Navigating California's AB 890: New Pathways to Nurse Practitioner Independence
In 2020, California made a significant move towards empowering nurse practitioners (NPs) with the passage of AB 890, which introduced a pathway for NPs to practice without physician supervision. Effective January 1, 2023, the Board of Registered Nursing has detailed the provisions of this new law, bringing California closer to the "full practice authority" (FPA) seen in many other states.
AB 890 introduces a two-tiered system:
103 NP License: Allows NPs to practice without standardized procedures after completing a transition-to-practice period of at least three years or 4,600 hours. However, this independence is limited to practice locations where physicians are also present, posing challenges for NPs in smaller or remote settings.
104 NP License: Grants full independence without the need for physician presence. To qualify, NPs must first hold a 103 license and practice for an additional three years. Although the law permits potential reductions in this requirement for Doctor of Nursing Practice (DNP) holders, no exceptions are currently being made. Thus, NPs must wait until at least 2026 to attain a 104 license.
While AB 890 marks progress, the stringent requirements may compel many experienced NPs to relocate to group practice settings to meet the qualifications. This shift could be more manageable for new NPs, but established professionals might face significant challenges.
The Board of Registered Nursing is working on additional resources and clarifications, and future legislative changes could further impact these pathways. Stay tuned for updates as California continues to evolve towards greater NP autonomy.
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