BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
SB 491 (Hernandez) - Nurse practitioners.
Amended: May 1, 2013 Policy Vote: B&P 6-1
Urgency: No Mandate: No
Hearing Date: May 13, 2013 Consultant: Brendan McCarthy
This bill does not meet the criteria for referral to the
Suspense File.
Bill Summary: SB 491 would expand the scope of practice for
nurse practitioners, by deleting the requirement that nurse
practitioners provide certain services only under the
supervision of a physician or surgeon.
Fiscal Impact:
One-time costs, likely about $75,000 to update existing
regulations (Board of Registered Nursing Fund).
Likely minor ongoing costs for enforcement (Board of
Registered Nursing Fund). The Board of Registered Nursing
indicates that there may be increased need for enforcement
activity under the bill, but that those costs are not
anticipated to be significant.
Background: Under current law, nurse practitioners are licensed
and regulated by the Board of Registered Nursing. Under current
law, nurse practitioners must meet certain educational
requirements.
Current law authorizes nurse practitioners to provide certain
services in consultation with a physician or surgeon or pursuant
to standardized procedures created by a physician or surgeon.
Proposed Law: SB 491 would expand the scope of practice for
nurse practitioners, by deleting the requirement that nurse
practitioners provide certain services only under the
supervision of a physician or surgeon.
Specifically, the bill would expand the scope of practice of a
nurse practitioner by authorizing a nurse practitioner to
provide the following services independently:
SB 491 (Hernandez)
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Order durable medical equipment;
Certify disability claims;
Make changes to a plan of treatment for certain home health
patients;
Assess patients, synthesize data, and apply the principals
of health care;
Mange patients' health status;
Analyze data to identify the nature of a health problem and
implement appropriate treatment;
Examine a patient and establish a medical diagnosis;
Order prescription drugs;
Refer patients to other health care providers;
Delegate duties to medical assistants;
Order hospice care;
Maintain malpractice insurance.
After July 1, 2016, the bill requires nurse practitioners to
hold certification from a national certifying body recognized by
the Board of Registered Nursing.
Related Legislation:
SB 352 (Pavley) authorizes certain medical professionals to
supervise medical assistants. That bill is in the Assembly.
SB 492 (Hernandez) would authorize an optometrist to
diagnose and treat certain medical conditions. That bill
will be heard in this committee.
SB 493 (Hernandez) would authorize pharmacists to order and
interpret tests and order medications. That bill will be
heard in this committee.
Proposed Author Amendments: Would delete delete the authority
for nurse practitioners to diagnose patients and perform
procedures, and make other technical changes.