BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 623
                                                                  Page  1


          SENATE THIRD READING
          SB 623 (Kehoe)
          As Amended August 7, 2012
          Majority vote

           SENATE VOTE  :Vote not relevant  
           
           HEALTH              13-6        APPROPRIATIONS      12-5        
           
           ----------------------------------------------------------------- 
          |Ayes:|Monning, Ammiano, Atkins, |Ayes:|Gatto, Blumenfield,       |
          |     |Bonilla, Eng, Gordon,     |     |Bradford,                 |
          |     |Hayashi,                  |     |Charles Calderon, Campos, |
          |     |Roger Hern�ndez, Bonnie   |     |Davis, Fuentes, Hall,     |
          |     |Lowenthal, Mitchell, Pan, |     |Hill, Cedillo, Mitchell,  |
          |     |V. Manuel P�rez, Williams |     |Solorio                   |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Logue, Garrick, Mansoor,  |Nays:|Harkey, Donnelly,         |
          |     |Nestande, Silva, Smyth    |     |Nielsen, Norby, Wagner    |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires the Office of Statewide Health Planning and 
          Development (OSHPD) to extend until January 1, 2014, the Health 
          Workforce Pilot Project No. 171 (HWPP No. 171) to evaluate the 
          safety, effectiveness, and acceptability of nurse practitioners 
          (NP's), certified nurse-midwives (CNMs), and physician 
          assistants (PAs) in providing aspiration abortions.  
          Specifically,  this bill  :   

          1)Requires OSHPD to extend the HWPP No. 171 to evaluate the 
            safety, effectiveness, and acceptability of NPs, CNMs, and PAs 
            in providing aspiration abortions in order to provide the 
            sponsors an opportunity to achieve publication of the data in 
            a peer-reviewed journal, to maintain the competence of the 
            clinicians trained during the course of the project, and to 
            authorize training of additional clinicians in first-trimester 
            aspiration technique, as outlined in the project application.  


          2)Requires that the HWPP No. 171 continue to satisfy the 
            requirements of OSHPD.

          3)Requires that the provisions in this bill remain in effect 








                                                                  SB 623
                                                                  Page  2


            only until January 1, 2014, and as of that date are repealed, 
            unless a later statute enacted before January 1, 2014, deletes 
            or extends that date.

          4)Clarifies that it is the intent of the Legislature that HWPP 
            No. 171 continue without interruption.

          5)Makes the following findings and declarations including, but 
            not limited to:

             a)   The Access through Primary Care Project, also known as 
               the HWPP No. 171, was approved in 2007 to teach new skills 
               to NPs, CNMs, and PAs, and to evaluate the safety and 
               efficacy of allowing NPs, CNMs, and PAs to use these new 
               skills to perform first trimester aspiration abortions;

             b)   The study investigators from the University of 
               California (UC) find, from the data submitted to OSHPD that 
               trainees of the HWPP No. 171 have achieved competency and 
               safely perform first trimester aspiration abortions using 
               the new skills acquired through the project.  The study 
               investigators intend to undergo additional peer review of 
               the data by submitting the results for publication in a 
               nationally recognized, peer-reviewed journal; and,

             c)   It is necessary to extend the HWPP No. 171 to maintain 
               the competencies of clinicians trained to date and to 
               authorize continued training of new clinicians while the 
               larger peer review process is conducted, and because the 
               HWPP No. 171 is likely to increase the availability of 
               safe, early abortion care that is limited in many areas of 
               California.
           
          EXISTING LAW  :  

          1)Authorizes OSHPD to, among other functions, collect data and 
            disseminate information about California's health care 
            infrastructure, promote equitable distribution of health care 
            outcomes, and publish information about health care outcomes.  
            Establishes within OSHPD the HWPP to designate experimental 
            health workforce projects as approved projects where the 
            projects are sponsored by community hospitals or clinics, 
            nonprofit educational institutions, or government agencies 
            engaged in health or education activities. 








                                                                  SB 623
                                                                  Page  3



          2)Establishes through regulations, the definitions and criteria 
            for administering the HWPP.

          3)Specifies that a NP, CNM, and PA may legally perform a 
            "nonsurgical" abortion that includes termination of pregnancy 
            through the use of pharmacological agents.  

           FISCAL EFFECT  :  According to the Assembly Appropriations 
          Committee, this bill would have negligible state fiscal impact.

          COMMENTS  :  According to the author, OSHPD initially approved the 
          HWPP No. 171 based on arguments by reproductive health care 
          provider groups that access to early abortion services is 
          severely constrained throughout the state.  The author maintains 
          that many counties have no accessible abortion providers.  As a 
          result of these access challenges in those parts of the state, 
          the author asserts, patients who are seeking an abortion after 
          already having made their decision, not only experience 
          prohibitive wait times in their own communities, but they also 
          often confront grueling travels to areas that have more 
          accessible abortion providers.  The author argues that this bill 
          will extend the HWPP No. 171 to allow the project to maintain 
          its momentum and study researchers from the UC to achieve 
          publication in a nationally-recognized peer-reviewed journal of 
          their study results, which find that trained clinicians may 
          safely provide first-trimester aspiration abortions.


           Analysis Prepared by  :    Tanya Robinson-Taylor / HEALTH / (916) 
          319-2097 


                                                                FN: 0005114