BILL ANALYSIS �
AB 2143
Page 1
ASSEMBLY THIRD READING
AB 2143 (Williams)
As Amended May 27, 2014
2/3 vote. Urgency
HEALTH 19-0 BUSINESS & PROFESSIONS
14-0
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|Ayes:|Pan, Maienschein, |Ayes:|Bonilla, Jones, |
| |Ammiano, Rendon, Bonilla, | |Bocanegra, Campos, |
| |Bonta, Ch�vez, Chesbro, | |Dickinson, Eggman, |
| |Gomez, Gonzalez, | |Gordon, Hagman, Holden, |
| |Roger Hern�ndez, | |Maienschein, Mullin, |
| |Lowenthal, Mansoor, | |Skinner, Ting, Wilk |
| |Nazarian, Waldron, | | |
| |Patterson, Ridley-Thomas, | | |
| |Wagner, Wieckowski | | |
| | | | |
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APPROPRIATIONS 17-0
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|Ayes:|Gatto, Bigelow, |
| |Bocanegra, Bradford, Ian |
| |Calderon, Campos, |
| |Donnelly, Eggman, Gomez, |
| |Holden, Jones, Linder, |
| |Pan, Quirk, |
| |Ridley-Thomas, Wagner, |
| |Weber |
| | |
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SUMMARY : Allows doctors of chiropractic (D.C.) to perform
specified laboratory (lab) tests as part of the qualifications
examinations for commercial drivers. Authorizes waivers from
state requirements for clinical labs when performing specified
tests, provided certain requirements are met. Requires a D.C.
to obtain a waiver and comply with all applicable requirements
for performing waived lab tests and requires the D.C. to refer
an applicant who has an abnormal reading to the applicant's
primary care physician. Contains an urgency clause to ensure
that the provisions of this bill go into immediate effect upon
enactment.
AB 2143
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EXISTING LAW :
1)Requires a clinical lab that performs tests of moderate or high
complexity to be licensed by the Department of Public Health
(DPH). Requires a clinical lab that performs "waived tests,"
which are tests of low complexity, to be registered, rather
than licensed, by DPH.
2)Prohibits anyone from performing a clinical lab test or
examination classified as waived under the federal Clinical
Laboratory Improvement Amendments (CLIA) of 1988, unless the
clinical lab test or examination is performed under the
overall operation and administration of the lab director, and
the test is performed by specified persons, including
physicians and surgeons, podiatrists, dentists, physician
assistants, or respiratory care practitioners.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill would have potential minor revenue losses
to DPH Laboratory Field Services, if individuals no longer
choose to register as CLIA-waived labs as a result of this
bill's exemption.
COMMENTS : According to the author, this bill grants D.C.s who
meet federal requirements the CLIA waiver so they can perform
specified waived tests. The author argues the bill contains
safeguards because it requires applicants to be referred to
their primary care physicians should the urine dipstick test
return an abnormal result. The author concludes this bill will
help fill the impending shortage of providers and reduce delays
for those commercial driver license holders who choose to have a
D.C. perform their physical.
Waived tests include test systems cleared by the Food and Drug
Administration (FDA) for home use and those tests approved for
waiver under the CLIA criteria. Although CLIA requires that
waived tests must be simple and have a low risk for erroneous
results, this does not mean that waived tests are completely
error-proof. Waived tests also include dipstick or tablet
reagent urinalysis (used to test glucose, hemoglobin, and
protein, among other things); fecal occult blood; ovulation
tests; urine pregnancy tests; and, blood glucose by glucose
monitoring devices cleared by the FDA specifically for home use.
AB 2143
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California clinical labs are subject to both federal and state
oversight. The United States Congress passed CLIA in 1988,
which established quality standards for all lab testing to
ensure the accuracy, reliability, and timeliness of patient test
results, regardless of where the test was performed. CLIA
regulates clinical labs based on the complexity (low, moderate,
or high) of the tests offered. State oversight of clinical labs
is administered by DPH, which regulates about 19,000 clinical
labs and their personnel statewide, monitors proficiency
testing, investigates complaints, and sanctions labs that
violate the law or regulations. DPH provides licensing,
registration, and certification services for clinical lab
facilities, blood banks, tissue banks, and the testing personnel
who perform professional pre-analytical, analytical, and
post-analytical testing services for these facilities.
Most commercial motor vehicle drivers must meet federal
Department of Transportation (DOT) requirements. Among the
requirements, commercial drivers must obtain a valid medical
certificate. DOT establishes requirements for healthcare
professionals that perform physical qualification examinations
for interstate commercial drivers. The federal requirements
have been strengthened recently in an effort to improve medical
oversight of commercial drivers and lessen the chances of
commercial motor vehicle-related crashes, injuries, and
fatalities. The new strengthened program creates a National
Registry of Certified Medical Examiners.
According to the California Chiropractic Association, the bill's
sponsor, D.C.s perform commercial driver's license medical
examinations and pre-employment physicals. As with every other
health care provider conducting the exams and physicals, the
D.C.s should be provided a CLIA waiver for the necessary urine
dipstick tests. They note that without this bill, commercial
driver license holders who choose a D.C. to perform their
required medical examination will have to make a separate
appointment with a lab to get the urine dipstick performed, the
test will require additional expense, and delay which will be
barriers to employment.
This bill has no known opposition.
Analysis Prepared by : Paula Villescaz / HEALTH / (916)
319-2097
AB 2143
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FN: 0003580