Today's Law As Amended


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SB-648 Venereal disease: chlamydia: treatment of partner.(1999-2000)



As Amends the Law Today


SECTION 1.
 (a) The Legislature finds and declares the following:
(1) One out of 10 couples in California has problems with fertility.
(2) Pelvic inflammatory disease (PID) is the leading preventable cause of tubal infertility.
(3) Recurrent genital chlamydial infections due to nontreatment of sexual partners of persons with these genital infections greatly contributes to the development of PID.
(4) Current rates of chlamydial infection among Californians warrant enhanced and expanded disease prevention and control efforts.
(5) Partner-delivered treatment is a recognized component of these control efforts.
(b) It is the intent of the Legislature that physicians and surgeons be allowed to ensure adequate medical treatment and management of sexual partners of persons diagnosed with chlamydia and for programs to support the medical evaluation and treatment of partners.

SEC. 2.

 Section 2242 of the Business and Professions Code is amended to read:

2242.
 (a) Prescribing, dispensing, or furnishing dangerous drugs as defined in Section 4022 without an appropriate  a good faith  prior examination and a  medical indication,  indication therefor,  constitutes unprofessional conduct. An appropriate prior examination does not require a synchronous interaction between the patient and the licensee and can be achieved through the use of telehealth, including, but not limited to, a self-screening tool or a questionnaire, provided that the licensee complies with the appropriate standard of care. 
(b) No licensee shall be found to have committed unprofessional conduct within the meaning of this section if, at the time the drugs were prescribed, dispensed, or furnished, any of the following applies:
(1) The licensee was a designated physician and surgeon or podiatrist serving in the absence of the patient’s physician and surgeon or podiatrist, as the case may be, and if the drugs were prescribed, dispensed, or furnished only as necessary to maintain the patient until the return of the patient’s  his or her  practitioner, but in any case no longer than 72 hours.
(2) The licensee transmitted the order for the drugs to a registered nurse or to a licensed vocational nurse in an inpatient facility, and if both of the following conditions exist:
(A) The practitioner had consulted with the registered nurse or licensed vocational nurse who had reviewed the patient’s records.
(B) The practitioner was designated as the practitioner to serve in the absence of the patient’s physician and surgeon or podiatrist, as the case may be.
(3) The licensee was a designated practitioner serving in the absence of the patient’s physician and surgeon or podiatrist, as the case may be, and was in possession of or had utilized the patient’s records and ordered the renewal of a medically indicated prescription for an amount not exceeding the original prescription in strength or amount or for more than one refill. refilling. 
(4) The licensee was acting in accordance with Section 120582 of the Health and Safety Code.

SEC. 3.

 Section 3502.1 of the Business and Professions Code is amended to read:

