BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
SB 323 (Hernandez) - Nurse practitioners: scope of practice
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|Version: April 22, 2015 |Policy Vote: B., P. & E.D. 7 - |
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|Urgency: No |Mandate: Yes |
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|Hearing Date: May 4, 2015 |Consultant: Brendan McCarthy |
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This bill does not meet the criteria for referral to the
Suspense File.
Bill
Summary: SB 323 would authorize a nurse practitioner who holds
a national certification to practice without physician
supervision in specified settings.
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
SB 323 (Hernandez) Page 1 of
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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 under supervision of a physician or surgeon or pursuant
to standardized procedures created by a physician or surgeon.
Current law allows nurse practitioners who are under the
supervision of a physician to prescribe Schedule II - V drugs. A
physician may supervise up to four prescribing nurse
practitioners or an unlimited number of non-prescribing nurse
practitioners.
Proposed Law:
SB 323 would authorize a nurse practitioner who holds a
national certification to practice without physician supervision
in specified settings.
The bill would allow a nurse practitioner who has been certified
by a national certification agency recognized by the Board of
Registered Nursing to practice independent of physician
supervision in specified settings, including clinics, health
facilities, accountable care organizations, group practices, and
medical groups. The bill would require a certified nurse
practitioner who is practicing independently under the bill to
maintain malpractice insurance.
When practicing in the specified settings, the bill would
authorize a certified nurse practitioner to:
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;
SB 323 (Hernandez) Page 2 of
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Delegate duties to medical assistants;
Order hospice care;
Related
Legislation: SB 491 (Hernandez, 2013) would have authorized a
nurse practitioner to practice independently after a period of
physician supervision. That bill was held on the Assembly
Appropriations Committee's Suspense File.
Staff
Comments: The only costs that may be incurred by a local agency
relate to crimes and infractions. Under the California
Constitution, such costs are not reimbursable by the state.
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