Bill Text: CA SB1069 | 2009-2010 | Regular Session | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Physician assistants.
Spectrum: Slight Partisan Bill (Democrat 3-1)
Status: (Passed) 2010-09-29 - Chaptered by Secretary of State. Chapter 512, Statutes of 2010. [SB1069 Detail]
Download: California-2009-SB1069-Amended.html
Bill Title: Physician assistants.
Spectrum: Slight Partisan Bill (Democrat 3-1)
Status: (Passed) 2010-09-29 - Chaptered by Secretary of State. Chapter 512, Statutes of 2010. [SB1069 Detail]
Download: California-2009-SB1069-Amended.html
BILL NUMBER: SB 1069 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY AUGUST 16, 2010
AMENDED IN SENATE MAY 5, 2010
AMENDED IN SENATE APRIL 12, 2010
AMENDED IN SENATE APRIL 5, 2010
INTRODUCED BY Senator Pavley
(Principal coauthor: Assembly Member Fletcher)
(Coauthors: Senators Correa and Negrete McLeod)
FEBRUARY 17, 2010
An act to amend Section 3501 of, and to add Sections 3502.2
, 3502.3, and 3528.5 and 3502.3 to, the
Business and Professions Code, to amend Sections 44336, 49406,
49423, 49455, 87408, 87408.5, and 87408.6 of, and to add Section
49458 to, the Education Code, and to amend Section 2881
of the Public Utilities Code, and to amend Section 2708 of
the Unemployment Insurance Code, relating to physician
assistants.
LEGISLATIVE COUNSEL'S DIGEST
SB 1069, as amended, Pavley. Physician assistants.
Existing law, the Physician Assistant Practice Act, is
administered by the Physician Assistant Committee of the Medical
Board of California and provides for the licensure and regulation of
physician assistants. Existing law provides that a physician
assistant may perform the medical services that are set forth by the
regulations of the board when the services are rendered under the
supervision of a licensed physician and surgeon. Existing law
requires a physician assistant and his or her supervising physician
to establish written guidelines for the adequate supervision of the
physician assistant. Existing law provides that those requirements
may be satisfied by adopting protocols for some or all of the tasks
performed by the physician assistant, as specified.
This bill would provide that a physician assistant acts as the
agent of the supervising physician when performing authorized
activities, and would authorize a physician assistant to perform
physical examinations and other specified medical services, as
defined, and sign and attest to any document evidencing those
examinations and other services, as required pursuant to specified
provisions of law. The bill would further provide that a delegation
of services agreement may authorize a physician assistant to order
durable medical equipment , certify disability, as
specified, and make arrangements with regard to home health
services or personal care services. The bill would make conforming
changes to provisions in the Education Code ,
and the Public Utilities Code , and the Unemployment
Insurance Code with regard to the performance of those
examinations and services and acceptance of those attestations. The
bill would also authorize a physician assistant to perform a physical
examination that is required for participation in an interscholastic
athletic program, as specified.
Under existing law regarding administrative adjudication, a
hearing to determine whether a license granted to a physician
assistant shall be revoked, suspended, limited, or conditioned is
initiated by filing an accusation. An accusation is a written
statement of charges that sets forth in ordinary and concise language
the acts or omissions with which a licensee is charged.
This bill would require an accusation against a physician
assistant to be filed against the physician assistant within 3 years
after the committee discovers, as defined, the act or omission
alleged as the ground for disciplinary action, or within 7 years
after the act or omission alleged as the ground for disciplinary
action occurs, whichever occurs first. This statute of limitation
would not apply to an accusation based on the procurement of a
license by fraud or misrepresentation, or upon an allegation of
unprofessional conduct based on incompetence, gross negligence, or
repeated negligent acts of the licensee upon proof of specified
facts. The bill would toll the limitations period in certain
circumstances and would also establish a different time limit for an
accusation alleging sexual misconduct by a licensee, as specified.
Vote: majority. Appropriation: no. Fiscal committee: yes
no . State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 3501 of the Business and Professions Code is
amended to read:
3501. As used in this chapter:
(a) "Board" means the Medical Board of California.
(b) "Approved program" means a program for the education of
physician assistants that has been formally approved by the
committee.
(c) "Trainee" means a person who is currently enrolled in an
approved program.
(d) "Physician assistant" means a person who meets the
requirements of this chapter and is licensed by the committee.
(e) "Supervising physician" means a physician and surgeon licensed
by the board or by the Osteopathic Medical Board of California who
supervises one or more physician assistants, who possesses a current
valid license to practice medicine, and who is not currently on
disciplinary probation for improper use of a physician assistant.
(f) "Supervision" means that a licensed physician and surgeon
oversees the activities of, and accepts responsibility for, the
medical services rendered by a physician assistant.
