Assembly Member Jim Wood
Focus On… is a Q&A style interview that highlights a member, a conversation with an authoritative expert, spotlights an innovative program, or profiles a trend. If you have a suggestion for a person or topic we should consider as a future Focus On… subject, please email CANP at admin@canpweb.org.
Jim Wood is a California Assembly member representing the 2nd Assembly District and is the author of AB 890, the legislation passed in September that allows California nurse practitioners to practice to the full extent of their training without physician supervision. Prior to being elected to the Assembly in 2014, he was the Mayor of Healdsburg and a dentist in Cloverdale.
Connections:
What made you decide to author Assembly Bill 890?
Assembly Member Wood:
After the failure of Senator Hernández’ bill, I began a multi-year journey to educate myself and develop legislation allowing nurse practitioners with additional experience, national certification and examination to practice independently of a physician. I served as a commissioner on the California Future Health Workforce Commission throughout 2018 and, in February 2019, the Commission issued its final report. One of the Commission’s top 10 recommendations was to maximize the role of nurse practitioners and expand their practice authority. That same month, I introduced AB 890.
I read more peer-reviewed research, “Quality of Primary Care by Advanced Practice Nurses: A Systematic Review,” which concluded that nurse practitioners provide care of comparable quality to physicians, even when they practice without physician oversight — referring patients to a physician or specialist when appropriate just the same as physicians do.
Connections:
You opposed earlier legislative attempts to get full practice authority for NPs. Why did you oppose them, and what changed your mind?
Assembly Member Wood:
Six years ago, during my very first year in the Legislature, I was not as informed as I am today on all the aspects of allowing nurse practitioners to practice without supervision by a physician. The earlier bill by Senator Hernández was not AB 890, and at that time, I was not confident that it contained everything a bill as significant as that should.
Connections:
Have you or anyone in your family ever been seen by an NP?
Assembly Member Wood:
Absolutely, and I have been impressed with the care, knowledge and compassion of that care.
Connections:
You are a health care provider in a fairly rural district. Did your experience affect your support for this effort?
Assembly Member Wood:
Absolutely. My district covers five Northern Californian counties, is mostly rural, and access to health care is not what it should be. California faces a growing shortage of primary care physicians, especially in rural areas and low-income inner city areas. Not enough new physicians are going into primary care, and a third of the physicians in the state are over 55 and considering retirement, according to a study by the Healthforce Center at UC-San Francisco.
Connections:
You have said that getting the bill through the legislature was at times very difficult. What were the greatest challenges you faced? Any surprises?
Assembly Member Wood:
One of the biggest challenges was bringing my colleagues along on the issue to make sure they had all the information they needed to make a decision. We faced significant opposition from physicians, physician advocacy organizations in California, and other outside physician groups. The political pressure they exerted on legislators was significant, to say the least, but I am proud and grateful that they overwhelmingly supported the bill because they trusted the research and the experiences of other states, listened to the information provided by CANP, nurse practitioners in their districts, and the 80+ members of the coalition that supported the bill. In the end, the facts won the day.
Connections:
What do you think was most influential in tipping the scales in favor of the bill?
Assembly Member Wood:
Helping my colleagues understand the issue, the support and assistance of CANP, and the coalition of 80 groups in support.
Connections:
The CMA and other physician groups have pushed for an expansion of medical residency programs and loan forgiveness to increase access to primary care in California. What is wrong with these strategies as ways to solve the crisis?
Assembly Member Wood:
There is nothing wrong with those programs at all; I have always supported them. They are great, but also extremely expensive, and there are only so many residency slots and only so much money available for loan forgiveness programs. Those programs alone cannot meet the need.
Connections:
The CMA has pledged to remain engaged in the regulatory process and implementation of AB 890. What can you anticipate in terms of the role of the legislature?
Assembly Member Wood:
As the author of AB 890, I will be following closely to ensure that regulatory implementation stays true to what the Legislature passed and the Governor signed. It must reflect full scope of practice for nurse practitioners after they meet the requirements. Unfortunately, materials provided by CMA do not accurately reflect that intent. I specifically included a paragraph in the legislation that refers to intent and a focus on making sure requirements are reasonable and not obstacles to implementation.
Connections:
What do you see as the role for NPs in the future of health care in California?
Assembly Member Wood:
Nurse practitioners are an essential part of the health care team and their ability to practice fully will have a huge impact on improving the quality of care and making health care more accessible.
Connections:
Are there other topics you think NPs and CANP should focus on in 2021?
Assembly Member Wood:
I hope CANP will stay involved in the regulatory implementation process and continue helping Californians understand the qualifications and value of NPs.
Connections:
Do you have concerns about the new conservative Supreme Court majority and potential threats to Obamacare? What could those mean for California and the large percentage of people who rely on the program?
Assembly Member Wood:
Obviously many of us are concerned about what impact a negative SCOTUS decision would have because more than 1.5 million Californians rely on it, and many more may need it as we experience the economic impact of the COVID pandemic. California has maximized the ACA more than any other state, and I am watching very carefully to see how we can address any impact a SCOTUS decision would have.