CAPA Addresses the Passage of Nurse Practitioner Legislation

Today, CAPA congratulates California's Nurse Practitioners (NPs) and the California Association for Nurse Practitioners (CANP) on Governor Newsom signing Assembly Bill 890 (AB 890), authored by Assembly Member Jim Wood, the Chair of the Assembly's Health Committee. Like the CAPA-sponsored Senate Bill 697 (SB 697) from last year, AB 890 offers NPs new opportunities to practice with a degree of autonomy in California that they have never enjoyed before. It represents 15 years' worth of their effort – obtaining new members, galvanizing their full membership, educating decision-makers about NP practice, and documenting the public health benefits of expanded practice opportunities.

Knowing what a battle it was to push SB 697 through, CAPA knows that AB 890 did not come easy. CAPA tips its hat to NPs and CANP.

As we applaud the NPs success, CAPA also wants to spotlight the implications of such an event for you and the PA profession.

What the passage of AB 890 underscores is how far PAs have to go to secure our livelihoods and our role in an ever-changing healthcare environment. We recognize that politics and advocacy isn't for everyone.

“But, everything you do, your professional dignity, and every dollar you earn can be traced back to a word in a law that was passed in Sacramento.”
For those who believe that successfully protecting the PA profession will simply “be handled” by CAPA, AAPA, and other PA organizations, we, must respectfully inform you that is a misconception. Your profession is only as strong and secure as your personal interest and commitment to it.

To protect and advance the future of California PAs, the blunt truth is that CAPA needs many more PAs to make just a couple small, personal commitments to their profession. Otherwise, any effort CAPA makes on your behalf fizzles and will not be taken seriously.
PA Independence vs. NP Independence 
After last year's SB 697, the scope of what a PA may provide is limited only by their experience and training and what is in the practice agreement. Likewise, the nature of the supervision required is left to the practice to decide on a PA-by-PA, setting by-setting basis, reflected in the practice agreement.

As described in AB 890, after 2023, an NP is permitted to provide certain services independent of a physician without a practice agreement. However, practically speaking, that independence is tightly constrained only to the most routine and uncomplicated cases. Additional requirements in the law comprehensively mandate NPs as to when physicians must be consulted and when patients must be referred to them. No mandatory statutory restrictions exist limiting PA practice in such a fashion
What Does AB 890 Actually Do For NPs? 
• Creates a new NP-specific Advisory Committee under the Board of Registered Nursing.
• Requires that an NP verbally inform new patients that they are not a physician.
• After certain additional education and experience (4,600 hours) requirements are met, allows NPs practicing alongside
physicians to do so without “standardized procedures.” (“Standardized procedures” refers to specific protocols governing NP
• After 2023, if an NP has been issued a certification from the Board of Registered Nursing, and met education and experience requirements, they may practice in settings where no physicians are present; but, may only offer specified services.
• Mandates that NPs consult with physicians in many specific circumstances.
• Requires NPs to establish a detailed, written “referral plan” for when they must refer patients to a physician, such as in such common circumstances as when a patient fails to respond to treatments “as predicted”, or does not fit the “commonly accepted” pattern for a disease or disorder.

Today, CAPA announces its newest initiative, CAPA SPEAKS-- an organized campaign dedicated to safeguarding and advancing the PA profession and your livelihoods. In the coming years, CAPA will: 
S erve PAs in California by offering more professional development programs
P romote PAs as an integral part of the healthcare team
E ducate the public about the role of PAs
A dvocate for the profession by continuing to develop PA legislation
K eep the PA profession at the forefront by contributing to healthcare policy and research 
S ecure the PA profession's long-term future in California 

CAPA asks you to help us, yourselves and other PAs change the tide of the profession by making PAs a strong, united voice. An organization that is 13,000 members strong is difficult for Sacramento to ignore. Through SB 697, CAPA advanced and secured the present for you. But what about your future? That would be up to you. So what are you waiting for?

Join CAPA today, make PAs impossible to ignore, and tell us how you want to contribute to CAPA SPEAKS!