(g) "Committee" or "examining committee" means the Physician
Assistant Committee.
(h) "Regulations" means the rules and regulations as set forth in
Chapter 13.8 (commencing with Section 1399.500) of Title 16 of the
California Code of Regulations.
(i) "Routine visual screening" means uninvasive nonpharmacological
simple testing for visual acuity, visual field defects, color
blindness, and depth perception.
(j) "Program manager" means the staff manager of the diversion
program, as designated by the executive officer of the board. The
program manager shall have background experience in dealing with
substance abuse issues.
(k) "Delegation of services agreement" means the writing that
delegates to a physician assistant from a supervising physician the
medical services the physician assistant is authorized to perform
consistent with subdivision (a) of Section 1399.540 of Title 16 of
the California Code of Regulations.
(l) "Other specified medical services" means tests or examinations
performed or ordered by a physician assistant practicing in
compliance with this chapter or regulations of the board promulgated
under this chapter.
(m) A physician assistant acts as an agent of the supervising
physician when performing any activity authorized by this chapter or
regulations promulgated by the board under this chapter.
SEC. 2. Section 3502.2 is added to the Business and Professions
Code, to read:
3502.2. Notwithstanding any other provision of law, a physician
assistant may perform the physical examination and any other
specified medical services that are required pursuant to Section 2881
of the Public Utilities Code and Sections 44336, 49406, 49423,
49455, 87408, 87408.5, and 87408.6 of the Education Code, practicing
in compliance with this chapter, and may sign and attest to any
certificate, card, form, or other documentation evidencing the
examination or other specified medical services.
SEC. 3. Section 3502.3 is added to the Business and Professions
Code, to read:
3502.3. (a) Notwithstanding any other provision of law, in
addition to any other practices that meet the general criteria set
forth in this chapter or the board's regulations for inclusion in a
delegation of services agreement, a delegation of services agreement
may authorize a physician assistant to do any of the following:
(1) Order durable medical equipment, subject to any limitations
set forth in Section 3502 or the delegation of services agreement.
Notwithstanding that authority, nothing in this paragraph shall
operate to limit the ability of a third-party payer to require prior
approval.
(2) After performance of a physical examination by the physician
assistant under the supervision of a physician and surgeon consistent
with this chapter, certify disability pursuant to Section 2708 of
the Unemployment Insurance Code.
(3)
(2) 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.
(b) Nothing in this section shall be construed to affect the
validity of any delegation of services agreement in effect prior to
the enactment of this section or those adopted subsequent to
enactment.
SEC. 4. Section 3528.5 is added to the Business
and Professions Code, to read:
3528.5. (a) Except as provided in subdivisions (b), (c), (d), and
(e), any accusation filed against a licensee pursuant to Section
11503 of the Government Code shall be filed within three years after
the committee discovers the act or omission alleged as the ground for
disciplinary action, or within seven years after the act or omission
alleged as the ground for disciplinary action occurs, whichever
occurs first.
(b) An accusation filed against a licensee pursuant to Section
11503 of the Government Code alleging the procurement of a license by
fraud or misrepresentation is not subject to the limitation provided
for by subdivision (a).
(c) An accusation filed against a licensee pursuant to Section
11503 of the Government Code alleging unprofessional conduct based on
incompetence, gross negligence, or repeated negligent acts of the
licensee is not subject to the limitation provided for by subdivision
(a) upon proof that the licensee intentionally concealed from
discovery his or her incompetence, gross negligence, or repeated
negligent acts.
(d) If an alleged act or omission involves a minor, the 7-year
limitations period provided for by subdivision (a) and the 10-year
limitations period provided for by subdivision (e) shall be tolled
until the minor reaches the age of majority. However, if the
committee discovers an alleged act of sexual contact with a minor
under Section 261, 286, 288, 288.5, 288a, or 289 of the Penal Code
after the limitations periods described in this subdivision have
otherwise expired, and there is independent evidence that
corroborates the allegation, an accusation shall be filed within
three years from the date the committee discovers that alleged act.
(e) An accusation filed against a licensee pursuant to Section
11503 of the Government Code alleging sexual misconduct shall be
filed within 3 years after the committee discovers the act or
omission alleged as the ground for disciplinary action, or within 10
years after the act or omission alleged as the ground for
disciplinary action occurs, whichever occurs first. This subdivision
shall apply to a complaint alleging sexual misconduct received by the
committee on and after January 1, 2011.
(f) The limitations period provided by subdivision (a) 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 committee due to an ongoing
criminal investigation.
(g) For purposes of this section, "discovers" means the latest of
the occurrence of any of the following with respect to each act or
omission alleged as the basis for disciplinary action:
(1) The date the committee receives a complaint or report
describing the act or omission.
(2) The date, subsequent to the original complaint or report, on
which the committee becomes aware of any additional acts or omissions
alleged as the basis for disciplinary action against the same
individual.
