BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2143
                                                                  Page  1

          Date of Hearing:   May 14, 2014

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                  AB 2143 (Williams) - As Amended:  March 28, 2014 

          Policy Committee:                             HealthVote:14-0
                       Business and Professions         Vote: 19-0

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill provides a waiver for chiropractors from state  
          requirements for clinical labs when performing specified urine  
          tests, provided the chiropractors are on the federal Department  
          of Transportation (DOT) national registry of examiners for  
          administering tests for qualification examinations for  
          commercial drivers.

           FISCAL EFFECT  

          Potential minor revenue losses to the Department of Public  
          Health (CDPH) Laboratory Field Services, if individuals no  
          longer choose to register as Clinical Laboratory Improvement Act  
          (CLIA)-waived laboratories as a result of this bill's exemption.

           COMMENTS  

           1)Purpose  . According to the author, this bill allows  
            chiropractors who meet federal requirements to perform certain  
            simple tests.  The author contends this bill will help fill  
            the impending shortage of providers and reduce delays for  
            those commercial drivers license holders who choose to have a  
            chiropractor perform their physical.

           2)CLIA, CLIA waived tests, and Exempt from CLIA Regulation  .  
            Federal and state law jointly govern the provision of  
            laboratory services, and DPH regulates laboratories on behalf  
            of the state and federal government.  The federal CLIA is the  
            federal statutory framework for laboratory oversight.  The  
            more complex the tests a laboratory performs, the more  
            stringent the regulation.  Most clinical laboratories perform  








                                                                  AB 2143
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            tests of moderate to high complexity, while many personnel  
            perform only "CLIA-waived" procedures.  CLIA-waived tests  
            include tests cleared by the FDA for home use, for example.   
            They must be simple and have a low risk for erroneous results.  
             Individuals performing such procedures must still register  
            with the state and apply for a federal certificate. 

           3)Staff Comment  . This bill would exempt chiropractors from all  
            CLIA regulation-even this lowest level of regulation for  
            CLIA-waived tests- for specified urine tests, if the  
            chiropractor was on a specified federal list of providers who  
            meet certain criteria specified by the federal Department of  
            Transportation.  Other recent attempts to loosen standards for  
            laboratory testing have allowed various health care  
            professionals to administer specified CLIA-waived lab tests.  
            Exempting providers completely from CLIA oversight is unusual.
           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081