Aligning Nurse Practitioner Statutes in California

Garrett K. Chan
Karen G. Duderstadt
Catherine Dower


Downloads

Passed in 2020, AB 890 recognizes and authorizes California nurse practitioners (NPs) to practice at the top of their competence without physician supervision and with a defined scope of practice. The implementation of AB 890 holds great promise for the state to expand access to high-quality care. However, California statute may need to be updated and harmonized with AB 890 to ensure that the additional capacity of NPs can be fully realized.

This report delineates a comprehensive and thorough review of the California codes related to NP practice that would benefit from alignment with AB 890. The report includes a table with these statutes and the corresponding analyses. The report also uses several examples in priority areas to underscore the importance of statutory alignment:

Access to Care. Certain areas of statute, such as the Knox-Keene Act of 1975, could be updated to align with AB 890’s recognition that NPs can practice without physician supervision. This alignment would support the participation of independently practicing NPs in a managed care context, thereby advancing the goals of increased access to care.

Opioid Crisis. When AB 890 is implemented, NPs will have full authority to prescribe buprenorphine and to treat those seeking help for opioid addiction, which will increase access options, particularly for people experiencing homelessness and other vulnerable populations in California. Statute and regulations could be updated to (1) explicitly authorize NPs to serve on medical staff committees or be eligible for medical staff membership of chemical dependency recovery hospitals and (2) include psychiatric mental health NPs on the list of Medi-Cal providers recognized for psychiatric and mental health services with county mental health plans.

Care of Older Adults. Under AB 890, NPs could independently treat patients in long-term care facilities. However, existing language in the Health and Safety Code limits their contributions. Specifically, the long-term care code sections related to patient admission and treatment could be updated to allow NPs to practice in these facilities, improving continuity of care and eliminating gaps in care.

Read the full report for more details.