Bill Seeking to Allow Nurse Practitioners to Perform Services Without Physician Supervision Gains Momentum


By Shana Sobel

AB 890 (Wood), as amended January 23, 2020, is a two-year bill that would add Article 8.5 (commencing with section 2837.100), and would repeal Section 2837.101, of the Business and Professions Code to authorize a nurse practitioner (NP) to provide certain services without physician supervision or standardized procedures. The bill would require independently-practicing NPs to pass a validated national exam, and complete a supervised, three-year transition-to -practice period. New article 8.5 would also establish a new Advanced Practice Registered Nursing (APRN) Board, and regulatory requirements to regulate NPs in independent practice.

New article 8.5 would also require NPs to inform all new patients the NP is not a physician or surgeon; in a language the patient understands. NPs would also be subject to consumer protection provisions applicable to physicians. Finally, Article 8.5 would require the APRN Board to work with the Department of Consumer Affairs’ Office of Professional Examination Services to conduct an occupational analysis of the NP practice, validate the required national certification exams, and provide supplemental exams if the national exam cannot be validated.

According to the author, this bill is intended to address California’s severe shortage of primary care providers by allowing NPs to provide the same care without the supervisory requirement. The author cites a recommendation by the California Future Health Workforce Commission to allow full practice authority for NPs as a means of improving California’s ability to meet workforce demands.

The California Association for Nurse Practitioners, among others in their coalition, support this bill, claiming it would enable NPs to fully utilize their skills and education for the benefit of higher-quality care, more primary care providers, more providers for Medi-Cal and uninsured patients, and cost savings.

By contrast, The California Medical Association (CMA), California Nurses Association/National Nurses United, and the Board of Registered Nursing (BRN) oppose this bill as amended. Specifically, CMA maintains its opposition due to a lack of details regarding the “standard of competency” the bill would require, the “undefined” scope of practice for unsupervised nurses, concern that this bill would not guarantee or incentivize access to care, and the “lack of a mechanism for grandfathering in experienced nurse practitioners.” BRN and the California Nurses Association/National Nurses United both oppose the provisions of the bill related to the creating of a new APRN Board, citing concerns about which board (APRN or BRN) would enforce and regulate which nurses, consumer confusion, and significant additional costs and loss in revenue to the BRN.

The bill was read in the Senate for the first time January 28, 2020, and awaits referral to a policy committee. [S. Rules] To make sure your views on this bill are heard, register on the legislature’s website and submit your comments to the author.


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