(3) The date the committee receives from the complainant a written
release of information pertaining to the complainant's diagnosis and
treatment.
SEC. 5. SEC. 4. Section 44336 of the
Education Code is amended to read:
44336. When required by the commission, the application for a
certification document or the renewal thereof shall be accompanied by
a certificate in such form as shall be prescribed by the commission,
from a physician and surgeon licensed under the provisions of the
Business and Professions Code or a physician assistant practicing in
compliance with Chapter 7.7 (commencing with Section 3500) of
Division 2 of the Business and Professions Code, showing that the
applicant is free from any contagious and communicable disease or
other disabling disease or defect unfitting the applicant to instruct
or associate with children.
SEC. 6. SEC. 5. Section 49406 of the
Education Code is amended to read:
49406. (a) Except as provided in subdivision (h), no person shall
be initially employed by a school district in a certificated or
classified position unless the person has submitted to an examination
within the past 60 days to determine that he or she is free of
active tuberculosis, by a physician and surgeon licensed under
Chapter 5 (commencing with Section 2000) of Division 2 of the
Business and Professions Code or a physician assistant practicing in
compliance with Chapter 7.7 (commencing with Section 3500) of
Division 2 of the Business and Professions Code. This examination
shall consist of either an approved intradermal tuberculin test or
any other test for tuberculosis infection that is recommended by the
federal Centers for Disease Control and Prevention (CDC) and licensed
by the federal Food and Drug Administration (FDA), which, if
positive, shall be followed by an X-ray of the lungs in accordance
with subdivision (f) of Section 120115 of the Health and Safety Code.
The X-ray film may be taken by a competent and qualified X-ray
technician if the X-ray film is subsequently interpreted by a
physician and surgeon licensed under Chapter 5 (commencing with
Section 2000) of Division 2 of the Business and Professions Code.
The district superintendent or his or her designee may exempt, for
a period not to exceed 60 days following termination of the
pregnancy, a pregnant employee from the requirement that a positive
intradermal tuberculin test be followed by an X-ray of the lungs.
(b) Thereafter, employees who are test negative by either the
tuberculin skin test or any other test for tuberculosis infection
recommended by the CDC and licensed by the FDA shall be required to
undergo the foregoing examination at least once each four years or
more often if directed by the governing board upon recommendation of
the local health officer for so long as the employee's test remains
negative. Once an employee has a documented positive test for
tuberculosis infection conducted pursuant to this subdivision which
has been followed by an X-ray, the foregoing examination is no longer
required, and a referral shall be made within 30 days of completion
of the examination to the local health officer to determine the need
for followup care.
(c) After the examination, each employee shall cause to be on file
with the district superintendent of schools a certificate from the
examining physician and surgeon or physician assistant showing the
employee was examined and found free from active tuberculosis. The
county board of education may require, by rule, that all their
certificates be filed in the office of the county superintendent of
schools or shall require their files be maintained in the office of
the county superintendent of schools if a majority of the governing
boards of the districts within the county so petition the county
board of education, except that in either case a district or
districts with a common board having an average daily attendance of
60,000 or more may elect to maintain the files for its employees in
that district. "Certificate," as used in this section, means a
certificate signed by the examining physician and surgeon or
physician assistant practicing in compliance with Chapter 7.7
(commencing with Section 3500) of Division 2 of the Business and
Professions Code or a notice from a public health agency or unit of
the American Lung Association that indicates freedom from active
tuberculosis. The latter, regardless of form, shall constitute
evidence of compliance with this section. Nothing in this section
shall prevent the governing board, upon recommendation of the local
health officer, from establishing a rule requiring a more extensive
or more frequent physical examination than required by this section,
but the rule shall provide for reimbursement on the same basis as
required in this section.
(d) This examination is a condition of initial employment and the
expense incident thereto shall be borne by the applicant unless
otherwise provided by rules of the governing board. However, the
board may, if an applicant is accepted for employment, reimburse that
person in a like manner prescribed in this section for employees.
(e) The governing board of each district shall reimburse the
employee for the cost, if any, of this examination. The board may
provide for the examination required by this section or may establish
a reasonable fee for the examination that is reimbursable to
employees of the district complying with the provisions of this
section.
(f) At the discretion of the governing board, this section shall
not apply to those employees not requiring certification
qualifications who are employed for any period of time less than a
school year whose functions do not require frequent or prolonged
contact with pupils.
The governing board may, however, require an examination described
in subdivision (b) and may, as a contract condition, require the
examination of persons employed under contract, other than those
persons specified in subdivision (a), if the board believes the
presence of these persons in and around school premises would
constitute a health hazard to pupils.
