BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1069|
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THIRD READING
Bill No: SB 1069
Author: Pavley (D), et al
Amended: 4/12/10
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE : 8-0,
4/12/10
AYES: Negrete McLeod, Wyland, Aanestad, Calderon, Correa,
Oropeza, Walters, Yee
NO VOTE RECORDED: Florez
SENATE JUDICIARY COMMITTEE : 4-0, 4/20/10
AYES: Corbett, Harman, Hancock, Leno
NO VOTE RECORDED: Walters
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
SUBJECT : Physician assistants
SOURCE : California Academy of Physician Assistants
DIGEST : This bill authorizes a physician assistant,
pursuant to a delegation of services agreement, to order
durable medical equipment, certify unemployment insurance
disability, and for individuals receiving home health
services or personal care services, after consultation with
the supervising physician, approve, sign, modify, or add to
a plan of treatment or plan of care. Also, authorizes
physician assistants to conduct specified medical
examinations and sign corresponding medical certificates
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for various individuals, and specifies certain statutes of
limitations for the filing of an accusation against a
licensee by the Physician Assistant Committee similar to
other health care licensing acts.
ANALYSIS :
Existing law:
1. Establishes the Physician Assistant Practice Act
administered by the Physician Assistant Committee
(Committee) of the Medical Board of California (MBC) to
regulate physician assistants.
2. Provides that a physician assistant (PA) may perform
those medical services as set forth by the regulations
of MBC when the services are rendered under the
supervision of a licensed physician and surgeon approved
by MBC, except as otherwise provided.
3. States that an accusation filed against a licensee shall
be filed within three years from the date the board
discovers the alleged act or omission that is the basis
for the disciplinary action or within seven years from
the date the alleged act or omission that is the basis
for the disciplinary action occurred, whichever occurs
first. This statute of limitations provision is
included in the practice act of the following health
care practitioners: dentists, physicians and surgeons,
psychologists, respiratory care therapists, marriage and
family therapists, social workers, and educational
psychologists. Defines "discovers" for purposes of this
provision, but only for the practice act that applies to
marriage and family therapists, social workers, and
educational psychologists.
4. Exempts an accusation alleging the procurement of a
license by fraud or misrepresentation from the statute
of limitations specified in #3 above.
5. States that an accusation alleging sexual misconduct
shall be filed within three years after the boards
discover the act or omission or within 10 years after
the act or omission.
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6. States that if an alleged act or omission involves a
minor, the seven-year limitations specified in #3 above
and the 10-year limitations specified in #5 above shall
be tolled until the minor reaches the age of majority.
Further states that for marriage and family therapists,
social workers, and educational therapists, if specified
acts are committed against a minor, the Board of
Behavioral Sciences (BBS), which regulates these health
care licensees, is authorized to take action regardless
of whether or not the act occurred prior to or after the
time the license was issued by BBS.
7. States that the limitations specified in #3 above shall
be tolled during any period if material evidence
necessary for prosecuting or determining whether a
disciplinary action would be appropriate is unavailable
to the boards due to an ongoing criminal investigation.
8. States that an accusation is a written statement of
charges against a healing arts licensee which shall set
forth in ordinary and concise language the acts or
omissions with which a licensee is charged.
This bill:
1. Defines delegation of services agreement as the writing
that delegates to a PA from a supervising physician the
medical services the PA is authorized to perform, as
specified.
2. Defines other specified medical services as tests or
exams performed by or ordered by a PA practicing in
compliance with the Physician Assistant Practice Act.
3. Specifies that a delegation of services agreement may
authorize a PA to do any of the following:
A. Order durable medical equipment, as specified.
States that this does not limit the ability of a
third-party payer to require prior approval for the
medical equipment.
B. Certify unemployment insurance disability, as
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specified, after performance of a physical
examination by the PA under the supervision of a
physician and surgeon, as specified.
C. For individuals receiving home health services or
personal care services, after consultation with the
supervising physician, approve, sign, modify, or add
to a plan of treatment or plan of care.
4. States that nothing in #3 above shall be construed to
affect the validity of any delegation of services
agreement in effect prior to the enactment of this bill,
as specified.
5. Requires any accusation filed against a licensee, except
as provided in #6 below, to be filed within three years
after the Committee discovers the act or omission
alleged as the grounds for disciplinary action or within
seven years after the act or omission alleged as the
grounds for disciplinary action occurs, whichever occurs
first.
6. Exempts the following from the statutes of limitations
specified in #5 above:
A. An accusation alleging the procurement of a
license by fraud or misrepresentation.
