The California Medical Association (CMA) has had some success neutralizing the three "scope-of-practice" bills that were introduced earlier this year.

Senate Bill 491 (Hernandez): Last week this bill failed to move out of committee on a 6-3 vote. The bill (SB 491) would allow nurse practitioners to open practices without any oversight from a trained medical doctor and prescribe narcotics without supervision. Although the bill failed to pass committee last week, it was granted reconsideration and will be voted on again next Tuesday in the Assembly Business, Professions and Consumer Protection Committee. While an important part of the health care delivery system, nurse practitioners simply do not have adequate training or education to be qualified to practice medicine without physician oversight.

Senate Bill 492 (Hernandez): This bill would allow optometrists to examine, prevent, diagnose and treat any disease, condition or disorder of the visual system, the human eye and adjacent related structures. This has become a two-year bill and is expected to be resurrected in the next legislative session. CMA believes this bill could place patients at risk of significant harm from having medical conditions diagnosed and treated by practitioners who lack the education, training and experience to do so.

Senate Bill 493 (Hernandez): After much negotiation, CMA was able to include language requiring additional training for pharmacists to initiate and administer vaccines, and provide contraceptives under this bill. CMA was also able to eliminate language that would have allowed pharmacists to independently prescribe dangerous smoking cessation drugs such as Chantix, instead limiting them to nicotine replacement therapy smoking cessation medications. With these modifications, CMA has moved to a neutral position on this bill. The bill passed Assembly Business, Profession and Consumer Protection Committee last week and now moves to Assembly Health Committee.

CMA strongly believes that simply expanding the scope of practice of allied health practitioners to give them independent and/or expanded practice will do nothing to improve access to care or quality of care in our state. Allowing practitioners to perform procedures they simply aren’t trained to do can only lead to unpredictable outcomes, higher costs and greater fragmentation of care.

Using successful models as a guide, California should be looking toward integrated, team-based care led by physicians. These teams will streamline care, maintain and improve patient safety and decrease costs of health care throughout the state.

Contact: Juan Thomas, (916) 551-2546 or jthomas@cmadocs.org.