BILL ANALYSIS Ó AB 599 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 599 (Bonilla) As Amended August 24, 2015 Majority vote -------------------------------------------------------------------- |ASSEMBLY: |77-0 |(April 30, |SENATE: |40-0 |(September 1, | | | |2015) | | |2015) | | | | | | | | | | | | | | | -------------------------------------------------------------------- Original Committee Reference: B. & P. SUMMARY: Authorizes a licensed cytotechnologist to perform all tests and procedures pertaining to cytology, under the overall operation and administration of a laboratory director. Specifically, this bill: 1)Defines, for purposes of this bill, a "qualified pathologist" as a physician and surgeon who is certified or eligible for certification in clinical or anatomical pathology by the American Board of Pathology or the American Osteopathic Board of Pathology. 2)Authorizes a licensed cytotechnologist to perform all tests and procedures pertaining to cytology under the overall operation and administration of a laboratory director, who must be a qualified pathologist. AB 599 Page 2 3)Provides examples of tests and procedures pertaining to cytology, including: a) Microscopic and nonmicroscopic methodologies; and, b) Tests and procedures that use molecular or genetic methodologies that are performed on cytologic specimens related to infectious disease or cancer diagnoses. 4)Provides that tests or procedures performed by a licensed cytotechnologist under this bill (Business and Professions Code Section 1270) must be performed in a licensed clinical laboratory certified in the subspecialty of diagnostic cytology. 5)Makes other technical, nonsubstantive changes. The Senate amendments: 1)Clarify that a cytotechnologist must perform all tests under the overall operation and administration of a laboratory director. 2)Require that the laboratory director must be a qualified pathologist. 3)Define "qualified pathologist" as a physician and surgeon who is certified or eligible for certification in clinical or anatomical pathology by the American Board of Pathology or the American Osteopathic Board of Pathology. 4)Require tests or procedures performed by a licensed AB 599 Page 3 cytotechnologist to be performed in a licensed clinical laboratory certified in the subspecialty of diagnostic cytology. FISCAL EFFECT: According to the Senate Appropriations Committee, this bill will result in one-time costs of about $120,000 per year for two years to develop and adopt regulations regarding training standards and the scope of practice for cytotechnologists by the Department of Public Health. The costs will be covered by licensing fee revenues. This bill will also result in minor ongoing costs to license cytotechnologists and enforce the revised standards by the Department of Public Health. COMMENTS: Purpose. This bill is co-sponsored by the California Society of Pathologists and the California Association of Cytotechnologists. According to the author, this bill "ensures that California law is updated as technology advances. More importantly, it ensures that we keep high-paying jobs here, in California. We train cytotechnologists but cannot keep them in the state because of our restricted statutory structure. In addition, labs send samples out of state to be analyzed because they cannot find enough cytotechnologists. [This bill] ameliorates this situation and keeps jobs in California, removes an incentive to send tissue samples out of state, and ensures that we have the workforce needed to fill laboratory need in California." Background. A cytotechnologist is a type of laboratory technician that performs tests specific to the field of cytology. According to the National Institutes of Health (NIH), cytology is the analysis of cells collected from a part of the body under a microscope. AB 599 Page 4 Cytological tests are used to determine what the cells look like and whether they are abnormal. Abnormal cells are indicators of cancer and precancerous changes. The tests may also be used to look for viral infections in cells. A cytological test differs from a biopsy in that only cells are examined, not pieces of tissue. Nonmicroscopic Tests. Under current state law, licensed cytotechnologists are limited to the examination of cells using a microscope. However, the sponsors note that advances in medicine and laboratory technology have resulted in new techniques that are not limited to a microscope. Because the new techniques are not limited to microscopes or slides, cytotechnologists are not able to perform them. Therefore, the author and the sponsors note that the situation incentivizes cytotechnologists to leave the state. This bill proposes to fix this issue by expanding the scope of practice of a licensed cytotechnologist to include all tests and procedures pertaining to cytology. This will allow a cytotechnologist to perform the co-testing on a single sample, without having to send it out. Analysis Prepared by: Vincent Chee / B. & P. / (916) 319-3301 FN: 0001634