Opposed a Bill to Allow Nurses to Dispense
Hormonal Birth Control
CNA Pitted against Planned Parenthood and Other Health Groups on AB 2348
In 2012, CNA opposed a bill to allow nurses to dispense hormonal birth control under a physician’s
orders. In opposing the bill CNA attempted to prevent women from obtaining birth control,
particularly women in poor areas who might only have access to community clinics as a means to
contain contraceptives.
Assembly Bill 2348 was introduced by Assemblywoman Holly Mitchell (AD-54) on February 24,
2012.
According to the
summary
from the Assembly, the bill authorizes registered nurses to dispense:
“1) Drugs or devices upon an order by a certified nurse-midwife, nurse practitioner, or physician
assistant if the RN is functioning within a licensed primary care clinic, as specified.
2) Hormonal contraceptives pursuant to standardized procedures, developed in compliance with
current law defining standardized procedures that RNs may implement, if the RN is functioning
within a licensed primary care clinic, as specified.”
HEADLINE: Planned Parenthood moves to improve access to reproductive health care As elected officials across the nation are passing laws to restrict access to women's
reproductive health care and defund family planning services, Planned Parenthood Affiliates of California (PPAC) including Six Rivers Planned Parenthood is sponsoring two common-sense bills that will improve access for thousands of women across the state…
Assembly Bill 2348 would make birth control methods more widely available by authorizing registered nurses to dispense birth control under a standardized procedure. Senate Bill 1338 would ensure women have access to comprehensive reproductive health care from local providers by authorizing nurse practitioners, certified nurse midwives and physician assistants to provide early safe abortion care under the terms of their licenses…
"When contraception and abortion are out of women's reach, unhealthy outcomes go up," observed Assemblywoman Holly Mitchell (D-Los Angeles) author of AB 2348. "We're trying to reduce the number of women who delay or forgo reproductive care they and their families need because the cost is too high or professional medical care is too far."…
In addition to PPAC, AB 2348 is sponsored by the California Family Health Council. It is supported by American Nurses Association of CA, United Nurses Associations of CA/Union of Healthcare Professionals, Ibis Reproductive Health, Maternal and Child Health Access, ACCESS Women's Health Justice, California Latinas for Reproductive Justice, National Council of Jewish Women, Law Students for Reproductive Justice, National Center for Youth Law, Citizens for Choice and Coalition Advancing Multipurpose Innovations (CAMI).
CNA was one of only a few medical professional associations that opposed the bill.
HEADLINE: Jerry Brown signs legislation expanding access to birth control
Supporters of Assembly Bill 2348 , by AssemblywomanHolly Mitchell , D-Los Angeles, say it will improve access to birth control, especially in poor and rural areas, reducing unplanned pregnancies.
The legislation pitted non-union Planned Parenthood clinics and other health groups against theCalifornia Nurses Association. The influential nurses union, which has donated millions of dollars to Brown and his causes, had said the measure could result in poor women
receiving lesser care.
Sacramento Bee, September 22, 2012 (emphasis added)
CNA Called Out for Taking Positions Counter to Public Health Needs
A June 2012 Dan Morain column from the Sacramento Bee highlighted many of the reasons it was odd
that CNA would oppose a bill that would improve the conditions of women, particularly poor
women.
HEADLINE: Is nurses union a health hazard?
The California Nurses Association can place its record of campaign wins against any of the other big-time players on the left. But watching its lobbyists work the Capitol halls, I'm left to wonder which side they're on…
But some of its stands run counter to public health. There is, for example, legislation that would permit registered nurses to dispense birth control pills in community clinics. Earlier this year, there was legislation that sought to expand a program by which nurse practitioners and nurse-midwives provide nonsurgical abortions.
The California Nurses Association contends that the measures could leave poor women with lesser care than people of means. Health care advocates viewed those claims as bogus, and believe the issue comes down to union representation.
Planned Parenthood is the main proponent of both bills. As it happens, Planned Parenthood clinics are not union shops.
Assemblywoman Holly Mitchell , D-Los Angeles, the author of the birth control legislation, is hardly antagonistic toward labor and has spent a career focused on issues related to poor women and children.
In the 1990s, Mitchell was a health policy analyst for the California Senate and later a lobbyist for the Western Center for Law and Poverty, one of the few voices in the Capitol for the underclass. More recently, she was chief executive of Crystal Stairs, a nonprofit that provides child care for 25,000 poor kids in Los Angeles.
"It is a basic woman's reproductive health issue," Mitchell said of her bill, Assembly Bill 2348, which awaits a Senate vote. "I am deeply disappointed that the opposition comes from a female-dominated health care profession, at a time when we are experiencing attacks in public policy settings on women's health choices."
The beneficiaries of her bill would be poor women. Most live in rural areas or inner cities where doctors rarely venture, are between 18 and 29, and have no health insurance.
