CAPA Sponsored SB 997 (Monning)
July 20, 2018
The Governor signed SB 997, Monning. Health care service plans: physician to enrollee ratios. SB 997 was a necessary step to ensure that CAPA’s 2013 sponsored bill, SB 494, was not repealed (sunsetted) on January 1, 2019. On January 1, 2014, SB 494 was enacted to expand the definition of a Primary Care Provider to include PAs and NPs. In addition, the bill allowed a health plan to increase the number of patients assigned to a primary care physician, based on the use of one or more PAs or NPs.
As a result of SB 494, for the past four years health plans have increased provider access for patients and have improved compliance with timely access laws. SB 997 ensures this can continue.

August 16, 2018
AB 3110 was held under submission, meaning it is dead. CAPA’s work to oppose the bill, along with the organizations listed below, was instrumental in stopping the bill from becoming law.

AB 3110 (Mullin) Athletic Trainers, as introduced, did not define what injuries or conditions can be treated by an athletic trainer, such as limiting the practice to the musculoskeletal system which is frequently inflicted with athletic injuries. Nor did the bill require the athletic trainer to refer a patient to another healthcare practitioner for the purpose of having a medical condition diagnosed or limit the practice settings to student-athletes, athletes or athletic settings. Without limiting this scope of practice, this bill created ambiguity about practice parameters and settings which may have allowed athletic trainers to assess and treat any medical condition or injury arising from an athletic injury in endless settings.
We recognize the important role of athletic trainers on the athletic healthcare team. However, AB 3110 as introduced (and through several amendments) created an uncertain and broad scope of practice, leaving several concerns for CAPA as related to patient care.

CAPA Sponsored SB 337 (Pavley)
Bill Information: Click Here
SB 337 Infographic: Click Here

October 6, 2015
Governor Brown signed SB 337 (Pavley) – PAs. This bill, sponsored by CAPA, was hard-fought and CAPA members united to contact legislators along the way and over the past several weeks, over a thousand of you sent emails to the Governor requesting he sign SB 337. Your voice was heard. This important piece of legislation – a HUGE WIN for California PAs – became law on January 1, 2016.

Key components of the bill include that practices and/or teams will be able to choose alternative options for documenting supervision and the 100% mandate for co-signature of scheduled medications may be reduced to 20% if specific criteria is met.

September 3, 2015
Once again CAPA members came through in a big way with hundreds of responses to the Action Alert asking them to contact their Assembly Member urging support for SB 337. Today the California State Assembly voted unanimously to approve SB 337! We will be asking for one more big push via an Action Alert as we make our way to the Governor’s office. CAPA members, PLEASE watch your email box for these important Action Alerts.

CAPA continues to work hard, getting ready for SB 337 to be heard on the Assembly Floor after the legislature reconvenes on August 17, 2015. CAPA members and their supervising physicians are urged to respond to Action Alerts. Watch your email box for these important action requests.

July 7, 2015 – SB 337 passed out of Assembly Appropriations Committee on consent.

June 22, 2015 – SB 337 successfully made it through the Assembly Business and Professions Committee without any “No” votes.

April 20, 2015 – CAPA President, Jeremy Adler, MS, PA-C, presented testimony in support of CAPA’s sponsored bill, SB 337 (Pavley) to the Senate Business, Professions and Economic Development Committee. We are proud to report that the bill received unanimous approval from members of the Committee. This is just the first of many Committee and floor votes needed before SB 337 makes its way to the Governor’s desk for signature.

February 26, 2015 – SB 337 (Pavley) would enable practice level determination of the method of documenting supervision. Physician supervision remains a key component of the physician/PA team, but co-signatures represent only one form of documentation, not supervision. As PAs, we have long known that we have a unique relationship with our supervising physicians and this relationship is dynamic across our various practice sites, medical specialties, education, experience and expertise. Almost 40 years ago, when medical charts were only paper, California lawmakers adopted co-signatures as the only way to document the supervision requirements of physicians. We know some settings function well with our existing co-signature documentation requirements, and for those settings, no changes may be needed, but new ways are proposed in SB 337 including medical record review meetings and other team developed systems.

