BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | AB 2193| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- 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 AB 2193 Page 2 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 AB 2193 Page 3 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. AB 2193 Page 4 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 AB 2193 Page 5 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 **** END ****