Bill Text: CA AB1841 | 2013-2014 | Regular Session | Chaptered
Bill Title: Medical assistants.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Passed) 2014-09-15 - Chaptered by Secretary of State - Chapter 333, Statutes of 2014. [AB1841 Detail]
Download: California-2013-AB1841-Chaptered.html
BILL NUMBER: AB 1841 CHAPTERED
BILL TEXT
CHAPTER 333
FILED WITH SECRETARY OF STATE SEPTEMBER 15, 2014
APPROVED BY GOVERNOR SEPTEMBER 15, 2014
PASSED THE SENATE AUGUST 11, 2014
PASSED THE ASSEMBLY AUGUST 18, 2014
AMENDED IN SENATE JUNE 2, 2014
AMENDED IN ASSEMBLY APRIL 21, 2014
INTRODUCED BY Assembly Member Mullin
(Coauthor: Senator Hernandez)
FEBRUARY 18, 2014
An act to amend Section 2069 of the Business and Professions Code,
relating to medicine.
LEGISLATIVE COUNSEL'S DIGEST
AB 1841, Mullin. Medical assistants.
Existing law, the Medical Practice Act, provides for the licensure
and regulation of the practice of medicine by the Medical Board of
California. The act authorizes a medical assistant to administer
medication only by intradermal, subcutaneous, or intramuscular
injections and to perform skin tests and additional technical
supportive services upon the specific authorization and supervision
of a licensed physician and surgeon, a licensed podiatrist, a
physician assistant, a nurse practitioner, or a certified
nurse-midwife. Existing law defines the term "technical supportive
services" to mean simple routine medical tasks and procedures that
may be safely performed by a medical assistant who has limited
training and who functions under the supervision of a licensed
physician and surgeon, a licensed podiatrist, a physician assistant,
a nurse practitioner, or a certified nurse-midwife. Existing law, the
Pharmacy Law, prohibits a prescriber, as defined, from dispensing
drugs to patients in his or her office unless specified conditions
are satisfied, and authorizes a certified nurse-midwife, a nurse
practitioner, a physician assistant, or a naturopathic doctor who
functions pursuant to a specified protocol or procedure to hand to a
patient of his or her supervising physician a properly labeled and
prepackaged prescription drug. Existing law authorizes specified
facilities licensed by the California State Board of Pharmacy to
purchase drugs at wholesale for administration or dispensing, under
the direction of a physician and surgeon, to patients registered for
care at those facilities.
This bill would specify that the "technical supportive services" a
medical assistant may perform in those California State Board of
Pharmacy licensed facilities also includes handing to a patient a
properly labeled and prepackaged prescription drug, other than a
controlled substance, ordered by a licensed physician and surgeon, a
licensed podiatrist, a physician assistant, a nurse practitioner, or
a certified nurse-midwife, as specified.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 2069 of the Business and Professions Code is
amended to read:
2069. (a) (1) Notwithstanding any other law, a medical assistant
may administer medication only by intradermal, subcutaneous, or
intramuscular injections and perform skin tests and additional
technical supportive services upon the specific authorization and
supervision of a licensed physician and surgeon or a licensed
podiatrist. A medical assistant may also perform all these tasks and
services upon the specific authorization of a physician assistant, a
nurse practitioner, or a certified nurse-midwife.
(2) The supervising physician and surgeon may, at his or her
discretion, in consultation with the nurse practitioner, certified
nurse-midwife, or physician assistant, provide written instructions
to be followed by a medical assistant in the performance of tasks or
supportive services. These written instructions may provide that the
supervisory function for the medical assistant for these tasks or
supportive services may be delegated to the nurse practitioner,
certified nurse-midwife, or physician assistant within the
standardized procedures or protocol, and that tasks may be performed
when the supervising physician and surgeon is not onsite, if either
of the following apply:
(A) The nurse practitioner or certified nurse-midwife is
functioning pursuant to standardized procedures, as defined by
Section 2725, or protocol. The standardized procedures or protocol,
including instructions for specific authorizations, shall be
developed and approved by the supervising physician and surgeon and
the nurse practitioner or certified nurse-midwife.
