SB 247 (Moorlach) Licensing Requirements
SB 562 (Lara) Californians for a Healthy California Act
AB 387 (Thurmond), Minimum Wage: Health Professionals
AB 613 (Nazarian), Healing Arts: Clinical Laboratories
AB 658 (Waldron) Clinical Laboratories
AB 659 (Ridley-Thomas) Medi-Cal Reimbursement Rates
Membership Involvement is the Key
Start here to find your legislators: http://www.legislature.ca.gov/legislators_and_districts.html
CAMLT Political Update
Public Policy Advocates, LLC, October 2017
The California Legislature’s final day and night of the first year of the two-year legislative session ended in the wee hours of September 15. The Governor had until October 15 to sign or veto legislation. The PPA/CAMLT agenda was dominated by optometrists wanting to expand their scope of practice to, among other things, order and perform waived lab tests without a lab director, Grifols and plasma centers wanting non-qualified personnel to do moderate complexity testing on plasma using the Reichert Protein Analyzer, and unions backing a bill to pay interns. In addition, PPA monitored a cross-section of bills from lab fees to antimicrobial infections to single-payer healthcare.
This session was not unlike every other over the 20 plus years that we have represented CAMLT. Though California requires higher laboratory personnel standards and requires licensing, every legislative session is marked by other allied health professions trying to expand their scope of practice to perform laboratory tests without the requisite education or lab director—pharmacists, primary care clinics, plasma collection centers, naturopaths, optometrists and chiropractors for starters. Without CAMLT, these many attempts to dilute or repeal laboratory and laboratory personnel licensing law would have succeeded.
What does this all mean for CAMLT? For more than 50 years, CAMLT has successfully defended laboratory standards to protect patients as others have tried to convince legislators to dilute licensing and personnel standards. CAMLT membership is critical. CAMLT must be strong financially and in membership numbers to effectively execute a legislative program and to educate key legislators and government officials. CAMLT is the only professional organization that exclusively protects the legislative interests of CLSs, MLTs, CPTs and other laboratory personnel in the best interest of the patient and in the best interest of the laboratory profession. It is the only professional association representing clinical laboratory science personnel that retains a lobbying firm in Sacramento to be the voice for clinical laboratory personnel in Sacramento before the legislature and state government. If CAMLT does not grow its membership or raise the necessary revenue to support its legislative program, there will be no legislative program to protect the profession and the patients it serves.
Organized labor has been extremely helpful in the past. But labor unions also represent chiropractors, optometrists, and pharmacists in addition to CLSs---the very professions at the forefront of diluting California laboratory law. So Labor has not been in a position to take these other professions head on when they want to expand their scopes into clinical laboratory science. This has now fallen almost exclusively to CAMLT to protect. Other laboratory personnel professional associations may provide continuing education, certification, or fellowship—but none have a Sacramento presence or help to financially underwrite CAMLT’s governmental program on behalf of the entire profession. The clinical laboratory profession must come together to unify and shore up its efforts to support CAMLT’s legislative and political agenda if it wants to preserve its profession and protect patients—not tomorrow, but now.
This year there were 30 new legislators elected. In the era of 12-year term limits, this affords CAMLT and its members time to systemically get to know and educate their legislators. Longer term limits afford CAMLT grass roots the opportunity to build champions in the legislature who know and understand the importance of California’s patient protections in California law. But legislators and their staff must be educated. This includes building a strong grass roots network that meets with legislators and a strong LAB-PAC.
RECRUIT NEW CAMLT MEMBERS! CONTRIBUTE TO LAB-PAC!
This last legislative session was rigorous in terms of bills legislating a frontal attack on the laboratory professions, depleting CAMLT resources. As expected, in the current legislative session, we are encountering the reintroduction of legislation that CAMLT and Public Policy Advocates successfully stopped from advancing in recent past legislative sessions. Only you can ensure the growth and vibrancy of a strong, well financed, well organized CAMLT to protect the best possible patient safety in laboratory testing and the preservation of your critical profession. Rise to the challenge. Recruit members to your professional organization —CAMLT. Contribute to LAB-PAC. Educate your own legislators. Only this will secure your future and the future of the patients that you serve.
