By Kendra J. Muller
AB 890 (Wood), as amended August 28, 2020, amends sections 650.01, 805, 805.5, and adds Article 8.5 to the Business and Professions Code regarding nursing practitioner guidelines. According to a bill analysis and as defined by the Board of Registered Nursing (BRN), a nurse practitioner is an advanced practice registered nurse who meets BRN education and certification requirements and possesses additional advanced practice educational preparation and skills in physical diagnosis, psycho-social assessment, and management of health-illness needs in primary or acute care.
Section 650.01 amends the Business and Professions Code to include nurses in the list of licensees who can work without physician supervision. Sections 805 and 805.5 amend requirements to make nurse practitioners subject to formal peer review of licensee qualifications and professional conduct. New Article 8.5 requires that BRN establish a new Nurse Practitioner Advisory Committee consisting of four nurses, one public member, and two physicians with demonstrated experience working with nurse practitioners. Article 8.5 also details the requirements for nurse practitioners to practice without physician supervision and instructs nurse practitioners to post a notice in a conspicuous public location stating they are not physicians and are regulated by BRN. Article 8.5 details the subsequent functions a nurse practitioner may perform, absent physician supervision.
Supporters state that the bill will reduce the shortage of physicians, especially in historically underrepresented areas. Supporters also claim that allowing nurses to practice without physician supervision will create cost savings without sacrificing quality healthcare. Opponents of the bill state that nurse practitioners do not have the training necessary to independently practice, and argue that the bill does not clarify when a nurse should refer a patient to a physician if the care is beyond the scope of the nurse practitioner’s training.
According to a bill analysis, when AB 890 was introduced, BRN opposed it unless amended because the new law would have created a new board separate from BRN, which they argued would generate consumer confusion as to who regulates nurses, as well as create a $3.6 million loss in revenue for BRN. [25:2 CRLR 51-52, 56] On August 28, 2020, the Senate amended AB 890 to place the new board under the jurisdiction of BRN.
Further, as stated at its February 20, 2020 meeting, the Board did not oppose the scope of practice for nurses but instead opposed the new board’s inclusion of two physicians on the Nurse Practitioner Advisory Committee. BRN claimed the new physician configurations would not be appropriate for a nursing board and requested the removal of the language including physicians to comprise the Nurse Practitioner Advisory Committee. As of the most recent Board meeting [Item 10.1 at 19] on September 20, 2020, BRN continued to oppose AB 890 unless amended.
Governor Newson signed AB 890 on September 29, 2020, (Chapter 265, Statutes of 2020), without the amendments to the Nurse Practitioner Advisory Committee sought by BRN. As a result, BRN will begin its configuration of the new committee.