AMENDED IN SENIOR SENATE OCTOBER 28, 2009

SENIOR ASSEMBLY PROPOSAL NO. 7

INTRODUCED BY SENIOR ASSEMBLY MEMBER WEINTRAUB

LEGISLATIVE COUNSEL'S DIGEST

AP 7: NURSE PRACTITIONERS: GERIATRICS.

THE NURSING PRACTICE ACT PROVIDES FOR THE LICENSURE AND REGULATION OF REGISTERED NURSES BY THE BOARD OF REGISTERED NURSING. EXISTING LAW ALSO PROVIDES FOR THE CERTIFICATION OF NURSE PRACTITIONERS, AS SPECIFIED, AND GENERALLY DEFINES A NURSE PRACTITIONER AS A REGISTERED NURSE WHO HAS SATISFACTORILY COMPLETED A NURSE PRACTITIONER PROGRAM APPROVED BY THE BOARD, AND WHO POSSESSES A MASTER’S DEGREE IN NURSING, A MASTER’S DEGREE IN A CLINICAL FIELD RELATED TO NURSING, OR A GRADUATE DEGREE IN NURSING.

THE MELLO-GRANLUND OLDER CALIFORNIANS ACT SETS FORTH THE STATE’S COMMITMENT TO ITS OLDER POPULATION AND OTHER POPULATIONS SERVED BY THE PROGRAMS ADMINISTERED BY THE CALIFORNIA DEPARTMENT OF AGING. IN THAT CONNECTION, THE LEGISLATURE HAS SPECIFIED THAT IT IS THE POLICY OF THIS STATE TO GIVE ATTENTION TO THE UNIQUE CONCERNS OF OUR MOST FRAIL AND VULNERABLE OLDER INDIVIDUALS, AS SPECIFIED.

THIS MEASURE WOULD MEMORIALIZE THE LEGISLATURE AND THE GOVERNOR TO ENACT LEGISLATION THAT WOULD ESTABLISH A STATE-FUNDED 2-YEAR PILOT PROJECT FOR THE TRAINING OF REGISTERED NURSES AS GERONTOLOGICAL NURSE PRACTITIONERS, TO BE IMPLEMENTED BY THE CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY AND THE STATE DEPARTMENT OF PUBLIC HEALTH.

VOTE: MAJORITY.

AP 7: RELATING TO NURSE PRACTITIONERS

WHEREAS, BY 2010, THE BABY BOOMERS WILL REPRESENT 25 PERCENT OF CALIFORNIA’S POPULATION AND, ACCORDING TO THE UNITED STATES CENSUS’ NEWEST PREDICTION, CALIFORNIA’S SENIOR POPULATION WILL DOUBLE BY 2020. THE CALIFORNIA DEPARTMENT OF AGING PROJECTS THAT, BEGINNING IN 2010, ONE IN FIVE CALIFORNIANS WILL BE 60 YEARS OF AGE OR OLDER AND, BETWEEN 2030 AND 2040, WHEN THE FIRST OF THE BABY BOOM GENERATION REACHES 85 YEARS OF AGE, THE PERCENTAGE OF ELDERLY WHO ARE IN THE OLDEST AGE GROUP WILL REACH 14 PERCENT; AND

WHEREAS, THE CALIFORNIA DEPARTMENT OF AGING REPORTS THAT, WHILE THE TOTAL POPULATION WILL APPROXIMATELY DOUBLE IN SIZE BETWEEN 1990 AND 2040, THE OLDEST OLD POPULATION WILL EXPERIENCE NEARLY A SIX-FOLD INCREASE, GROWING FROM JUST UNDER 300,000 TO OVER 1.7 MILLION PERSONS; AND

WHEREAS, ONLY ONE IN 99 PERSONS IN 1990 WERE IN THE OLDEST OLD AGE GROUP, AND ONE IN 34 PERSONS WILL BE IN THIS AGE GROUP BY 2040. THE OLDEST OLD OFTEN HAVE SEVERE CHRONIC HEALTH PROBLEMS THAT DEMAND SPECIAL ATTENTION, AND THE RAPID GROWTH OF THIS POPULATION GROUP HAS MANY IMPLICATIONS FOR INDIVIDUALS, FAMILIES, AND GOVERNMENTS; AND