3502.1.
 (a)  In addition to the medical  services authorized in the regulations adopted pursuant to Section 3502,  by the board,  and except as prohibited by Section 3502, a PA may furnish or order a drug or device subject to all of the following: while under the supervision of a licensed physician and surgeon or physicians and surgeons approved by the board, a physician assistant may administer or provide medication to a patient, or transmit orally, or in writing on a patient’s record or in a drug order, an order to a person who may lawfully furnish the medication or medical device pursuant to subdivisions (c) and (d). A physician assistant also may dispense, furnish, or otherwise provide prescription antibiotic drugs in accordance with Section 120582 of the Health and Safety Code and subdivisions (c) and (d). 
(a) The PA shall furnish or order a drug or device in accordance with the practice agreement and consistent with the PA’s educational preparation or for which clinical competency has been established and maintained.
(b) (1) A practice agreement authorizing a PA to order or furnish a drug or device shall specify which PA or PAs may furnish or order a drug or device, which drugs or devices may be furnished or ordered, under what circumstances, the extent of physician and surgeon supervision, the method of periodic review of the PA’s competence, including peer review, and review of the practice agreement.
(2) In addition to the requirements in paragraph (1), if the practice agreement authorizes the PA to furnish a Schedule II controlled substance, the practice agreement shall address the diagnosis of the illness, injury, or condition for which the PA may furnish the Schedule II controlled substance.
(c) The PA shall furnish or order drugs or devices under physician and surgeon supervision. This subdivision shall not be construed to require the physical presence of the physician and surgeon, but does require the following:
(1) Adherence to adequate supervision as agreed to in the practice agreement.
(2) The physician and surgeon be available by telephone or other electronic communication method at the time the PA examines the patient.
(d) (1) Except as provided in paragraph (2), the PA may furnish or order only those Schedule II through Schedule V controlled substances under the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code) that have been agreed upon in the practice agreement.
(2) The PA may furnish or order Schedule II or III controlled substances, as defined in Sections 11055 and 11056, respectively, of the Health and Safety Code, in accordance with the practice agreement or a patient-specific order approved by the treating or supervising physician and surgeon.
(e) (1) The PA has satisfactorily completed a course in pharmacology covering the drugs or devices to be furnished or ordered under this section or has completed a program for instruction of PAs that meet the requirements of Section 1399.530 of Title 16 of the California Code of Regulations, as that provision read on June 7, 2019.
(2) (1)  A supervising  physician and surgeon through a practice agreement may determine the extent of supervision necessary pursuant to this section in the furnishing or ordering of drugs and devices. who delegates authority to issue a drug order to a physician assistant may limit this authority by specifying the manner in which the physician assistant may issue delegated prescriptions. 
(3) (2)  PAs who hold an active license, who are authorized through a practice agreement to furnish Schedule II controlled substances, and who are registered with the United States Drug Enforcement Administration, and who have not successfully completed a one-time course in compliance with Sections 1399.610 and 1399.612 of Title 16 of the California Code of Regulations, as those provisions read on June 7, 2019, shall complete, as part of their continuing education requirements, a course that covers Schedule II controlled substances, and the risks of addiction associated with their use, based on the standards developed by the board. The board shall establish the requirements for satisfactory completion of this subdivision. Evidence of completion of a course meeting the standards, including pharmacological content, established in Sections 1399.610 and 1399.612 of Title 16 of the California Code of Regulations, as those provisions read on June 7, 2019, shall be deemed to meet the requirements of this section. Each supervising physician and surgeon who delegates the authority to issue a drug order to a physician assistant shall first prepare and adopt a written, practice specific, formulary and protocols that specify all criteria for the use of a particular drug or device, and any contraindications for the selection. The drugs listed shall constitute the formulary and shall include only drugs that are appropriate for use in the type of practice engaged in by the supervising physician and surgeon. When issuing a drug order, the physician assistant is acting on behalf of and as an agent for a supervising physician and surgeon. 
(f) For purposes of this section:
(1) “Furnishing” or “ordering” shall include the following:
(A) Ordering a drug or device in accordance with the practice agreement.
(B) Transmitting an order of a supervising physician and surgeon.
(C) Dispensing a medication pursuant to Section 4170.
(2) (b)  “Drug order” or “order”  for purposes of this section  means an order for medication that is dispensed to or for an ultimate user, issued by a PA  a patient, issued and signed by a physician assistant acting  as an individual practitioner, practitioner  within the meaning of Section 1306.02 of Title 21 of the Code of Federal Regulations. Notwithstanding any other provision of law, all of the following shall apply: 
(1) A drug order issued pursuant to this section shall be treated in the same manner as a prescription or order of the supervising physician.
(2) All references to “prescription” in this code and the Health and Safety Code shall include drug orders issued by physician assistants pursuant to authority granted by their supervising physicians.
(g) (3)  Notwithstanding any other law, (1) a drug order issued pursuant to this section shall be treated in the same manner as a prescription of a supervising physician; (2) all references to “prescription” in this code and the Health and Safety Code shall include drug orders issued by physician assistants; and (3) the  The  signature of a PA  physician assistant  on a drug order issued in accordance with this section  shall be deemed to be the signature of a prescriber for purposes of this code and the Health and Safety Code.
(c) A drug order for any patient cared for by the physician assistant that is issued by the physician assistant shall either be based on the protocols described in subdivision (a) or shall be approved by the supervising physician before it is filled or carried out.
(1) A physician assistant shall not administer or provide a drug or issue a drug order for a drug other than for a drug listed in the formulary without advance approval from a supervising physician and surgeon for the particular patient. At the direction and under the supervision of a physician and surgeon, a physician assistant may hand to a patient of the supervising physician and surgeon a properly labeled prescription drug prepackaged by a physician and surgeon, manufacturer as defined in the Pharmacy Law, or a pharmacist.
(2) A physician assistant may not administer, provide or issue a drug order for Schedule II through Schedule V controlled substances without advance approval by a supervising physician and surgeon for the particular patient.
(3) Any drug order issued by a physician assistant shall be subject to a reasonable quantitative limitation consistent with customary medical practice in the supervising physician and surgeon’s practice.
(d) A written drug order issued pursuant to subdivision (a), except a written drug order in a patient’s medical record in a health facility or medical practice, shall contain the printed name, address, and phone number of the supervising physician and surgeon, the printed or stamped name and license number of the physician assistant, and the signature of the physician assistant. Further, a written drug order for a controlled substance, except a written drug order in a patient’s medical record in a health facility or a medical practice, shall include the federal controlled substances registration number of the physician assistant. The requirements of this subdivision may be met through stamping or otherwise imprinting on the supervising physician and surgeon’s prescription blank to show the name, license number, and if applicable, the federal controlled substances number of the physician assistant, and shall be signed by the physician assistant. When using a drug order, the physician assistant is acting on behalf of and as the agent of a supervising physician and surgeon.
(e) The medical record of any patient cared for by a physician assistant for whom the supervising physician and surgeon’s drug order has been issued or carried out shall be reviewed and countersigned and dated by a supervising physician and surgeon within seven days.
(f) All physician assistants who are authorized by their supervising physicians to issue drug orders for controlled substances shall register with the United States Drug Enforcement Administration (DEA).

SEC. 4.

 Section 120500 of the Health and Safety Code is amended to read:

120500.
 As used in the Communicable Disease Prevention and Control Act (Section 27) “venereal diseases” means syphilis, gonorrhea, chancroid, lymphopathia venereum, granuloma inguinale, and chlamydia.

SEC. 5.

 Section 120582 is added to the Health and Safety Code, to read:

120582.
 (a) Notwithstanding any other provision of law, a physician and surgeon who diagnoses a sexually transmitted chlamydia infection in an individual patient may prescribe, dispense, furnish, or otherwise provide prescription antibiotic drugs to that patient’s sexual partner or partners without examination of that patient’s partner or partners. The department may adopt regulations to implement this section.
(b) Notwithstanding any other provision of law, a nurse practitioner pursuant to Section 2836.1 of the Business and Professions Code, a certified nurse-midwife pursuant to Section 2746.51 of the Business and Professions Code, and a physician assistant pursuant to Section 3502.1 of the Business and Professions Code may dispense, furnish, or otherwise provide prescription antibiotic drugs to the sexual partner or partners of a patient with a diagnosed sexually transmitted chlamydia infection without examination of the patient’s sexual partner or partners.