California passed a law, AB-890, effective January 1, 2023, giving NPs in their state more autonomy than they previously enjoyed. It’s being implemented in a stepwise fashion. And like many laws, it’s rather confusing for everyone involved.
On January 12, 2022, NPBO was lucky enough to host a webinar with Melanie Balestra who is a nurse practitioner and an attorney in California, where she spent nearly 2 hours answering questions.
Full Practice Authority (FPA) for Nurse Practitioners is something that all states are striving for. Since there is a lot of confusion as to just what true FPA is, I thought I would read to you what American Nurse Practitioner Association states. I’ll link to it in the show notes for anyone wanting to delve further.
“AANP supports the Consensus Model for Advanced Practice Registered Nurses and the adoption of the National Council of State Boards of Nursing Model Practice Act. NPs with FPA are required to meet educational requirements for licensure; maintain national certification and consult and refer to other healthcare providers, when warranted by patient needs. They remain accountable to the public and the state board of nursing for providing the high standard of care set nationally.”
In California, many are saying AB-890 will grant FPA. And while it’s true that once you qualify for 103 status (104 is not effective until 2026), you’ll be able to practice without protocols, you’ll still need a physician’s sign-off that you are completed the required number of supervised hours.
Another huge issue for NP practice owners in California, as Melanie points out repeatedly, is the issues of whose patients are you seeing, and problems with 3rd party reimbursement to NPs.
Listen or watch to learn more and keep abreast of further developments from the BRN and CANP.
Please leave your comments below.
- California Board of Nursing AB 890 Status Update
- CANP AB 890 Resources
- The Process Protocol Workbook, Rebecca Zettler, RN, MS, FNP
- Balestra Healthcare Law – Melanie Balestra, NP, JD
- AANP Full Practice Brief
- AANP Practice Map
- Catch up on all the NP Business Matters podcasts here.
- Check out the Nurse Practitioners in Business Facebook Group
- Become a Member of the NPBO™
- Ready to start your own practice?
Connect with the Podcast
You can find the NP Business Matters Podcast on popular podcasting platforms:
- Apple Podcast
- Google Podcast
- Amazon Music/Audible
- And others. You’ll also find us in your favorite podcast player.
And as always, please subscribe, leave a rating, and share with your colleagues.
If you have requests for topics and/or guests, you can leave us a comment below, or anonymously fill out this form.
Are you in California or plan to move to California? How will AB-890 impact your business and practice?
Ok so now next in line should be New Jersey which has the most antiquated restrictions for NPs. When I moved from NY many years ago, where the restrictions were less, NJ took forever to verify my credentials. Although I've officially retired from a local hospital, I still work as a consultant.
Why does California have to make things so difficult? As far as I know no other state has such a ridiculous protocol for FPA. They were initially going to add a test, just for California. We are nationally board certified. We don't need another test! They just want to be "special." What is hilarious is the the Board of Nursing is totally disorganized just in renewing licenses. People have actually gone to their office in Sacramento and camped out just to try to get their licenses renewed. So, how are they going to handle this complicated scheme?
I’m sure many are asking the same questions you are.
I am a nationally certified (ANCC) Psychiatric Mental Health Nurse Practitioner. The 103 NP application only lists Psychiatric Mental Health Across the Lifespan which was not an option when I got certified in 2012. Can I still apply for the 103 NP?
I would think they are the same, but the CA board is who you should ask.