The following is legislation that PPA tracked or lobbied on behalf of CAMLT for the 2017-2018 session. Check below for updates on bill status, Legislator lists, and Committee assignments.
AB 387 (Thurmond) Minimum Wage: Health Professionals: Interns, as amended 5/30/17 – OPPOSE
- This bill will require health care entities to pay allied health students minimum wage for time spent in clinical or experimental training that is required for state licensure or certification
- Clinical laboratory trainees/interns cannot provide laboratory services except under direct and responsible supervision, and as such, they should not be redefined as employees and clinical laboratories should not be re-defined as trainee/intern employers
- Increasing the cost of student training may force some laboratories to reduce or stop providing clinical rotations and/or stymie new laboratories from providing clinical rotations which will further reduce the number of new laboratory professionals entering the workforce and exacerbate existing clinical laboratory personnel workforce shortages
AB 387 would expand the definition of “employer” to include a person who directly or indirectly, or through an agent or any other person, employs or exercises control over the wages, hours, or working conditions of a person engaged in a period of supervised work experience to satisfy requirements for licensure, registration, or certification as an allied health professional and that any person engaged in a period of supervised work experience to satisfy requirements for licensure, registration, or certification as an Allied Health Professional be subject to the minimum wage law.
Clinical laboratory trainees/interns cannot release results and cannot work without supervision. Clinical laboratory rotations are funded exclusively by the host laboratory; costs are not reimbursed by Medi-Cal, Medicare, private insurance or other resources. Increasing the cost of student training may force some laboratories to reduce or stop providing clinical rotations and/or stymie new laboratories from providing clinical rotations which will further reduce the number of new laboratory professionals entering the workforce and exacerbate existing clinical laboratory personnel workforce shortages. Currently, many laboratories training students already pay a stipend that meet or exceed the minimum wage requirement proposed by this bill. Instead of legislating a minimum salary that some laboratories cannot afford, individual training laboratories should decide what they can afford to pay students so not to jeopardize the existing pipeline of students who eventually qualify to enter the workforce. SEIU is the Sponsor of the bill. Location: AB 387 was held on the Assembly Floor due to lack of votes needed for passage and was subsequently made a 2-year bill. The measure is not eligible to be heard again until January 2018, but will face stringent deadlines. AB 387 would have to move out of the Assembly by January 31 – no easy task.
AB 443 (Salas), Healing Arts: Optometry: Required Examination: Notice, as amended 9/8/17 – WATCH
- Amends the current language with regard to diabetes testing to allow optometrists to collect blood specimen by the finger prick method
AB 443 was introduced as a “spot” bill which Public Policy Advocates flagged to watch for amendments. Originally an optometry bill dealing with examination/notice, the measure morphed into scope of practice legislation. The bill would revise the scope of the practice of optometry by providing that the practice of optometry includes the provision of habilitative optometric services. The measure additionally would authorize an optometrist to be certified in the administration of specified immunizations and would establish a fee for that purpose. AB 443 would also allow an optometrist to perform skin testing to diagnose ocular allergies limited to the superficial layer of skin, collect blood through skin puncture for diabetes testing, treat eyelid inflammation/inadequate eyelash growth and eliminates the protocols that specify when an optometrist must refer a patient to another provider. Previous scope of practice expansion optometry legislation which CAMLT through PPA opposed includes SB 492 (Hernandez) in 2013-14, which died on the Assembly Floor and SB 622 (Hernandez) in 2015-16 which was referred to committee but never heard. The Author's office and Sponsors indicate that they will not change lab law in this bill this year. Location: AB 443 passed the Senate September 13 and the Assembly September 16. Governor Brown signed AB 443 into law October 7.
AB 613 (Nazarian), Healing Arts: Clinical Laboratories, as amended 8/29/17 — OPPOSE
- Would allow High School graduates to perform the moderately complex total protein refractometer test on potential plasma donors at plasma collection centers.
