BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1524
                                                                  Page  1

          Date of Hearing:   August 8, 2012

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                   SB 1524 (Hern�ndez) - As Amended:  June 6, 2012 

          Policy Committee:                             Business and 
          Professions  Vote:                            9-0

          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:              No

           SUMMARY  

          This bill deletes requirements that nurse practitioners (NPs) 
          and certified nurse-midwives (CNMs) complete six months of 
          physician and surgeon supervised experience in the furnishing or 
          ordering drugs and devices, before prescribing or ordering drugs 
          or devices.

           FISCAL EFFECT  

          Negligible state fiscal effect.

           COMMENTS  

           1)Rationale  . The author states a 6-month physician supervisory 
            requirement is unnecessary and prevents NPs and CNMs from 
            practicing to the fullest extent of their training.  He 
            further contends the requirement is redundant given that the 
            law already requires physician supervision of CNMs who furnish 
            drugs or devices, and physician involvement in developing 
            standardized procedures for furnishing.   He points to reports 
            that this requirement creates barriers to hiring and making 
            use of NPs and CNMs.  

            Finally, he indicates the requirement is outdated, as it 
            became law before the California Board of Registered Nursing 
            (BRN) required pharmacology training as part of nursing 
            educational programs.  The California Nurse-Midwives 
            Association and the California Association of Nurse 
            Practitioners, who support this bill, believe advanced 
            practice nurses now gain the required education, skills, and 
            supervision during their courses of study.








                                                                  SB 1524
                                                                  Page  2


           2)Background  . NP and CNM are two of several advanced practice 
            certifications offered by the BRN.  An NP is a registered 
            nurse who possesses additional preparation and skills in 
            physical diagnosis and psychosocial assessment necessary to 
            provide primary health care.  A CNM may, under the supervision 
            of a licensed physician and surgeon, provide prenatal, labor 
            and delivery, and postpartum care.  BRN regulations require 
            pharmacology training, as well as supervised clinical 
            experience, for both certifications.  Both NPs and CNMs may 
            only furnish drugs or devices pursuant to standardized 
            procedures, and may only furnish drugs or devices under 
            physician supervision.

           3)Opposition  .  The CA Chapter of the American College of 
            Cardiology opposes this bill, citing more stringent 
            requirements before physicians may furnish and potential harm 
            to patients. 

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081