BILL ANALYSIS
SB 171
Page 1
Date of Hearing: June 16, 2009
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
SB 171 (Pavley) - As Amended: May 18, 2009
SENATE VOTE : 39-0
SUBJECT : Certified employees: medical certificates.
SUMMARY : Permits physician assistants (PAs) and licensed
advanced practice registered nurses (APRNs) to conduct medical
examinations and issue medical certificates for employment with
a school district or county superintendent of schools.
Specifically, this bill :
1)Permits PAs, under the supervision of a physician, and APRNs,
under a physician standardized procedure and protocol, to
conduct medical examinations and issue medical certificates
for employment with a school district or county superintendent
of schools, as specified.
2)Permits any commissioned medical officer who is exempted from
licensure pursuant to federal law to conduct medical
examinations and issue medical certificates for employment
with a school district or county superintendent of schools, as
specified.
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 or 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.
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3)Defines a certificated person as a person who holds one or
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 services 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, and school library services, as
specified.
5)Provides that a PA 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.
6)Defines an APRN as those individuals satisfying the
requirements of nurse-midwives, nurse anesthetists, nurse
practitioners, and clinical nurse specialists.
7)Permits an APRN to perform certain medical procedures under a
physician standardized procedure and protocol.
8)Authorizes a licensed PA or APRN 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.
FISCAL EFFECT : Unknown. This bill is keyed non-fiscal.
COMMENTS :
Purpose of this bill . According to the author's office, "This
bill would clarify the inconsistency in existing law by allowing
Mid-level Practitioners [PAs and APRNs] to conduct medical
examinations and submit the subsequent medical exam certificate
for school teachers and others seeking employment by a school
district or a county superintendent of schools. Since the
Legislature has already determined that Mid-level Practitioners
can safely perform these medical examinations and various other
medical services either under physician supervision or under a
collaborative agreement with a physician, this bill by no means
would expand the scope of practice of Mid-level Practitioners."
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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 get a
medical certificate prior to employment. The certificate is
evidence that the applicant is free from any disabling disease
which makes the applicant unfit to instruct or associate with
children. This certificate must be submitted to the governing
board or county superintendent directly by a physician and
surgeon or a commissioned medical officer, as specified.
Positions requiring certification qualifications include
teachers, and positions whose functions relate to educational or
vocational counseling, guidance and placement services, school
health programs and school library services.
California law currently authorizes PAs and APRNs to conduct
medical examinations, but the Education Code does not
specifically acknowledge this ability as it relates to
certifications for employment. This bill updates the Education
Code to reflect the scope of practice of PAs and APRNs in the
Business and Professions Code.
Suggested amendments : The committee may wish to consider
technical amendments that clarify that APRNs may conduct medical
examinations under standardized procedures and protocols:
On page 2, line 16 and line 33; on page 3, line 26; and on page
4, line 3
delete "who is qualified to perform a medical examination" and
add
"acting under standardized procedures and protocols in
compliance with Chapter 6 (commencing with Section 2725) of
Division 2 of the Business and Professions Code,
REGISTERED SUPPORT / OPPOSITION :
Support
California Academy of Physician Assistants (sponsor)
California Association for Nurse Practitioners
California Medical Association
California Nurse-Midwives Association
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Los Angeles County of Education
United Nurses Associations of California/Union of Health Care
Professionals
Opposition
None on file.
Analysis Prepared by : Sarah Huchel / B. & P. / (916) 319-3301