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Senate Bill 323

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Alex Crotteau

on 20 April 2016

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Transcript of Senate Bill 323

Targeted groups and how to spread the news about SB 323
Little Opposition and Much to Gain
What is on the Agenda?
Who Are the Winners and Losers?
The main argument against SB 323 is that patients will be receiving treatment from lesser trained practitioners. The California Medical Association (CMA) is the major opposition for this bill. They state, "SB 323 ... reverses 40 years of policy that has maintained high quality healthcare for every Californian by allowing lesser trained practitioners to practice medicine without providing adequate patient protections and medical standards."
The groups targeted were elected officials such as Senators and other members of legislature.

: Email campaign were used by each chapter (27 total) of the CANP (California Association of Nurse Practitioners)

: Lobby day 16: May 24, 2016, in Sheraton Grand Sacramento Hotel-personally meet Senators

: On-sight lobby: a week in November called NP week to promote recognition of the NP profession by visiting local state assembly members and Senators.
Monday, February 23, 2015
Vol XCIII, No. 311
Policy Challenge details and Supporting Nursing Association
What Is Senate Bill 323 and How Does It Effect Future APRNs
Non-legislative strategies
The California Association for Nurse Practitioners (CANP) supports Senate Bill 323 which would enable California to join 21 other states and the District of Columbia as jurisdictions that permit NPs to practice to the full extend of their education, experience, and expertise. The bill authorizes the implementation of standardized procedures that authorize a nurse practitioner to perform certain acts, including ordering durable medical equipment, certifying disability for purposes of unemployment insurance after physical examination and collaboration with a physician or surgeon, and, for an individual receiving home health services or personal care services, approving, signing, modifying, or, adding to a plan of treatment or plan of care after consultation with a physician or surgeon.
Since its establishment in 1977, the CANP has provided a forum and unifying voice for NPs statewide, often joining forces with other state and national organizations, to advance the profession and bridge healthcare needs.
Senate Bill 323
Nurse Practitioners Scope of Practice

Since the passing of the Affordable Care Act there has been a massive influx of patients looking for primary healthcare providers which has lead to extensive wait times to see physicians and subsequent gaps in care in under served communities. To fill these gaps, many states have enacted legislation to allow NPs to practice without the oversight of a physician. This has helped shape the role of the NP as a primary provider and has also worked to prove that masters prepared nurses can deliver high quality primary care. A systemic review was performed which, "supports a high level of evidence that APRNs provide safe, effective, quality care to a number of specific populations in a variety of settings." While this bill was defeated in the California Senate in June 2015, grassroots efforts are still being organized to push for continued awareness.
The ones with the most to gain from this legislature is the patients. With more access to prevention focused primary care NPs, healthcare would be more efficient and less expensive, which in turn could drive down the national cost of health expenditures.
With the expansion of the NPs scope to practice independently also comes the need to open new businesses in rural areas. This will act as an economic catalyst for these under served communities.

Where is it?
Key Points

1) The ability to practice independently of a physician or surgeon.
2) The Nurse Practitioner must maintain liability insurance.
3) The Nurse Practitioner would be required to refer a patient with a condition out of their scope of a practice to the appropriate physician.
4) The ability to order, furnish, prescribe, or procure drugs and devices.
Non-legislative strategies that were utilized to support initiatives

*The use of social media (Facebook, Twitter, LinkedIn, and Instagram) to join the conversation and to share views and opinions

*Flyers handout to patients during visit regarding NP role

*Published news and opinions
Senate Bill 323 had been amended several times last year because there were things that they didn’t like in the bill. The bill is now waiting for the July house sitting where they will make a vote on it. The Bill will either be passed or denied and lose its life. In other words the Bill has one more chance of passing and if it fails then nurse practitioners have to get together again and start all over creating another Bill, introducing it and moving it up the ranks through the process until it becomes a new Senate Bill.
How far along is SB 323?
With 5 million new insured patients being added essentially overnight to the health-care system, the patient load on primary care providers has become a burden. The long wait for appointments has turned simple ailments into chronic conditions for some patients, and has frustrated many more. The road is difficult and many organizations have opposed the SB323 - these include (AMA, CMA,MBC, UAPD,CA-ACC and CSPS). These roadblocks are felt as we study SB323 and learn about the difficult and arduous task it is to get a bill through the maze-like legislative process that we all share. But in order for this specific SB 323 to be passed as law, all certified nurse practitioners have to articulate their support as one voice advocating for our profession to practice autonomously to the full extent of our education, training and expertise.
On Policy and Process
The Implications Are Coming
One major implication of SB 323, is that it will provide an effective way for nurse practitioners to fill in the gap and address the burden created by the new influx of patients resulting from the new Affordable Care Act and the lack of doctors at the primary care level. This Bill implies that if a nurse practitioner is certified by a nationally accredited body they will be allowed to perform their practice without physician supervision. The duties of the autonomous nurse practitioner will include but not be limited to independent practice and prescriptive authority, standardized procedures i.e. ordering medical equipment, certifying disability for purpose of unemployment insurance, and provide home health service.
Hope for the Future
Alex Crotteau
Paul Buenaventura
Ilsu Min
California Association for Nurse Practitioners. (2016) Senate bill 323
resource center grassroots outreach remains critical, as measure remains under consideration. Retrieved from http://canpweb.org/advocacy/senate-bill-323-resource-center/

California Association of Nurse Practitioner. (2015). Bill Review and Analysis process.
Support/ Oppose? Not position?. Retrieved from http://canpweb.org/advocacy/senate

"We in America do not have government by the majority. We have government by the majority who participate." -Thomas Jefferson
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