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First Application for Waiver from California Title 22 Operative Restrictions Pending Approval

Cardiac Surgical PA's who have been practicing in California may finally have a solution to the outdated California Title 22 Restriction on surgical first assisting while on cardio-pulmonary bypass! The APACVS and AAPA have been working for a decade on developing a solution for this barrier to care. After a recent discussion with the Department Head for Healthcare Regulations, the California Department of Health has admitted that the Title 22 Restriction is outdated and needs to be replaced. Pending a re-writing of the Title 22 Regulation, which is estimated to take approximately 10 years, Hospital Centers who wish to use PA's as surgical first assistants will be allowed to obtain a waiver from this portion of the regulation. Per the California Department of Health, each hospital center will be required to discuss the specific reasons for the waiver request. As a test case, the first application was recently submitted to Los Angeles County, as this is the largest County in the State of California. It has just been re-submitted and the State of California has 60 days to approve or reject the application.
Another promising meeting will be occurring between the California Department of Health and representatives of the APACVS and AAPA on Thursday, November 3, 2016 in Sacramento, California.

The purpose of this meeting is to assist the California Department of Health to rewrite the outdated regulations to allow the Cardiac Surgeon, and not the State of California, to choose the proper surgical assist(s) based on the complexity of the procedure. This regulatory change would be a long term solution and would place California in line with the 49 other states and District of Columbia.

Once the initial application is approved, and a standardized process is developed, the APACVS will place the resultant process on our website and happily assist all Hospital Centers/PA's who wish to apply.

As Legislative/Regulatory and Professional Advocacy is a benefit of APACVS membership, please feel free to contact the National Office or a current member of the Board of Directors if there are issues in your State of Residence that need a resolution.



Steven Gottesfeld, PA-C, APACVS Vice President



Steven Gottesfeld, PA-C
APACVS President

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