A bill by California’s Senator Ed Hernandez that would have allowed nurse practitioners to practice without the direct supervision of a physician failed in committee Friday, after significant lobbying from the California Medical Association.
Supporters of the bill were hopeful that expanding nurse practitioner’s scope of practice and allowing them to open independent practices would help the state handle the influx of newly insured patients who will seek primary care services when the Affordable Care Act takes effect. Currently, only 16 of the state’s 58 counties have enough primary care physicians. Opponents of the bill, including the California Medical Association, argued there was no guarantee NPs would open clinics in the underserved areas and that nurse practitioners do not have the level of clinical training physicians have.
The opposition caused Hernandez to alter the terms of the bill so that NPs would only be allowed to work independently in certain settings, such as hospitals and clinics. The new restrictions didn’t sit well with the American Association of Nurse Practitioners who pulled its support for the bill. The association didn’t want the constricting bill to become a model that other states would follow. So in a way, the bill’s defeat has a silver lining. Currently, 17 states and the District of Columbia allow nurse practitioners to work autonomously, and, Hernandez told the Los Angeles Times, “The fight is not over” in California. The Senator said he plans to try again next year.
