SB 622 (Hernandez), Optometry
AB 1418 (Lara), Clinical Laboratory Testing
AB 387 (Thurmond), Minimum Wage: Health Professionals
AB 613 (Nazarian), Healing Arts: Clinical Laboratories
AB 940 (Ridley-Thomas and Waldron), Clinical Laboratories
SB 75 (CDPH), Clinical Laboratories: EQC and IQCP
Membership Involvement is the Key
Start here to find your legislators: http://www.legislature.ca.gov/
CAMLT Political Update
Public Policy Advocates, LLC, March 2017
The 2017-18 Legislative Session was gaveled in on December 5, 2016 for the swearing-in of all Assembly Members and those Senate Members that stood election in November. Following a day of other ceremonies and celebrations, legislators returned to their home districts until January 4, 2017. The November election produced two-thirds super majorities of Democrats in both Houses of the Legislature, which was expected in the Assembly but not the Senate. While these super majorities will theoretically allow the Democrats to pass any and all things requiring a two-thirds vote, including, but not limited to taxes and constitutional amendments, given the number of “moderate” Democrats, specifically in the Assembly, many political pundits doubt there will be a flurry of taxes and other two-thirds vote issues pass, but those same pundits agree some high-profile measures will reach the Governor’s desk.
The legislature has now passed the bill introduction period. The deadline to introduce legislation was February 17. As of this writing, a combined total of 2,672 bills have been introduced by the Senate and the Assembly. While we have heard that there will be legislation introduced to expand the scope of practice with regard to optometry, to date that has not happened. Public Policy Advocates will continue to monitor daily bill introductions for any legislation that might adversely affect CAMLT.
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 underwrite CAMLT’s governmental representation 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—not tomorrow, but now.
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. 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. 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!
Recent legislative sessions have been very rigorous and active in terms of bills legislating a frontal attack on the CLS, MLT and CPT professions, depleting CAMLT resources. Only you can ensure the growth and vibrancy of 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.
The following is legislation that PPA has identified through the bill introduction process that either directly or may through amendments affect CAMLT. Check below for updates on bill status, Legislator lists, and Committee assignments.
AB 387 (Thurmond) Minimum Wage: Health Professionals: Interns, as introduced 2/9/17 – 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: Passed out of the Assembly Labor and Employment Committee on March 29. The bill will be heard in the Appropriations Committee next; no date set.
AB 443 (Salas), Healing Arts: Optometry: Required Examination: Notice, as introduced 2/13/17 – WATCH
This bill currently does not affect CAMLT, however, we have been told that it is a "spot" bill. We are tracking in the event the measure is amended and used as a vehicle for scope of expansion language into clinical laboratory practice.
AB 613 (Nazarian), Healing Arts: Clinical Laboratories, as amended 3/27/17 — 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 lets 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.
AB 940 (Ridley-Thomas and Waldron), Clinical Laboratories, as amended 8/20/2015—WATCH
According to the sponsor, the California Clinical Laboratory Association, AB 940 is intended to allow for Co-Directors of high complexity laboratories, an applicant for bioanalyst, to obtain out of state training, create embryology and biochemical genetics licensure categories, allow the Department of Public Health to issue licenses for clinical embryologist and clinical biochemical geneticist, and allow the Department of Public Health to charge a fee for the licensing of clinical embryologist, clinical biochemical geneticist, clinical cytogeneticist or clinical molecular biologist. AB 940 amends the definition of laboratory director to clarify that the laboratory director on the laboratory’s CLIA certificate meets the qualifications under CLIA for the type and complexity of tests being offered by the laboratory and also amends the definition of laboratory director to allow a scientist, licensed under state law to direct a laboratory performing high complexity tests, such as a bioanalyst, to become a co-director of a laboratory performing high complexity tests without having to meet the CLIA requirements. A licensed bioanalyst, if qualified under CLIA, may act as a CLIA laboratory director or as a co-laboratory director, deletes the two new license categories of reproductive biology and biochemical genetics, renames the license for clinical molecular biologist to the license for clinical genetic molecular biologist, and makes other conforming changes. According to the sponsor “this bill will reestablish a true career ladder in the California clinical laboratory field.” The Governor signed this measure.
