California Assembly Bill AB154 Amended / Bill

 BILL NUMBER: AB 154AMENDED BILL TEXT AMENDED IN ASSEMBLY MARCH 19, 2013 INTRODUCED BY Assembly Member Atkins JANUARY 22, 2013  An act relating to reproductive health care.   An act to amend Section 2253 of, and to add Sections 734, 2725.4, and 3502.4 to, the Business and Professions Code, and to amend Section 123468 of the Health and Safety Code, relating to healing arts.  LEGISLATIVE COUNSEL'S DIGEST AB 154, as amended, Atkins.  Healing arts: reproductive health care.   Abortion.  Existing law makes it a public offense, punishable by a fine not exceeding $10,000 or imprisonment, or both, for a person to perform or assist in performing a surgical abortion if the person does not have a valid license to practice as a physician and surgeon, or to assist in performing a surgical abortion without a valid license or certificate obtained in accordance with some other law that authorizes him or her to perform the functions necessary to assist in performing a surgical abortion. Existing law also makes it a public offense, punishable by a fine not exceeding $10,000 or imprisonment, or both, for a person to perform or assist in performing a nonsurgical abortion if the person does not have a valid license to practice as a physician and surgeon or does not have a valid license or certificate obtained in accordance with some other law authorizing him or her to perform or assist in performing the functions necessary for a nonsurgical abortion. Under existing law, nonsurgical abortion includes termination of pregnancy through the use of pharmacological agents. Existing law, the Nursing Practice Act, provides for the licensure and regulation of registered nurses, including nurse practitioners and certified nurse-midwives, by the Board of Registered Nursing. Existing law, the Physician Assistant Practice Act, provides for the licensure and regulation of physician assistants by the Physician Assistant Committee of the Medical Board of California.  Existing law authorizes the Office of Statewide Health Planning and Development to designate experimental health workforce projects as approved projects that, among other things, teach new skills to existing categories of health care personnel. The office has designated a pilot project, known as the Access through Primary Care Project, relating to the provision of health care services involving pregnancy.   This bill would state that it is the intent of the Legislature to enact legislation that would expand access to reproductive health care in California by allowing qualified health care professionals to perform early abortions.   This bill would instead make it a public offense, punishable by a fine not exceeding $10,000 or imprisonment, or both, for a person to perform an abortion if the person does not have a valid license to practice as a physician and surgeon, except that it would not be a public offense for a person to perform an abortion by medication or aspiration techniques in the first trimester of pregnancy if he or she holds a license or certificate authorizing him or her to perform the functions necessary for an abortion by medication or aspiration techniques. The bill would also require a nurse practitioner, certified nurse-midwife, or physician assistant to complete training, as specified, in order to perform an abortion by aspiration techniques, and would indefinitely authorize a nurse practitioner, certified nurse-midwife, or physician assistant who completed a specified training program and achieved clinical competency to continue to perform abortions by aspiration techniques. The bill would delete the references to a nonsurgical abortion and would delete the restrictions on assisting with abortion procedures. The bill would also make technical, nonsubstantive changes.   Because the bill would change the definition of crimes, the bill would impose a state-mandated local program.   The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.   This bill would provide that no reimbursement is required by this act for a specified reason.  Vote: majority. Appropriation: no. Fiscal committee:  no   yes  . State-mandated local program:  no   yes  . THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:  SECTION 1.   Section 734 is added to the   Business and Professions Code   , to read:   734. It is unprofessional conduct for any nurse practitioner, certified nurse midwife, or physician assistant to perform an abortion pursuant to Section 2253, without prior completion of training and validation of clinical competency.   SEC. 2.   