(g) If the governing board of a school district determines by
resolution, after hearing, that the health of pupils in the district
would not be jeopardized thereby, this section shall not apply to any
employee of the district who files an affidavit stating that he or
she adheres to the faith or teachings of any well-recognized
religious sect, denomination, or organization and in accordance with
its creed, tenets, or principles depends for healing upon prayer in
the practice of religion and that to the best of his or her knowledge
and belief he or she is free from active tuberculosis. If at any
time there should be probable cause to believe that the affiant is
afflicted with active tuberculosis, he or she may be excluded from
service until the governing board of the employing district is
satisfied that he or she is not so afflicted.
(h) A person who transfers his or her employment from one school
or school district to another shall be deemed to meet the
requirements of subdivision (a) if that person can produce a
certificate which shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the school previously employing him or her that
it has a certificate on file which contains that showing.
A person who transfers his or her employment from a private or
parochial elementary school, secondary school, or nursery school to a
school or school district subject to this section shall be deemed to
meet the requirements of subdivision (a) if that person can produce
a certificate as provided for in Section 121525 of the Health and
Safety Code that shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the school previously employing him or her that
it has a certificate on file which contains that showing.
(i) Any governing board or county superintendent of schools
providing for the transportation of pupils under contract authorized
by Section 39800, 39801, or any other provision of law shall require
as a condition of the contract the examination for active
tuberculosis, as provided by subdivision (a), of all drivers
transporting these pupils, provided that private contracted drivers
who transport these pupils on an infrequent basis, not to exceed once
a month, shall be excluded from this requirement.
SEC. 7. SEC. 6. Section 49423 of the
Education Code is amended to read:
49423. (a) Notwithstanding Section 49422, any pupil who is
required to take, during the regular schoolday, medication prescribed
for him or her by a physician and surgeon or ordered for him or her
by a physician assistant practicing in compliance with Chapter 7.7
(commencing with Section 3500) of Division 2 of the Business and
Professions Code, may be assisted by the school nurse or other
designated school personnel or may carry and self-administer
prescription auto-injectable epinephrine if the school district
receives the appropriate written statements identified in subdivision
(b).
(b) (1) In order for a pupil to be assisted by a school nurse or
other designated school personnel pursuant to subdivision (a), the
school district shall obtain both a written statement from the
physician and surgeon or physician assistant detailing the name of
the medication, method, amount, and time schedules by which the
medication is to be taken and a written statement from the parent,
foster parent, or guardian of the pupil indicating the desire that
the school district assist the pupil in the matters set forth in the
statement of the physician and surgeon or physician assistant.
(2) In order for a pupil to carry and self-administer prescription
auto-injectable epinephrine pursuant to subdivision (a), the school
district shall obtain both a written statement from the physician and
surgeon or physician assistant detailing the name of the medication,
method, amount, and time schedules by which the medication is to be
taken, and confirming that the pupil is able to self-administer
auto-injectable epinephrine, and a written statement from the parent,
foster parent, or guardian of the pupil consenting to the
self-administration, providing a release for the school nurse or
other designated school personnel to consult with the health care
provider of the pupil regarding any questions that may arise with
regard to the medication, and releasing the school district and
school personnel from civil liability if the self-administering pupil
suffers an adverse reaction as a result of self-administering
medication pursuant to this paragraph.
(3) The written statements specified in this subdivision shall be
provided at least annually and more frequently if the medication,
dosage, frequency of administration, or reason for administration
changes.
(c) A pupil may be subject to disciplinary action pursuant to
Section 48900 if that pupil uses auto-injectable epinephrine in a
manner other than as prescribed.
SEC. 8. SEC. 7. Section 49455 of the
Education Code is amended to read:
49455. Upon first enrollment in a California school district of a
child at a California elementary school, and at least every third
year thereafter until the child has completed the eighth grade, the
child's vision shall be appraised by the school nurse or other
authorized person under Section 49452. This evaluation shall include
tests for visual acuity and color vision; however, color vision shall
be appraised once and only on male children, and the results of the
appraisal shall be entered in the health record of the pupil. Color
vision appraisal need not begin until the male pupil has reached the
first grade. Gross external observation of the child's eyes, visual
performance, and perception shall be done by the school nurse and the
classroom teacher. The evaluation may be waived, if the child's
parents so desire, by their presenting of a certificate from a
physician and surgeon, a physician assistant practicing in compliance
with Chapter 7.7 (commencing with Section 3500) of Division 2 of the
Business and Professions Code, or an optometrist setting out the
results of a determination of the child's vision, including visual
acuity and color vision.
The provisions of this section shall not apply to any child whose
parents or guardian file with the principal of the school in which
the child is enrolling, a statement in writing that they adhere to
the faith or teachings of any well-recognized religious sect,
denomination, or organization and in accordance with its creed,
tenets, or principles depend for healing upon prayer in the practice
of their religion.
