California Nurse Practitioners on Hold, Again

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California Nurse Practitioners on Hold, Again

New bill on NP autonomy is pulled from the legislative calendar

By Elizabeth Hanink, RN, BSN, PHN
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According to the American Association of Nurse Practitioners and the 2012 Pearson Report (published in the American Journal of Nurse Practitioners), California is one of the most restrictive states in the nation when it comes to NP autonomy. That situation will continue for at least another year: A new bill aimed at expanding California NPs’ scope of practice has been removed from the current legislative schedule.

Playing Politics

The move was due to heavy political pressure from the California Medical Association (CMA), which strongly opposes greater autonomy for nurse practitioners. Last year, a similar measure, S.B. 491, collapsed because a CMA lobbying campaign forced amendments that eventually alienated even supporters like the AARP.

Despite the CMA’s opposition, NP autonomy is gaining support. The Federal Trade Commission recently issued a paper entitled “Policy Perspectives: Competition and the Regulation of Advanced Practice Nurses,” which advises state legislatures to be cautious about limiting APRN practice.

The FTC paper cites research demonstrating that NPs provide safe and effective care and warns that imposing legal restrictions that limit patients’ access to APRNs “may reduce competition that benefits consumers.”

An Effective Step

One of the potential benefits of giving NPs more autonomy is lower costs. According to a recent report prepared by the Bay Area Council Economic Institute and sponsored by the Robert Wood Johnson Foundation and AARP, California could reduce healthcare spending by $1.8 billion over the next decade if nurse practitioners were allowed a broader scope of practice.     

The report also argues that allowing NPs to practice independently would be “one of the most effective steps” to increase access to primary care services.  


Notes on Nurse Practitioners

NPs in California: 18,000
NPs in the United States: 171,000
NPs trained each year: 9,000
Colleges and universities with an NP program: 325
Year NP program developed: 1965
First NP: Loretta Ford

It’s often been said that the role of nurse practitioners should be expanded to serve the additional patients covered by the Affordable Care Act. There is historical precedent for such an action.

In 1965, Medicare and Medicaid were signed into law. Suddenly, medical services were needed for millions of seniors, low-income women and children, and people with disabilities. Because physicians were unable to meet this demand, the role of nurse practitioner was developed.    

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