- Standards outlined in the bill for high school students performing this test does not ensure the health and safety of plasma donors.
This measure is the reintroduction of AB 757 (Gomez) that CAMLT opposed and was ultimately vetoed by the Governor in 2015 due to concerns that the standards outlined in the bill for persons to perform this test does not ensure the health and safety of plasma donors. AB 613 authorizes a person with training set forth in the bill that exceeds federal Clinical Laboratory Improvement Amendments (CLIA) standards but allows non-qualified personnel under California laboratory law (BPC 1206.5(b)) perform moderate complexity testing with regard to plasma. AB 613 would allow lesser trained and educated persons than currently permitted by law to perform a total protein refractometer analysis, categorized as a moderately complex test by the Food and Drug Administration, in a licensed plasma collection facility. If the protein refractometer test and/or calibration is done incorrectly there is potential to cause donor harm. AB 613 is sponsored by the Plasma Protein Therapeutics Association and is supported by Grifols and the California Chronic Care Coalition. Location: AB 613 is now a 2-year bill. The Sponsors maintain that they have yet to workout amendments relative to supervision and reporting standards related to unlicensed personnel performing total protein tests. This bill will be heard in the Senate in 2018.
AB 658 (Waldron) Clinical Laboratories, as amended 4/6/17 –NEUTRAL
- This bill proposes that annual licensure fee for clinical laboratories be suspended for two years (2018 & 2019)
This measure is a result of the release on September 10, 2015 from the office of the State Auditor a report on the Laboratory Field Services (LFS) branch of the Department of Public Health which noted in its audit findings that since 2008 LFS has collected more than $12 million in lab fees that it has not spent. AB 658 proposes that by requiring LFS to suspend the annual licensure fee for clinical laboratories for two years (2018 & 2019), this will allow the Department to spend down the surplus in funds to an appropriate operating level. AB 658 is sponsored by the California Clinical Laboratory Association. Location: AB 658 passed both houses September 11 and chaptered by Secretary of State September 28.
AB 659 (Ridley-Thomas) Medical Reimbursement Rates, as amended 6/26/17 –NEUTRAL/WATCH
- This bill reduces the frequency by which clinical laboratories submit reports to every 3 years rather than annually beginning in 2019
Current law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed by, and funded pursuant to, federal Medicaid Program provisions. Existing law also restricts the Medi-Cal reimbursement rate for clinical laboratory or laboratory services, and also requires that laboratory service providers submit annual data reports to the department, for the purpose of establishing rates for clinical or laboratory services based on the lowest amounts other payers are paying providers for similar services. AB 659 reduces the frequency by which clinical laboratories submit reports to every 3 years rather than annually beginning in 2019. Location: AB 659 was approved by the Governor September 28.
SB 43 (Hill) Antimicrobial-Resistant Infection: Reporting, as amended 4/5/17 – WATCH
SB 43 would require general acute care hospitals and clinical laboratories to submit a report to the department, commencing July 1, 2018, and each July 1 thereafter, containing an antibiogram of the facility for the previous year. The bill would require the department, commencing January 1, 2019, and each January 1 thereafter, to publish and post on its Internet Web site a report, based on the data reported by hospitals and clinical laboratories, and from certificates of death, which would include designated information relating to the incidence, type, and distribution of antimicrobial-resistant infections and the number of deaths for which antimicrobial resistance is listed on the certificate of death as the disease or condition directly leading to death, an antecedent cause, or a significant condition contributing to death. SB 43 would also prohibit data collected pursuant to the bill from being disclosed to the public on a facility-specific basis, but would allow for the disclosure of case-specific information, under prescribed circumstances. Location: SB 43 was set for hearing in Assembly Health committee but was cancelled July 11 at the request of the Author. The bill awaits another hearing date.
SB 247 (Moorlach) Licensing Requirements, as amended 4/17/17 –WATCH
SB 247 was initially introduced as a “spot bill” dealing with licensing requirements. PPA had flagged the legislation to watch for amendments due to the licensing component. On April 17, the bill was amended to deal with Professions and Vocations with regard to business surety bonds. In its current form, SB 247 does not affect clinical laboratories in any way. We will continue to monitor the bill for any future amendments. Location: SB 247 failed deadline and was made a 2-year bill and is not eligible to be heard again until January 2018.
