Bill Text: CA SB294 | 2009-2010 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Professions and vocations: regulation.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2010-09-30 - Chaptered by Secretary of State. Chapter 695, Statutes of 2010. [SB294 Detail]

Download: California-2009-SB294-Amended.html

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BILL NUMBER: SB 294	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  JUNE 8, 2009
	AMENDED IN SENATE  MARCH 31, 2009

INTRODUCED BY   Senator Negrete McLeod

                        FEBRUARY 25, 2009

   An act to add Section 2835.7 to the Business and Professions Code,
relating to nurse practitioners.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 294, as amended, Negrete McLeod. Nurse practitioners.
   Existing law, the Nursing Practice Act, provides for the
certification and regulation of nurse practitioners and
nurse-midwives by the Board of Registered Nursing and specifies
requirements for qualification or certification as a nurse
practitioner. Under the act, the practice of nursing is defined, in
part, as providing direct and indirect patient care services, as
specified, including the dispensing of drugs or devices under
specified circumstances. The practice of nursing is also described as
the implementation, based on observed abnormalities, of standardized
procedures, defined as policies and protocols developed by specified
facilities in collaboration with administrators and health
professionals, including physicians and surgeons and nurses.
   This bill would authorize the implementation of standardized
procedures that would expand the duties of a nurse practitioner in
the scope of his or her practice, as enumerated. The bill would make
specified findings and declarations in that regard.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares all of the
following:
   (a) Nurse practitioners  play a vital and cost-effective
role in the delivery of health care services both independently and
in collaboration with physicians and surgeons and other health care
providers. Nurse practitioners are involved in almost every setting
in which health care services are delivered, and, in collaboration
with physicians and surgeons, directly   are r 
 egistered nurses who have a graduate education and clinical
training, and who  provide a wide range of services and care.
   (b) Under current law, nurse practitioners have the same statutory
authority to provide services and care as do registered nurses.
However, the law allows those registered nurses  that meet
the education requirements for certification as nurse practitioners
  who the Board of Registered Nursing has determined
meet the standards for a nurse practitioner  to provide care and
services beyond those specified in statute for registered nurses
 where those services are performed  pursuant to
standardized procedures and protocols  adopted by each entity
delivering health care services in which a nurse practitioner
practices.   developed through collaboration among
administrators and health professionals, including physicians and
surgeons, in the organized health care system in which a nurse
practitioner practices. 
   (c) The Legislature reiterates its intention to allow each
 health care setting   organized health care
system  in which a nurse practitioner practices to 
select and control the services nurse practitioners may perform and
provide   define those services nurse practitioners may
perform in standardized procedures developed  pursuant to
Section 2725 of the Business and Professions Code  , and that
it is not the intention of the Legislature to grant nurse
practitioners the authority to independently perform services beyond
the level set forth in statute for registered nurses outside of the
standardized procedures.   . 
   (d) Notwithstanding the foregoing, the Legislature finds that
there  is   may be some  ambiguity in
current law regarding what services and functions to be performed by
nurse practitioners may be included in standardized procedures and
protocols.  This ambiguity results in disruptions and delays
in care, disputes over billings, and duplication of services.

   (e) Therefore,  it is the intent of the Legislature to
provide clarification   to remove this  
ambiguity, the Legislature hereby clarifies  that standardized
procedures and protocols may include the specified services and
functions set forth in this act so that health care entities may
allow nurse practitioners to engage in those activities if the
entities choose to do so, and that third-party payors understand that
those services and functions can be performed by nurse practitioners
if they are included in an entity's standardized procedures and
protocols.
  SEC. 2.  Section 2835.7 is added to the Business and Professions
Code, to read:
   2835.7.  (a) Notwithstanding any other provision of law, in
addition to any other practices that meet the general criteria set
forth in statute or regulation for inclusion in standardized
procedures developed through collaboration among administrators and
health professionals, including physicians and surgeons and nurses,
pursuant to Section 2725, standardized procedures may be implemented
that authorize a nurse practitioner to do any of the following:
   (1) Order durable medical equipment, subject to any limitations
set forth in the standardized procedures. Notwithstanding that
authority, nothing in this paragraph shall operate to limit the
ability of a third-party payor to require prior approval.
   (2) After performance of a physical examination by the nurse
practitioner and collaboration with a physician and surgeon, certify
disability pursuant to Section 2708 of the Unemployment Insurance
Code.
   (3) For individuals receiving home health services or personal
care services, after consultation with the treating physician and
surgeon, approve, sign, modify, or add to a plan of treatment or plan
of care.
   (b)  Nothing in this section shall be construed to affect the
validity of any standardized procedures in effect prior to the
enactment of this section or those adopted subsequent to enactment.