News
Official Publication of the California Academy of Physician Assistants
November/December 2011
\The Magazine
SB 233 – Why Did We Do That? by Beth Grivett, PA-C, Legislative Affairs Committee Chair
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egislative goals are discussed every year in the fall. When the CAPA Board approved the legislative agenda, 2011 was looking like a quiet year. That is until we heard from a CAPA member working in orthopedic surgery who had just been told that he could no longer perform consultations in the emergency department at his hospital. We inquired further and found that Mission Hospital was written up for allowing PAs to consult in the ER. After investigation, we found the citation, which quoted Section 1317 of the Health and Safety Code pertaining to emergency services, stated that only a physician can
perform a consultation in the emergency department. Furthermore, this code stated that only a physician can TREAT a patient in the emergency department. Obviously, PAs provide care, both as providers in the ER and as providers in specialty services which perform consultations in the ER. Although most PAs in the state practice in a primary care specialty, the next largest practice areas are in the emergency department and orthopedic surgery. So, CAPA felt compelled to act. This was clearly a concern at this one hospital site, but what if other hospitals followed suit out of fear of a cita-
Legislator of the Year by Beth Grivett, PA-C, Legislative Affairs Committee Chair
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have been doing legislative affairs for CAPA for over 10 years and it has been rare to find a true champion in the legislature. CAPA’s lobbyist works to find legislators to author our sponsored bills. Thankfully, a few years ago, he found Senator Fran
Pavley. In 2009, SB 171 was passed which specifically allowed PAs to perform pre-employment physicals for school district employees. The following year we built on that bill and got SB 1069 passed. SB 1069 allows PAs to do numerous things which needed to be codified in regulation, including ordering durable medical equipment and home health services for Medicare beneficiaries, more pre-employment physicals, perform athletic screening physicals for high school students, order medications for children to have on campus during their school day and order amplified hearing devices for the deaf and hard of hearing. I would have thought Continued on page 9
tion? At least one inspector took this code literally to mean that a PA could not legally perform these services. Now that SB 233 has passed, what is different? Hopefully, not much! We expect that starting January 1, 2012, Mission Hospital can again allow their PAs to provide consultative services in the emergency department. We expect that we have eliminated the possibility that other hospitals will limit the practices of PAs. In the following excerpts, PAs are included in “other appropriate licensed persons.” But, always remember that your Delegation of Services Agreement should explicitly state which functions your supervising physician has delegated to you. This should include the setting, as well as, specific tasks such as “consultation” or “stabilization and transfer” as they apply to your particular job. Remember that a supervising physician or hospital can choose NOT to delegate tasks to you even if the new law allows you to perform these tasks. They can impose additional restrictions or require more stringent supervision than the law Continued on page 2
ALERT!
New Regulations See Page 5