NP Scope in CA for 2023

california law np scope private practice Mar 02, 2023

Introduction

As most nurse practitioners know, there is a bill called Assembly Bill 890 that Governor Newsom signed into law in September of 2020. In it, he and the legislature have tasked the Board of Registered Nursing to come up with two new categories of nurse practitioners: 103 NP & 104 NP. While exciting for nurse practitioners in California, it’s important to understand what can be done today and what needs to wait for a few more years.

Assembly Bill 890 103 NP & 104 NP

The two categories in Assembly Bill 890 are categorized by the code section that have been created under the Business and Professions Code of California. They're commonly referred to as a 103 NPs and 104 NPs and that goes together with Business and Professions Code section 2837.103 and 2837.104 respectively. On January 1, 2023, what is now in effect is that 103 NPs can work in a group setting with at least one physician and surgeon within the practice, but there are some relaxations on the standardized procedures that they must work under. While 103 NPs and 104 NPs having new rules are great, they don't significantly extend or alter the current scope of practice although there is some flexibility to work without standardized procedures. Exciting? Yes, but nurse practitioners don't just get that automatically.

What can nurse practitioners do now?

Nurse practitioners need to apply with the California Board of Nursing to become a 103 NP and get the standardized procedures requirement relaxed for them. So, they are eligible to do that right now as of January 1, 2023. Where there's a lot of misinformation and where I've seen this a lot is for people thinking that “Oh great, we're getting a ton of practice, and it takes effect January 1, 2023, so I can practice now independently starting in January 2023.” That might have seemed to be the case, at first glance, but the Board of Registered Nursing has put out a lot of clarifying information about it including a Frequently Asked Questions section, which we'll link to here for review.

What can happen later?

What is very clear is that there is a three-year requirement to work as a 103 NP before nurse practitioners are eligible to work as a 104 NP. So, what does that mean? Nobody in California is eligible to be a 104 NP until 2026. While it's great that independent practice is coming and nurse practitioners can eventually work independently within the population of their national certification, they do need right now to be working as a nurse practitioner with another doctor or in a group practice.

Once they complete those three years, they can apply for it through the board. By the time 2026 comes around, an application process and procedure will be in place for them to apply to practice independently. So again, they will not just be automatically permitted to work independently January 1, 2026.

Conclusion

If you're a NP in California, I highly encourage you to go to the Board of Registered Nursing which is the primary source of your information to understand the ins and outs, and to check out their Frequently Asked Questions section which is very helpful on that account. All over their website, it's very clear that independent practice is not on the table until 2026.

It's great news that it's coming for those nurse practitioners in California for the future. Many states don't have this available to nurse practitioners, and many states don't have it on the horizon either. Right now, the best thing you can do is work towards independent practice and apply with the board to become a 103 NP.