BILL NUMBER: SB 294	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JULY 1, 2009
	AMENDED IN ASSEMBLY  JUNE 8, 2009
	AMENDED IN SENATE  MARCH 31, 2009

INTRODUCED BY   Senator Negrete McLeod

                        FEBRUARY 25, 2009

   An act to add Section 2835.7 to the Business and Professions Code,
relating to nurse practitioners.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 294, as amended, Negrete McLeod. Nurse practitioners.
   Existing law, the Nursing Practice Act, provides for the
certification and regulation of nurse practitioners and
nurse-midwives by the Board of Registered Nursing and specifies
requirements for qualification or certification as a nurse
practitioner. Under the act, the practice of nursing is defined, in
part, as providing direct and indirect patient care services, as
specified, including the dispensing of drugs or devices under
specified circumstances. The practice of nursing is also described as
the implementation, based on observed abnormalities, of standardized
procedures, defined as policies and protocols developed by specified
facilities in collaboration with administrators and health
professionals, including physicians and surgeons and nurses.
   This bill would authorize the implementation of standardized
procedures that would expand the duties of a nurse practitioner in
the scope of his or her practice, as enumerated. The bill would make
specified findings and declarations in that regard.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) Nurse practitioners are registered nurses who have a graduate
education and clinical training, and who provide a wide range of
services and care.
   (b) Under current law, nurse practitioners have the same statutory
authority to provide services and care as do registered nurses.
However, the law allows those registered nurses who the Board of
Registered Nursing has determined meet the standards for a nurse
practitioner to provide care and services beyond those specified in
statute for registered nurses where those services are performed
pursuant to standardized procedures and protocols developed through
collaboration among administrators and health professionals,
including physicians and surgeons, in the organized health care
system in which a nurse practitioner practices.
   (c) The Legislature reiterates its intention to allow each
organized health care system in which a nurse practitioner practices
to define those services nurse practitioners may perform in
standardized procedures developed pursuant to Section 2725 of the
Business and Professions Code.
   (d) Notwithstanding the foregoing, the Legislature finds that
there may be some ambiguity in current law regarding what services
and functions to be performed by nurse practitioners may be included
in standardized procedures and protocols.
   (e) Therefore, to remove this ambiguity, the Legislature hereby
clarifies that standardized procedures and protocols may include the
specified services and functions set forth in this act so that health
care entities may allow nurse practitioners to engage in those
activities if the entities choose to do so, and that third-party
payors understand that those services and functions can be performed
by nurse practitioners if they are included in an entity's
standardized procedures and protocols.
  SEC. 2.  Section 2835.7 is added to the Business and Professions
Code, to read:
   2835.7.  (a)  Notwithstanding any other provision of law,
in   In  addition to any other practices that meet
the general criteria set forth in statute or regulation for inclusion
in standardized procedures developed through collaboration among
administrators and health professionals, including physicians and
surgeons and nurses, pursuant to Section 2725, standardized
procedures may be implemented that authorize a nurse practitioner to
do any of the following:
   (1) Order durable medical equipment, subject to any limitations
set forth in the standardized procedures. Notwithstanding that
authority, nothing in this paragraph shall operate to limit the
ability of a third-party payor to require prior approval.
   (2) After performance of a physical examination by the nurse
practitioner and collaboration with a physician and surgeon, certify
disability pursuant to Section 2708 of the Unemployment Insurance
Code.
   (3) For individuals receiving home health services or personal
care services, after consultation with the treating physician and
surgeon, approve, sign, modify, or add to a plan of treatment or plan
of care.
   (b)  Nothing in this section shall be construed to affect the
validity of any standardized procedures in effect prior to the
enactment of this section or those adopted subsequent to enactment.