BILL ANALYSIS
----------------------------------------------------------
|Hearing Date:March 23, 2009 |Bill No:SB |
| |171 |
----------------------------------------------------------
SENATE COMMITTEE ON BUSINESS, PROFESSIONS AND ECONOMIC
DEVELOPMENT
Senator Gloria Negrete McLeod, Chair
Bill No: SB 171Author:Pavley
As Introduced: February 14, 2009 Fiscal: No
SUBJECT: Certificated employees: medical certificates.
SUMMARY: Allows physician assistants to perform a physical
examination and submit directly to the governing board or
county superintendent of schools the medical certificate
of a person wishing to be employed in a position requiring
certification qualifications, or in a retirant position
(former retired employee of a school district), as a
condition of initial employment.
Existing law:
1)Requires a school district or county superintendent of
schools to require a candidate for a position requiring
certification qualifications or a retirant position, if
the candidate has not previously been employed in a
position requiring certification qualifications in this
state or has not previously been employed as a retirant,
to obtain a medical certificate showing that the
candidate is free from any disabling disease that would
make the candidate unfit to instruct or associate with
children.
2)Requires a physician and surgeon, or a commissioned
medical officer, as specified, to submit a medical
certificate directly to the governing board of the school
district or the county superintendent of schools.
3)Defines certificated person as a person who holds one or
SB 171
Page 2
more documents such as a certificate, a credential, or a
life diploma, which singly or in combination licenses the
holder to engage in the school service designated in the
document or documents.
4)Defines a position requiring certification qualifications
to include teachers, or functions associated with
educational or vocational counseling, guidance, and
placement services, school health program, school library
services, as specified.
5)Provides for the regulation and licensing of physician
assistants by the Physician Assistant Committee
(Committee) of the Medical Board of California (MBC).
6)Provides that a physician assistant may perform those
medical services as set forth by the regulations of the
MBC when the services are rendered under the supervision
of a licensed physician and surgeon approved by the MBC,
except as otherwise provided.
7)Authorizes a licensed physician assistant or advanced
practice registered nurse to give the medical examination
required of an applicant for a certificate to drive a
school bus, school pupil activity bus, youth bus, general
public paratransit vehicle, or farm labor vehicle.
This bill:
1)Allows a physician assistant to submit directly to the
governing board of a school district or county
superintendent of schools, a medical certificate for a
person wishing to be employed in a position requiring
certification qualifications, or a retirant position, as
a condition of initial employment.
2)Permits a physician assistant to perform a periodic
medical examination as may be required by a school
district or a county superintendent of schools of
certificated employees or retirant employee to determine
that such employees are free from any communicable
disease making it unfit to instruct or associate with
children.
SB 171
Page 3
FISCAL EFFECT: This bill has been keyed "non-fiscal" by
Legislative Counsel.
COMMENTS:
1.Purpose. According to the sponsor of this bill, the
California Academy of Physician Assistants (CAPA), this
measure is needed to clarify an inconsistency in existing
law by allowing physician assistants, under the
supervision of a physician, to conduct medical
examinations on applicants seeking employment with a
school district or a county superintendent of schools.
CAPA points out that although current law only allows
these medical examinations to be performed by physicians,
the law does not restrict the ability of clinically
competent physician assistants to perform medical or
physical examinations and other routine medical services.
In addition, CAPA indicates that California is in the
midst of an access to care crisis and these
inconsistencies in existing law overburden physicians
with routine duties that should be performed by
clinically competent physician assistants. Particularly
in underserved areas, it is not always practical for a
physician to be available at all times.
2.Background. Current law requires a school district or
county superintendent of schools which employs a person
in a position requiring certification qualifications or a
retirant employee applicant, if that person has not been
previously employed in a position requiring certification
qualifications, to require a medical certificate in a
form prescribed by the State Board of Education showing
that the applicant is free from any disabling disease
which makes the applicant unfit to instruct or associate
with children. The medical certificate must be submitted
directly to the governing board or county superintendent
by a physician and surgeon or a commissioned medical
officer, as specified. Current law also requires that
the medical examination be conducted not more than six
months before the submission of the certificate.
Positions requiring certification qualifications include
teachers, and positions whose functions relate to
educational or vocational counseling, guidance and
SB 171
Page 4
placement services, school health programs and school
library services.
3.Arguments in Support. The American Federation of State,
County and Municipal Employees (AFSCME) is in support of
this measure. Both AFSCME and CAPA indicate that this
bill would help reduce costs and increase access to
physical examinations without negatively affecting
patient care or safety.
4.Prior Legislation. SB 139 (Bass, Chapter 158, Statutes
of 2007) authorized a licensed physician assistant or
advanced practice registered nurse to give the medical
examination required of an applicant for a certificate to
drive a school bus, school pupil activity bus, youth bus,
general public paratransit vehicle, or farm labor
vehicle.
5.Policy Consideration. Advance practice nurses, such as
nurse practitioners, are increasingly conducting medical
and physical examinations in physicians' offices. At
some point in time, there should be consideration given
that advance practice registered nurses, as defined in
the Nurse Practice Act, who are authorized to provide
medical examinations, also be permitted to submit medical
certificates to the governing board or county
superintendent of schools and conduct the medical
examinations specified in this bill.
SUPPORT AND OPPOSITION:
Support :
California Academy of Physician Assistants (Sponsor)
American Federation of State, County, and Municipal
Employees
United Nurses Associations of California/Union of Health
Care Professionals
Opposition:
None on file as of March 16, 2009.
SB 171
Page 5
Consultant: Rosielyn Pulmano