SEC. 9. SEC. 8. Section 49458 is
added to the Education Code, to read:
49458. When a school district or a county superintendent of
schools requires a physical examination as a condition of
participation in an interscholastic athletic program, the physical
examination may be performed by a physician and surgeon or physician
assistant practicing in compliance with Chapter 7.7 (commencing with
Section 3500) of Division 2 of the Business and Professions Code.
SEC. 10. SEC. 9. Section 87408 of
the Education Code is amended to read:
87408. (a) When a community college district wishes to employ a
person in an academic position and that person has not previously
been employed in an academic position in this state, the district
shall require a medical certificate showing that the applicant is
free from any communicable disease, including, but not limited to,
active tuberculosis, unfitting the applicant to instruct or associate
with students. The medical certificate shall be submitted directly
to the governing board by a physician and surgeon licensed under the
Business and Professions Code, a physician assistant practicing in
compliance with Chapter 7.7 (commencing with Section 3500) of
Division 2 of the Business and Professions Code, or a commissioned
medical officer exempted from licensure. The medical examination
shall have been conducted not more than six months before the
submission of the certificate and shall be at the expense of the
applicant. A governing board may offer a contract of employment to an
applicant subject to the submission of the required medical
certificate. Notwithstanding Section 87031, the medical certificate
shall become a part of the personnel record of the employee and shall
be open to the employee or his or her designee.
(b) The governing board of a community college district may
require academic employees to undergo a periodic medical examination
by a physician and surgeon licensed under the Business and
Professions Code, a physician assistant practicing in compliance with
Chapter 7.7 (commencing with Section 3500) of Division 2 of the
Business and Professions Code, or a commissioned medical officer
exempted from licensure, to determine that the employee is free from
any communicable disease, including, but not limited to, active
tuberculosis, unfitting the applicant to instruct or associate with
students. The periodic medical examination shall be at the expense of
the district. The medical certificate shall become a part of the
personnel record of the employee and shall be open to the employee or
his or her designee.
SEC. 11. SEC. 10. Section 87408.5 of
the Education Code is amended to read:
87408.5. (a) When a community college district wishes to employ a
retirant who is retired for service, and such person has not been
previously employed as a retirant, such district shall require, as a
condition of initial employment as a retirant, a medical certificate
showing that the retirant is free from any disabling disease
unfitting him or her to instruct or associate with students. The
medical certificate shall be completed and submitted directly to the
community college district by a physician and surgeon licensed under
the Business and Professions Code, a physician assistant practicing
in compliance with Chapter 7.7 (commencing with Section 3500) of
Division 2 of the Business and Professions Code, or a commissioned
medical officer exempted from licensure. A medical examination shall
be required for the completion of the medical certificate. The
examination shall be conducted not more than six months before the
completion and submission of the certificate and shall be at the
expense of the retirant. The medical certificate shall become a part
of the personnel record of the employee and shall be open to the
employee or his or her designee.
(b) The community college district that initially employed the
retirant, or any district that subsequently employs the retirant, may
require a periodic medical examination by a physician and surgeon
licensed under the Business and Professions Code, a physician
assistant practicing in compliance with Chapter 7.7 (commencing with
Section 3500) of Division 2 of the Business and Professions Code, or
a commissioned medical officer exempted from licensure, to determine
that the retirant is free from any communicable disease unfitting him
or her to instruct or associate with students. The periodic medical
examination shall be at the expense of the community college
district. The medical certificate shall become a part of the
personnel record of the retirant and shall be open to the retirant or
his or her designee.
SEC. 12. SEC. 11. Section 87408.6 of
the Education Code is amended to read:
87408.6. (a) Except as provided in subdivision (h), no person
shall be initially employed by a community college district in an
academic or classified position unless the person has submitted to an
examination within the past 60 days to determine that he or she is
free of active tuberculosis, by a physician and surgeon licensed
under Chapter 5 (commencing with Section 2000) of Division 2 of the
Business and Professions Code or a physician assistant practicing in
compliance with Chapter 7.7 (commencing with Section 3500) of
Division 2 of the Business and Professions Code. This examination
shall consist of an approved intradermal tuberculin test or any other
test for tuberculosis infection recommended by the federal Centers
for Disease Control and Prevention (CDC) and licensed by the federal
Food and Drug Administration (FDA), that, if positive, shall be
followed by an X-ray of the lungs.
The X-ray film may be taken by a competent and qualified X-ray
technician if the X-ray film is subsequently interpreted by a
physician and surgeon licensed under Chapter 5 (commencing with
Section 2000) of Division 2 of the Business and Professions Code.
The district superintendent, or his or her designee, may exempt,
for a period not to exceed 60 days following termination of the
pregnancy, a pregnant employee from the requirement that a positive
intradermal tuberculin test
be followed by an X-ray of the lungs.