(B) The physician assistant is functioning pursuant to regulated
services defined in Section 3502, including instructions for specific
authorizations, and is approved to do so by the supervising
physician and surgeon.
(b) As used in this section and Sections 2070 and 2071, the
following definitions apply:
(1) "Medical assistant" means a person who may be unlicensed, who
performs basic administrative, clerical, and technical supportive
services in compliance with this section and Section 2070 for a
licensed physician and surgeon or a licensed podiatrist, or group
thereof, for a medical or podiatry corporation, for a physician
assistant, a nurse practitioner, or a certified nurse-midwife as
provided in subdivision (a), or for a health care service plan, who
is at least 18 years of age, and who has had at least the minimum
amount of hours of appropriate training pursuant to standards
established by the board. The medical assistant shall be issued a
certificate by the training institution or instructor indicating
satisfactory completion of the required training. A copy of the
certificate shall be retained as a record by each employer of the
medical assistant.
(2) "Specific authorization" means a specific written order
prepared by the supervising physician and surgeon or the supervising
podiatrist, or the physician assistant, the nurse practitioner, or
the certified nurse-midwife as provided in subdivision (a),
authorizing the procedures to be performed on a patient, which shall
be placed in the patient's medical record, or a standing order
prepared by the supervising physician and surgeon or the supervising
podiatrist, or the physician assistant, the nurse practitioner, or
the certified nurse-midwife as provided in subdivision (a),
authorizing the procedures to be performed, the duration of which
shall be consistent with accepted medical practice. A notation of the
standing order shall be placed on the patient's medical record.
(3) "Supervision" means the supervision of procedures authorized
by this section by the following practitioners, within the scope of
their respective practices, who shall be physically present in the
treatment facility during the performance of those procedures:
(A) A licensed physician and surgeon.
(B) A licensed podiatrist.
(C) A physician assistant, nurse practitioner, or certified
nurse-midwife as provided in subdivision (a).
(4) (A) "Technical supportive services" means simple routine
medical tasks and procedures that may be safely performed by a
medical assistant who has limited training and who functions under
the supervision of a licensed physician and surgeon or a licensed
podiatrist, or a physician assistant, a nurse practitioner, or a
certified nurse-midwife as provided in subdivision (a).
(B) Notwithstanding any other law, in a facility licensed by the
California State Board of Pharmacy under Section 4180 or 4190, other
than a facility operated by the state, "technical supportive services"
also includes handing to a patient a prepackaged prescription drug,
excluding a controlled substance, that is labeled in compliance with
Section 4170 and all other applicable state and federal laws and
ordered by a licensed physician and surgeon, a licensed podiatrist, a
physician assistant, a nurse practitioner, or a certified
nurse-midwife in accordance with subdivision (a). In every instance,
prior to handing the medication to a patient pursuant to this
subparagraph, the properly labeled and prepackaged prescription drug
shall have the patient's name affixed to the package and a licensed
physician and surgeon, a licensed podiatrist, a physician assistant,
a nurse practitioner, or a certified nurse-midwife shall verify that
it is the correct medication and dosage for that specific patient and
shall provide the appropriate patient consultation regarding use of
the drug.
(c) Nothing in this section shall be construed as authorizing any
of the following:
(1) The licensure of medical assistants.
(2) The administration of local anesthetic agents by a medical
assistant.
(3) The board to adopt any regulations that violate the
prohibitions on diagnosis or treatment in Section 2052.
(4) A medical assistant to perform any clinical laboratory test or
examination for which he or she is not authorized by Chapter 3
(commencing with Section 1200).
(5) A nurse practitioner, certified nurse-midwife, or physician
assistant to be a laboratory director of a clinical laboratory, as
those terms are defined in paragraph (8) of subdivision (a) of
Section 1206 and subdivision (a) of Section 1209.
(d) A nurse practitioner, certified nurse-midwife, or physician
assistant shall not authorize a medical assistant to perform any
clinical laboratory test or examination for which the medical
assistant is not authorized by Chapter 3 (commencing with Section
1200). A violation of this subdivision constitutes unprofessional
conduct.
(e) Notwithstanding any other law, a medical assistant shall not
be employed for inpatient care in a licensed general acute care
hospital, as defined in subdivision (a) of Section 1250 of the Health
and Safety Code.
