California provider status bill passes state Senate

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Proposed legislation intended to address shortage of primary care providers

On May 29, the California state Senate approved its pharmacist provider status bill (SB 493) that would expand the scope of practice for pharmacy and would specifically name pharmacists as providers. SB 493 now moves to the California State Assembly for consideration.

The proposed state legislation is intended to help address California’s shortage of primary care services, according to its sponsor.

“The significance of the current legislative step is two-fold,” California Pharmacists Association (CPhA) CEO Jon R. Roth, CAE, told pharmacist.com. “First, it has been voted out of the Senate, the bill’s house of origin. In order to achieve that step, we had to work to remove all the active opposition to the bill. That will allow the bill to be viewed more favorably as it moves over to the California Assembly.”

The legislation was introduced on February 21 as part of a package of bills by California state Sen. Ed Hernandez, OD, a practicing optometrist and Chair of the state Senate Health Committee. Hernandez also introduced legislation involving other providers: nurse practitioners (SB 491) and optometrists (SB 492). A parallel bill introduced for physician assistants is being carried by another author.

The bills would address the “current primary care physician workforce shortage” that will be compounded when 4.7 million more Californians become eligible for health insurance starting in 2014 under the Affordable Care Act, according to a fact sheet released by Hernandez’s office. The number of primary care physicians actively practicing in California is at the very bottom range of, or below, the state’s need, and the distribution of these physicians is also poor.

SB 493 would amend California state law to read that the practice of pharmacy is a profession; that “pharmacy practice is a dynamic, patient-oriented health service that applies a scientific body of knowledge to improve and promote patient health by means of appropriate drug use, drug-related therapy, and communication for clinical and consultative purposes”; that “pharmacy practice is continually evolving to include more sophisticated and comprehensive patient care activities”; and that “pharmacists are health care providers who have the authority to provide health care services.”

Examples of new authorities for pharmacists in California would include furnishing self-administered hormonal contraceptives, prescription smoking cessation drugs, and prescription drugs not requiring a diagnosis that are recommended for international travelers; ordering and interpreting tests to monitor and manage the efficacy and toxicity of drug therapies; and independently initiating and administering routine vaccinations.

The integrity of the bill has largely been preserved as it has proceeded through the California state Senate, Roth said.

Californians for Accessible Healthcare, the coalition supporting SB 491, SB 492, and SB 493, includes CPhA, the California Society of Health-System Pharmacists, California Association of Nurse Practitioners, and California Optometric Association. On the other side, Coalition for Patient Access and Quality Care, comprising the California Medical Association (CMA) and several other provider groups, oppose the legislation, according to a May 30 CMA news release.

“CPhA member pharmacists have been extremely active in making their voice heard at the capitol,” Roth said. “While much of the negotiation with the opposition was done by CPhA staff and consultants, it was the members’ outreach to legislators that helped affirm the importance of this legislation to the patients of this state. Many pharmacists met with their legislators, wrote letters, or made phone calls asking for a ‘yes’ vote on this bill.”

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