BILL ANALYSIS
SB 294
Page 1
Date of Hearing: July 15, 2009
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Kevin De Leon, Chair
SB 294 (Negrete McLeod) - As Amended: July 1, 2009
Policy Committee: Business &
Professions Vote: 10-0
Urgency: No State Mandated Local Program:
No Reimbursable:
SUMMARY
This bill clarifies standardized procedures and protocols
governing nurse practitioner (NP) scope of practice by adding
procedures to the Nursing Practice Act. Specifically, this bill
authorizes NP to:
1)Order durable medical equipment.
2)Certify disability for unemployment insurance eligibility
purposes.
3)Sign, modify, or add to a plan of treatment or plan of care
for home health or personal care services after consultation
with a treating physician or surgeon.
FISCAL EFFECT
Absorbable workload to the Board of Registered Nursing (BRN) to
continue oversight of the NP scope of practice.
COMMENTS
1)Rationale . This bill is sponsored by the California
Association of Nurse Practitioners to reduce ambiguity about
what services may be authorized and provided by NP under
current law standardized procedures. NP are required to work
in collaboration with a supervising physician and follow
standardized written procedures. Within the parameters set by
these procedures they may order tests, diagnose patients, or
order medication. California limits the number of NP an
individual physician may supervise to four if the NP are
SB 294
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furnishing medications. The clarifications made in this bill
will ensure payment for these specific activities will be
reimbursed by third party payers.
2)Background . The Nursing Practice Act licenses and regulates
nurse practitioners under the jurisdiction of BRN. The NP
scope of practice was created 50 years ago to address an
increasing physician shortage nationally. NP provide primary
care in many patient care settings. There are 145,000 NP
nationally and 14,300 practicing in California. Under current
law, a registered nurse who wants to be licensed as a NP must
submit education, work experience, and other credentials to
the BRN to receive the NP certification. Nurse practitioners
are registered nurses with additional graduate training with
at least a Master's in Nursing.
3)Related Legislation . AB 1436 (Hernandez) in 2008 and SB 809
(Ashburn) in 2007 defined the NP scope of practice. Neither
bill passed policy committees in their respective houses of
origin.
Analysis Prepared by : Mary Ader / APPR. / (916) 319-2081