California El Camino Real Association of Occupational Health Nurses
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Legislative Update

Posted almost 5 years ago

State Bill # Summary Status
CA AB5  Worker status: employees and independent contractors. 2019-05-02 / Intro
To Assembly Appropriations Committee
CA SB11  Health care coverage: mental health parity. 2019-05-01 / Intro
To Senate Appropriations Committee
CA SB24  Public health: public university student health centers: abortion by medication techniques. 2019-04-24 / Intro
To Senate Appropriations Committee
CA SCA3  Property taxation: change in ownership: inheritance exclusion. 2019-04-30 / Intro
[Hearing: May 7 @ 9:30 am]

To Senate Elections and Constitutional Amendments Committee

Read about bill AB5  https://calaborfed.org/5-reasons-the-ca-legislature-must-say-yes-on-ab-5/

Read about bill SB 11:   This bill prohibits a mental health plan or insurer that provides prescription drug benefits for the treatment of substance use disorders from imposing any prior authorization requirements or any step therapy requirements before authorizing coverage for FDAapproved prescriptions. This bill also requires health plans and insurers to submit an annual report to the Department of Managed Health Care or the Department of Insurance to certify compliance with state and federal parity laws.

Read about SB24:

California state SB 24 — the “College Student Right to Access Act”— was approved by the Senate Health Committee on Wednesday in a seven-to-three vote.

SB 24, introduced by Senator Connie Leyva, D-Chino, in December 2018, would give students on CSU and UC campuses access to medical abortions, also known as nonsurgical abortion or the “abortion pill.”

The bill is a continuation of Leyva’s earlier legislature in the same field. She introduced SB 320 in 2017, which had similar provisions to SB 24. SB 320, however, was vetoed by then-governor Jerry Brown in 2018.

“SB 24 is an important step toward ensuring the right to abortion is available to all Californians and that our college students don’t face unnecessary barriers,” Leyva said in a statement on her website. “Students should not have to travel off campus or miss class or work responsibilities in order to receive care that can easily be provided at a student health center.”

SB 24 has its origins at UC Berkeley, with the Students United for Reproductive Justice at Berkeley organization, or SURJ. Its goal was to create a “less complicated and more accessible process of getting medication abortion,” according to Phoebe Abramowitz, campus senior and director of SURJ.

SURJ received support from the Women’s Policy Institute, part of the Women’s Foundation of California, which helped connect the organization to Leyva and bring the issue to the state level, according to Abramowitz.

The discussion about the bill also includes barriers specific to particular demographics on campus.

Read about SCA 3:

SCA 3, as introduced, Hill. Property taxation: change in ownership: inheritance exclusion.
The California Constitution generally limits ad valorem taxes on real property to 1% of the full cash value of that property. For purposes of this limitation, “full cash value” is defined as the assessor’s valuation of real property as shown on the 1975–76 tax bill under “full cash value” or, thereafter, the appraised value of that real property when purchased, newly constructed, or a change in ownership has occurred. The California Constitution specifies various transfers that are not deemed to be a “purchase” or “change in ownership” of a property for these purposes, including the purchase or transfer of a principal residence from parents to their children, or, under certain circumstances, from grandparents to their grandchildren, and the purchase or transfer of the first $1,000,000 of the full cash value of all other real property transferred from parents or grandparents to their children or grandchildren.
This measure would limit the above-decribed $1,000,000 exclusion for purchases or transfers of real property other than a principal residence to purchases or transfers of nonresidential real property. The measure, except as provided, would provide that the transfer of the principal residence of a parent or grandparent is excluded from “purchase” or “change in ownership” under these provisions only if the transferee uses the residence as his or her principal residence within 12 months after the transfer. If the transferee subsequently ceases to use the residence as his or her principal residence, the measure would require that the residence be assessed at its full cash value as of the date of the transfer from the parent or grandparent to the transferee. The measure would provide that these changes apply to a purchase or transfer of real property on or after the effective date of the measure. The measure would also make various nonsubstantive changes.

