HARRISBURG — Gov. Ed Rendell could not persuade state lawmakers this year to embrace the cornerstone of his sweeping health care reform plan: expanding state-subsidized health coverage to roughly 800,000 uninsured adults.

But his administration won some smaller victories in its effort to lower the cost and improve the quality and availability of health care.

Certain health care professionals who aren't doctors, such as nurse midwives and nurse practitioners, were granted broader authority to provide basic medical care. And hospitals and nursing homes face new requirements for reporting and reducing the number of infections contracted by patients under their care.

The administration views non-doctor health professionals as a crucial link in the health care system because they provide preventive care at lower prices, filling a void left by a declining number of general-practice physicians in some parts of the state.

Pennsylvania's laws previously prevented nurse practitioners — registered nurses with advanced degrees and specialized training — from performing the full range of health care duties for which they have been trained, such as ordering medical equipment and making referrals for certain medical therapies, said Morgan Plant, a lobbyist for the Pennsylvania Coalition of Nurse Practitioners.

The changes will also end Pennsylvania's distinction as the only state barring nurse midwives from prescribing drugs. However, midwives will not be able to write prescriptions until state regulations are updated to conform with the new law.

Other regulatory changes will need to address issues such as how many nurse practitioners a doctor may supervise at one time, Plant said.

Reducing hospital-acquired infections, which the administration says added nearly $3.5 billion to hospital charges last year, is another goal of Rendell's plan.

Another new law requires hospitals, outpatient surgery centers and nursing homes to develop state-approved infection control systems and report all hospital-acquired infections to the U.S. Centers for Disease Control and Prevention. Facilities that reduce infections by 10 percent from the previous year will be rewarded with cash payments.