Current Legislation (August 2013)
AB 1215 (Hagman and Holden), Clinical Laboratories – This bill, co-sponsored by CAMLT, was signed into law by Governor Brown. AB 1215 will permit Clinical Laboratory Scientists, both generalists and specialists, to be laboratory directors for the purposes of clinical laboratory tests classified as waived under CLIA.CLSs, who are the most qualified of any other allied health provider to direct a waived lab can finally do so starting January 1, 2014. For more information, see below.
SB 264 (Pavley), Accountable Care Organizations
SB 491 (Hernandez), Nurse Practitioners
SB 492 (Hernandez), Optometric Corporations
SB 493 (Hernandez), Pharmacy Practice
AB 213 (Logue), Healing Arts: licensure and certification
AB 399 (Fox), Clinical Laboratories
AB 722 (Lowenthal), Vehicles: driver’s licenses: medical examinations
AB 830 (Holden), Clinical Laboratories
AB 1215 (Hagman and Holden), Clinical Laboratories
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CAMLT Political Update
Public Policy Advocates, LLC, October 2013
Legislature Recesses for the Year
The Legislature completed its legislative agenda for the first year of the 2013-2014 session on September 12. This has been an extremely active legislative session which, in addition to the hundreds of bills sent by the Legislature to the Governor for consideration, included a special legislative session on health care reform in anticipation of the Affordable Care Act, a deal between lawmakers and the Governor on the reform of prison policy and major policy action on immigrant rights and minimum wage in California. The Governor has until October 13 to sign or veto the bills on his desk. Legislators will return for the second year of the legislative session in January 2014.
This year, Public Policy Advocates (PPA) successfully co-sponsored legislation for CAMLT, AB 1215 introduced by Assembly Members Curt Hagman and Chris Holden, and heavily opposed efforts to expand scopes of practice by optometrists and chiropractors into clinical laboratory testing without a laboratory director. We expect a major push by the Associations representing these professions to renew these legislative efforts next year.
CAMLT Legislative Challenges
While Public Policy Advocates (PPA) was successful the second year of the 2011-2012 legislative session in stopping several major pieces of legislation that would have allowed others to perform Clinical Laboratory Science without sufficient training and education, we were actively engaged on bills that returned or had been introduced along those same lines in 2013. 2013 was an extremely active year that not only required hours of high intensity lobbying, but a significant engagement by the CAMLT Governmental Affairs Committee. In 2013, CAMLT not only co-sponsored a bill for the first time in almost twenty years, but is also engaged on a number of bills that would permit the practice of clinical laboratory science without requisite education/training and without a lab director. CAMLT members must make it a priority to meet with their legislators to educate them about clinical laboratory science. Be sure to reference the CAMLT Grassroots Guide on the CAMLT website for “how to” meet and interact with elected officials and their staff.
The following is legislation that the CAMLT Governmental Affairs Committee directed PPA to engage in or monitor. Check this website regularly for updates on bill status, legislator lists, and committee assignments.
AB 213 (Logue) Healing Arts: licensure and certification requirements: military experience, as amended 4/18/13 – WATCH
This bill is intended to give military personnel a career pathway to licensure or certification when they have military experience in certain health related disciplines that is applicable and equivalent. This would include radiologic technologists, nuclear medicine technologists, certified nurse assistants, certified home health aides, certified hemodialysis technicians, and nursing home administrators as well as medical laboratory technicians and clinical laboratory scientists. From CAMLT’s perspective, this bill, while well intended, was duplicative of existing law with regard to CLSs and MLTs with equivalent military training, education and experience. Ultimately, this bill died in Assembly Appropriations. The author’s office indicates that they do not intend to resurrect the bill next year.
AB 399 (Fox) Clinical Laboratories, as introduced 2/15/13 – WATCH
Current law authorizes the State Department of Public Health application fees, annual renewal fees, and fees associated with enforcements, and to establish the fees for licensing examinations and for medical laboratory technician licenses. This bill would authorize the department to charge appropriate license fees whenever it determines that a new category of licensure is necessary. CAMLT is awaiting amendments to this California Clinical Laboratory Association sponsored bill. AB 399 failed to move out of its committee of origin this year, so cannot be heard until next year.
AB 722 (Lowenthal) Vehicles: driver’s licenses: medical examinations, as amended 5/28/13 — WATCH
This bill is sponsored by the California Chiropractic Association. Current law requires applicants for an original or renewal certificate to drive certain vehicles to submit a report, on a form approved by the department, of a medical examination of the applicant given not more than two years prior to the date of the application by a physician licensed to practice medicine, a licensed advanced practice registered nurse qualified to perform a medical examination, or a licensed physician assistant. This bill would add a doctor of chiropractic to the list of persons who may make a report of a medical examination of the specified applicants. While the chiropractors initially intended to introduce legislation allowing for urine dipstick testing without a lab director for commercial driving and employment physicals, after meeting with us they opted for the approach embodied in AB 722. AB 722 was signed into law by the Governor on 8/27/13.
