California NP's

Specialties NP

Published

Join the California Association for Nurse Practitioners in garnering support for SB 491 (Hernandez), if passed, this is a substantial piece of legislation that would make our state part of the progressive group of states that allow for full practice rights to NP's without physician involvement.

http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_0451-0500/sb_491_bill_20130401_amended_sen_v98.htm

Is this bill bad enough to actively oppose?

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

From my standpoint, no. The bill keeps the status quo in terms of physician-NP collaboration minus the red tape involved in keeping an updated standardized procedure and drug formulary for some NP's. It also clarifies roles that were vague before (ordering DME's, home care, hospice care, etc.). AANP is a political arm - they will oppose any state's attempt to write laws that say, "a nurse practitioner shall not supplant a physician and surgeon" in an attempt to protect NP's.

CANP believes that the bill as it looks now is still a step forward from what we have now. I have a feeling that they have taken on a strategy that will involve slowly but surely moving towards real independence instead of a drastic move. I'm sure they will not stop lobbying even after this bill becomes law, only by then, the push will be to remove that bolded problematic statement I typed above.

Excerpts from AANP's position:

“The original legislation supported by AANP would have significantly improved health care delivery and increased access to care for millions of Californians by providing patients with full and direct access to nurse practitioner services. Unfortunately, recent amendments to SB 491 in the California Assembly Business, Professions and Consumer Protection Committee have dramatically changed the bill to a point where the state would not only retain the status quo, but impose added barriers to patients and the provider community.

“The amended bill would make it a crime for nurse practitioners to “supplant” physicians and continue to require unnecessary oversight, negating workforce gains contained in the prior bill. These changes undermine the very heart of the legislation’s original objectives, creating additional, unnecessary regulatory roadblocks just as national health care reform is necessitating that the industry streamline care delivery models. California would remain one of the most restrictive states for nurse practitioners in the nation.

“For these reasons, AANP has no choice but to actively oppose the revised bill".

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Thanks juan. Your designation "guide" is well deserved.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

It's the old and tired rhetoric of rationalizing less training and risk to patient safety in an era when there are already independent practice state for NP's in at least 1/3 of the US. It boils down to turf protection and in a politically-charged issue, you can't expect AMA (or CMA) to do anything less.

The issue is out there and more mainstream media outlets are bringing it in the open:

Bracing for Obamacare: Nurse practitioners fill doc shortage gap - NBC News.com

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Specializes in Family Practice, Urgent Care, Cardiac Ca.

California SB 491 has officially been voted out of legislation until at least next year, as of yesterday. Sigh.... :p

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Will they allow that widened scope of practice still without having to be Certified? I learned in my review course that three states still did not require certification but that it was hard to get hired without it. California was one of those along with Kansas and New York. Would this law include those who are not certified? If so, seems like liability would be an immense issue!

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
Will they allow that widened scope of practice still without having to be Certified? I learned in my review course that three states still did not require certification but that it was hard to get hired without it. California was one of those along with Kansas and New York. Would this law include those who are not certified? If so, seems like liability would be an immense issue!

The bill actually proposes national certification for all NP's in California. While the state does not require national certification currently, many employers include national certification as a qualification for candidates.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

...another thing I'd like to point out is that NY and CA only grants NP licenses without national certification to applicants who attended state-approved NP programs. The Boards of Nursing in both states have a list of all the state approved programs (there are 22 approved NP programs in CA, 13 are in state universities). While there is arguably some variability in the quality of these approved programs, all approved programs in California are based in California. Graduates of out of state programs must take the national boards and pass it to receive a license as an NP.

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Specializes in Neurosurgery, Neurology.

Thought some may be interested to know that a bill in California was recently signed by the governor giving pharmacists the status of healthcare provider, as well as the "Advanced Practice Pharmacist" role.

California provider status bill becomes law | American Pharmacists Association

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Why am I not surprised?

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This whole process has been beyond bleak. I would rather just go practice in an independent state then fight the money and power of AMA. Our political network was weak compared to this organization. I am grateful for Senator Hernandez. We are lucky to have somebody like him on our side. This senator seems to really understand our healthcare system. Wish we had more like him who did.

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