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nurse.JPGA watered-down bill allowing nurse practitioners to operate independently of physicians passed during reconsideration in an Assembly committee Tuesday after failing to earn enough votes last week.

Senate Bill 491 by Ed Hernandez, D-West Covina, increases the scope of practice of nurse practitioners by allowing them to practice independently of physicians in certain medical facilities, such as hospitals, clinics and skilled nursing facilities. Amid fierce lobbying in opposition, including by the California Medical Association, which represents doctors, Hernandez removed language in the bill that would have allowed nurse practitioners to operate completely independent of physician oversight after 6,240 hours of supervised practice.

"We heard thoughtful testimony last week and it was clear that members wanted to find common ground to help California bridge the provider gap and ensure that we all have access to quality healthcare," Hernandez said in a statement.

AARP, which previously supported the bill, changed to opposition following the bill's changes, saying "these amendments will actually undermine the intent of the law," which is to expand access to health care.

Another amendment to the bill noted that a nurse practitioner working independently cannot replace a physician or surgeon, which was a concern for labor groups.

SB 491 is headed to the Assembly Appropriations Committee, where it will join Hernandez's second scope-of-practice bill regarding the authority of pharmacists. SB 493 increases the role of pharmacist by allowing them to give immunizations and prescribe some drugs. The bill passed the Assembly Health Committee on Tuesday.

Hernandez said it's critical that California is prepared for the increased demand for care once federal law requires nearly everyone to have health insurance.

A third bill by Hernandez that would have expanded the kind of medical services optometrists can offer in California was dropped for this legislative session.

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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