BILL ANALYSIS Ó AB 2348 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 2348 (Mitchell) As Amended August 20, 2012 Majority vote ----------------------------------------------------------------- |ASSEMBLY: |44-28|(May 31, 2012) |SENATE: |23-15|(August 22, | | | | | | |2012) | ----------------------------------------------------------------- Original Committee Reference: B.,P. & C.P. SUMMARY : Allows registered nurses (RNs) to dispense and administer hormonal contraceptives under a standardized procedure, as specified, and allows RNs to dispense drugs and devices upon an order by a certified nurse-midwife (CNM), a nurse practitioner (NP), or a physician assistant (PA) while functioning within specified clinic settings. The Senate amendments : 1)Expand the types of clinics in which an RN may dispense drugs or devices upon an order by a physician and surgeon, a CNM, an NP, or a PA to include intermittent clinics and student health centers operated by public higher education institutions. 2)Delete language limiting the settings in which RNs may dispense hormonal contraceptives, thereby allowing RNs to dispense hormonal contraceptives in any setting. 3)Expand the components that must be included in the standardized procedure under which RNs may dispense hormonal contraceptives to include: a) Successful completion of training and competency assessment, on which the selection of RNs who may dispense or administer hormonal contraceptives will be based; b) 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 (USMEC); AB 2348 Page 2 c) Demonstration of competency in providing the appropriate prior examination comprised of checking blood pressure, weight, and patient and family health history, including medications taken by the patient; d) Criteria and procedure for identification, documentation, and referral of patients with contraindications for hormonal contraceptives and patients in need of a follow-up visit to a physician and surgeon, NP, CNM, or PA; e) Adherence to current law, which makes it unprofessional conduct to prescribe, dispense or furnish dangerous drugs without an appropriate examination and a medical indication, in a manner developed through collaboration with health care providers, including physicians and surgeons, CNMs, NPs, PAs, and RNs. 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 USMEC; and, f) If a patient has been seen exclusively by an RN for three consecutive years, the patient shall be evaluated by a physician and surgeon, NP, CNM, or PA prior to continuing the dispensation or administration of hormonal contraceptives. 4)State that nothing in this bill 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 California Pharmacy Law. AS PASSED BY THE ASSEMBLY , this bill allowed RNs to dispense drugs and devices upon an order by a CNM, an NP, or a PA while functioning within specified clinic settings, and allowed RNs to dispense and administer hormonal contraceptives under a standardized procedure while functioning within specified clinic settings. FISCAL EFFECT : Unknown. This bill is keyed non-fiscal by the Legislative Counsel. COMMENTS : This bill was amended in the Senate, and is AB 2348 Page 3 consistent with Assembly Actions. Analysis Prepared by : Angela Mapp / B.,P. & C.P. / (916) 319-3301 FN: 0005325