BILL ANALYSIS �
SB 1524
Page 1
SENATE THIRD READING
SB 1524 (Ed Hernandez)
As Amended June 28, 2012
Majority vote
SENATE VOTE :35-0
BUSINESS & PROFESSIONS 9-0
APPROPRIATIONS 17-0
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|Ayes:|Hayashi, Bill Berryhill, |Ayes:|Fuentes, Harkey, |
| |Allen, Butler, Eng, | |Blumenfield, Bradford, |
| |Hagman, Hill, Ma, Smyth | |Charles Calderon, Campos, |
| | | |Davis, Donnelly, Gatto, |
| | | |Hall, Hill, Lara, |
| | | |Mitchell, Nielsen, Norby, |
| | | |Solorio, Wagner |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Deletes a requirement that certified nurse-midwives
(CNMs) and nurse practitioners (NPs) complete at least six
months of physician-supervised experience in the furnishing or
ordering of drugs or devices, and provides that a physician and
surgeon may determine the extent of supervision necessary in the
furnishing or ordering of drugs and devices by CNMs and NPs, as
specified.
EXISTING LAW :
1)Establishes the Nursing Practice Act which provides for the
certification and regulation of registered nurses (RNs) and
advanced practice RNs, including CNMs and NPs, by the Board of
Registered Nursing (BRN) within the Department of Consumer
Affairs.
2)Provides that the practice of nursing includes direct and
indirect patient services, including but not limited to, the
administration of medications and therapeutic agents necessary
to implement a treatment, disease prevention, or
rehabilitative regimen ordered by and within the scope of
licensure of a physician, dentist, podiatrist, or clinical
psychologist.
SB 1524
Page 2
3)Provides that the practice of nursing may be performed under
"standardized procedures," as defined, for specified
functions, treatments and procedures.
4)Provides that a CNM may furnish or order drugs or devices,
including controlled substances, if furnished or ordered
incidentally to the provision of family planning services,
routine health care or perinatal care, or care rendered
consistent with the certified nurse-midwife's practice; occurs
under physician and surgeon supervision; is in accordance with
standardized procedures or protocols as specified; and, is
conditional on the issuance of a furnishing number by the BRN
after the BRN certifies that the CNM has completed at least
six months of physician and surgeon supervised experience in
the furnishing or ordering of drugs or devices and a course in
pharmacology covering the drugs or devices to be furnished or
ordered.
5)Provides that an NP may furnish or order drugs or devices,
including controlled substances, if it is consistent with an
NPs educational preparation or for which clinical competency
has been established and maintained; occurs under physician
and surgeon supervision; is in accordance with standardized
procedures or protocols as specified; and, the BRN has
certified prior to issuing a furnishing number, as required,
that the NP has completed at least six months of physician and
surgeon supervised experience in the furnishing or ordering of
drugs or devices, and a course in pharmacology covering the
drugs or devices to be furnished or ordered.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, negligible state fiscal effect.
COMMENTS : According to the author, "(Current law requirements
to complete at least six months of physician-supervised
experience in the furnishing or ordering of drugs or devices) is
a barrier to employment for new graduates and those moving to
California. Increasing access to care is a key goal in
California, as we have a shortage of health care providers in
underserved areas around the state. NPs and CNMs can be a key
part of providing health care to those areas, and increasing our
health care safety net.
SB 1524
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"The six-month supervisory requirement is an arbitrary barrier
and prevents NP and CNM practice to the fullest extent of their
training. The requirement is redundant given that the law
already requires physician supervision of CNMs who are
furnishing and physician involvement in developing standardized
procedures for furnishing. New graduates frequently report
facing challenges in being hired without a furnishing number.
Also, NPs and CNMs who previously worked out-of-state are also
required to provide certification of six-months physician
supervised prescription writing, regardless of past experience.
"There is no evidence that six months of physician supervised
prescription writing actually protects the health and safety of
consumers. There is a wealth of research, however, that
demonstrates that NPs and CNMs are safe, effective healthcare
professionals. The removal of this portion of statute will
significantly improve patient access to advanced practice
nursing providers, without reducing any protections for the
health and safety of consumers in California."
According to the author, safely furnishing medications is a
standard component of NP and CNM practice and education. During
the graduate education programs in California, student NPs and
CNMs complete pharmacology training and have a minimum of 12
months of direct clinical experience with a supervising NP or
CNM. The students furnish medications under direct supervision
and are evaluated as competent in furnishing and prescribing
prior to graduation based on national standards.
Analysis Prepared by : Angela Mapp / B.,P. & C.P. / (916)
319-3301
FN: 0004924