critique
AB- 890
Allowing California Nurse Practitioners to Work Independently
MSN 565: Nursing Leadership and Health Policy
Gurpreet Kaur (slides 3,9)
Steve Meza (slides 4,5,8)
Marlis Hamory (slides 1,2,6,7)
Dr. Cathy
October 14, 2021
How The Policy Issue Was Identified..
The CANP (California Association of Nurse Practitioners) along with other nurse organizations collected data from peer- reviewed research, surveys, polls, demographic trends, and using PESTE analysis tool.
The data identified the policy issue…………..
CALIFORNIA HAS A SEVERE HEALTHCARE PROVIDER SHORTAGE
Limited cultural match Between providers and Population
Cultural and linguistic limitations create barriers to health care
Barriers to utilizing health
workers and technological
Innovations
Utilization is expected to increase because of the aging population and technological advances
Insufficient supply of healthcare professionals
Especially in primary care, prevention, behavioral health, and aging-related services
Imbalanced Geographical
Distribution
Too few health workers in rural areas and inner-city urban areas
(CANP, 2019).
-NPs can provide high-quality care in a safe environment.
-The bill would allow the NPs to practice without the use of standard procedures.
•In addition to better access to care, the AANP highlights the following other benefits of having full practice authority NPs:
• Full Practice Authority eliminates the need for an NP to consult with a physician in order to provide required care.
•Cost savings
AB- 890 would close the provider gap
Setting the Agenda for AB 890
Throughout the legislative process, the CANP led a 80 plus
Member coalition group called Close the Provider Gap. This group provided research- based details to lawmakers and the public about the many merits of this law.
(AANP, 2021).
Cost savings to the organizations and the payers
A Nurse Leaders Input
Dr. Glenmore Hendricks
https://www.linkedin.com/in/dr-glenmore-hendricks-dnp-anp-c-385a4999/
https://www.linkedin.com/in/dr-glenmore-hendricks-dnp-anp-c-385a4999/
“Dr. Glenmore Hendricks is nurse practitioner at the Riverside Medical Clinic. He earned his Masters of Science degree (MSN) as an adult primary care Nurse Practitioner in 2004 from California State University, Los Angeles, and a Doctor of Nursing Practice degree from California State University, Long Beach. Over the last 12 years, Dr. Hendricks has practiced in both internal medicine and urgent care settings. Throughout his 18 year nursing career he has worked as a critical care nurse (including trauma, surgical and medical care), and has held leadership positions in both hospital and Ambulatory Care departments. He has been a member of California Association for Nurse Practitioners since 2003, and served on the board as Treasurer, and president for the Inland Empire Chapter. A strong advocate for NP practice and healthcare policy working to improve both access and quality healthcare in the state of California”
“The Interview”
October 11, 2021 with Dr. Glenmore Hendricks
Dr Hendricks who had the most impact to the AB-890 Bill?
-Assembly member Jim Woods, from 2nd Assembly District, had a major contribution to getting AB-890 passed.
Will the AB-890 implementation have any challenges?
-Yes, It’s going to be a rough road because it might restrict Nurse Practitioners more than the current law.. There is a lot of work to be done because it’s not a full practice bill.
Who played a major role in lobbying this bill?
-Kristy Weise is our main lobbyist and is our go to person at the Capitol.
Dr Hendricks was only able to discuss the AB-890 bill at a broad base level.
-According to Dr. Hendricks, This new law would remove current law that allows nurse practitioners to practice under a doctor or physician.
Who Are The Major Stakeholders?
Private and Public Payers
Providers and Professional Organizations
The Public
Lawmakers
Who will be affected by the policy change?
Who Are the Opposition Groups?
Medical Doctors, lawmakers, and the public (not thinking NPs are qualified to be independent)
(CANP, 2021).
