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Sb 491-492-493 Fact Sheet Final

Sb 491-492-493 Fact Sheet Final

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Published by: vomeditor on Apr 11, 2013
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SBs 491/492/493 (Ed Hernandez)
Utilizing the Health Care Continuum to Increase Access to Care
SB 491, SB 492, and SB 493 are a package of bills intended to allow Nurse Practitioners (NPs),pharmacists, and optometrists to practice to the full extent of their education and training in orderto expand access to the health care delivery system for the millions of Californians who will havenew access to coverage through implementation of the federal Patient Protection and AffordableCare Act of 2010 (ACA).
Primary Care Physician Workforce Shortage
According to a report commissioned by the California Health Care Foundation, the number of primary care physicians actively practicing in California is at the very bottom range of, or below,the state's need based on Council on Graduate Medical Education estimates. The distribution of these physicians is also poor. In 2008, there were 69,460 actively practicing physicians inCalifornia (this includes Doctors of Medicine and Doctors of Osteopathic Medicine), and only 35percent of these physicians reported practicing primary care. This equates to 63 active primarycare physicians in patient care per 100,000 persons. According to the Council on Graduate MedicalEducation, a range of 60 to 80 primary care physicians are needed per 100,000 in order toadequately meet the needs of the population. When the same metric is applied regionally, only 16
of California’s 58 counties fall within the needed supply range for primary care physicians.
Inother words, less than one third of Californians live in a community where they have access to thehealth care services they need.
As a result of implementation of the ACA, about 4.7 million more Californians will be eligible forhealth insurance starting in 2014. The newly insured will increase demand for health care on analready strained system. Furthermore, the ACA aims to change how care is delivered. It willprovide incentives for expanded and improved primary care, which may affect demand for somehealth care professionals more than others, and create team-based models of service delivery.Research indicates that health care reform will place higher skill demands on all members of thehealthcare workforce as systems try to improve quality while limiting costs. The scale of changewith health care reform is unlike anything that the state has previously faced. Studies have foundthat persons with health insurance use more health care services than uninsured persons,particularly in primary care and preventive services. This was found in Massachusetts, whichexperienced a substantial increase in demand for primary care services as a result of its 2006health reform. Many newly insured Californians will have a pent-up demand for services and willcreate even more pressure on the already strained health care system, particularly in medicallyunderserved areas.
SBs 491/492/493 - Fact SheetPage 2
Background on Provider Groups
NPs are advanced practice registered nurses who have pursued higher education, a master’s or
doctorate degree, and certifi
cation as an NP. In order to be more competitive in today’s job
market, many NPs now pursue additional specialty education and training in specialties like
pediatrics, geriatrics, women’s health, while many remain focused on providing primary care. NPs
play an important role in the health care delivery system and provide care in a variety of settingsincluding hospitals, community clinics, and private practice settings including in many medicallyunderserved communities throughout the state. There are approximately 17,000 nursepractitioners licensed by the Board of Registered Nursing in California.Doctors of optometry are extensively educated and trained according to a national standard.California doctors of optometry complete four years of undergraduate education and four years of post-graduate education, and many complete one year of residency. Doctors of optometry havemore than 100 class hours in pharmacology, equal to that of medical practitioners, dentists andpodiatrists. Optometric doctors are on the front line of eye and vision care and understand howearly diagnosis and treatment of conditions like diabetes and cancer can save millions of dollarsdownstream. Optometric doctors can do more than measure and correct vision and prescribe andfit lenses. As front line health care providers, they are able to monitor blood pressure and provideother basic primary care services.Pharmacists provide patient care that optimizes medication therapy and promotes health,wellness, and disease prevention. Pharmacists complete a four year post-graduate doctoraltraining program that includes extensive training in human anatomy and physiology, recognitionand treatment of diseases and conditions, pharmacology, optimal medication use, as well asexperience in direct patient care in multiple health care settings through clinical rotations.Many pharmacists complete a residency program and obtain board certification in a specializedarea of practice.
These bills
A recent 
New York Times
editorial stated
There is plenty of evidence that well-trained healthworkers can provide routine service that is every bit as good or even better than what patientswould receive from a doctor. And because they are paid less than the doctors, they can save thepatient and the h
ealthcare system money.”
SB 491/492/493 will allow for better utilization of ourexisting infrastructure of trained medical providers to bridge the provider gap through expandedpractice.Californians deserve access to high quality primary care offered by a range of safe, efficient, andregulated providers. Physician assistants, nurse practitioners, pharmacists and optometrists haveall significantly advanced their educational, testing, and certification programs over the past decade. They've enhanced clinical training, moved to graduate or advanced degrees, and upgradedprogram accreditation processes.Other states have recognized these advances with practice acts that align with professionalcompetence and advanced education. But California's practice acts have not kept pace. We can nolonger afford to get by on a fraction of our professional capacity. In California we have a robust network of providers that are well-trained, evenly distributed throughout the state, regulated by

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