WHEREAS, THE UNITED STATES IS IN THE THROES OF A MAJOR GERIATRICIAN SHORTAGE: SINCE 2000, THE NUMBER OF GERIATRICIANS IN THE UNITED STATES HAS FALLEN 22 PERCENT TO 7,100, AND, ACCORDING TO A MAY 2008 INSTITUTE OF MEDICINE REPORT, THE OUTLOOK FOR THE FUTURE IS NOT MUCH BETTER. BY 2030, THERE WILL BE JUST 8,000 GERIATRICIANS, DESPITE THE FACT THAT THE UNITED STATES WILL NEED ABOUT 36,000 GERIATRICIANS TO COVER THE WORKLOAD AS THE NUMBER OF AMERICANS 65 YEARS OF AGE AND OLDER MUSHROOMS; AND

WHEREAS, CALIFORNIA HAS ONLY 1,044 PRACTICING GERIATRIC MEDICAL DOCTORS, AND THERE EXISTS AN IMPERATIVE FOR INDIVIDUALS TO BE TRAINED TO ASSIST IN MEETING THE HEALTH NEEDS OF CALIFORNIA’S AGING POPULATION; AND

WHEREAS, THE GERONTOLOGICAL NURSE PRACTITIONER (GNP) IS A REGISTERED NURSE WHO HAS COMPLETED A GRADUATE LEVEL GERONTOLOGICAL NURSE PRACTITIONER PROGRAM AND IS QUALIFIED TO PROVIDE A FULL RANGE OF HEALTH CARE SERVICES ON THE WELLNESS-ILLNESS HEALTH CARE CONTINUUM AT AN ADVANCED LEVEL TO OLDER ADULTS. THE GNP PRACTICE INCLUDES INDEPENDENT AND INTERDEPENDENT DECISIONMAKING, AND IS DIRECTLY ACCOUNTABLE FOR CLINICAL JUDGMENTS. THE GRADUATE LEVEL PREPARATION EXPANDS THE GNP’S ROLE TO INCLUDE DIFFERENTIAL DIAGNOSIS AND DISEASE MANAGEMENT, PARTICIPATION IN AND USE OF RESEARCH, DEVELOPMENT AND IMPLEMENTATION OF HEALTH POLICY, LEADERSHIP, EDUCATION, CASE MANAGEMENT, AND CONSULTATION; NOW, THEREFORE, BE IT

RESOLVED, BY THE SENIOR ASSEMBLY AND THE SENIOR SENATE, JOINTLY, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA AT ITS 2009 REGULAR SESSION, A MAJORITY OF THE MEMBERS VOTING THEREFOR, HEREBY PROPOSES THAT A TWO-YEAR PILOT PROJECT BE ESTABLISHED FOR A STATE-FUNDED PROGRAM FOR THE TRAINING OF REGISTERED NURSES TO BECOME GERONTOLOGICAL NURSE PRACTITIONERS. PROGRAMS WOULD BE ESTABLISHED IN NORTHERN, CENTRTAL, AND SOUTHERN CALIFORNIA; AND BE IT FURTHER

RESOLVED, THAT THE LEGISLATURE AND THE GOVERNOR OF THE STATE OF CALIFORNIA ENACT APPROPRIATE LEGISLATION TO, AND THE CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY AND THE STATE DEPARTMENT OF PUBLIC HEALTH ADOPT IMPLEMENTING POLICIES AND TAKE IMMEDIATE ACTIONS TO, ESTABLISH A TWO YEAR PILOT PROJECT FOR A STATE-FUNDED PROGRAM FOR THE TRAINING OF REGISTERED NURSES TO BECOME GERONTOLOGICAL NURSE PRACTITIONERS; AND BE IT FURTHER

RESOLVED, THAT THE SENIOR LEGISLATURE OF THE STATE OF CALIFORNIA RESPECTFULLY MEMORIALIZES THE LEGISLATURE AND THE GOVERNOR OF THE STATE OF CALIFORNIA TO ENACT APPROPRIATE LEGISLATION THAT WOULD ADDRESS THE CONCERNS SET FORTH IN THIS MEASURE; AND BE IT FURTHER

RESOLVED, THAT A COPY OF THIS MEASURE BE TRANSMITTED TO THE SPEAKER OF THE ASSEMBLY, THE PRESIDENT PRO TEMPORE OF THE SENATE, AND THE GOVERNOR OF THE STATE OF CALIFORNIA.

RN 09 16462

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