SB 562 (Lara) Californians for a Healthy California Act, as amended 5/26/17 – WATCH
SB 562 was added to CAMLT’s legislative tracking list simply because it was an important health care bill. This measure would have enabled the Legislature to enact legislation that would establish a comprehensive universal single-payer health care coverage program and a health care cost control system for the benefit of all residents of that state. SB 562, while well intended, would have cost the state $400 billion. The measure passed out of Senate Appropriations and from the Senate without a viable funding plan. Once in the Assembly, SB 562 was ordered to be held at the desk by Speaker Anthony Rendon. While SB 562 is currently “shelved”, it does not mean it is dead, it could, conceivably, be revived in the Assembly.
Have You Met with Your Legislators? If Not, Why Not?
For the last fifty years, CAMLT has continued to successfully weather advertent or inadvertent legislative assaults on clinical laboratory testing that would jeopardize patient safety, but these assaults continue. It is critical that CAMLT build its membership and engage with and educate California's elected officials. Legislators are eligible to serve up to 12 years under our new term limit law. 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? They are at home in their districts until January. 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 laboratory 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 current roster below 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, MLT or CPT; 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 laboratory personnel shortage and what it takes to eliminate it.
Make it a priority to meet with your Legislators. Remember, these interactions are integral components of your grassroots program. For tips, please refer to the CAMLT Grassroots Guide and Talking Points on this website.
Laboratory Brochure for Legislators Now Available
CAMLT has developed an attractive tri-fold brochure which is now available to members and others for use in explaining the Laboratory profession to Legislators. This brochure is appropriate to use to describe the role of the clinical laboratory in the delivery of quality of healthcare. This brochure can be downloaded and printed by you or ordered directly from CAMLT (email: email@example.com) to hand out to legislators or their staff when you meet with them.
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 laboratory issues that arise in committee.
Assembly Business, Professions and Consumer Protection Committee: Evan Low (D-Chair) Joaquin Arambula (D), Bill Brough (R-Vice Chair), Catharine Baker (R), Richard Bloom (D), David Chiu (D), Jordan Cunningham (D), Susan Talamantes Eggman (D), Mike Gipson (D), Timothy Grayson (D), Chris Holden (D), Jacqui Irwin (D), Chad Mayes (R), Kevin Mullin (D), Marc Steinorth (R), Phillip Ting (D)
Assembly Health Committee: Jim Wood (D-Chair), Brian Maienschein (R-Vice Chair), Rob Bonta (D), Autumn Burke (D), Heath Flora (R), Monique Limon (D), Kevin McCarty (D) Adrin Nazarian (D), Sebastian Ridley-Thomas (D), Freddie Rodriguez (D), Miguel Santiago (D), Marc Steinorth (R), Tony Thurmond (D), Marie Waldron (R), 1 Vacancy
Senate Business, Professions and Economic Development Committee: Jerry Hill (D-Chair), Jean Fuller (R-Vice Chair), Bill Dodd (D), Cathleen Galgiani (D), Steve Glazer (D)
Senate Health Committee: Ed Hernandez (D-Chair), Janet Nguyen (R-Vice Chair), Toni Atkins (D), Connie Leyva (D), Holly Mitchell (D), Bill Monning (D), Josh Newman (D), Jim Nielsen (R), Richard Roth (D)
Below are the Legislators for the 2017-2018 Legislative Session:
Senator and Cities Represented by District:
Assembly Member and Cities Represented by District
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 to donate online or for a donation form. Your gift in any amount will help your profession. Contribute now!
Please mail donations made payable to:
39656 Mission Blvd., Fremont, CA 94539-1766
Please write a check to LAB-PAC or donate online now!
Recruit New CAMLT Members!
This has been a very rigorous and active legislative session 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.
Ensure the best possible patient safety in laboratory testing, and preserve your important profession.