BILL NUMBER: AB 2348	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 7, 2012
	AMENDED IN SENATE  JUNE 27, 2012
	AMENDED IN SENATE  JUNE 20, 2012
	AMENDED IN ASSEMBLY  MAY 29, 2012
	AMENDED IN ASSEMBLY  MARCH 29, 2012

INTRODUCED BY   Assembly Member Mitchell
   (Principal coauthors: Assembly Members Atkins, Butler, and
Chesbro)
   (Coauthor: Assembly Member Ma)
   (Coauthor: Senator De León)

                        FEBRUARY 24, 2012

   An act to amend Section 2725.1 of, and to add Section 2725.2 to,
the Business and Professions Code, relating to healing arts.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2348, as amended, Mitchell. Registered nurses: dispensation of
drugs.
   Existing law, the Nursing Practice Act, authorizes a registered
nurse to dispense drugs or devices upon an order by a licensed
physician and surgeon if the nurse is functioning within a specified
clinic.
   This bill would, in addition, authorize a registered nurse to
dispense specified drugs or devices upon an order issued by a
certified nurse-midwife, nurse practitioner, or physician assistant
if the nurse is functioning within a specified clinic. The bill would
also authorize a registered nurse to dispense or administer hormonal
contraceptives in strict adherence to specified standardized
procedures.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


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

  SECTION 1.  Section 2725.1 of the Business and Professions Code is
amended to read:
   2725.1.  (a) Notwithstanding any other provision of law, a
registered nurse may dispense drugs or devices upon an order by a
licensed physician and surgeon or an order by a certified
nurse-midwife, nurse practitioner, or physician assistant issued
pursuant to Section 2746.51, 2836.1, or 3502.1, respectively, if the
registered nurse is functioning within a licensed primary care clinic
as defined in subdivision (a) of Section 1204 of, or within a clinic
as defined in subdivision (b), (c), (h), or (j) of Section 1206 of,
the Health and Safety Code.
   (b) No clinic shall employ a registered nurse to perform
dispensing duties exclusively. No registered nurse shall dispense
drugs in a pharmacy, keep a pharmacy, open shop, or drugstore for the
retailing of drugs or poisons. No registered nurse shall compound
drugs. Dispensing of drugs by a registered nurse, except a certified
nurse-midwife who functions pursuant to a standardized procedure or
protocol described in Section 2746.51 or a nurse practitioner who
functions pursuant to a standardized procedure described in Section
2836.1, or protocol, shall not include substances included in the
California Uniform Controlled Substances Act (Division 10 (commencing
with Section 11000) of the Health and Safety Code). Nothing in this
section shall exempt a clinic from the provisions of Article 13
(commencing with Section 4180) of Chapter 9.
   (c) Nothing in this section shall be construed to limit any other
authority granted to a certified nurse-midwife pursuant to Article
2.5 (commencing with Section 2746), to a nurse practitioner pursuant
to Article 8 (commencing with Section 2834), or to a physician
assistant pursuant to Chapter 7.7 (commencing with Section 3500).
   (d) Nothing in this section shall be construed to affect the sites
or types of health care facilities at which drugs or devices are
authorized to be dispensed pursuant to Chapter 9 (commencing with
Section 4000).
  SEC. 2.  Section 2725.2 is added to the Business and Professions
Code, to read:
   2725.2.  (a) Notwithstanding any other provision of law, a
registered nurse may dispense self-administered hormonal
contraceptives approved by the federal Food and Drug Administration
(FDA) and may administer injections of hormonal contraceptives
approved by the FDA in strict adherence to standardized procedures
developed in compliance with subdivision (c) of Section 2725.
   (b) The standardized procedure described in subdivision (a) shall
include all of the following:
   (1) Which nurse, based on successful completion of training and
competency assessment, may dispense or administer the hormonal
contraceptives.
   (2) Minimum training requirements regarding educating patients on
medical standards for ongoing women's preventive health,
contraception options education and counseling, properly eliciting,
documenting, and assessing patient and family health history, and
utilization of the United States Medical Eligibility Criteria for
Contraceptive Use.
   (3) Demonstration of competency in providing the appropriate
patient examination comprised of checking blood pressure,
temperature, weight, and patient and family health history, including
medications taken by the patient.
   (4) Which hormonal contraceptives may be dispensed or administered
under specified circumstances, utilizing the most recent version of
the United States Medical Eligibility Criteria for Contraceptive Use.

   (5) Criteria and procedure for identification, documentation, and
referral of patients with contraindications for hormonal
contraceptives and patients in need of a followup visit to a
supervising physician and surgeon.
   (6) The extent of physician and surgeon supervision required.
   (7) The method of periodic review of the nurse's competence.
   (8) The method of periodic review of the standardized procedure,
including, but not limited to, the required frequency of review and
the person conducting that review. 
   (c) For purposes of this section, in compliance with subdivision
(a) of Section 2242, an "appropriate patient examination" shall be
consistent with the evidence-based practice guidelines adopted by the
federal Centers for Disease Control and Prevention in conjunction
with the United States Medical Eligibility Criteria for Contraceptive
Use.  
   (9) Adherence to subdivision (a) of Section 2242 in a manner
developed through collaboration with health care providers, including
physicians and surgeons, certified nurse-midwives, nurse
practitioners, physician assistants, and registered nurses, and the
appropriate prior examination shall be consistent with the
evidence-based practice guidelines adopted by the federal Centers for
Disease Control and Prevention in conjunction with the United States
Medical Eligibility Criteria for Contraceptive Use.  
   (d) 
    (c)  Nothing in this section shall be construed to
affect the sites or types of health care facilities at which drugs or
devices are authorized to be dispensed pursuant to Chapter 9
(commencing with Section 4000).