The bill would allow registered nurses who work in licensed community clinics to dispense the contraceptives, so long they have training and operate under physicians' orders. Other unions representing nurses support the bill.
"It is our mission to increase access to birth control," said Kathy Kneer, the longtime head of Planned Parenthood in California. "We have something we know is safe. The issue is, how do we remove barriers to obtaining birth control?" …
The California Nurses Association dismisses labor-management partnerships, as it goes off on its own. Its tactics have worked, some of the time. But a nurses' union that opposes allowing nurses to give birth control pills to poor women should ask itself how long that run of good fortune will last
.
Dan Morain Column, Sacramento Bee, June 17, 2012
The column also highlighted other instances of CNA taking counterintuitive positions on public
health bills.
There are other examples of the nurses union taking odd stands. The union is fighting county public health officers over legislation that seeks to encourage nurses who work with patients to get flu shots.
Last year, the union fought a bill permitting volunteer public school employees to administer a particular drug to epileptic children who are in the midst of life-threatening seizures. Union lobbyists argued unsuccessfully that nurses should administer the drug, though few schools can afford nurses.
Being an outlier is familiar territory for the California Nurses Association. Most unions sided with President Barack Obama and advocated for the Affordable Care Act in 2009. The nurses union held out for more, Medicare for all, despite the lack of political support for the
concept…
"We take on fights that are part of the greater public interest," said Chuck Idelson, the union's communication director.
Dan Morain Column, Sacramento Bee, June 17, 2012
Governor Brown Stated AB 2348 Empowered Women and Reaffirmed Their
Basic Rights
AB 2348 was signed into law by Governor Edmund G. Brown on September 22, 2012. He made a
statement from Planned Parenthood that the legislation empowered women and reaffirmed
HEADLINE: Jerry Brown signs legislation expanding access to birth control
Gov. Jerry Brown signed legislation today allowing registered nurses to dispense birth
control in clinics, depicting California as a place above recent controversies nationally about
contraception.
"Instead of shrinking back and trying to take away women's health care services or birth control, we're empowering women, and we do it proudly," Brown said at a Planned Parenthood headquarters here. "Today, we're realizing the dream that women have a right to control their own destiny, not with some guys in the Legislature who think they know better."
Sacramento Bee, September 22, 2012 (emphasis added)
HEADLINE: Brown signs law allowing women speedier access to birth control Gov. Jerry Brown signed into law Saturday a bill that will give women new and easier avenues for obtaining birth control.
AB 2348 gives registered nurses the ability to dispense not only hormonal contraceptives through a regulated procedure but the ability to give out drugs and devices after being authorized by a certified nurse-midwife, nurse practitioner or physician assistant. The bill expands the settings in which RNs can give out drugs or devices to include
intermittent clinics and student health centers. It also takes away all limits on settings where RNs can dispense contraceptives.
Brown, surrounded by supporters of the bill, signed AB 2348 at the Planned Parenthood’s Los Angeles headquarters.
“At a time when some seek to turn back the clock and restrict women’s health choices, California is expanding access to birth control and reaffirming every woman’s basic Constitutional rights,” Brown said in a press release.
Orange County Register, September 24, 2012 (emphasis added)
Governor Brown and Assembly Speaker Perez Criticized AB 2348’s Opponents
as not Being Progressive
After signing AB 2348 Governor Brown went on record as saying that progressive Democrats had
supported the measure. Assembly Speaker Perez criticized Republican who opposed the bill for
attacking women’s reproductive rights.
HEADLINE: Jerry Brown signs legislation expanding access to birth control
"I would also just say as part of the chemistry of legislation, you'll find that allies become adversaries for certain bills," Brown said. "Generally speaking, the great family of
progressive, thoughtful Democrats are on board, for the most part."…
Brown, speaking in the state's largest media market, criticized Republicans for their
opposition to Mitchell's bill, while Assembly Speaker John A. Perez lamented what he called a "fierce assault" on reproductive rights.
Sacramento Bee, September 22, 2012
CNA Criticized the Measure after It Became Law
Even after AB 2348 became law, CNA was active in their criticism of the measure.
HEADLINE: Nurses Can Dispense Hormonal Birth Control In California, But New Law Draws Controversy
California's registered nurses can now dispense hormonal contraceptives such as birth control pills without a pelvic or comprehensive physical exam, and without direct physician supervision…
The California Nurses Association, however, was among numerous organizations that did not support the bill.
"RNs in general were shocked," said Bonnie Castillo, the association's government relations director. "They felt it was half-baked and backward. RNs care first and foremost about their patients. They don't want to be complicit in a model that's unsafe."…
Doug Lorenz, a spokesman for Assemblyman Jeff Gorell, R-Camarillo, said he didn't vote for the bill because of the CNA's lack of support.
"If an organization is opposing a bill that has to do with the job duties of its own members, you have to take their opinion to heart," Lorenz said.
