BILL ANALYSIS                                                                                                                                                                                                    Ó






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          |SENATE RULES COMMITTEE            |                       AB 2193|
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                                   THIRD READING 


          Bill No:  AB 2193
          Author:   Salas (D), et al.
          Amended:  8/16/16 in Senate
          Vote:     21 

           SENATE BUS., PROF. & ECON. DEV. COMMITTEE:  9-0, 6/27/16
           AYES:  Hill, Bates, Block, Gaines, Galgiani, Hernandez,  
            Jackson, Mendoza, Wieckowski

           SENATE APPROPRIATIONS COMMITTEE:  7-0, 8/11/16
           AYES:  Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen

           ASSEMBLY FLOOR:  80-0, 5/31/16 - See last page for vote

           SUBJECT:   California Board of Podiatric Medicine:  Physician  
                     Assistant Board:  extension


          SOURCE:    Author


          DIGEST:  This bill extends the operation of the Board of  
          Podiatric Medicine (BPM), the operation of the Physician  
          Assistant Board (PAB), and the PAB's authority to appoint an  
          executive officer from January 1, 2017 to January 1, 2021.  


          ANALYSIS:  


          Existing law:
          
          1)Establishes the BPM within the jurisdiction of the Medical  








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            Board of California (MBC) until January 1, 2017.  Provides  
            that the repeal of the enacting statute renders the BPM  
            subject to review by the appropriate policy committees of the  
            Legislature.  (Business and Professions Code (BPC) § 2460)
          2)Establishes the PAB within the jurisdiction of the MBC until  
            January 1, 2017.  Provides that the repeal of the enacting  
            statute renders the PAB subject to review by the appropriate  
            policy committees of the Legislature.  (BPC § 3504)


          3)Requires, until January 1, 2017, and except as provided in BPC  
            §§ 159.5 and 2020, the PAB to employ within the limits of the  
            Physician Assistant Fund all personnel necessary to carry out  
            the provisions of the Physician Assistant Practice Act,  
            including an executive officer who shall be exempt from civil  
            service.  Requires the MBC and PAB to make all necessary  
            expenditures to carry out the provisions of the Physician  
            Assistant Practice Act from the Physician Assistant Fund.   
            (BPC § 3512) 


          This bill:


          1)Extends the sunset dates for the BPM and the PAB until January  
            1, 2021 and clarifies that the Podiatric Medicine fund is  
            subject to appropriation by the Legislature.


          2)Extends the PAB's authority to appoint an executive officer  
            until January 1, 202 and makes the Physician Assistant Board  
            Fund subject to appropriation by the Legislature.


          Background

          This bill is sponsored by the Author, and is one of five "sunset  
          bills" the Author is sponsoring this Session.  According to the  
          Author, "because the boards are set to sunset in 2017, the date  
          needs to be extended to ensure the continued regulation of the  
          professions."

          Board of Podiatric Medicine.  BPM is a licensing board under the  
          Department of Consumer Affairs (DCA).  BPM licenses and  







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          regulates doctors of podiatric medicine (DPMs). In the Medical  
          Practice Act, a license to practice podiatric medicine is called  
          a "certificate," but it is indistinguishable from other  
          professional licenses.  It is a misdemeanor to practice  
          podiatric medicine or use the title DPM, podiatrist, or similar  
          designation without a license.  The Practice Act defines  
          "podiatric medicine" as all medical treatment of the foot,  
          ankle, and tendons that insert into the foot, including  
          diagnosis, surgery, and the nonsurgical treatment of the muscles  
          and tendons of the leg governing the functions of the foot.  
          Therefore, a DPM's scope of practice is similar to that of a  
          physician and surgeon who specializes in the foot and ankle.   
          However, unlike a physician and surgeon, whose scope is only  
          limited by the licensee's own area of competence, a DPM's scope  
          is limited by the license to the foot and ankle.  Historically,  
          the BPM was a committee within MBC.  Currently, however, the BPM  
          functions as an independent board, similar to other licensing  
          boards under the DCA.  Still, the Practice Act continues to  
          describe the BPM as "within the jurisdiction of" the MBC. As a  
          result, the BPM makes recommendations for DPM licensure to the  
          MBC, while the MBC officially issues the licenses, but defers  
          completely to the judgment of BPM.  The BPM licenses  
          approximately 2,000 DPMs. On average, it issues 106 licenses  
          each year and renews on average 1,106 licenses each year.  The  
          purpose of the BPM's licensing program is to protect the public  
          and consumers by ensuring minimum competency in practitioners.  
          Applicants for a DPM license must graduate from a college of  
          podiatric medicine that has been approved by the BPM, pass Part  
          I, II and III of the national exam and successfully complete two  
          years of postgraduate training.

          Physician Assistant Board.  PAB is also a licensing board under  
          DCA.  PAB licenses and regulates physician assistants (PAs). PAs  
          provide health care services under the supervision of a  
          physician and surgeon.  PA functions include performing  
          diagnostic, therapeutic, preventive, and health maintenance  
          services. Currently, the PAB has over 10,000 licensed PAs.   
          Historically, the PAB was a committee within the MBC, however,  
          the current PAB is an independent board with regulatory  
          authority to enforce the Physician Assistant  Practice Act.  The  
          PAB still utilizes many of the MBC's services, including  
          enforcement, information technology, and fund management via a  
          contract with MBC. 








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          The PAB's mandates include:

           Approval of the educational and training requirements of PAs
           Licensing of PAs.
           Promoting the health and safety of California health care  
            consumers by enhancing the competence of PAs.
           Coordinating investigation and disciplinary processes
           Providing information and education regarding the PAB or PA  
            professionals to California consumers.
           Managing a diversion/monitoring program for PAs with  
            alcohol/substance abuse problems.

          2015-16 Sunset Review.  Beginning in 2015, the Senate Business  
          and Professions Committee and the Assembly Business and  
          Professions Committee (Committees) conducted joint oversight  
          hearings to review 12 regulatory entities.  The Committees  
          conducted two hearings in March and joined with the Senate  
          Committee on Education and Assembly Committee on Higher  
          Education to review the Bureau for Private Postsecondary  
          Education.  This bill and the accompanying sunset bills are  
          intended to implement legislative changes as recommended by  
          staff of the Committees and which are reflected in the  
          Background Papers prepared by Committee staff for each agency  
          and program reviewed this year.


          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   No


          According to the Senate Committee on Appropriations analysis  
          dated August 11, 2016, this bill will result in ongoing costs of  
          $1.5 million per year for the continuing operation of the BPM  
          and ongoing costs of $1.7 million per year for the continuing  
          operation of the PAB). All costs to operate both boards are paid  
          for with license fee revenues. 




          SUPPORT:   (Verified8/16/16)


          California Academy of Physician Assistants







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          OPPOSITION:   (Verified8/16/16)


          None received




          ASSEMBLY FLOOR:  80-0, 5/31/16
          AYES:  Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker,  
            Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke,  
            Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley,  
            Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth  
            Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto,  
            Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper,  
            Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim,  
            Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis,  
            Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte,  
            O'Donnell, Olsen, Patterson, Quirk, Ridley-Thomas, Rodriguez,  
            Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting,  
            Wagner, Waldron, Weber, Wilk, Williams, Wood, Rendon

          Prepared by:Sarah Mason / B., P. & E.D. / (916) 651-4104
          8/16/16 17:38:48


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