BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1069|
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UNFINISHED BUSINESS
Bill No: SB 1069
Author: Pavley (D), et al
Amended: 8/16/10
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
SENATE FLOOR : 30-0, 5/10/10
AYES: Aanestad, Alquist, Ashburn, Calderon, Cedillo,
Cogdill, Correa, Cox, DeSaulnier, Ducheny, Florez,
Hancock, Hollingsworth, Huff, Kehoe, Leno, Lowenthal,
Negrete McLeod, Padilla, Pavley, Price, Romero, Runner,
Simitian, Steinberg, Walters, Wolk, Wright, Wyland, Yee
NO VOTE RECORDED: Corbett, Denham, Dutton, Harman, Liu,
Oropeza, Strickland, Wiggins, Vacancy, Vacancy
ASSEMBLY FLOOR : 75-0, 8/18/10 - See last page for vote
SUBJECT : Physician assistants
SOURCE : California Academy of Physician Assistants
CONTINUED
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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
for various individuals.
Assembly Amendments prohibit a physician assistant from
certifying disability after performing a physical
examination under the supervision of a physician and
surgeon, as specified, delete provisions relating to the
timing of accusation filings, and delete "physician
assistant" from the definition of "practitioner" in the
Unemployment Insurance Code.
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 (PAs).
2. Provides that a 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
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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 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.
6. 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 either 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. For individuals receiving home health services or
personal care services, after consultation with the
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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. 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.
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
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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.
6. 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 8/18/10)
California Academy of Physician Assistants (source)
American Congress of Obstetricians and Gynecologists
American Federation of State, County and Municipal
Employees
California Academy of Family Physicians
California Assisted Living Association
California Chapter of the American College of Emergency
Physicians
California Medical Association
California Psychiatric Association
California Radiological Society
Medical Board of California
Osteopathic Physicians and Surgeons of California
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
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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.
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Bass, Beall,
Bill Berryhill, Tom Berryhill, Block, Blumenfield,
Bradford, Brownley, Buchanan, Caballero, Carter, Chesbro,
Conway, Cook, Coto, Davis, De La Torre, De Leon, DeVore,
Eng, Feuer, Fletcher, Fong, Fuentes, Fuller, Furutani,
Gaines, Galgiani, Garrick, Gatto, Gilmore, Hagman, Hall,
Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,
Jeffries, Jones, Knight, Lieu, Bonnie Lowenthal, Ma,
Mendoza, Miller, Monning, Nava, Nestande, Niello,
Nielsen, Norby, V. Manuel Perez, Portantino, Ruskin,
Salas, Saldana, Silva, Skinner, Smyth, Solorio, Audra
Strickland, Swanson, Torlakson, Torres, Torrico, Tran,
Villines, Yamada, John A. Perez
NO VOTE RECORDED: Blakeslee, Charles Calderon, Evans,
Logue, Vacancy
JJA:mw 8/18/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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