(b) Thereafter, employees who are skin test negative, or negative
by any other test recommended by the CDC and licensed by the FDA,
shall be required to undergo the foregoing examination at least once
each four years or more often if directed by the governing board upon
recommendation of the local health officer for so long as the
employee remains test negative by either the tuberculin skin test or
any other test recommended by the CDC and licensed by the FDA. Once
an employee has a documented positive skin test or any other test
that has been recommended by the CDC and licensed by the FDA that has
been followed by an X-ray, the foregoing examinations shall no
longer be required, and referral shall be made within 30 days of
completion of the examination to the local health officer to
determine the need for followup care.
(c) After the examination, each employee shall cause to be on file
with the district superintendent a certificate from the examining
physician and surgeon or physician assistant showing the employee was
examined and found free from active tuberculosis. "Certificate," as
used in this subdivision, means a certificate signed by the examining
physician and surgeon or physician assistant, or a notice from a
public health agency or unit of the American Lung Association that
indicates freedom from active tuberculosis. The latter, regardless of
form, shall constitute evidence of compliance with this section.
(d) This examination is a condition of initial employment and the
expense incident thereto shall be borne by the applicant unless
otherwise provided by rules of the governing board. However, the
board may, if an applicant is accepted for employment, reimburse the
person in a like manner prescribed for employees in subdivision (e).
(e) The governing board of each district shall reimburse the
employee for the cost, if any, of this examination. The board may
provide for the examination required by this section or may establish
a reasonable fee for the examination that is reimbursable to
employees of the district complying with this section.
(f) At the discretion of the governing board, this section shall
not apply to those employees not requiring certification
qualifications who are employed for any period of time less than a
college year whose functions do not require frequent or prolonged
contact with students.
The governing board may, however, require the examination and may,
as a contract condition, require the examination of persons employed
under contract, other than those persons specified in subdivision
(a), if the board believes the presence of these persons in and
around college premises would constitute a health hazard to students.
(g) If the governing board of a community college district
determines by resolution, after hearing, that the health of students
in the district would not be jeopardized thereby, this section shall
not apply to any employee of the district who files an affidavit
stating that he or she adheres to the faith or teachings of any
well-recognized religious sect, denomination, or organization and in
accordance with its creed, tenets, or principles depends for healing
upon prayer in the practice of religion and that to the best of his
or her knowledge and belief he or she is free from active
tuberculosis. If at any time there should be probable cause to
believe that the affiant is afflicted with active tuberculosis, he or
she may be excluded from service until the governing board of the
employing district is satisfied that he or she is not so afflicted.
(h) A person who transfers his or her employment from one campus
or community college district to another shall be deemed to meet the
requirements of subdivision (a) if the person can produce a
certificate that shows that he or she was examined within the past
four years and was found to be free of communicable tuberculosis, or
if it is verified by the college previously employing him or her that
it has a certificate on file that contains that showing.
A person who transfers his or her employment from a private or
parochial elementary school, secondary school, or nursery school to
the community college district subject to this section shall be
deemed to meet the requirements of subdivision (a) if the person can
produce a certificate as provided for in Section 121525 of the Health
and Safety Code that shows that he or she was examined within the
past four years and was found to be free of communicable
tuberculosis, or if it is verified by the school previously employing
him or her that it has the certificate on file.
(i) Any governing board of a community college district providing
for the transportation of students under contract shall require as a
condition of the contract the examination for active tuberculosis, as
provided in subdivision (a), of all drivers transporting the
students, provided that privately contracted drivers who transport
the students on an infrequent basis, not to exceed once a month,
shall be excluded from this requirement.
(j) Examinations required pursuant to subdivision (i) shall be
made available without charge by the local health officer.
SEC. 13. SEC. 12. Section 2881 of
the Public Utilities Code is amended to read:
2881. (a) The commission shall design and implement a program to
provide a telecommunications device capable of serving the needs of
individuals who are deaf or hearing impaired, together with a single
party line, at no charge additional to the basic exchange rate, to
any subscriber who is certified as an individual who is deaf or
hearing impaired by a licensed physician and surgeon, audiologist, or
a qualified state or federal agency, as determined by the
commission, and to any subscriber that is an organization
representing individuals who are deaf or hearing impaired, as
determined and specified by the commission pursuant to subdivision
(e). A licensed hearing aid dispenser may certify the need of an
individual to participate in the program if that individual has been
previously fitted with an amplified device by the dispenser and the
dispenser has the individual's hearing records on file prior to
certification. In addition, a physician assistant may certify the
needs of an individual who has been diagnosed by a physician and
surgeon as being deaf or hearing impaired to participate in the
program after reviewing the medical records or copies of the medical
records containing that diagnosis.