AB 830 (Holden) Clinical Laboratories, as amended 3/21/2013—WATCH
Sponsored by the United Nurses Associations of California/Union of Health Care Professionals who also have CLS and MLT membership within the union, this bill was introduced as a spot bill. The UNA/UHCP has decided to have this bill held in favor of co-sponsoring AB 1215 with CAMLT.
AB 1215 (Hagman and Holden) Clinical Laboratories, as amended 4/9/13 – CAMLT CO-SPONSORED BILL
CAMLT co-sponsored this bill along with the Engineers and Scientists of California, IFPTE, Local 20, Western States Council of the United Food and Commercial Workers, and the United Nurses Associations of California/Union of Health Care Professionals. In the wake of attempted legislation over the years to allow various allied health professionals to do laboratory testing without a lab director, AB 1215 which will permit Clinical Laboratory Scientists, both generalists and specialists, to be laboratory directors for purposes of clinical laboratory tests classified as waived under the Federal Clinical Laboratory Improvement Amendments of 1988 (CLIA). Under CLIA, CLS’s can be waived lab directors. Under California law, only physicians, surgeons, and naturopaths can be lab directors, along with optometrists and pharmacists who secured statutory authority last year to be lab directors in a more limited way. It is only reasonable that the very professionals trained specifically in clinical laboratory science be utilized to the maximum of their education and training. The implementation of the Affordable Care Act (ACA) will extend health benefits to an estimated 4.7 million uninsured Californians by 2018. This will dramatically increase the demand for care and ancillary services such as clinical laboratory testing. AB 1215 will improve access to clinical laboratory tests and testing oversight without compromising patient safety. Co-authored by Assembly Member Hagman, a Republican, and Assembly Member Holden, a Democrat, AB 1215 passed out of the Legislature without a single “no” vote. AB 1215 is also supported by the AFL-CIO, Blood Centers of California, American Federation of State, County and Municipal Employees, and the California Society of Pathologists. AB 1215 was signed into law by the Governor on August 28.
SB 264 (Pavley), Accountable Care Organizations, as introduced 2/13/13 – SUPPORT
Sponsored by the California Society of Pathologists and the College of American Pathologists, this bill is intended to create a state mandated physician advisory process to be used by Accountable Care Organizations specifically with regard to guidelines or protocols relative to the provision of clinical laboratory testing. The objective is to allow for optimal coordination between treating physicians and laboratory directors to promote care coordination so that California patients receive all medically necessary clinical laboratory testing for diagnosis and treatment as the implementation of the Affordable Care Act strives to control health care costs. SB 264 failed to move out of its committee of origin and therefore cannot be taken up again until next year.
SB 491 (Hernandez), Nurse Practitioners, as amended 8/14/13 – WATCH
Designed to broaden the scope of Nurse Practitioners practice, including the requirement that they must practice in consultation with a physician and surgeon, SB 491 was strongly opposed by the California Medical Association. The bill would permit Nurse Practitioners to diagnose, perform therapeutic procedures and prescribe drugs and devices. SB 491 struggled to get out of the Assembly Business, Professions and Consumer Protection Committee but ultimately went on to the Assembly Appropriations Committee. The measure ran into complications when AARP switched their position from support to oppose based on amendments to the bill. SB 491 was held under submission in Assembly Appropriations Committee and cannot be heard again until next year.
SB 492 (Hernandez) Optometric Corporations, as amended 9/6/13 – OPPOSE
This bill would significantly expand the scope of practice for optometrists and was opposed by the California Medical Association and the California Academy of Eye Physicians and Surgeons. Of particular interest to CAMLT was that the bill at one point would have authorized an optometrist to perform and order appropriate laboratory and diagnostic imaging tests. There was no limitation other than the Board of Optometry to establish by regulation, education and examination requirements for licensure to ensure the competence of optometrists to conduct lab tests. The bill outright repealed the agreements reached last year restricting optometrists to CLIA waived tests necessary for the diagnosis of conditions and diseases of the eye or adnexa within their scope of practice. SB 492 was scheduled to be heard in the Assembly Business, Professions and Consumer Protection Committee on August 13 but was pulled from calendar and made a 2-year bill, meaning that it can be heard early next year.
SB 493 (Hernandez), Pharmacy Practice, as amended 5/28/13 – WATCH
This bill significantly expands the scope of practice of pharmacists and is focused primarily around contraceptives, drug therapies, ordering and interpreting tests for monitoring and managing drug therapies, physical assessments, and the functions of advance practice pharmacists. This bill was taken up on the Senate Appropriations Suspense File on May 23 and passed out of Committee with clarifying amendments relative to duties on a unanimous vote. SB 493 subsequently moved through both houses and was signed into law by the Governor on October 1.
