BILL ANALYSIS                                                                                                                                                                                                    Ó



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          CONCURRENCE IN SENATE AMENDMENTS


          AB  
          757 (Gomez)


          As Amended  June 22, 2015


          Majority vote


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          |ASSEMBLY:  | 74-0 | (May 22,      |SENATE: |39-0  | (August 24,     |
          |           |      |2015)          |        |      |2015)            |
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          Original Committee Reference:  B. & P.


          SUMMARY:  Authorizes a person, who meets specified criteria, to  
          perform a total protein refractometer test using an automatic,  
          button-operated refractometer with a digital readout in a  
          licensed plasma collection facility in this state.   
          Specifically, this bill:


          1)Authorizes a person whose qualifications are at least the  
            equivalent of those specified in Code of Federal Regulations  
            Title 42, Section 493.1423(b)(4) to perform a total protein  
            refractometer test using an automatic, button-operated  
            refractometer with a digital readout in a licensed plasma  
            collection facility in this state if all of the following  
            conditions are met:
             a)   The person has earned a high school diploma or  
               equivalent, as determined by the Centers for Medicare and  
               Medicaid Services (CMS) pursuant to the federal Clinical  
               Laboratory Improvement Amendments of 1998 (CLIA) (42 United  








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               States Code Section 263a);
             b)   The person performs the total protein refractometer test  
               using an automatic, button-operated refractometer with a  
               digital readout in a licensed plasma collection facility;


             c)   The person's training in the proper procedure to be  
               employed when performing a total protein refractometer test  
               using an automatic, button-operated refractometer with a  
               digital readout has been certified by a physician and  
               surgeon licensed in this state or by a licensed clinical  
               laboratory director who is in charge of the licensed plasma  
               collection facility, or their certified, trained designate.  
                The instructor must document, and the plasma collection  
               facility must maintain the documentation of, the  
               individual's successful completion of training in the  
               performance of the total protein refractometer test using  
               an automatic, button-operated refractometer with a digital  
               readout;


             d)   The person performs the total protein refractometer test  
               using an automatic, button-operated refractometer with a  
               digital readout under the direction and supervision of the  
               physician and surgeon or licensed clinical laboratory  
               director; and,


             e)   The person submits the test results for interpretation  
               to the physician and surgeon or licensed clinical  
               laboratory director under whose direction and supervision  
               he or she performed the test using an automatic,  
               button-operated refractometer with a digital readout.


          2)States that no reimbursement is required pursuant to  
            California Constitution Article XIII B, Section 6, as  
            specified. 
          The Senate amendments increase the required qualifications to  
          perform the test (a moderate complexity test) from a medical  
          assistant to a person qualified to perform the test under  
          federal law. 








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          FISCAL EFFECT:  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.  



          COMMENTS:  


          Purpose.  This bill is sponsored by Grifols, Inc.  According to  
          the author, "Plasma donation centers are critical to ensuring  
          the availability of therapies that treat rate, chronic, and  
          sometimes life-threatening diseases.  AB 757 would authorize a  
          medical assistant who meets specified criteria to perform a  
          total protein refractometer test analysis - a standard, mostly  
          automated procedure performed during donor intake and assessment  
          to determine donor eligibility - in state licensed plasma  
          collection facility in California.  This will help promote  
          efficiencies, where appropriate, in the biomedical industry  
          while continuing to prioritize patient health and safety."


          Background.  In California, only licensed or certified  
            individuals may perform moderate complexity tests.  This bill  
            would create an exception to the requirement under state law  
            for a total protein refractometer test, which is a moderate  
            complexity test.  However, it will still require the person to  
            meet the qualifications required under federal law to perform  
            a moderate complexity test, including having earned a high  
            school diploma or equivalent and having documentation of  
            training appropriate for the testing performed prior to  
            analyzing patient specimens.  The training must ensure that  
            the individual has:


          1)The skills required for proper specimen collection, including  
            patient preparation, if applicable, labeling, handling,  
            preservation or fixation, processing or preparation,  
            transportation and storage of specimens;










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          2)The skills required for implementing all standard laboratory  
            procedures;


          3)The skills required for performing each test method and for  
            proper instrument use;


          4)The skills required for performing preventive maintenance,  
            troubleshooting and calibration procedures related to each  
            test performed; 


          5)A working knowledge of reagent stability and storage;


          6)The skills required to implement the quality control policies  
            and procedures of the laboratory;


          7)An awareness of the factors that influence test results; and,


          8)The skills required to assess and verify the validity of  
            patient test results through the evaluation of quality control  
            sample values prior to reporting patient test results.


          Total Protein Refractometer Test.  The measurement of total  
            protein uses an instrument called a refractometer.  A  
            refractometer is a device that shines a beam of light through  
            a sample of liquid.  The device measures the amount of light  
            that is refracted (bent) due to the solids in the sample.  In  
            blood, protein causes light to bend.  The greater the amount  
            of protein, the more light is bent from the light path.   
            According to the sponsors, Grifols measures a potential plasma  
            donor's total protein levels as part of the initial screening  
            process.  


          Analysis Prepared by:                                             
          Vincent Chee / B. & P. / (916) 319-3301  FN: 0001303








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