Nursing & Healthcare News

Closing in on NP Autonomy

A.B.890 passes both houses of the Legislature

Nurse practitioner is sitting next to a female patient who is holding her baby

In June, Working Nurse reported on A.B.890, a path-to-autonomy bill for California nurse practitioners. That bill now awaits the signature of Gov. Newsom.

Small Steps Forward

The battle for APRN autonomy in California has resulted in stalemate after stalemate, but independent practice for at least some California NPs now appears tantalizingly close to reality. An amended version of A.B.890, the path-to-autonomy bill the Assembly approved earlier this year, passed the State Senate on August 28.

As Working Nurse previously reported, this bill would not provide autonomy for all NPs, and its requirements for independent practice would be among the strictest in the nation, including national certification, completion of at least 4,600 hours of “transition to practice” experience and other requirements to be established by regulation.

Hiring Now

The bill doesn’t cover other APRNs, although S.B.1237, a bill to allow certified nurse midwives to attend low-risk births without supervision, is also on its way to Newsom’s desk.

The Last Hurdles

The amended version of A.B.890 establishes additional parameters for the transition-to-practice requirements, which now include experience “managing a panel of patients, working in a complex healthcare setting, interpersonal communication, interpersonal collaboration and team-based care, professionalism, and business management of a practice.”

Nursing Education

However, NPs may be able to count at least some past experience towards these requirements, which wasn’t the case with the version that passed the Assembly earlier this year.

The current version avoids the competing-boards problem of the earlier Assembly version. Instead, it would create a new nurse practitioner advisory committee, consisting of four NPs, two physicians and one public member, to “advise and make recommendations to” the BRN regarding NP autonomy.

This committee would be largely responsible for establishing the requirements for independent practice, including the transition-to-practice requirements.

Even if the governor signs the bill (which the California Medical Association strongly opposes), it’s unlikely that any California NPs would be authorized to practice independently before 2023.

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