually, to Department of  
            Consumer Affairs to update an existing interface with EDD to  
            share PA licensure data (Physician Assistant Fund). 

           COMMENTS  :   

          1)Purpose of this bill.  This bill authorizes a PA to certify  
            disability for purposes of obtaining DI.  This bill is  
            sponsored by the California Academy of Physician Assistants.    
              

          2)Author's statement.  According to the author's office,  
            "California law does not authorize physician assistants to  
            certify claims for DI with the Employment Development  
            Department.  The restrictions related to EDD forms are  
            inconsistent with the scope-of-practice of a physician  
            assistant, which allows them to act as an agent of their  
            supervising physician in performing medical examinations as  
            well as most other medical services.  The law pertaining to DI  
            is also inconsistent with a physician assistants' ability to  
            certify other claims of temporary disability, such as Paid  
            Family Leave under the Family Medical Leave Act and the  
            California Family Rights Act, but not claims for Disability  
            Insurance."   

          3)Physician assistants.  A PA is a licensed and skilled health  
            care professional who is trained to obtain medical histories,  
            conduct physical examinations, diagnose and treat illnesses,  
            prescribe medication, order and interpret lab tests, perform  
            procedures, assist in surgery, provide patient education and  
            counseling, and make rounds in hospitals and nursing homes.   

            The Physician Assistant Board (PAB) in California licenses and  
            regulates the approximately 9,000 PAs in California.  PAB  
            consists of nine members; one physician member from the  
            Medical Board of California; four licensed physician  








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            assistants and four public members.  PAB is supported entirely  
            by fees imposed upon the professional community it regulates  
            and received no reimbursement from taxpayers or from the  
            General Fund.

            A PA must attend a PAB-approved training program associated  
            with a medical school that includes classroom studies and  
            clinical experience.  The average length of a PA education  
            program is 26 months (three academic years).  A PA must also  
            take and pass the Physician Assistant National Certifying  
            Examination administered by the National Commission on  
            Certification of Physician Assistants.

            PAs are currently authorized to sign for the issuance of  
            disabled person placards, certify licensees to drive standard  
            commercial vehicles, school buses, general public  
            transportation vehicles, and farm labor vehicles.  PAs are  
            also authorized to conduct physical examinations and sign  
            corresponding forms or certificates for those seeking  
            employment in school districts or with the county  
            superintendent of schools.  Finally, PAs may sign for claims  
            of temporary disability for Paid Family Leave and workers'  
            compensation insurance.  

            By expanding PA's signing authority to include certification  
            for DI, this bill would more fully align DI requirements with  
            PA's scope of practice. 

          4)SDI programs.  DI provides partial wage replacement to  
            eligible workers who are unable to work because of a  
            disability, which includes a non-industrial injury, illness,  
            or pregnancy related condition.  According to the California  
            Unemployment Insurance Code, disability is defined as any  
            mental or physical illness or injury which prevents you from  
            performing your regular or customary work, as specified.  
            Currently, a physician, dentist, podiatrist, or a nurse  
            practitioner (after a physical examination and in  
            collaboration with a physician and surgeon), or as to normal  
            pregnancy or childbirth, a midwife, nurse midwife, or nurse  
            practitioner, may certify for DI.  This bill will add a PA to  
            that list.  
           

          Analysis Prepared by :    Sarah Huchel / B., P. & C.P. / (916)  








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          319-3301 


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