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Assembly Bill Could Allow Nurse Practitioners to Provide Primary Care

On Thursday, May 7th, the California Senate voted 25–5–9 to pass SB 323 (Hernandez), which sets down a framework that would allow nurse practitioners to provide primary care in California. Nurse practitioners would be allowed to perform basic diagnosing and prescribing roles without direct physician oversight in settings including community clinics, IPAs and group practices.

The shortage of providers in parts of the state has been a long-standing issue, reflecting a larger trend of provider shortages in rural areas across America. The United States Department of Health and Human Services’ Health Resources and Services Administration currently designates approximately 6,100 areas as a “primary care health professional shortage area,” meaning that the physician to population ratio is 1:3,500 or higher. Nearly 40% of these areas are located in California. Proponents of the bill hope to address the persistent primary care provider shortage that has plagued these parts of the state.

The California Medical Association voiced its opposition to the bill, citing concerns about the need for oversight for nurse practitioners, who do not go through the same training required by doctors. State Senator Richard Pan (D-Sacramento) echoed their concerns, stating that the California Board of Registered Nurses was not adequately prepared to oversee diagnosis and treatment, an action typically handled by the California Medical Board which oversees doctors. State Senator Ed Hernandez, the bill’s author, noted that nurse practitioners currently play a key role in providing care for Medicaid patients, and that allowing nurse practitioners to prescribe medication has not led to an increase in medical malpractice rates. He also highlighted that 20 other states have already expanded the scope of practice for nurse practitioners, with 17 states also allowing them to prescribe medication as they can in California.

SB 323 completed its first reading before the State Assembly on May 7th, and is currently under consideration.

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