Health

California state lawmaker tries again to expand nurse practitioners' authority

Nurse practitioners would be able to diagnose and treat patients and write prescriptions without a doctor's supervision under SB 323, introduced by State Senator Ed Hernandez (D-West Covina).
Nurse practitioners would be able to diagnose and treat patients and write prescriptions without a doctor's supervision under SB 323, introduced by State Senator Ed Hernandez (D-West Covina).
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California State Sen. Ed Hernandez (D-West Covina) has re-introduced a bill that would expand the authority of nurse practitioners to provide primary care without supervision by a physician.

In a statement, Hernandez said the bill, SB 323, would help California meet the growing demand it faces for primary care as a result of the Affordable Care Act, which has newly insured 2.5 million Californians.

This is the second time around for Hernandez' bill. A similar measure he introduced in 2013 failed amid opposition - first from the California Medical Association, which represents physicians - and then from the American Association of Nurse Practitioners, which dropped its support for the bill after it was amended to appease the physicians’ group.

Nurse practitioners are registered nurses with advanced degrees and national certification who often provide primary care identical to what a doctor provides. But in California, the state’s 19,000 registered nurse practitioners must work under a physician’s supervision.

The bill that Hernandez introduced on Tuesday is a "spot" bill, a bare-bones measure written quickly to meet the Friday deadline for filing new legislation. But according to Hernandez, once fleshed out, SB 323 would propose granting nurse practitioners "full practice authority."

That generally means the ability to diagnose patients, provide primary care, and write prescriptions without a doctor’s supervision.

Hernandez and other supporters of the change argue that nurse practitioners already provide routine primary care that is just as good as a physician’s. They say removing the requirement for physician oversight would free nurse practitioners up to treat more patients and help meet California’s growing demand for primary care providers.

"We can no longer afford to get by on a fraction of our professional capacity," Hernandez said in his statement.

He argued that the change would save patients and the health care system money, since nurse practitioners are paid less than doctors.

Supporters of the bill also point out that 19 states and the District of Columbia already grant nurse practitioners full practice authority.

The California Medical Association has not yet taken a position on the latest bill. Spokeswoman Molly Weedn said it would do so next month, once the legislation is fleshed out.

The Medical Association strongly opposed the 2013 version of the bill, arguing that allowing nurse practitioners to diagnose and treat patients without a doctor’s oversight could put patients at risk.

"Our biggest concern is making sure patient safety is a priority and making sure they have care led by the highest trained medical professionals," Weedn said Friday.

A fact sheet released by Hernandez’s office this week said the new bill will aim to deploy nurse practitioners "in a team-based delivery model where they work collaboratively with physicians."