BILL ANALYSIS �
------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 623|
|Office of Senate Floor Analyses | |
|1020 N Street, Suite 524 | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
------------------------------------------------------------
UNFINISHED BUSINESS
Bill No: SB 623
Author: Kehoe (D), et al.
Amended: 8/7/12
Vote: 21
PRIOR VOTES NOT RELEVANT
ASSEMBLY FLOOR : 52-26, 8/23/12 - See last page for vote
SENATE HEALTH COMMITTEE : 6-3, 8/29/12 (pursuant to Senate
Rule 29.10)
AYES: Hernandez, Alquist, De Le�n, DeSaulnier, Rubio, Wolk
NOES: Harman, Anderson, Blakeslee
SUBJECT : Public health: health workforce projects
SOURCE : American Civil Liberties Union
Planned Parenthood Affiliates of California
DIGEST : This bill 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.
Assembly Amendments delete the Senate version of the bill,
which dealt with marine antifouling paint, and instead add
the current language.
CONTINUED
SB 623
Page
2
ANALYSIS :
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
No. 171 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.
2. Establishes through regulations, the definitions and
criteria for administering the HWPP No. 171.
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.
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 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
CONTINUED
SB 623
Page
3
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.
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.
Comments
According to the author's office, 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's
office 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
CONTINUED
SB 623
Page
4
grueling travels to areas that have more accessible
abortion providers. The author's office argues that this
bill extends 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.
Related legislation
SB 1338 (Kehoe, 2012) would have allowed a NP, CNM, and PA
who had completed training in the HWPP No. 171 to continue
to perform abortions by aspiration technique. SB 1338
failed passage in the Senate Business, Professions and
Economic Development Committee.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: No
According to the Assembly Appropriations Committee, this
bill would have negligible state fiscal impact.
SUPPORT : (Verified 8/29/12)
American Civil Liberties Union (co-source)
Planned Parenthood Affiliates of California (co-source)
Access Women's Health Justice
ACT for Women and Girls
American Nurses Association of California
California Association of Nurse Practitioners
California Medical Association
California Nurse Midwives Association
California Nurses Association
NARAL Pro-Choice California
Planned Parenthood Advocacy Project Los Angeles County
Planned Parenthood Mar Monte
Service Employees International Union, California State
Council
Six Rivers Planned Parenthood
OPPOSITION : (Verified 8/29/12)
CONTINUED
SB 623
Page
5
California Catholic Conference
California Right to Life Committee
Life Priority Network
Traditional Values Coalition
ARGUMENTS IN SUPPORT : Planned Parenthood Affiliates of
California (PPAC) and the American Civil Liberties Union
(ACLU) of California, co-sponsors of this bill, write in
support that access to the full range of first-trimester
reproductive health services is an important aspect of
women's health. According to PPAC and ACLU, an estimated
one in three women will decide to terminate a pregnancy by
age 45, yet many women often do not have sufficient access
to early, safe abortions because of the limited number of
physicians providing the services in their communities.
PPAC and ACLU maintain that by increasing the number of
aspiration providers, this bill helps to ensure women
receive comprehensive reproductive health care from local
providers they know and trust. Supporters also write that
by extending the HWPP No. 171, this bill will allow the
project to be properly analyzed, while preserving the
knowledge of the clinicians who have been trained through
the project.
ARGUMENTS IN OPPOSITION : The California Right to Life
Committee, Inc. writes in opposition that the HWPP No. 171,
lacking any informed consent from the patient and employing
non-physicians as abortionists, places women's health and
safety in danger and removes their right of choice to
control their own health care decisions. The Life Priority
Network (LPN) writes that the HWPP No. 171 has been touted
as increasing women's access to abortion in rural areas,
but medical safety must always take priority. LPN poses the
question if qualified physicians are not available in rural
areas now, how is a woman's safety improved by affording
her an aspiration abortion with its potential for a
punctured uterus? California Catholic Conference, Inc.
(CCC) writes in opposition that this bill is a late
introduction "gut and amend" bill, designed to address the
failure of SB 1338 (Kehoe) earlier this year. According to
CCC, SB 1338 failed because the anecdotal statistics
presented by the project managers could not withstand
perfunctory scrutiny. CCC argues it is opposed to this
ill-considered, last minute and unfortunate extension of
CONTINUED
SB 623
Page
6
the authorization and funding for the training of
abortionists.
ASSEMBLY FLOOR : 52-26, 8/23/12
AYES: Alejo, Allen, Ammiano, Atkins, Beall, Block,
Blumenfield, Bonilla, Bradford, Brownley, Buchanan,
Butler, Charles Calderon, Campos, Carter, Cedillo,
Chesbro, Davis, Dickinson, Eng, Feuer, Fletcher, Fong,
Fuentes, Furutani, Galgiani, Gatto, Gordon, Hall,
Hayashi, Hill, Huber, Hueso, Huffman, Lara, Bonnie
Lowenthal, Ma, Mendoza, Mitchell, Monning, Pan, Perea, V.
Manuel P�rez, Portantino, Skinner, Solorio, Swanson,
Torres, Wieckowski, Williams, Yamada, John A. P�rez
NOES: Achadjian, Bill Berryhill, Conway, Cook, Donnelly,
Beth Gaines, Garrick, Grove, Hagman, Halderman, Harkey,
Jeffries, Jones, Knight, Logue, Mansoor, Miller, Morrell,
Nestande, Nielsen, Norby, Olsen, Silva, Smyth, Valadao,
Wagner
NO VOTE RECORDED: Gorell, Roger Hern�ndez
JJA:d 8/31/12 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
**** END ****
CONTINUED