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 Page 2 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