Nurse Practitioner Bill Loses Supporter After 'Drastic' Last-Minute Amendments

by David Gorn

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An amended bill that would modify the role of nurse practitioners in California is expected to be voted on today by the Assembly Committee on Business, Professions and Consumer Protection. Today's vote -- which is supposed to be taken without discussion -- has been complicated by the withdrawal of support from one its previous endorsers.

The American Association of Retired Persons switched its "support" position to "oppose" yesterday for SB 491 by Sen. Ed Hernandez (D-West Covina) after amendments were introduced that AARP officials said would gut the bill.

"Basically now it says nurse practitioners may not supplant a physician, and doing that would be a crime. We have a real problem with that," said Blanca Castro, advocacy director for AARP. "There was a second path in there, where nurse practitioners would have had full independence to open their own practice and that second pathway has been removed."

Those last-minute changes are "drastic," according to Castro.

"It moots the whole intent of this bill," she said.

Bill author Hernandez said the changes do limit the scope of the bill, but that it remains a viable and important piece of legislation.

"I am disappointed that AARP has decided to oppose SB 491. They have been a good partner, and I certainly appreciate the hard work they’ve done to try to get full practice autonomy for California’s 17,000 nurse practitioners," Hernandez said.

"It is unfortunate that the reality of the political process has narrowed the bill substantially," he said, "but we intend to press forward." 

The bill failed to muster enough votes to pass last week. Today's second vote is supposed to occur without discussion because it was discussed last week before falling two votes shy of passing.

In last week's vote, five legislators abstained from voting, prompting Hernandez to make concessions to try to pass the bill in today's rehearing. To Castro and AARP, those amendments went too far.

"With a consumer organization like AARP, we're not taking sides. It's not doctors vs. nurses -- we don't get into that," Castro said. "It's about access, and the demand that's coming for primary care. We were trying to prepare for that."


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