BILL ANALYSIS �
SB 1083
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Date of Hearing: June 17, 2014
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Susan A. Bonilla, Chair
SB 1083 (Pavley) - As Introduced: February 19, 2014
SENATE VOTE : 36-0
SUBJECT : Physician assistants: disability certifications.
SUMMARY : Authorizes a physician assistant (PA) to certify
disability for purposes of disability insurance (DI).
Specifically, this bill :
1) Permits a PA to certify disability after performing a
physical examination under the supervision of a physician.
2) Expands the definition of a practitioner in the Unemployment
Insurance Code (UIC) to include a physician assistant who has
performed a physical examination under the supervision of a
physician and surgeon.
EXISTING LAW :
1)Establishes the Physician Assistant Board to license and
regulate the practice of PAs. (Business and Professions Code
(BPC) Sections 3500 et seq.)
2)Authorizes a PA to perform those medical services set forth in
regulations when the services are rendered under the
supervision of a licensed physician and surgeon who is
physically available to the PA for consultation, as specified.
(BPC 3502)
3)Authorizes a PA to certify the needs of an individual who has
been diagnosed by a physician and surgeon as being deaf or
hearing impaired to participate in a telecommunications
program for the deaf or hearing impaired after reviewing the
medical records or copies of the medical records containing
that diagnosis. (Public Utilities Code Section 2881(a))
4)Authorizes a PA to certify that an applicant for a teaching
credential or certificate is free from any contagious and
communicable disease or other disabling disease or defect
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unfitting the applicant to instruct or associate with
children. (Education Code Section 44336)
5)Authorizes a PA under the supervision of a physician to carry
out the initial report for, and authorize temporary disability
for no more than, three calendar days. (Labor Code Section
3209.10)
6)Authorizes a PA to certify medical conditions for the purposes
of the Family Medical Leave Act and the California Family
Rights Act. (Government Code Section 12945.2 (c)(6)(B))
7)Authorizes a PA to perform a medical examination on an
applicant for an original or renewal certificate to drive a
schoolbus, school pupil activity bus, youth bus, general
public paratransit vehicle, or farm labor vehicle. (Vehicle
Code Section 12517.2)
8)Defines "practitioner" for purposes of certifying disability
as a person duly licensed or certified in California acting
within the scope of his or her license or certification who is
a dentist, podiatrist, or a nurse practitioner, and in the
case of a nurse practitioner, after performance of a physical
examination by a nurse practitioner and collaboration with a
physician and surgeon, or as to normal pregnancy or
childbirth, a midwife or nurse midwife, or nurse practitioner.
(Unemployment Insurance Code Section 2708 (e)(2))
FISCAL EFFECT : None. This bill is keyed non-fiscal by the
Legislative Counsel.
COMMENTS :
1)Purpose of this bill . This bill authorizes a PA to certify
disability for purposes of obtaining DI. This bill is
sponsored by the California Academy of Physician Assistants.
2)Author's statement . According to the author's office,
"California law does not authorize physician assistants to
certify claims for DI with the Employment Development
Department. The restrictions related to EDD forms are
inconsistent with the scope-of-practice of a physician
assistant, which allows them to act as an agent of their
supervising physician in performing medical examinations as
well as most other medical services. The law pertaining to DI
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is also inconsistent with a physician assistants' ability to
certify other claims of temporary disability, such as Paid
Family Leave under the Family Medical Leave Act and the
California Family Rights Act, but not claims for Disability
Insurance.
"SB 1083 would authorize a physician assistant to certify a
claim for DI. Including physician assistants as a recognized
practitioner, acting as an agent of the supervising physician
under a delegation of services agreement, who may certify DI,
would clarify the inconsistency and omissions in existing
law."
3)Physician assistants . A PA is a licensed and skilled health
care professional who is trained to obtain medical histories,
conduct physical examinations, diagnose and treat illnesses,
prescribe medication, order and interpret lab tests, perform
procedures, assist in surgery, provide patient education and
counseling, and make rounds in hospitals and nursing homes.
The Physician Assistant Board (PAB) in California licenses and
regulates the approximately 9,000 PAs in California. PAB
consists of 9 members; 1 physician member from the Medical
Board of California; 4 licensed physician assistants and 4
public members. PAB is supported entirely by fees imposed upon
the professional community it regulates and received no
reimbursement from taxpayers or from the General Fund.
A PA must attend a PAB-approved training program associated
with a medical school that includes classroom studies and
clinical experience. The average length of a PA education
program is 26 months (three academic years). A PA must also
take and pass the Physician Assistant National Certifying
Examination administered by the National Commission on
Certification of Physician Assistants.
PAs are currently authorized to sign for the issuance of
disabled person placards, certify licensees to drive standard
commercial vehicles, school buses, general public
transportation vehicles, and farm labor vehicles. PAs are
also authorized to conduct physical examinations and sign
corresponding forms or certificates for those seeking
employment in school districts or with the county
superintendent of schools. Finally, PAs may sign for claims of
temporary disability for Paid Family Leave and workers'
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compensation insurance.
By expanding PA's signing authority to include certification
for DI, this bill would more fully align DI requirements with
PA's scope of practice.
4)State Disability Insurance (SDI) programs . DI provides
partial wage replacement to eligible workers who are unable to
work because of a disability, which includes a non-industrial
injury, illness, or pregnancy related condition. According to
the California Unemployment Insurance Code, disability is
defined as any mental or physical illness or injury which
prevents you from performing your regular or customary work,
as specified.
Currently, a physician, dentist, podiatrist, or a nurse
practitioner (after a physical examination and in
collaboration with a physician and surgeon), or as to normal
pregnancy or childbirth, a midwife, nurse midwife, or nurse
practitioner, may certify for DI. This bill will add a PA to
that list.
5)Arguments in support . The California Academy of Physician
Assistants write, "Currently, California law does not
authorize PAs to certify claims to DI with the EDD. The
restrictions related to EDD forms are inconsistent with the
scope-of-practice of a PA, which allows them to act as an
agent of their supervising physician in performing medical
examinations as well as most other medical services. The law
pertaining to DI is also inconsistent with a PA's ability to
certify other claims of temporary disability, such as Paid
Family Leave under the Family Medical Leave Act and the
California Family Rights Act, but not claims for Disability
Insurance."
REGISTERED SUPPORT / OPPOSITION :
Support
California Academy of Physician Assistants (sponsor)
Kaiser Permanente
Medical Board of California
Physician Assistant Board
Opposition
SB 1083
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None on file
Analysis Prepared by : Sarah Huchel / B.,P. & C.P. / (916)
319-3301