Amid the deluge of health care bills signed and vetoed by the governor in recent days, absent were several bills that would have expanded the scope of practice of mid-level health clinicians.
So-called scope of practice bills have been gaining traction in statehouses around the country as lawmakers seek to increase access to providers in the face of a nationwide shortage of primary care physicians.
In California, four scope-of-practice bills failed to make it to the governor’s desk:
- SB 538 for naturopathic doctors;
- AB 1306 for certified nurse midwives;
- SB 323 for nurse practitioners; and
- SB 622 for optometrists.
State Sen. Ed Hernandez (D-West Covina), the author of both SB 323 and SB 622, said he will continue to try to advance the bills in the coming session. Both bills are two-year bills so will be considered again in January.
“The reason why I think this is important is, as a legislator, I have a responsibility to make sure everyone in this state has the opportunity to have access to healthcare,” Hernandez said in a phone interview. “I will continually bring back these bills as long as I am in office.”
The California Medical Association opposed three of the bills. In its legislative wrap-up released Wednesday, the CMA wrote that their defeat sent “an unequivocal rejection of scope of expansions as an answer to care access issues.”
SB 323 would permit a nurse practitioner to practice without physician supervision if the nurse practitioner is certified by a national body, maintains liability insurance and is practicing in a medical group, clinic, health facility or accountable care organization. At least 21 states have enacted scope of practice legislation that allows nurse practitioners to diagnose and treat patients independent of a physician.
The CMA was neutral on AB 1306, by Assembly member Autumn Burke (D-Inglewood), relating to certified nurse midwifes. That bill also died in committee.