California Nurse Practitioner Independence Bill Heads to Governor’s Desk

Posted By American Med Spa Association, Tuesday, September 1, 2020

California Assembly Bill 890 (AB 890), which was introduced last year, has passed both the state’s House and Senate and now heads to the governor’s desk for his signature. We previously covered AB 890 when it was introduced, and earlier this year; the bill and all of its amendments can be reviewed in full here. While this is a major change for California’s nurse practitioners (NPs), there are some important provisions to be aware of—specifically, AB 890 will not allow NPs to practice at their own independently owned practice until at least 2023.
As is often the case, bills seldom make it through the legislative process unchanged. Originally, AB 890 would allow NPs to practice without the need for physician supervision. Under its current language, an NP can practice without standardized procedures and without the routine presence of a physician. However, before practicing without the standardized procedures, NPs will need to complete a transition-to-practice period under physician supervision for three full-time-equivalent years or 4,600 hours. Once they are granted the ability to practice without standardized procedures, the NP would be limited to a certain set of practice settings, all of which must have one or more physician or surgeon practicing there as well. These include:
When practicing in these settings and without standardized procedures, the NP can:
Beginning in 2023, nurse practitioners who have been practicing without standardized procedures can be granted a certification to practice outside the limited list of settings. In order to obtain this certification, the NP needs to have completed the transition-to-practice period and then practiced without standardized procedures for three additional years. (The board may elect to lower this requirement for those holding a doctor of nursing practice). NPs with this certification would need to carry their own liability coverage, have a duty to inform the patient of their license status, and need to adopt consultation and collaboration procedures for emergent situations.
With the passage of AB 890, California becomes the latest state to join the national trend moving toward NP practice as independent health care providers. While most states have some form of transition to full independence for NPs, California is unique in having both a transition period to supervision independence and a second period for practice-setting independence. Fortunately, AB 890 does clearly lay out a path to full independence for NPs.