California Senate passes bill to let nurse practitioners practice on their own

(Business Journal) Legislation to allow licensed nurse practitioners and optometrists expand their practices and provide more primary care sailed out of the State Senate Tuesday on bipartisan votes.

A third scope-of-practice bill to expand what pharmacists can do faced a final vote in the Senate Wednesday.

One of the most controversial bill packages of the year, the legislation seeks to use the existing workforce of medical professionals to bridge a shortage of physicians in many parts of the state at a time when a huge influx of new patients is expected.

“I am grateful that senators from both parties and from rural as well as urban districts understand the need to provide high quality, affordable health care from nurse practitioners with millions of more patients expected to be seeking primary medical care with the advent of Obamacare,” Sen. Ed Hernandez, a Democrat from Los Angeles, said in a news release following Senate approval for Senate Bill 491. The legislation seeks to let nurse practitioners to have stand-alone practices, as they do in 17 other states. It passed by a vote of 22-12.

Senate Bill 492, which permits optometrists to diagnose and treat additional conditions, give vaccinations and do surgical and nonsurgical primary care procedures, also won Senate approval Tuesday. The vote was 25-5.

A third piece of legislation, Senate Bill 493, would allow pharmacists to perform specified procedures, order and interpret tests for purposes of managing drug therapies, and perform other tasks. It was pending final approval by the Senate Wednesday afternoon.

A fourth scope-of-practice bill, Senate Bill 352 by Sen. Fran Pavley, a Democrat from Agoura Hills, would let medical assistants to perform tasks under supervision of physician assistants, nurse practitioners or other certified professionals without a doctor on the premises. The bill is waiting its first committee hearing in the Assembly; it was approved by the Senate, 36-2, on April 22.

Other bills in the works expand with physical therapists can do.

“These bills are not the answers to the physician shortage problem,” said Molly Weedn, a spokeswoman for the California Medical Association. “CMA supports utilizing all allied health professionals to the extent of their training, and to that end, we should be exploring ways to develop more team-based models led by a physician.”

Expanding scope of practice outside what professionals are trained to do would not only jeopardize patient safety, it would further fragment the health care delivery system,” Weedn added.

There are training requirements in some of the bills.