On Tuesday, the Assembly Committee on Business and Professions rejected a bill (SB 323) that aimed to allow nurse practitioners to treat patients without the supervision of a physician if certified by an authority such as a hospital, medical group, accountable care organization or clinic, the Sacramento Bee's "Capitol Alert" reports (Walters, "Capitol Alert," Sacramento Bee, 6/30).
Background on Bill
Under the bill, by Sen. Ed Hernandez (D-West Covina), nurse practitioners would have been able to manage the health of patients, conduct assessments and order and prescribe medications, lab tests and medical devices.
The bill would require a nurse practitioner to refer a patient to a physician if a situation presents itself that is beyond their scope of practice.
So-called scope-of-practice legislation aims to improve patient access to health services at a time of nationwide physician shortages. By 2025, there will be a nationwide shortage of between 45,000 and 90,000 primary and specialty care physicians, according to information from the Association of American Medical Colleges (Vesely, California Healthline, 5/5).
Details of Rejection
The rejection came after Hernandez refused to add an amendment to the bill that would have banned nurse practitioners from corporate employment in the same way as physicians.
Several groups that backed SB 323 said they would pull their support if the amendment was added ("Capitol Alert," Sacramento Bee, 6/30).
In a statement, Luther Cobb -- president of the California Medical Association, which opposed the bill -- said, "SB 323 would have done nothing to address access to care, and absent a bar on the corporate practice of medicine, adequate physician and medical board oversight, and the extensive training necessary, this legislation would have only put Californians at risk."
However, Donna Emanuele -- president of the California Nurses Association, which backed the bill -- said the measure would have "allowed California's nurse practitioners to do what they are already doing every day -- providing vital health care services often without a physician in the room or even in the building."
Following the vote, Hernandez said, "I am baffled by the opponents' argument that this bill will somehow put patient safety at risk without producing a shred of evidence to support their position." He also noted that the Institute of Medicine "has clearly shown that patient outcomes with NPs are as good or better than with physicians."
Hernandez's staff said he plans to reintroduce the legislation next year (Aguilera, "KPCC News," KPCC, 6/30).