BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 599


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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          599 (Bonilla)


          As Amended  August 24, 2015


          Majority vote


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          |ASSEMBLY:  |77-0  |(April 30,     |SENATE: |40-0  |(September 1,    |
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          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.









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          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


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            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. 









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          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