Legislative Strategies
Legislative and Non- Legislative Strategies
Non-Legislative Strategies
Lobbying/ campaigning/protests
Emailing
Forming Close the Gap Coalition to work with legislators
(Patton et al., 2019).
Using media to inform public and stakeholders about AB-890
Jurisdiction- Board of Registered Nursing (BRN)
will oversee AB 890 implementation and the regulations of bill
(CANP, 2021).
AB 890- The Two New NP Categories
The Section 103 NP Category
The Section 104 NP Category
-The NP has passed a national NP board certification examination (CANP, 2020)
-The NP holds a certification as an NP from a national certifying body accredited by the National Commission for Certifying Agencies or the American Board of Nursing Specialties and recognized by the BRN (CANP, 2020).
-The NP provides documentation that the NP education was consistent to already existing BRN regulations (CANP, 2020).
-The NP has completed a transition to practice (TTP) in California of a minimum of three full-time equivalent years of practice or 4600 hours (CANP, 2020).
-The 104 NP must meet all of the same requirements as the 103 NPs: • National certification • OPES exam, if applicable • BRN-approved NP education • TTP (CANP, 2020).
-Holds a valid and active RN license and a master’s degree in nursing or other clinical field related to nursing or a doctoral degree in nursing (CANP, 2020).
-The NP has practiced as an NP in good standing for at least three years, not inclusive of the TTP. The BRN may, at its discretion, lower this requirement for an NP who holds a Doctorate of Nursing Practice (DNP) based on practice experience gained in the course of doctoral education (CANP, 2020)
-All 103 and 104 NPs will need to complete a “transition to practice” (TTP) (CANP, 2020).
-AB 890 will create two new categories of nurse practitioners (NPs) to function independently within a defined scope of practice without standardized procedures (CANP, 2020)
-In order for NPs to be eligible to practice independently under these two categories, certain provisions of the law need to be further refined through the promulgation of regulations by the Board of Registered Nursing (BRN) (CANP, 2020).
-A summary of key provisions of the law with a description of the pre-requisite work is described (CANP, 2020).
-103 is how we are currently doing it
-104 is trying to go independently.
Where is AB 890 Now and Future Implications…?
New bill AB 892
to clarify new
roles of NPs
categories 103/104
With AB 890, 39
million citizens
will have greater
access to care
The vast majority
of the state’s 27,700 NPs have at least 3 years
experience
NP entrepreneurs
to open up own
individual or group
clinics
PROVIDERS
COMPETITION
COST
With less administration paperwork, NPs can spend MORE time with patients
“We need AB 890 more than ever since we are having a healthcare personnel shortage owning to the Covid-19 pandemic, “ said Nancy McPherson, state director of AARP of California (Winifred et al., 2020).
(CANP, 2021).
References
American Association of Nurse Practitioners (AANP). (2021). Information and resources for California nurse
practitioners. https://aanp.org
Bill text - AB-890 Nurse Practitioners: Scope of practice: Practice without standardized procedures. (n.d.). Retrieved October
12, 2021, from https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB890
California Association for Nurse Practitioners (CANP). (2020). AB-890* an overview. Retrieved October 12, 2021 from:
https://canpweb.org/canp/assets/File/AB%20890/AB890%20Information%20Sheet%20(General).pdf
Linkedin.(2021). Dr. Glenmore Hendricks DNP, ANP-C. Retrieved October 12, 2021 from:
https://.www.linkedin.com/in/dr-glenmore-hendricks-dnp-anp-c-385a4999/
Patton, R. M. Zalon, L. M., Ludwick, R. (2019). Nurses Making Policy: From Bedside to Boardroom. Springer Publishing
Company, LLC.
Winifred Quinn, PhD, FAANP(H), Claudio Gualtieri, JD. (2020, September 30). New Law to Improve Californians Access to
Care Consumers to Benefit from Improved Health Equity. Campaign for Action. Retrieved October 12, 2021, from
https://campaignforaction.org/new-law-to-improve-californians-access-to-care/