AB 2120 Liu [OPPOSE] Expand Certifiers for Handicapped Placards

AB 2120, as introduced, Liu Vehicles: disabled persons: disabled
veterans: parking placards.
Existing law authorizes the Department of Motor Vehicles to issue
distinguishing placards to disabled persons or disabled veterans, to
be used for parking purposes, as described. Prior to issuing the
parking placard, the Department of Motor Vehicles requires the
submission of a certificate, signed by an authorized health care
professional, providing a full description substantiating the
applicant's disability, unless the disability is readily observable
and uncontested. Under existing law, the authorized health care
professional that signs the certificate is required to retain
information sufficient to substantiate the certificate, and make the
information available to certain entities, upon request of the
department.
This bill would expand the health care professionals authorized to
sign the certificate substantiating the applicant's disability to
include nurse practitioners, certified nurse midwives, and physician
assistants.

MINORITY OPINION to SUPPORT
I proffer my support for this bill.

One issue to be considered carefully is how Health
Mangling (read Managment) Organizations have relied
more and more heavily on the allied health care
professional to provide comprehensive medical care.
D.O. (Osteopathic Doctor i.e. Chiropractor and the
like), C.N.M. (Certified Nurse Midwife), C.N.P
(Certified Nurse Practioner), and P.A. (Physicians
Assistant) personnel have undergone extensive academic
and clinical training and are assuming more and more
of a primary care role within the "modern" health care
delivery model.

My husband received his care from a P.A. who is now in
charge of the urgent care department of a
multi-specialty, multi-location medical group and I
have received gynecologic care from a C.N.P. There
are legitimate medical conditions that women are
diagnosed with everyday that can fall into the
category of an impairment, temporary more likely than
permanent that a C.N.P or C.N.M. will diagnose and
treat as well as refer to other appropriate
specialties if necessary. A P.A. is qualified and
licensed to provide medical care including surgery.
Medicare, Medi-Cal and all of the private HMO's are
requiring assignment to allied health care
professionals all in the name of cost cutting. That
is not to say that any medical care provider is better
than another, more approachable, more appropriate than
another, more competent than another but if a person
requires a placard application completed and they do
not see an M.D, how are they supposed to accomplish
this?

I envision the need to make a consultation appointment
with an M.D whose office cannot set an appointment for
3 months and it will take up to 1 month just to get
their medical documentation to that M.D. who will then
need another 2 weeks to read through it and make a
determination of necessity when their regular
practioner who knows them and their medical
condition(s) like a book can do this in one visit.

Although I fully recognize and totally agree that the
medical determinations of pediatricians are suspect
for authorizing a placard for a 21 year old person who
was their patient until their 18th birthday just
because they whined a little to get a placard to avoid
paying exorbatant parking fees at college is but one
example of a system that has been demonstrated to be
corrupt and has demonstrated real and serious cases of
abuse.

But we must remember the changing face of medical
health care delivery systems and that the D.O, P.A,
C.N.M, and other allied health care professionals have
assumed a front and center role. This bill expands
their ability to provide their patient with disAbility
the public services they require by being allowed to
complete and authorize a parking placard. Following
the UCLA scandal, there were additional enforceable
provisions
of protection against the rempant abuses we saw. I do
not believe this bill, in any way, tampers with
existing law.

Ruthee Goldkorn