DIGEST KEY

Vote: 2/3   Appropriation: no   Fiscal Committee: yes   Local Program: no  

Assembly bill 890: Full Practice Authority

Nurse practitioners, who undergo more training than registered nurses, have been lobbying the Legislature for years to care for patients on their own without a physician’s approval. They’ve argued this change in state law would ensure the state’s aging population has access to medical care.

The California Medical Assn., the powerful lobbying arm for the state's doctors, has so far blocked those efforts. But this year could be different, with a key lawmaker, Assemblyman Jim Wood (D-Healdsburg), switching sides.

Wood, who voted against a 2015 bill to grant autonomy to nurse practitioners, is authoring this year’s version of the legislation. Wood said he became convinced a change was needed because of the growing gap between primary care providers and patients, particularly in rural and inner-city areas. He hopes other reluctant lawmakers will flip, too.

“A lot of people are lacking care,” said Wood, who is a dentist. “As we expand more and more to offering care to everyone, to not have providers is an empty promise and we can’t do that in California.”

Assembly Bill 890 faced its first hearing in the state Legislature on Tuesday, where the bill was approved 16-0 by the Assembly Business and Professions Committee. Several lawmakers, however, said they could end up voting against the measure if it makes it to a full Assembly vote and if issues raised by doctors are not addressed.

The bill still has a difficult path ahead to clear the Assembly before it would then go to the Senate, which has been welcoming to previous attempts to expand the scope of practice for nurse practitioners. The bill next heads to the Assembly Appropriations Committee, a common graveyard for legislative attempts.

Megan Allred, a lobbyist for the California Medical Assn., said negotiations with Wood would continue, but that “there are significant areas in which we differ from the author and supporters of the bill.”

Among the changes Wood made to the bill in hopes of addressing concerns from the doctors group were provisions to create a new licensing board to oversee nurse practitioners who work independently and to require a minimum level of experience before a nurse practitioner can work without a doctor’s oversight.

The medical association said it continues to have concerns that nurse practitioners lack the extensive education or clinical training needed to practice without supervision by a doctor. The group said there are more effective ways to address the shortage of medical providers, such as expanding doctor residency programs.

The California Future Health Workforce Commission, a group that includes Wood and is co-chaired by University of California President Janet Napolitano, released a report in February proposing that the state invest in expanding doctor training programs and create incentives like loan forgiveness and scholarships for students who pledge to work in rural areas of the state where shortages are most severe.

But, the group also urged lawmakers to grant nurse practitioners across the state more autonomy as part of a $3-billion plan to ensure California can meet the medical needs of residents.

Two previous bills by former state Sen. Ed Hernandez (D-West Covina) in 2013 and 2015passed the Senate, but failed in the Assembly.

Wood said working on the commission’s report, which highlighted the state’s looming healthcare crisis, prompted him to reevaluate his opposition to expanding the role of nurse practitioners in the state. The state does not currently have enough doctors and nurse practitioners and more than one-third of those who are practicing are approaching retirement age.

California is expected to face a massive workforce shortage in the next decade, with the state needing 4,100 more doctors and 600,000 additional home care workers, the commission said in its report.

At the same time, Gov. Gavin Newsom wants to widely expand healthcare access for lower-income and immigrant communities. Newsom proposed extending Medi-Cal coverage to young adults who are in the U.S. illegally and providing more subsidies for middle-class families struggling to afford health insurance, with Democratic lawmakers taking up both of those issues in the Legislature.

Surani Kwan, a nurse practitioner at Russian River Clinic in Sonoma County, said this year’s effort comes as more people are seeing the effects of the doctor shortage and have experience being treated by nurse practitioners.

California is one of 28 states that require nurse practitioners to work under a doctor’s oversight, although the state does not require the physician to be in the same clinic or city, just available by phone.

Kwan said under AB 890, current patients would continue to have the same quality of care, but the bill would ease burdens for those setting up new practices in places like the Central Valley where it can be difficult or expensive to contract with a doctor.

“Physicians don’t sit at your side and supervise what you do,” Kwan said. “This will change the face of healthcare. It doesn’t change what we do, we will do what we are trained to do in school. It will enable nurse practitioners to run clinics without having to have a physician sign off.”