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California Nurse Practitioners Gain More Autonomy - In 2023

Nurse practitioner Alexander Panis at a mobile COVID-19 testing station in Compton. (Robyn Beck/AFP via Getty Images)
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A new law signed this week by Governor Newsom aims to ease California’s primary care shortage by allowing nurse practitioners to operate without a doctor’s supervision.

Nurse practitioners have masters or doctorates in nursing and other advanced training.

Until now, nurse practitioners were required to have a contract with a doctor and pay for oversight. The idea is that they can consult with the doctor if they need to, or in case of emergency. For years, nurse's groups said this requirement was unnecessary and needlessly cost thousands of dollars.

Under the new law, nurse practitioners will be able to see patients in their own practice, but only after working under a doctor's supervision for at least three years. California joins 38 other states that grant some level of autonomy to nurse practitioners — but it doesn’t take effect until 2023.

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AB 890 expands the role of nurse practitioners and allows them to practice independently in some settings, without a supervising physician. State Assemblyman Jim Wood (D-Healdsburg) pitched the bill as a way to help combat the state’s provider shortage.


Nurse practitioners have been trying to lift restrictions on their scope of practice for years. The nurses’ union as well as the state’s hospital association were among the bill’s supporters.


California’s doctor lobby argued that the legislation posed a threat to patient safety and that it wouldn't necessarily guarantee growth in the provider workforce.


Nurse practitioners are highly trained nurses with a master’s degree, who work largely in primary care, an area of great need in the state. By some projections, California will need about 8,200 more primary care doctors by 2030.


Newsom signed this bill into law on Sept. 29.

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Ibarra reports for Cal Matters

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