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nurse.JPGA bill that would give California's nurse practitioners more autonomy failed 6-3 Tuesday in an Assembly committee after four Democrats did not vote.

Senate Bill 491 is one of three "scope-of-practice" bills by Sen. Ed Hernandez, D-West Covina, that would increase the medical duties of optometrists, nurse practitioners and pharmacists.

Senate Bill 493, on pharmacists' roles, passed 12-0 in the Assembly Business, Professions and Consumer Protection Committee before members heard the nurse practitioner measure. That bill was granted reconsideration for next week, when Senate Bill 492, which covers the role of optometrists, is scheduled to be heard.

Before the committee voted on SB 491, Hernandez said he knew the vote would be tough.

Not voting were Assembly Democrats Raul Bocanegra of Los Angeles, Nora Campos of San Jose, Richard Gordon of Menlo Park, Chris Holden of Pasadena and Republican Curt Hagman of Chino Hills.

Assemblywoman Nancy Skinner, D-Berkeley, said she struggled with the nurse practitioner bill at first, but independent studies ultimately showed her that it would not be dangerous, as opponents suggested.

"I think it's important," said Susan Talamantes Eggman, D-Stockton. "I think the policy is right. I think the politics are hard. We all have to make decisions based on that."

Dr. Paul Phinney, president of the California Medical Association, said the nurse practitioner bill would fragment care. The association changed its opposition to the pharmacists' bill to neutral after working with Hernandez, but it still opposes the nurse practitioner bill.

"Collaboration is part of the pharmacy bill," Phinney told committee members. "It's not in this (nurse practitioner) bill."

PHOTO: Nurse practitioner Theresa Gilliland checks a patient's heart beat in this 2003 file photo. The Sacramento Bee / Florence Low.



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