Meet with Your Legislators
For the last twenty years, CAMLT has continued to successfully weather advertant or inadvertent legislative assaults on clinical laboratory testing that would jeopardize patient safety. To continue to do so, it is critical that CAMLT build its membership and engage with and educate California’s elected officials. Term limits bring a crop of 30 plus new legislators every two years. Because of the newly drawn legislative districts which happen every ten years after the census, there were 40 new legislators at the start of legislative session last year. Most of these legislators will serve 12 year terms. It is imperative to build “legislative champions” for clinical laboratory science and the patients who rely on educated, qualified laboratory personnel for accurate and reliable testing results.
Have you met with your legislators? Make sure to educate your elected officials about clinical laboratory issues! Meet with your legislators in your district, send letters explaining CAMLT’s philosophy, invite legislators and their staff to tour your laboratories, and introduce yourself as a constituent. The sponsors of legislation, such as optometrists and chiropractors, to expand their scope of practice into areas of clinical testing are well heeled and well organized. It is imperative that CAMLT members engage in the process that affects the laboratory profession.
- Which Legislator represents your home or laboratory? Visit the CAMLT website for a current roster of Legislators and the cities they represent.
- Visit their offices. Make an appointment with your Legislators’ District offices.
- EDUCATE! Explain to Legislators and their consultants what it takes to be a CLS; what you do; why it is important to maintain the integrity of the Laboratory Director when other personnel are doing laboratory tests, even if they are waived; why other allied health providers shouldn’t be Laboratory Directors; the CLS shortage and what it takes to eliminate it.
Make it a priority to meet with your Legislators between now and January. Remember, these interactions are integral components of your grassroots program. For tips, please refer to the CAMLT Grassroots Guide on this website.
Please note that it is particularly crucial to meet with Legislators who participate on the Assembly and Senate committees through which CAMLT bills most frequently pass so they are better prepared to tackle complex CLS issues that arise in committee.
Assembly Business, Professions and Consumer Protection Committee: Susan Bonilla (D-Chair), Brian Jones (R-Vice Chair), Raul Bocanegra (D), Nora Campos (D), Roger Dickinson (D), Susan Eggman (D), Rich Gordon (D), Curt Hagman (R), Chris Holden (D), Brian Maienschein (R), Kevin Mullin (D), Nancy Skinner (D), Phil Ting (D), Scott Wilk (R)
Assembly Health Committee: Richard Pan (D-Chair), Dan Logue (R-Vice Chair), Tom Ammiano (D), Toni Atkins (D), Susan Bonilla (D), Rob Bonta (D), Wes Chesbro (D), Jimmy Gomez (D), Roger Hernandez (D), Bonnie Lowenthal (D), Brian Maienschein (R), Allan Mansoor (D), Holly Mitchell (D), Adrin Nazarian (D), Brian Nestande (R), V. Manuel Perez (D), Don Wagner (R), Bob Wieckowski (D), Scott Wilk (D)
Senate Business, Professions and Economic Development Committee: Ted Lieu (D-Chair), Bill Emmerson (R-Vice Chair), Marty Block (D), Ellen Corbett (D), Cathleen Galgiani (D), Ed Hernandez (D), Jerry Hill (D), Alex Padilla (D), Mark Wyland (R), Leland Yee (D)
Senate Health Committee: Ed Hernandez (D-Chair), Joel Anderson (R-Vice Chair), Jim Beall (D), Kevin de Leon (D), Mark DeSaulnier (D), Bill Monning (D), Jim Nielsen (R), Fran Pavley (D), Lois Wolk (D)
Strengthen Your Voice: Contribute Today!
Please donate to the CAMLT Lab-PAC fund. Lab-PAC is a critical means of supporting and electing Legislators to the California Legislature who share a like-minded philosophy with CAMLT and who are open-minded to learning the issues and challenges facing your profession. Encourage the colleagues you work with. Get your chapters and chapter members to contribute. Talk to your vendors. Get involved! Your voice in the political process is much louder as CAMLT than as an individual. Contribute to the collective resources of CAMLT to grow your political clout. Visit the Lab-PAC page for a donation form. Your gift in any amount will help your profession. Contribute now!
Please mail donations made payable to: LAB-PAC
1895 Mowry Ave., #112, Fremont, CA 94538-1766.
Please write a check to LAB-PAC now!
Recruit New CAMLT Members!
As we have said, this has been one of the most rigorous and challenging legislative sessions in a long time in terms of bills legislating a frontal attack on the laboratory profession. Only you can ensure the growth and vibrancy or a strong, well organized CAMLT. Rise to the challenge. Recruit members to your professional organization – CAMLT. Contribute to your Lab-PAC. Meet with your legislators. CAMLT Membership Information
Ensure the best possible patient safety in laboratory testing, and preserve your important profession.