B. An accusation alleging unprofessional conduct
based on incompetence, gross negligence, or repeated
negligent acts, as specified.
7. States that if an alleged act or omission involves a
minor, the seven-year limitations period provided for in
#5 above and the 10-year limitations provided in #8
below shall be tolled until the minor reaches the age of
majority. However, if the Committee discovers an
alleged act of sexual contact with a minor under
specified sections of the Penal Code after the
limitations periods have otherwise expired, and there is
independent evidence that corroborates the allegation,
an accusation shall be filed within three years from the
date the Committee discovers that alleged act.
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8. An accusation alleging sexual misconduct shall be filed
within three years after the Committee discovers the act
or omission alleged as the grounds for disciplinary
action, or within 10 years after the act or omission
alleged as the grounds for disciplinary action occurs,
whichever occurs first. Specifies that this provision
applies to complaints alleging sexual misconduct
received by the Committee on or after January 1, 2011.
9. States that the statute of limitations provided for in
#5 above shall be tolled during any period if material
evidence necessary for prosecuting or determining
whether a disciplinary action would be appropriate is
unavailable to the Committee due to an ongoing criminal
investigation.
10.Defines "discovers" as the latest of the occurrence of
any of the following with respect to each act or
omission alleged as the basis for disciplinary action:
A. The date the committee receives a complaint or
report describing the act or omission.
B. The date, subsequent to the original complaint or
report, on which the committee becomes aware of any
additional acts or omissions alleged as the basis for
disciplinary action against the same individual.
C. The date the committee receives from the
complainant a written release of information
pertaining to the complainant's diagnosis and
treatment.
11.Authorizes a PA to do the following:
A. Certify that an applicant for a teacher
certification or renewal of certification is free
from any contagious or communicable disease or other
disabling disease or defect, as specified.
B. Conduct medical examinations and certify that an
individual that is initially employed by a school
district in a certificated or classified position, is
free from tuberculosis, as specified.
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C. Order medications for any pupil to take during the
regular school day, as specified, and provide written
statements to the school district detailing
information about the medication.
D. Certify the results of a determination of a
child's vision to be presented by a parent to the
school district for waiving a required vision
assessment of school-aged children.
E. Perform a physical examination of a student
participating in an interscholastic athletic program,
as specified.
F. Conduct medical examination and certify that an
applicant for an academic position at a community
college district is free from any communicable
disease, including tuberculosis.
G. Conduct medical examination and certify that a
retirant applicant of a community college district is
free from any disabling disease.
H. Conduct medical examination and certify that
anyone who wishes to be employed in an academic or
classified position at a community college is free of
active tuberculosis, as specified.
I. Certify the need for an individual who has been
diagnosed by a licensed physician and surgeon as
being deaf or hearing impaired to participate in a
program implemented by the Public Utilities
Commission (PUC) to provide telecommunications
devices for deaf or hearing impaired, as specified.
J. Certify an individual's disability, thereby
qualifying an individual to participate in the
state's specialized or supplemental telephone
communications equipment program, as specified.
12.Includes PAs in the definition of practitioner who could
certify medical eligibility for unemployment disability
benefits.
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13.Authorizes a physician and surgeon to perform a required
physical examination of a student as a condition of
participation in an interscholastic athletic program.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
SUPPORT : (Verified 5/4/10)
California Academy of Physician Assistants (source)
American Congress of Obstetricians and Gynecologists
American Federation of State, County and Municipal
Employees
California Assisted Living Association
California Medical Association
California Radiological Society
United Nurses Association of California/Union of Health
Care Professionals
ARGUMENTS IN SUPPORT : The California Academy of
Physician Assistants (CAPA) is the sponsor of this bill.
CAPA states that this bill clarifies various
inconsistencies and omissions in existing law by allowing
PAs to order durable medical equipment, certify disability
for purposes of unemployment insurance eligibility,
approve, sign, modify or add to a treatment plan for home
health or personal care services, and conduct specified
physical examinations and sign corresponding certificates
or forms. CAPA points out that all of these functions
would be performed under physician supervision and
consistent with existing PA scope of practice.
Additionally, CAPA points out that there is a need to
establish statute of limitations provisions for PAs. CAPA
states that the primary purpose for statute of limitation
provisions is to assure fairness to defendants. The
ability to prepare a defense is clearly undermined in cases
where a claim is not pursued for a long period of time
because evidence is lost, memories fade and witnesses
disappear. Statute of limitation provisions also assures
the prosecuting agencies can devote their resources to more
recent misdeeds.
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JJA:mw 5/4/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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