SB 75 (CDPH), Clinical Laboratories: EQC and IQCP, as amended 6/16/15 – SUPPORT
California Clinical Laboratories are regulated under federal law, CLIA and CDPH pursuant to Business and Professions Code Section 1200 et. seq. For more than a decade, CDPH has allowed California laboratories to utilize federally approved alternative QC programs such as Equivalent Quality Control (EQC) and Individualized Quality Control Plan (IQCP) in lieu of default QC to meet certain quality standards when performing laboratory tests. However, CDPH recently conducted a review of federal regulations and state statutes and determined that EQC and IQCP may not be authorized under California law. Stakeholders have requested state law be amended to allow for EQC to be used until December 31, 2015 and begin use of IQCP as of January 1, 2016. This proposed CDPH Budget Item is part of the May Revise of the state budget and was heard May 21 in the Senate Budget and Fiscal Review Subcommittee #3 on Health and Human Services. Governor Brown signed the budget and this related bill on June 24, effective date was January 1, 2015.
AB 1939 (Patterson), Licensing Requirements, as amended 4/12/16 – WATCH/MONITOR FOR AMENDMENTS
AB 1939 while not directed at licensed laboratory personnel, it gets at the principle that reciprocity from other states should be allowed. While this may be acceptable for other licensed entities, it is not for CLSs, MLTs or CPTs. This measure initially would have required the Director of the Department of Consumer Affairs (DCA) to conduct a study on whether occupational licensing requirements create an unnecessary barrier to labor entry and labor mobility, particularly for dislocated workers, service members and military spouses, but the author agreed to take an amendment putting the Legislative Analyst’s Office in charge of the study. The study would then be submitted to the Legislature as well as the DCA. Since there is movement in this area, AB 1939 was monitored closely. AB 1939 was sponsored by its author. AB 1939 was held in Assembly Appropriations, did not advance out of committee.
SB 622 (Hernandez), Optometry, as amended 6/22/16 – NEUTRAL
- Amends the current language with regard to diabetes testing to allow optometrists to collect blood specimen by the finger prick method
SB 622 was initially introduced as a vocational nursing bill, and was amended to deal with optometry and scope of practice expansion. Similar to SB 492 (Hernandez) which died on the Assembly Floor last session, SB 622, if passed, would expand the scope of practice for optometrists to include expanded ability to order and perform the Clinical Laboratory Improvement Amendments (CLIA) waived tests, use noninvasive, nonsurgical technology to treat a condition authorized by the Optometric Act, perform laser and minor procedures, and administer certain vaccines. This bill was amended on June 22, 2016 to return it to existing law with regard to clinical laboratory testing. At which time, CAMLT removed its opposition and changed its position to neutral. SB 622 was scheduled to be heard in the Assembly Business and Professions Committee on June 28 but was canceled at the request of the author and subsequently died.
AB 1418 (Lara), Clinical Laboratory Testing, as amended 4/13/16 – OPPOSE
- Would allow persons to order any laboratory test on themselves without a health care provider’s request on a direct access basis
- Test results will not be interpreted by a health care provider or considered along with clinical history that may lead to misinterpretation, misdiagnosis or even death
Existing law authorizes a person to request, and a licensed clinical laboratory or public health laboratory to perform specified clinical laboratory tests, including pregnancy, glucose level, cholesterol, and occult blood tests, as well as authorize a registered clinical laboratory to perform these tests if the test is subject to a certificate of waiver under the Clinical Laboratory Improvement Amendments of 1988 and the laboratory has registered with the State Department of Public Health. SB 1418 would have repealed those provisions and allowed a person to request, and a licensed clinical laboratory or public health laboratory to perform, any laboratory test that the laboratory offers to the public on a direct access basis without a health care provider’s request. SB 1418 was sponsored by Theranos. SB 1418 was set to be heard in the Senate Business and Professions committee on 4/18/16, but after the urging from CAMLT, was pulled at the request of the author..
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 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: firstname.lastname@example.org) 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: Rudy Salas (D-Chair) Joaquin Arambula (D), Bill Brough (R-Vice Chair), Catharine Baker (R), Richard Bloom (D), David Chiu (D), Jordan Cunningham (D), Brian Dahle (R), Susan Talamantes Eggman (D), Mike Gipson (D), Timothy Grayson (D), Chris Holden (D), Evan Low (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), James Gallagher (R), Monique Limon (D), Kevin McCarty (D) Adrin Nazarian (D), Jim Patterson (R), Sharon Quirk-Silva (D), Sebastian Ridley-Thomas (D), Freddie Rodriguez (D), Miguel Santiago (D), Tony Thurmond (D), Marie Waldron (R)
Senate Business, Professions and Economic Development Committee: Jerry Hill (D-Chair), Patricia Bates (R-Vice Chair), Bill Dodd (D), Cathleen Galgiani (D), Steve Glazer (D), Ed Hernandez (D), Josh Newman (D) Richard Pan (D), Scott Wilk (R)
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.