SB 337 will require considerable education among all stakeholders and we will rely heavily on our members. At critical points along the way we will ask you to answer our calls to action for emails and letters when lawmakers, regulators and other stakeholders need to hear who we are and the profession we represent.

CAPA Sponsored SB 1083 (Pavley) Legislation to Permit PAs to Certify Disability
Bill Information: Click Here
CAPA sponsored legislation which amends the Physician Assistant Practice Act to authorize a PA to certify Employment Development Department (EDD) disability claims, after performance of a physical examination by the PA under the supervision of a physician and surgeon. The bill also expands the definition of practitioner to include a PA.

October 2014 – SB 1083 is written with a date of “on or before Jan. 1, 2017”. The reason for the possible delayed implementation is due to IT upgrades within the Employment Development Department. They are currently undergoing several phases of system and software upgrades and requested an amendment to the bill to which would allow for flexibility within their timeline. That said, we are hopeful that implementation will be sooner rather than later. We will keep CAPA members posted along the way.

September 18, 2014 – SB 1083 (Pavley) Legislation to Permit Physician Assistants to Certify Disability has been signed by Governor Brown!

August 27, 2014 – SB 1083 (Pavley) Legislation to Permit Physician Assistants to Certify Disability is on the Governor’s desk! We hope you and your colleagues will contact the Governor and ask for his signature on this important piece of legislation.

August 26, 2014- SB 1083 (Pavley) Legislation to Permit Physician Assistants to Certify Disability passed out of the Senate with 35 Aye and 0 Noe votes.

August 25, 2014- The California State Assembly voted 79 to 0 in favor of SB 1083 (Pavley) Legislation to Permit Physician Assistants to Certify Disability. The bill will now go to the Senate for concurrence. Shortly thereafter, SB 1083 will arrive on the Governor’s desk for signature. We have worked extremely hard to get this important piece of legislation to the Governor. Soon CAPA members will receive a Call to Action or two asking them to send an email to the Governor encouraging him to sign SB 1083. We will make it very simple to complete with a quick link in the email. When you receive the Action Alert – please follow the instructions in the request and ask your supervising physician and others to also contact the Governor and ask for his signature on SB 1083 (Pavley). Together we can make this happen.

April 28, 2014- CAPA’s Sponsored Bill, SB 1083 (Pavley) Legislation to Permit Physician Assistants to Certify Disability passed out of the Senate with 36 Aye and 0 Noe votes.

April 21, 2014 – SB 1083 (Pavley): Legislation to Permit PAs to Certify Disability successfully passed out of the Senate Business, Professions and Economic Development Committee. Next week the bill will be heard on the Senate Floor. Then off to the Assembly. We still have a long way to go before SB 1083 arrives at the Governor’s desk. We appreciate your membership in CAPA. In the coming weeks we will be asking for you to contact your legislator about SB 1083. We hope you will respond to the Call to Action when it arrives in your email box.

Our sincere thanks to Greg Mennie, MSed, PA-C, who traveled to Sacramento to testify before the Senate Business, Professions and Economic Development Committee on April 21, about the merits of SB 1083 (Pavley). Greg is pictured above with CAPA lobbyist, Kathryn Scott and Public Policy Director, Teresa Anderson. And, of course, the California Bear in front of the Governor’s office! Thank you, Greg.

February 19, 2014 – There is no doubt that Senator Pavley is a strong advocate and champion for the PA profession. We are fortunate that she is taking on yet another important practice issue for the profession by authoring SB 1083: Physician Assistant Disability Certification. Currently, PAs are not authorized to certify claims for Disability Insurance (DI) with the Employment Development Department (EDD). The restrictions related to EDD forms are inconsistent with the scope-of-practice of a PA and result in a significant barrier to practice.

