Board authorizes renewal rulemaking and debates medical-record and POLST bill language

At its May 18 meeting the California Physician Assistant Board approved beginning formal rulemaking to put the board’s renewal processes into regulation and discussed several bills that could affect PA practice.

Regulations counsel Christie Shields presented a proposal to capture online and paper renewal processes, to permit selecting inactive status at renewal, to map reinstatement steps, and to reflect that current NCCPA certification satisfies continuing-education requirements in some cases. The board adopted a motion directing staff to submit the proposed regulatory text for 16 CCR sections 1399.507, 1399.514, 1399.615 and 1399.619 to the director of the Department of Consumer Affairs and to initiate the rulemaking process; the executive officer was authorized to make non-substantive edits and complete the process if no adverse comments are received.

The board also heard a Medical Board report and discussed AB 1637, which originally would have limited who can alter medical records to physicians; presenters noted the measure was amended to permit authorized individuals (scribes, medical assistants or others delegated by the authorizing physician) to make addenda and that nuances remain about when a physician must countersign. Board members asked staff to place AB 1637 on a future agenda for deeper consideration of interactions with PA practice changes effected by SB 697.

On POLST language (AB 2140), members debated whether the draft text as written makes nurse practitioners and physician assistants subject to physician supervision when signing portable orders, or whether the phrasing is ambiguous. The board adopted a watch position and directed the executive officer to send a letter to the bill’s author asking for clarification; the motion also requested the letter emphasize whether nurse practitioners practicing under standardized procedures and PAs are intended to be included or excluded from the supervision language.

Why it matters: Initiating the renewal rulemaking will change how applicants interact with the board (including online convenience fees and the ability to choose inactive status during renewal). The legislative discussions could alter scope-of-practice, charting, and signature/countersignature rules that affect day-to-day PA practice.

What’s next: Staff will submit the rulemaking package to the DCA director and proceed through the 45-day comment period; the board will follow up with legal and legislative staff on AB 1637 and will send the requested clarification letter on AB 2140.