Floor Vote Next for Nurse Practitioner Bill

A bill that would allow nurse practitioners in California to practice without physician supervision under certain circumstances passed the Senate Committee on Appropriations in a 5-0 vote on Monday and now heads to the Senate floor.

SB 323, by Sen. Ed Hernandez (D-West Covina), would allow nurse practitioners to practice without the supervision of a physician if certified by an authority such as a hospital, medical group, accountable care organization or clinic. Under the bill, nurse practitioners could 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 the 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.

“We can no longer afford to get by on the fraction of our capacity,” Hernandez said at the appropriations committee hearing.

Nurse practitioners are registered nurses with additional training and education who often specialize in a specific area such as pediatrics or women’s health. They are required to hold a master’s degree in nursing. As of 2013, there were 18,541 active nurse practitioners in the state, according to the state Board of Nursing.

The California Hospital Association supports the bill, saying that it could save on costly emergency department visits by improving access to preventative care.

The California Medical Association opposes the bill. CMA officials said they are working on proposed amendments.

Several other scope of practice bills are pending in the state Legislature. SB 622, also by Hernandez, would authorize optometrists to use nonsurgical technology and diagnostic pharmaceutical agents and also administer vaccines to children over age three. That bill, also opposed by the CMA, is on the Senate floor.

“Medical doctors perform hundreds more procedures and have tens of thousands more hours of training than what would be required of optometrists under this bill,” said Luther Cobb, president of the CMA, in a statement.

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