Section 2253 of the   Business and Professions Code   is amended to read: 2253. (a) Failure to comply with the Reproductive Privacy Act (Article 2.5 (commencing with Section 123460) of Chapter 2 of Part 2 of Division 106 of the Health and Safety Code)  in performing, assisting, procuring or aiding, abetting, attempting, agreeing, or offering to procure an illegal abortion  constitutes unprofessional conduct. (b) (1)  A   Except as provided in paragraph (2), a  person is subject to  Sections   Section  2052  and 2053  if he or she performs  or assists in performing a surgical   an  abortion, and at the time of so doing, does not have a valid, unrevoked, and unsuspended license to practice as a physician and surgeon  as provided in this chapter, or if he or she assists in performing a surgical abortion and does not have a valid, unrevoked, and unsuspended license or certificate obtained in accordance with some other provision of law that authorizes him or her to perform the functions necessary to assist in performing a surgical abortion  . (2) A person  is   shall not be  subject to  Sections   Section  2052  and 2053  if he or she performs  or assists in performing a nonsurgical abortion,   an abortion by medication or aspiration techniques in the first trimester of pregnancy,  and at the time of so doing,  does not have a valid, unrevoked, and unsuspended license to practice as a physician and surgeon as provided in this chapter, or does not have   has  a valid, unrevoked, and unsuspended license or certificate obtained in accordance with some other provision of law  , including, but not limited to, the Nursing Practice Act (Chapter 6 (commencing with Section 2700)) or the Physician Assistant Practice Act (Chapter 7.7   (commencing with Section 3500)),  that authorizes him or her to perform  or assist in performing  the functions necessary for  a nonsurgical abortion.   an abortion by medication or aspiration techniques   .   (c) For purposes of this section, "nonsurgical abortion" includes termination of the use of pharmacological agents.   (c) In order to perform an abortion by aspiration techniques pursuant to paragraph (2) of subdivision (b), a person shall comply with Section 2725.4 or 3502.4.   SEC. 3.   Section 2725.4 is added to the   Business and Professions Code   , to read:   2725.4. (a) In order to perform an abortion by aspiration techniques, a person with a license or certificate to practice as a nurse practitioner or a certified nurse-midwife shall complete training recognized by the Board of Registered Nursing. Beginning January 1, 2014, and until January 1, 2016, the competency-based training protocols established by Health Workforce Pilot Project (HWPP) No. 171 through the Office of Statewide Health Planning and Development shall be used. (b) A nurse practitioner or certified nurse-midwife who has completed training and achieved clinical competency through HWPP No. 171 shall be authorized to perform abortions by aspiration techniques.   SEC. 4.   Section 3502.4 is added to the   Business and Professions Code   , to read:   3502.4. (a) In order to receive authority from his or her supervising physician and surgeon to perform an abortion by aspiration techniques, a physician assistant shall complete training either through training programs approved by the Physician Assistant Board pursuant to Section 3513 or by training to perform medical services which augment his or her current areas of competency pursuant to Section 1399.543 of Title 16 of the California Code of Regulations. Beginning January 1, 2014, and until January 1, 2016, the training and clinical competency protocols established by Health Workforce Pilot Project (HWPP) No. 171 through the Office of Statewide Health Planning and Development shall be used as training and clinical competency guidelines to meet this requirement. (b) The training protocols established by HWPP No. 171 shall be deemed to meet the standards of the Physician Assistant Board. A physician assistant who has completed training and achieved clinical competency through HWPP No. 171 shall be authorized to perform abortions by aspiration techniques.   SEC. 5.   Section 123468 of the   Health and Safety Code  is amended to read:  123468. The performance of an abortion is unauthorized if either of the following is true: (a) The person performing  or assisting in performing  the abortion is not a health care provider authorized to perform  or assist in performing  an abortion pursuant to Section 2253 of the Business and Professions Code. (b) The abortion is performed on a viable fetus, and both of the following are established: (1) In the good faith medical judgment of the physician, the fetus was viable. (2) In the good faith medical judgment of the physician, continuation of the pregnancy posed no risk to life or health of the pregnant woman.  SEC. 6.   No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.   SECTION 1.   It is the intent of the Legislature to enact legislation that would expand access to reproductive health care in California by allowing qualified health care professionals to perform early abortions, provided that the functions are within the scope of their licenses.