The Legislative and Regulatory Process

SB 1375 (Atkins)

CANP-sponsored Senate Bill 1375, co-authored by Senate President Pro Tem Toni G. Atkins (D-San Diego) and Assemblymember Jim Wood (D-Santa Rosa), was signed into law by Governor Gavin Newsom on September 27, 2022.

SB 1375 will increase access to affordable, quality abortion care and reproductive health services in California. It clarifies existing laws so that trained and experienced nurse practitioners can provide this critically needed care without physician supervision. 

California has a shortage of primary care clinicians—especially in Latino, Black, and Native American communities—a problem that is expected to get even more dire over the next 10 years. Over 40 percent of counties in California do not have clinics that provide abortions.

As the bill sponsor, CANP led the advocacy effort and worked with our Close the Provider Gap coalition to ensure SB 1375 crossed the finish line. As a nonpartisan advocacy organization in support of advancing the NP practice in California, we are focused on and committed to removing restrictions on the practice of nurse practitioners so that patients can receive timely, uninterrupted, and high-quality care in all health care settings. 

Nurse practitioners will continue to advocate for legislation that bridges health care needs for communities and patients across California.

Board of Registered Nursing Regulatory Process Status

In order to implement the provisions of AB 890, the Board of Registered Nursing (BRN) will follow state law for outlining, editing, and finalizing regulations. The BRN's Nurse Practitioner Advisory Committee (NPAC) was established by AB 890 and reports to the BRN Practice Committee, which then reports to the full Board.

On November 14, 2022, the BRN voted to adopt the AB 890 regulations. The regulatory package will now be sent to the Business, Consumer Services & Housing Agency for finalization, then the Office of Administrative Law for approval.

On September 20, 2022, the BRN released its proposed regulations, Notice of Proposed Action: Categories of Nurse Practitioners and Scope of Practice, which would amend and add sections pursuant to AB 890. 

On November 17, 2021, the Board of Registered Nursing voted to initiate the rulemaking process for AB 890 regulations. This means that the formal regulatory process has begun. The regulations adopted by the BRN were approved by the NPAC prior to the meeting of the full Board on Nov. 16, 2021. 

CANP remains actively engaged in the regulatory process, working to ensure the regulations ultimately adopted are true to the spirit and intent of AB 890 and expand access to care throughout California. Per AB 890, the BRN must adopt regulations by January 1, 2023. 

Additionally, the BRN has had a preliminary presentation by the Office of Professional Examination Services to investigate whether NPs will need a supplemental examination. No determination has been made yet on OPES' recommendations.

When the regulations are finalized, approved, and deemed in accordance with the law, NPs will be able to practice without physician supervision.

CANP is working with our coalition partners, the BRN, and CANP stakeholders to ensure that the regulations allow NPs to practice to the full extent of their education and training and to care more directly for patients. We will continue to keep our members informed of important milestones and ways to engage.

About AB 890

More on the BRN Process

AB 890 created two different categories of NPs, defined by the settings in which they practice and named for the section of the state code in which the law resides. Each category has different requirements the NP must complete before being allowed to practice without physician supervision. You can find more details about the two categories of NPs below and here.

103 NPs – Work in a Collaborative Setting

Practice Setting

103 NPs work in practice settings in which there is a collaborative medical team, such as clinics, medical group practices, home health agencies, and hospice facilities. Correctional treatment centers and state hospitals are exempt from this law and NPs at those facilities will continue to practice under standardized procedures.

Requirements

NPs practicing without physician supervision in collaborative practice settings must:

• Pass a national NP board certification exam;
• Hold a certification as an NP from an accredited national certifying body;
• Provide documentation that NP education was consistent with BRN regulations;
• Pass a supplemental exam only if the Office of Professional Examination Services determines that a supplemental exam is required after evaluating the national NP certification examinations against the scope of practice of NPs delineated in AB 890;
• And complete a transition to practice of 3 years of practice or 4,600 hours.

104 NPs – NPs in Their Own Practice

Practice Setting

104 NPs work in practice settings outside of those defined in section 103, which means that an NP can open up their own practice. The option for NPs to practice in these settings begins January 1, 2023. 

Requirements

NPs opening their own practice must:

• Meet all of the same requirements as 103 NPs;
• And have practiced as an NP in good standing for at least 3 years, not inclusive of the transition to practice.
  • The BRN can reduce the number of years in this requirement for NPs who holds a Doctor of Nursing Practice (DNP). The BRN has introduced this topic for discussion.