Though certifying disability has been a barrier in PA practice for quite some time, recent changes within the EDD have created an additional barrier as some key State Disability Insurance services have been automated via an online version. The online system only allows for a single physician/practitioner electronic signature thereby eliminating the only mechanism for the supervising physician to sign the actual EDD form after the PA has performed the exam. The new version of the Claim for Disability Insurance Benefits, including the Physician/Practitioner’s Supplementary Certificate DE 2525XX, is designed with Optical Character Recognition (OCR) functionality and must be submitted in this format in order to expedite forms processing in the SDI online system. Although a hard copy version remains available, it takes significantly longer and must still be completed on OCR forms that use special ink that can be scanned and matched to an on-line data system for processing. According to the EDD, this new online system is being implemented to promote efficiency and reduce cost while following the HIPAA regulations and guidelines.

Current law recognizes licensed medical or osteopathic physicians, an authorized medical officer of a U.S. Government facility, chiropractor, podiatrist, optometrist, dentist, psychologist, nurse practitioner (after examination and collaboration with a physician and/or surgeon), licensed mid-wife, nurse-midwife, or nurse practitioner (for normal pregnancy or child-birth), or an accredited religious practitioner as practitioners who are authorized to certify claims for Disability Insurance (DI). Including PAs 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 and remove barriers in PA practice.

We are so fortunate to have Senator Pavley as a strong advocate in the Legislature and an incredibly active and strong CAPA membership that is ready, willing and able to respond to the CALL TO ACTION. Be on the lookout for the Call to Action requests as they will be coming soon!

CAPA Sponsored SB 352 (Pavley) Medical Assistant Supervision
Authorizes the supervising physician and surgeon, at his or her discretion, in consultation with the nurse practitioner, certified nurse-midwife, or PA, 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 PA within the standardized procedures or protocol, and that tasks may be performed when the supervising physician and surgeon is not onsite.

CAPA Sponsored SB 494 (Monning) Health Care Providers
The bill would add non-physician medical practitioners, to the definition of a primary care provider and would define non-physician medical practitioner to include a PA or a nurse practitioner Authorize up to an additional 1,000 health plan enrollees to a primary care physician for each full-time equivalent non-physician provider.

CAPA Sponsored Legislation SB 233 (Pavley)

Emergency services and care Existing law allows PAs to perform a variety of medical services set forth by regulations adopted by the Medical Board of California (MBC) when rendered under the supervision of a physician. Specifically, regulations promulgated by the MBC authorize a PAs to perform medical services such as patient histories and physical examinations, ordering X-rays, diagnostic studies, instituting treatment procedures, initiating hospital admissions, ordering medications, and performing surgical procedures.

This bill would amend section 1317.1 of the Health and Safety Code for the purpose of clarifying explicitly that a PA can provide treatment and consultation in an emergency care setting. Status: Signed by the Governor and became effective January 2012

CAPA Sponsored SB 1069 (Pavley/ Fletcher) Physician Assistants 
This bill would provide that a PA acts as the agent of the supervising physician when performing authorized activities, and would authorize a PA 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 PA to order durable medical equipment 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 with regard to the performance of those examinations and services and acceptance of those attestations. The bill would also authorize a PA to perform a physical examination that is required for participation in an interscholastic athletic program, as specified.

Status: Signed into law by the Governor on September 29, 2010

CAPA Sponsored AB 3 (Bass) – CA Physician Team Practice Improvement Act Will eliminate many long-standing problems which burden our physician partners and provide barriers to our patients seeking our care. AB 3 specifically will address four major issues: Patient-Specific Authority for scheduled medications Ratios of Supervising Physician to Physician Assistant Chart Countersignature Medi-cal Covered Procedure Codes Status: Signed by the Governor on 10/10/07, became effective

January 1, 2008. AB 139 (Bass) – DMV Physicals Current law already allows clinically competent practitioners to conduct medical examinations on applicants seeking a class A, B and C license who primarily drive standard commercial vehicles. This bill clarifies an inconsistency in existing law and will allow PAs to conduct medical examinations on applicants seeking a license to drive a school bus, youth activity bus, farm labor vehicle and paratransit vehicles. Status: Signed by the Governor, became effective January 1, 2008