(b) The commission shall also design and implement a program to
provide a dual-party relay system, using third-party intervention to
connect individuals who are deaf or hearing impaired and offices of
organizations representing individuals who are deaf or hearing
impaired, as determined and specified by the commission pursuant to
subdivision (e), with persons of normal hearing by way of
intercommunications devices for individuals who are deaf or hearing
impaired and the telephone system, making available reasonable access
of all phases of public telephone service to telephone subscribers
who are deaf or hearing impaired. In order to make a dual-party relay
system that will meet the requirements of individuals who are deaf
or hearing impaired available at a reasonable cost, the commission
shall initiate an investigation, conduct public hearings to determine
the most cost-effective method of providing dual-party relay service
to the deaf or hearing impaired when using a telecommunications
device, and solicit the advice, counsel, and physical assistance of
statewide nonprofit consumer organizations of the deaf, during the
development and implementation of the system. The commission shall
phase in this program, on a geographical basis, over a three-year
period ending on January 1, 1987. The commission shall apply for
certification of this program under rules adopted by the Federal
Communications Commission pursuant to Section 401 of the federal
Americans with Disabilities Act of 1990 (Public Law 101-336).
(c) The commission shall also design and implement a program
whereby specialized or supplemental telephone communications
equipment may be provided to subscribers who are certified to be
disabled at no charge additional to the basic exchange rate. The
certification, including a statement of visual or medical need for
specialized telecommunications equipment, shall be provided by a
licensed optometrist, physician and surgeon, or physician assistant,
acting within the scope of practice of his or her license, or by a
qualified state or federal agency as determined by the commission.
The commission shall, in this connection, study the feasibility of,
and implement, if determined to be feasible, personal income
criteria, in addition to the certification of disability, for
determining a subscriber's eligibility under this subdivision.
(d) The commission shall establish a rate recovery mechanism
through a surcharge not to exceed one-half of 1 percent uniformly
applied to a subscriber's intrastate telephone service, other than
one-way radio paging service and universal telephone service, both
within a service area and between service areas, to allow providers
of the equipment and service specified in subdivisions (a), (b), and
(c), to recover costs as they are incurred under this section. The
surcharge shall be in effect until January 1, 2014. The commission
shall require that the programs implemented under this section be
identified on subscribers' bills, and shall establish a fund and
require separate accounting for each of the programs implemented
under this section.
(e) The commission shall determine and specify those statewide
organizations representing the deaf or hearing impaired that shall
receive a telecommunications device pursuant to subdivision (a) or a
dual-party relay system pursuant to subdivision (b), or both, and in
which offices the equipment shall be installed in the case of an
organization having more than one office.
(f) The commission may direct any telephone corporation subject to
its jurisdiction to comply with its determinations and
specifications pursuant to this section.
(g) The commission shall annually review the surcharge level and
the balances in the funds established pursuant to subdivision (d).
Until January 1, 2014, the commission shall be authorized to make,
within the limits set by subdivision (d), any necessary adjustments
to the surcharge to ensure that the programs supported thereby are
adequately funded and that the fund balances are not excessive. A
fund balance which is projected to exceed six months' worth of
projected expenses at the end of the fiscal year is excessive.
(h) The commission shall prepare and submit to the Legislature, on
or before December 31 of each year, a report on the fiscal status of
the programs established and funded pursuant to this section and
Sections 2881.1 and 2881.2. The report shall include a statement of
the surcharge level established pursuant to subdivision (d) and
revenues produced by the surcharge, an accounting of program
expenses, and an evaluation of options for controlling those expenses
and increasing program efficiency, including, but not limited to,
all of the following proposals:
(1) The establishment of a means test for persons to qualify for
program equipment or free or reduced charges for the use of
telecommunication services.
(2) If and to the extent not prohibited under Section 401 of the
federal Americans with Disabilities Act of 1990 (Public Law 101-336),
the imposition of limits or other restrictions on maximum usage
levels for the relay service, which shall include the development of
a program to provide basic communications requirements to all relay
users at discounted rates, including discounted toll-call rates, and,
for usage in excess of those basic requirements, at rates which
recover the full costs of service.
(3) More efficient means for obtaining and distributing equipment
to qualified subscribers.
(4) The establishment of quality standards for increasing the
efficiency of the relay system.
(i) In order to continue to meet the access needs of individuals
with functional limitations of hearing, vision, movement,
manipulation, speech and interpretation of information, the
commission shall perform ongoing assessment of, and if appropriate,
expand the scope of the program to allow for additional access
capability consistent with evolving telecommunications technology.
(j) The commission shall structure the programs required by this
section so that any charge imposed to promote the goals of universal
service reasonably equals the value of the benefits of universal
service to contributing entities and their subscribers.
