Is Independent Practice For NP’s Coming to California?

Alex R. Thiersch | 3.8.19

A new bill introduced in California would allow nurse practitioners (NPs) to practice without the need for physician supervision. Many states have already passed laws granting NPs independent practice authority, but California, which has long been at the forefront of developing medical regulations, has thus far not followed suit. This may change with the proposed bill, although passage is by no means certain. You can review the text of House Bill 890 (AB 890) in full here.

Currently, CA requires a standardized protocol with a supervising physician in order for NP’s to practice.  AB 890 would allow NPs who have practiced under physician supervision for a certain number of hours (not yet determined) to practice independently. The national trend has been moving towards allowing NPs to practice as independent healthcare providers without the need for physician supervision or collaboration.  In that regard AB 890 is right in line with that trend, and if passed, would make California NPs independent health care providers in their own right.

However, the bill may not be as close to passing as one might think. Interestingly, the bill itself is missing a lot of features that are typically seen in other states’ independent practice bills.  For example, other states usually have additional practice requirements and a mechanism for the Board to verify that the nurse meets the requirements.  AB 890 also does not expressly address prescribing privileges, which is typical of other NP independent practice laws.  The absence of these provisions AB 890 likely will need to be addressed before approval.

If ultimately passed, NPs in California would be able to do the following tasks without a supervising physician or standardized protocols: 1) conduct advanced assessments, 2) order diagnostic procedures, 3) establish diagnoses, 4) prescribe and institute therapies, 5) delegate tasks to medical assistants, 6) perform disability examinations, and 7) other acts that require training and education and that are recognized as appropriate.

We will keep an eye on AB 890and provide updates where necessary.

For more information on independent NP practice in California or another state, please contact ByrdAdatto at info@byrdadatto.com.

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