New Law Alert: California 2021
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While coronavirus dominated much of the California legislative landscape in 2020, a number of bills on a variety of subjects impacting health care providers were signed into law by Governor Newsom. Following are a few new laws you should be aware of; all are effective January 1, 2021 unless otherwise noted.
Employee Notification of COVID-19 Exposure: AB 685 (Reyes) requires employers to provide written notification within 24 hours to their employees if they are potentially exposed, at the workplace, to a person who was infectious with COVID-19 or who was subject to a COVID-19 related quarantine order. The law specifically exempts from the notification requirement healthcare employees who conduct COVID-19 testing or screening, or employees that provide direct care to individuals known to have tested positive for COVID-19. The written notice of exposure should include COVID-19 related benefits and options, including COVID-19 related leave, sick leave, and anti-retaliation and anti-discrimination protections of the employee, as well as the employer’s disinfection and safety plan to be implemented per CDC guidelines. Written notice can be made in a manner the employer normally uses to communicate employment-related information, including (but not limited to) personal service, email, or text message and shall be in both English and the language understood by the majority of employees.
MIEC Recommends that practices draft a sample notice with the assistance of an HR professional, including any COVID-related benefits, so that it is ready to be deployed as needed.
Nurse Practitioners: Practice without Standardized Procedures: AB 890 (Wood) requires the Board of Registered Nursing to define minimum standards for a nurse practitioner to transition to practice more independently. Beginning January 1, 2023, the law authorizes nurse practitioners who meet certain education, experience, and certification requirements to perform specified functions without standardized procedures, including (but not limited to) ordering, performing and interpreting diagnostic procedures, certifying disability, and prescribing, administering, dispensing, and furnishing controlled substances. The law does not eliminate physician supervision and requires that physician consultation shall be obtained under the following circumstances:
- Emergent conditions requiring prompt medical intervention after initial stabilizing care has been started.
- Acute decompensation of patient situation.
- Problem which is not resolving as anticipated.
- History, physical or lab findings inconsistent with clinical perspective.
- Upon request of patient.
Furthermore, qualifying nurse practitioners are required to establish a plan for referral of complex medical cases and emergencies.
Nurse Midwives Scope of Practice: SB 1237 (Dodd) delineates an independent scope of practice for certified nurse midwives (CNMs), including “low risk” pregnancy and childbirth, prenatal, intrapartum, and postpartum care, family planning care, and immediate care for the newborn. “Low-risk pregnancy” means a pregnancy in which all of the following conditions are met:
- There is a single fetus.
- There is a cephalic presentation at onset of labor.
- The gestational age of the fetus is greater than or equal to 37 weeks and zero days and less than or equal to 42 weeks and zero days at the time of delivery.
- Labor can be spontaneous or induced.
- The patient has no preexisting disease or condition, whether arising out of the pregnancy or otherwise, that adversely effects the pregnancy and that the nurse-midwife is not qualified to independently address.
Nurse midwives may care for patients who do not meet the above criteria so long as the nurse midwife has signed, mutually agreed upon policies and procedures with a physician that delineate the parameters for consultation, collaboration, and transfer of care. All emergencies must be transferred to a physician immediately. For additional provisions of the new law regarding furnishing of drugs, patient notification and consent, and more, please see this summary provided by the California Nurse Midwives Association.
PPE Stockpiles SB 275 (Pan): Commencing January 1, 2023, this law requires “health care employers,” including clinics, health facilities and home health agencies to maintain an inventory of Personal Protective Equipment (PPE) for use in the event of a declared state of emergency. The definition of “health care employers” for purposes of this law does NOT include an independent medical practice that is physician-owned and operated, unless the medical practice is operated or maintained exclusively as part of an integrated health system or health facility.
Revised Reporting Requirements for Controlled Substances AB 528 (Pan): Dispensing of a controlled substance must be reported to the Controlled Substance Utilization Review and Evaluation System (CURES) within one working day after the medication is released to the patient or the patient’s representative. Previously, the deadline to report was seven days after dispensing. Further, this law requires reporting the dispensing of Schedule V drugs, in addition to Schedules II, III, and IV. This requirement applies to pharmacists and prescribers who dispense controlled substances.
Reminder: Revised Security Prescription Pads Requirements Now in Effect
Per legislation signed into law in 2019, prescription pads used to write and fill prescriptions for controlled substances are required to have a 12-character serial number, a corresponding barcode, and other security features. California-approved security printers have been issuing these prescription pads since the beginning of 2020; however effective January 1, 2021 pharmacies are unable to fill a controlled substance prescription that is not on a compliant form, except for limited emergency situations.