By Emily Powers
At its meeting on April 20, 2023, the Board of Registered Nursing (BRN) considered the four public comments it received from the 45-day public comment period to add section 1410.5 to Article 2 of Division 14 of Title 16 of the California Code of Regulations (CCR), to eliminate the nursing-related natural science laboratory educational requirement for out-of-state applicants, streamlining the application process for these potential licensees. The Board approved its responses and voted to approve the proposed text as noticed. The Board originally gave notice of the proposal on February 17, 2023. [28: CRLR 27–28]
BRN describes out-of-state applicants’ previous educational barriers in the Initial Statement of Reasons. BRN currently regulates over 502,000 Registered Nurses (RNs) and almost 34,000 Nurse Practitioners (NPs) (page 1). BRN licenses registered nurses and certifies Advanced Practice Registered Nurses (APRN), which include certified nurse-midwives, registered nurse anesthetists, clinical nurse specialists, public health nurses, and NPs. To be licensed as RN’s, applicants can either receive licensure by examination or by endorsement. The examination process is for applicants who have never been licensed in another state or territory and entails passing the National Council Licensure Examination (NCLEX-RN). The endorsement process is for applicants who hold a current and active RN license in another state, U.S. territory, or Canada and who passed the NCLEX-RN or State Board Test Pool Examination.
Endorsement applicants must have completed an education program meeting the California requirements in 16 CCR section 1426. One of the requirements is the completion of a nursing-related natural science laboratory. This laboratory requirement caused delays and prevented licensure for out-of-state applicants because many other states do not have the same nursing-related natural science laboratory requirements. Applicants also found it challenging to prove they completed a laboratory when it was not clearly stated on their transcripts.
The BRN decided to create an exemption to the laboratory requirement for out-of-state applicants seeking endorsement in California. The new rule states:
An applicant licensed in another jurisdiction who has been practicing in good standing for at least 2 years will not need to retake any anatomy, physiology, or microbiology courses that include a laboratory component pursuant to section 1426, if the application required by section 1410 includes proof of successful completion of anatomy, physiology, and microbiology coursework, with or without a laboratory component, as part of their nursing education preparation. (Title 16 CCR section 1410.5(b)).
The Board determined that practicing in good standing for two years in another state illustrates that the applicant is a safe practitioner. BRN stated the benefits of this change include helping “California to recruit and maintain a larger pool of qualified nurses from across the country, thereby increasing access to care” and reducing “administrative workload for the Board’s licensing staff.”
On August 16, 2023, the Board issued its Final Statement of Reasons, summarizing each public comment and issuing a response, as discussed at its April 20 meeting. On August 18, 2023, the Office of Administrative Law approved the rulemaking action. The regulatory action was effective on October 1, 2023.