Advocacy Spotlights
CAPA’s Fight for SB 697
A Reflection by Jeremy Adler, DMSc, PA-C, DFAAPA
CAPA entered the 2019 legislative session with an ambitious goal: to fully implement AAPA’s Optimal Team Practice (OTP) policy in California. Senator Anna Caballero recognized that removing barriers to PA practice would directly improve healthcare access in her district, and SB 697 was born from that vision. Although the core provision to remove the legal requirement of physician supervision was eventually amended out to save the bill from defeat, the resulting advancements for the profession were still monumental.
The journey was a legislative rollercoaster. SB 697 was the most complex and contentious bill CAPA had ever supported, even drawing unprecedented opposition testimony from the PA Board during committee hearings. Adding to the volatility, CAPA underwent a change in lobbyists mid-cycle. Despite these hurdles, the bill ultimately passed without a single “no” vote in committee or on the floor of either house. I cannot imagine a time when CAPA has worked harder, yet made the effort appear so seamless.
Prior to this legislation, PAs obtained their legal authority to practice medicine as an agent for, and directly from, their supervising physician. SB 697 established a true PA scope of practice and uncoupled the services PAs provide from a physician's specific authority, linking them instead to the PAs own education, experience, training, and competence. A host of other advancements were included, such as elimination of chart co-signatures, elimination of medical record review meetings, elimination of rigid protocols/formularies, elimination of the former requirements of the supervision physician's name appearing on the PA prescription, and many others. Additionally, the bill removed the requirement for the physical presence of a supervising physician, instead empowering clinical teams to determine how best to practice together in their unique settings.
As a spokesperson for this bill, it became apparent that much of what PAs do every day is poorly understood. While we know that we improve health, empower teams, and increase access, much of the legislature still perceived us as merely “assisting” physicians. SB 697 became a vehicle to showcase the vital work PAs do across our state and why modernizing our practice act improves both the quality of and access to care.
An off-the-cuff remark from a key legislator during SB697 has stuck with me, saying that California’s PAs would likely need to drop “assistant” from their title to truly achieve OTP. While SB 697 realized many of our profession’s goals, it is not the end. It has positioned us perfectly for future efforts to remove of state-mandated physician supervision and complete our transition to the title of Physician Associate.
Explore previously featured CAPA leaders and their contributions to the profession.
View Advocacy Spotlight Archive →