SEC. 14. Section 2708 of the Unemployment
Insurance Code is amended to read:
2708. (a) (1) In accordance with the director's authorized
regulations, and except as provided in subdivision (c) and Sections
2708.1 and 2709, a claimant shall establish medical eligibility for
each uninterrupted period of disability by filing a first claim for
disability benefits supported by the certificate of a treating
physician or practitioner that establishes the sickness, injury, or
pregnancy of the employee, or the condition of the family member that
warrants the care of the employee. For subsequent periods of
uninterrupted disability after the period covered by the initial
certificate or any preceding continued claim, a claimant shall file a
continued claim for those benefits supported by the certificate of a
treating physician or practitioner. A certificate filed to establish
medical eligibility for the employee's own sickness, injury, or
pregnancy shall contain a diagnosis and diagnostic code prescribed in
the International Classification of Diseases, or, where no diagnosis
has yet been obtained, a detailed statement of symptoms.
(2) A certificate filed to establish medical eligibility of the
employee's own sickness, injury, or pregnancy shall also contain a
statement of medical facts including secondary diagnoses when
applicable, within the physician's or practitioner's knowledge, based
on a physical examination and a documented medical history of the
claimant by the physician or practitioner, indicating the physician's
or practitioner's conclusion as to the claimant's disability, and a
statement of the physician's or practitioner's opinion as to the
expected duration of the disability.
(b) An employee shall be required to file a certificate to
establish eligibility when taking leave to care for a family member
with a serious health condition. The certificate shall be developed
by the department. In order to establish medical eligibility of the
serious health condition of the family member that warrants the care
of the employee, the information shall be within the physician's or
practitioner's knowledge and shall be based on a physical examination
and documented medical history of the family member and shall
contain all of the following:
(1) A diagnosis and diagnostic code prescribed in the
International Classification of Diseases, or, where no diagnosis has
yet been obtained, a detailed statement of symptoms.
(2) The date, if known, on which the condition commenced.
(3) The probable duration of the condition.
(4) An estimate of the amount of time that the physician or
practitioner believes the employee is needed to care for the child,
parent, spouse, or domestic partner.
(5) (A) A statement that the serious health condition warrants the
participation of the employee to provide care for his or her child,
parent, spouse, or domestic partner.
(B) "Warrants the participation of the employee" includes, but is
not limited to, providing psychological comfort, and arranging "third
party" care for the child, parent, spouse, or domestic partner, as
well as directly providing, or participating in, the medical care.
(c) The department shall develop a certification form for bonding
that is separate and distinct from the certificate required in
subdivision (a) for an employee taking leave to bond with a minor
child within the first year of the child's birth or placement in
connection with foster care or adoption.
(d) The first and any continuing claim of an individual who
obtains care and treatment outside this state shall be supported by a
certificate of a treating physician or practitioner duly licensed or
certified by the state or foreign country in which the claimant is
receiving the care and treatment. If a physician or practitioner
licensed by and practicing in a foreign country is under
investigation by the department for filing false claims and the
department does not have legal remedies to conduct a criminal
investigation or prosecution in that country, the department may
suspend the processing of all further certifications until the
physician or practitioner fully cooperates, and continues to
cooperate with the investigation. A physician or practitioner
licensed by and practicing in a foreign country who has been
convicted of filing false claims with the department may not file a
certificate in support of a claim for disability benefits for a
period of five years.
(e) For purposes of this part:
(1) "Physician" has the same meaning as defined in Section 3209.3
of the Labor Code.
(2) "Practitioner" means a person duly licensed or certified in
California acting within the scope of his or her license or
certification who is a dentist, podiatrist, physician assistant, or
as to normal pregnancy or childbirth, a midwife, nurse midwife, or
nurse practitioner.
(f) For a claimant who is hospitalized in or under the authority
of a county hospital in this state, a certificate of initial and
continuing medical disability, if any, shall satisfy the requirements
of this section if the disability is shown by the claimant's
hospital chart, and the certificate is signed by the hospital's
registrar. For a claimant hospitalized in or under the care of a
medical facility of the United States government, a certificate of
initial and continuing medical disability, if any, shall satisfy the
requirements of this section if the disability is shown by the
claimant's hospital chart, and the certificate is signed by a medical
officer of the facility duly authorized to do so.
(g) Nothing in this section shall be construed to preclude the
department from requesting additional medical evidence to supplement
the first or any continued claim if the additional evidence can be
procured without additional cost to the claimant. The department may
require that the additional evidence include any or all of the
following:
(1) Identification of diagnoses.
(2) Identification of symptoms.
(3) A statement setting forth the facts of the claimant's
disability. The statement shall be completed by any of the following
individuals:
(A) The physician or practitioner treating the claimant.
(B) The registrar, authorized medical officer, or other duly
authorized official of the hospital or health facility treating the
claimant.
(C) An examining physician or other representative of the
department.
