BILL ANALYSIS Ó
AB 2348
Page 1
ASSEMBLY THIRD READING
AB 2348 (Mitchell)
As Amended May 29, 2012
Majority vote
BUSINESS & PROFESSIONS 6-3
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|Ayes:|Hayashi, Allen, Butler, | | |
| |Eng, Hill, Ma | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Bill Berryhill, Hagman, | | |
| |Smyth | | |
| | | | |
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SUMMARY : Allows registered nurses (RNs) to dispense and
administer hormonal contraceptives in primary care clinics.
Specifically, this bill :
1)Allows RNs to dispense drugs or devices upon an order issued
pursuant to existing law, as specified, by a certified
nurse-midwife (CNM), nurse practitioner (NP), or physician
assistant (PA) if the RN is functioning within a licensed
primary care clinic, as specified.
2)Allows RNs to dispense self-administered hormonal
contraceptives approved by the federal Food and Drug
Administration (FDA) and to administer injections of hormonal
contraceptives approved by the FDA in strict adherence to
standardized procedures developed in compliance with existing
law if the RN is functioning within a licensed primary care
clinic, as specified. The standardized procedure shall
specify all of the following:
a) Which nurse may dispense or administer the hormonal
contraceptives;
b) 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;
c) The extent of physician and surgeon supervision
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required;
d) The method of periodic review of the RN's competence;
and,
e) 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.
EXISTING LAW :
1)Regulates and licenses physicians and surgeons and PAs via the
Medical Board of California (MBC).
2)Regulates and licenses RNs, including advanced practice nurses
in the categories of CNM or NP, via the Board of Registered
Nursing (BRN).
3)Allows RNs to dispense drugs or other devices upon an order by
a physician and surgeon if the RN is functioning within a
licensed clinic, as specified.
4)Defines "standardized procedures," as it pertains to RN's
scope of practice, to mean policies and protocols developed by
an organized health care system or a health facility licensed
by Department of Public Health (DPH), as specified, through
collaboration among administrators and health professionals,
including physicians and nurses. These policies and protocols
shall be subject to any guidelines for standardized procedures
that the Division of Licensing of the MBC and the BRN may
jointly promulgate. If promulgated, the guidelines shall be
administered by the BRN.
FISCAL EFFECT : Unknown. This bill is keyed non-fiscal by the
Legislative Counsel.
COMMENTS : According to the author, "Across California, many
women lack access to birth control, leaving them at significant
risk of unintended pregnancy. In some parts of the state,
patients of community health clinics cannot access hormonal
contraceptives because of the limited supply of prescribers and
others who are legally authorized to order or furnish these
medications. Lack of enough appropriate staff can result in
health centers closing or reducing hours, compounding many
communities' unmet family planning needs. For a woman in need
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of birth control these types of shortages can mean waiting long
periods of time to schedule a health center appointment, sitting
in a waiting room for hours before being seen, or driving long
distances to see a provider. All of these barriers place her at
greater risk of unintended pregnancy."
The BRN regulates California RNs. There are more than 300,000
RNs in California providing health care services in a variety of
settings. RNs use a number of titles in their practice,
including certified nurse anesthetist, CNM, clinical nurse
specialist, critical care nurse, NP, and public health nurse.
Existing law allows RNs working in primary care clinics to
dispense drugs or other devices only upon an order by a
physician and surgeon. This bill expands the number of
practitioners under whose orders an RN may dispense medications
to include CNMs, NPs, and PAs.
This bill also allows RNs to dispense hormonal contraceptives
pursuant to standardized procedures as that term is defined in
existing law governing RN's scope of practice.
Analysis Prepared by : Angela Mapp / B.,P. & C.P. / (916)
319-3301
FN: 0003989