Steinberg Institute

The Steinberg Institute supports AB 890 to grant full practice authority to nurse practitioners

Posted on Thursday, February 21, 2019

Proposed law follows release of groundbreaking report recommending an end to outdated regulations so California can fill growing healthcare workforce gaps

SACRAMENTO, CA – The Steinberg Institute hails AB 890 by Assemblymember Jim Wood (D-Santa Rosa) as an important bill that would help California meet patient mental health needs by giving nurse practitioners, including psychiatric specialists, the ability to work to the full extent of their training.

California needs fully empowered nurse practitioners to help alleviate a “looming crisis” of inadequate access to quality, affordable care, particularly in the area of mental health as the state is facing a growing shortage of psychiatrists, according to a report released this month by the California Future Health Workforce Commission.

Yet California is the only western state that still restricts nurse practitioners by requiring that they only practice and prescribe with physician oversight, said the commission, which was co-chaired by University of California President Janet Napolitano and Dignity Health President and CEO Lloyd Dean. Twenty two other states don’t have such restrictions.

“The time has come for California to stop letting its citizens suffer from preventable or treatable illnesses just because qualified and highly trained nurse practitioners are shackled by outdated rules,” said Steinberg Institute Executive Director Maggie Merritt. “Let nurse practitioners do their jobs.”

Freeing up nurse practitioners from unnecessary physician oversight – as AB 890 would do, following a transitional period of physician supervision – can help address the gap in mental health services, particularly in rural and underserved areas, and their numbers should be increased, the commission said. A large body of research, meanwhile, has linked restrictions on nurse practitioners with keeping their numbers down.

Those who argue for the status quo regulatory regime for nurse practitioners say physician oversight is necessary to ensure quality of care, but dozens of studies demonstrate that the quality of nurse practitioner care is comparable to that of physician care and that there is no difference in the quality of care when there are no physician oversight requirements, the commission said.

Studies have also found that allowing nurse practitioners full practice authority is associated with greater access to care and lower costs. So reported the prestigious Bay Area Council Economic Institute in 2014.

Regarding mental healthcare, the need for psychiatric nurse practitioners will only grow, the commission warned, as the Healthforce Center at UCSF projected a 34 percent decrease in the number of psychiatrists in California between 2016 and 2028. Nearly 17 percent of California’s population has mental health needs and one in 20 suffers from serious mental illness, but half of the people with mental illness receive no care, the commission said.

AB 890 will be heard in the Assembly Business and Professions Committee next month.

For more information: Patrick Hoge (office) 916-297-4494, (cell) 510-435-2320, patrick@steinberginstitute.org

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