Bills of Interest Still in Play When Legislators Return August 6

After an intense few weeks of activity, the Legislature adjourned for the summer recess in mid-July. Legislators have left the Capitol and returned to their districts to focus on their constituents and for many, their re-election campaigns. During this time, there is very little "official" business going on at the Capitol. There is no floor session, committee hearings, or amendments being processed. There is however, lots of time for stakeholders to meet and attempt to hammer out remaining issues and conflicts before the end of session. Legislators return to the Capitol on August 6 and race to the finish line of the session deadline at midnight on August 31. Here's a quick recap of what remains in play when legislators return:

SB 1524 (Hernandez) -- CANP continues to work hard to ensure passage of SB 1524, which eliminates the requirement that NPs and certified nurse midwives have six months of physician supervised prescribing experience before they receive a furnishing number. We have heard from newly certified NPs and NP students that this requirement has become a barrier to employment for many NPs, who find physicians prefer NOT to take on the obligation of supervising, tracking hours, and reporting to the BRN. CANP has been working with the California Nurses Association (CNA) and the California Medical Association (CMA) to ensure their neutrality. Recently, we were very happy to learn that the California Chapter of the American College of Cardiology, which had adopted an oppose position on the bill, re-evaluated its position and is now neutral. This is an excellent development and thanks go to the many NPs who lobbied their physician colleagues. Unfortunately, the California Academy of Family Physicians remains the only opposition to SB 1524. The bill will be heard in the Assembly Appropriations Committee in early August, then will go to the Assembly Floor for a vote. Lastly, it will go back to the Senate for a floor vote. Then on to the Governor ... stay tuned for more updates and how you can help by contacting your local legislators.

SB 623 (Kehoe) -- After the failure of Senator Kehoe's SB 1338, which would have allowed NPs, PAs, and CNMs to perform first trimester abortions, Senator Kehoe has amended her SB 623 to extend the OSHPD Workforce Pilot project for an additional year, until 2014. The OSHPD pilot has been in place since 2007 and has been training these allied health professionals to perform this procedure. SB 623 passed the Assembly Health Committee last week and will be heard in the Assembly Appropriations Committee in early August. Because SB 623 is a "gut and amend", it will have to be heard in the Senate Health and Appropriations Committees and the full Senate in August. CANP is supporting SB 623, as the CANP Board voted to support SB 1338.

SB 393 (Hernandez) -- CANP continues to work with the California Academy of Family Physicians to pass SB 393, which would create a definition of a "medical home" in California law. SB 393 continues to be a very complicated bill to pass given the definition of medical homes that exists in Medi-Cal, the intersection of the language in the Affordable Care Act that defines medical homes, and the interests of all of the stakeholders involved. Many CANP members have objected to the "physician-directed" language that is currently in the bill. Because NPs work under standardized procedures which include (indirect) physician supervision, the "physician-directed" language reflects existing practice. Of course, a physician may delegate management of the medical home to the NPs he or she works with, as is being done in many settings already. SB 393 passed the Senate Health Committee and will next be heard in the Senate Appropriations Committee in August.

AB 2348 (Mitchell) -- Sponsored by Planned Parenthood Affiliates of California and the California Family Health Council, AB 2348 would expand the scope of practice of registered nurses by allowing them to perform a medical assessment of patients in community clinics for the purposes of dispensing hormonal contraceptives. According to the sponsors, they have been unable to hire NPs to work in their clinics and need to find an alternative means of providing patient care. CANP voted to oppose AB 2348 based upon language that would have made the NP liable for the RN's practice, as well as language in the bill that was overly broad and would have significantly expanded RN scope beyond an RN's education and training. While CANP is supportive of creative means of expanding access to health care, AB 2348 in its earlier versions went too far. CANP Legislative Advocate Kristy Wiese has spent many, many hours working with the sponsors and Assembly Member Mitchell to craft amendments which narrow the bill and will enable CANP to adopt a neutral position in August. AB 2348 has become one of the more controversial scope of practice bills before the Legislature this session, with strong opposition from the California Nurses Association and the American College of Obstetricians and Gynecologists. Early in July, the bill passed the Senate Business and Professions Committee after an almost two-hour hearing on the bill. Stakeholder meetings are expected to continue over the recess before AB 2348 goes to the full Senate for a vote.

The 2012 legislative session is shaping up as the busiest yet for NP issues. As California gets closer to full implementation of the Affordable Care Act and begins to grapple with workforce and access issues,CANP will likely find itself even busier than ever at the Capitol.