How Does SB 1375’s Proposed Transition-to-Practice Period Compare to Other States?

In 2020, California took an important step to expand access to care and to address primary care workforce shortages by passing AB 890, which creates a pathway for nurse practitioners (NPs) to treat patients independently (meaning the NP does not have to be supervised by a physician). More than half of US states already allow NPs to practice independently. Research shows that access to primary care is better in these states and that the quality of primary care provided by NPs is similar to that delivered by physicians.1

AB 890 delegated to the California Board of Registered Nursing (BRN) the authority to establish the minimum amount of clinical experience and mentorship that an NP must receive before being allowed to practice independently (referred to as a transition-to-practice [TTP] period). As of July 2022, the BRN has not released draft regulations, which could result in a delay of AB 890’s January 1, 2023, implementation date.

SB 1375’s proposed transition-to-practice period of 4,600 hours would be among the most robust in the country. Of the 30 other states (plus Washington, DC) that allow NPs to practice independently, 16 don’t require any TTP period. Eight states have a TTP period of 2,400 hours or less.

In 2022, California Senate pro Tempore Toni Atkins introduced SB 1375, which clarifies the TTP requirement by specifying that an NP with at least three full-time equivalent years or 4,600 hours of experience can practice independently. SB 1375 will allow qualified NPs to begin practicing independently in 2023 who otherwise may be delayed, given the timeline of the AB 890 regulations. See how the TTP period in SB 1375 compares to other states that allow NPs to practice independently.

Notes

  1. Joanne Spetz, California’s Nurse Practitioners: How Scope of Practice Laws Impact Care, California Health Care Foundation, May 2019.