By Kristy Wiese
Legislative Advocate
The 2021 legislative session continues to forge forward with Governor Newsom releasing his revised budget (“May Revise”) on May 14. The May Revise unveiled a $268 billion ($175.9 billion General Fund) State Budget for the 2021-22 fiscal year as California is experiencing what Newsom called an “historic, unprecedented, generational and transformational budget.” The Budget includes a $75.7 billion surplus and an additional $25 billion in federal relief. Given the significant surplus, the May Revision increases health and human services funding compared to the January Budget by over $12 billion. Overall spending is $207.7 billion ($54.2 billion GF and $153.5 billion other funds) for all health and human services programs, not including COVID-19 related costs. The Budget seeks to address the impacts of the pandemic by linking services like childcare and housing to health and behavioral health.
Following weeks of negotiations between the Governor and Democratic leaders, the State Legislature approved a new budget largely mirroring the Governor's May Revise just before the constitutional deadline of June 15; however, negotiations will continue as they work to address unresolved differences, revenues and shortfalls.
May 21 marked the last day for fiscal committees to meet and report to the floor bills introduced in their house. CANP remains engaged on a number of bills continuing through the legislative process, including high-priority AB 852 (Wood), the “Clean-up” bill for AB 890 addresses some of the unresolved issues as well as makes some general corrections to the Business and Professions Code to reflect the change to NP practice. AB 852 was voted on unanimously in the Assembly Appropriations Committee on May 5 and passed off the Assembly Floor on May 24 with a vote of 64-0. AB 852 has been double referred to Senate Judiciary and the Senate Business and Professions Committees. The Senate Judiciary Committee will look at the portion of the bill that amends the evidence code. Both committees will hear the bill prior to the deadline on July 14.
In addition to AB 852, CANP has taken a position of support on additional bills this session that have now passed out of their house of origin and continue to move through the process, including:
- AB 369 (Kamlager) which will require the State Department of Health Care Services to implement a program of presumptive Medi-Cal eligibility for persons experiencing homelessness and require the department to authorize an enrolled Medi-Cal provider to issue a temporary Medi-Cal benefits identification.
- AB 925 (Dahle), which will authorize law enforcement agencies to seek reimbursement from the state for providers to offset to cost of sexual assault examinations.
- SB 65 (Skinner), which will require comprehensive investigations into maternal and infant mortality and morbidity, improve data collection and research on socio-economic factors that contribute to negative birth outcomes, expand postpartum health care for parents and babies, and improve access to health options like doulas and midwives.
- SB 306 (Pan), which names the prescribing of antibiotics to the sexual partner of a patient diagnosed with an STD as “expedited partner therapy” or “EPT” and requires health care providers to include EPT on a prescription if they are unable to obtain the name of the patient’s sexual partner. It also allows pharmacists to dispense the prescription without a name on the label if the prescription includes “EPT.”
- SB 365 (Caballero), which mandates Medi-Cal reimbursement for e-consult services provided by Medi-Cal providers.
- SB 380 (Eggman), which reduces certain administrative barriers under the End of Life Option Act and deletes the Act’s sunset date.
Beyond the Budget and legislation, the second Sunset Review Oversight Hearing for the California Board of Registered Nursing was held on May 19. The hearing was scheduled to allow the Legislature time to ask questions of the Board of Registered Nursing (BRN) that were not addressed during the first hearing, which took place on March 12. There was no specific discussion of AB 890 implementation during the hearing, but Senator Richard Pan did signal that he believes legislation should be enacted to increase continuing education requirements for NPs from 30 hours to 50 hours, similar to what is required of MDs.
The BRN’s Nurse Practitioner Advisory Committee (NPAC) held its first meeting on April 21 and its second meeting on May 11. Nurse Practitioner Samantha Gables Farr was elected chair of the committee, and Dr. Edward Ray (an MD) was named Vice Chair. The NPAC will meet four times per year and will create subcommittees of two or three people to work on AB 890 implementation. The NPAC will report to the BRN Practice Committee, which will then report to the full Board. BRN staff are beginning to draft the AB 890 regulations, prioritizing transition to practice.
The Office of Professional Examination Services (OPES) has also begun work on its modified occupational analysis of AB 890. The role of OPES is to review existing NP exams and ensure those programs meet psychometric and legal standards; ensure California practitioners (“subject matter experts”) are represented or involved in process; and determine how California content is assessed or represented in the process. OPES will interview subject matter experts who work closely with NPs, including associations and those familiar with NP scope of practice, AB 890 and the profession. If OPES finds that the existing national exams meet its criteria, there will not be a need to create a new, California-specific exam. If OPES does determine a new exam is needed, there would likely only be one exam, not multiple exams for different specialties.
The NPAC is also beginning work on the AB 890 transition to practice regulations. The next meeting of the NPAC has not yet been determined, but the AB 890 interested parties meeting will take place in July, date TBD.
On a broader scale, reopening from COVID-19 and the recall of Governor Gavin Newsom continue to be at the forefront in Sacramento. The California State Department of Public Health has released that effective June 15, all sectors listed in the Blueprint Activities and Business Tiers Chart in California may return to usual operations (with limited exceptions for Mega Events). On May 28, a total of 37,100,162 vaccine doses had been administered statewide.
As the 2021 legislative session continues, CANP will remail actively engage on prioritized legislation and focused on the successful implementation of AB 890.