California's AB 890 Signed Into Law

[AbeTheBabe]

I'm in Cali at a large ortho practice. In surgical specialties, it seems PAs really dominate. We have nearly 2 dozen PAs and exactly 0 NPs. There was 1 NP when I first started, they got rid of him in under a year. Unfortunately, I know this isn't the case in other specialties.

[Joelseff]

About joining CAPA...

 

I have some friends who are practicing PAs in Cali but are NOT members of CAPA despite their employer paying for dues. They just simply forget to register. That I think is unacceptable especially in these times. We need to have a presence at the state legislature and in California, CAPA is the only way to do that with any kind of impact. So if you're like my friends in Cali, please join CAPA.

 

Same goes for those in other states. Join your state society!

 

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[dfw6er]

10 hours ago, Joelseff said:

About joining CAPA...

 

I have some friends who are practicing PAs in Cali but are NOT members of CAPA despite their employer paying for dues. They just simply forget to register. That I think is unacceptable especially in these times. We need to have a presence at the state legislature and in California, CAPA is the only way to do that with any kind of impact. So if you're like my friends in Cali, please join CAPA.

 

Same goes for those in other states. Join your state society!

 

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My employer automatically enrolled all PAs whose primary site was in CA in CAPA......at out-of-state sites we staffed, PAs were enrolled in SEMPA membership.  And they actively encouraged PAs to run for office.  They'd send out emails when one of us was running for CAPA or SEMPA membership.  I think Fred Wu was a recent past-president of SEMPA and my organization backed him as much as they could.  

More than that, I think a lot of us older PAs who are looking to get out of practicing but want to stay in the field somehow really need to seek administrative roles so we can help influence hiring patterns and offset the pro-NP hiring policies a lot of CNOs and nursing administrators seem to push.

 

10 hours ago, Joelseff said:

 

 

 

 

 

 

 

 

 

[Hope2PA]

Few issues I’ve noticed influence hospital admin are 1) PA’s require more paperwork and supervision. They don’t want to deal with the extra work. 2) Nurses are everywhere in management. They do push for NP over PA and reference the extra paperwork and supervision for PA vs. NP.  At a local hospital, they have rotating board Members. Always a couple docs, always an NP, and/or RN.  Folks, you got to step up. 3) I don’t care how many of you think PA is a great brand, it is not. Even in a hospital with PA’s there are many employees, including Doc’s who have no real grasp of the education and abilities of PA’s. They are not identified as being able to function on their own like NP. So obviously my number 3 is a different title that will serve well in the future. A future that will require cutting ties form being physician dependent. 

 

Edited January 30, 2020 by Hope2PA
Typos

[Joelseff]

Few issues I’ve noticed influence hospital admin are 1) PA’s require more paperwork and supervision. They don’t want to deal with the extra work. 2) Nurses are everywhere in management. They do push for NP over PA and reference the extra paperwork and supervision for PA vs. NP.  At a local hospital, they have rotating board Members. Always a couple docs, always an NP, and/or RN.  Folks, you got to step up. 3) I don’t care how many of you think PA is a great brand, it is not. Even in a hospital with PA’s there are many employees, including Doc’s who have no real grasp of the education and abilities of PA’s. They are not identified as being able to function on their own like NP. So obviously my number 3 is a different title that will serve well in the future. A future that will require cutting ties form being physician dependent. 

 

I don't think we are a good "brand." what we are are excellent clinicians and have been for over 50 years... The branding is what we lack. Things are moving though but yeah we can all blame "the old guard" who fell asleep at the wheel for the last several decades but we can either cry about it and complain or be part of the solution. We have A LOT of work to do.

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[Cideous]

It's hard to be taken seriously when you are an.....Assistant.

[TexasPA28]

On 1/29/2020 at 4:09 PM, EMEDPA said:

I am interviewing for a rural per diem position in EM at the end of next month. The facility only uses EM residents or PAs and they use them interchangeably. NPs not invited to apply. And this facility is affiliated with a major medical center, so I am hoping the tides are turning a bit in our favor. I know this is anecdote, but there are good jobs out there. They may not be as plentiful as they once were, but they are there.Back in the day (1996) I was offered 4 jobs even before taking PANCE. 

I'd run far away from a program like that.  ACGME rules require EM residents to be supervised by MDs, even for third party moonlighting sites.  Can't do that in a facility with no MDs on site.  That program is in violation of ACGME rules and it's a matter of time before they get the hammer thrown down on them.

[MediMike]

2 hours ago, TexasPA28 said:

I'd run far away from a program like that.  ACGME rules require EM residents to be supervised by MDs, even for third party moonlighting sites.  Can't do that in a facility with no MDs on site.  That program is in violation of ACGME rules and it's a matter of time before they get the hammer thrown down on them.

Interesting. You have a source for this? I did some quick Google-Fu as I've never heard that and didn't see anything resembling a statement to that effect on EMRA, ACEP or ACGME

[EMEDPA]

14 hours ago, TexasPA28 said:

I'd run far away from a program like that.  ACGME rules require EM residents to be supervised by MDs, even for third party moonlighting sites.  Can't do that in a facility with no MDs on site.  That program is in violation of ACGME rules and it's a matter of time before they get the hammer thrown down on them.

you misunderstood me. They staff either a PA or an EM resident, not both at the same time. 3rd yr EM residents can moonlight without an attending on site. They have a medical license already.

[JOhnny888]

16 hours ago, TexasPA28 said:

I'd run far away from a program like that.  ACGME rules require EM residents to be supervised by MDs, even for third party moonlighting sites.  Can't do that in a facility with no MDs on site.  That program is in violation of ACGME rules and it's a matter of time before they get the hammer thrown down on them.

Lol are you really going to try and jump on EM residents for moonlighting.... and you wonder why there is hostility 

[Joelseff]

I received this from CAPA regarding the bill for NPs in California. Interesting how the CNA and CBRN are opposed to it along with CMA.

 

Here it is:

 

Good Morning PA ******,

 

Thank you for contacting the CAPA office. We are aware of the proposed legislation AB 890: Nurse practitioners: scope of practice: practice without standardized procedures. The bill would grant specific new privileges to NPs, but it does not grant full independent practice. CAPA is working with a lobbyist in Sacramento to monitor the bill. We have been informed that the California Medical Association (CMA), the California Nurses Association (CNA), and the California Board of Registered Nursing are in opposition of this bill.

 

CAPA leaders are currently devising an outreach/awareness plan to educate medical professionals, such as those who hire PAs, about the PA profession and the defining differences between PAs and NPs. The PA profession was created to be a part of team-based care, and CAPA is working to ensure that the PA profession continues to play a pivotal role for healthcare within the team.

 

We hope this information helps and if you have any questions, please let us know.

 

We thank you for your continued support of CAPA and hope you have a great day!

 

 

-ok, apparently it is not full independence for them either. Will try to get more specifics when I have time to read the bill. Alright folks let's keep fighting back. I'm certain some ppl believe they aren't doing enough but State societies do look out for us as much as they can but are hamstrung. Please support your state chapters and AAPA.

 

 

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[Joelseff]

I tried sending Dr. Wood a message on his site but I am not in his district (Santa Rosa). I tried spoofing the zip but it said my address was not in the district. I cannot find an email address for him. I found him on linkedin and requested to connect.

 

I want to talk to him about including PAs in NP legislation... Let's see where this goes... Not too hopeful but gotta try!

 

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[Kaepora]

On 2/20/2020 at 3:14 PM, Joelseff said:

I received this from CAPA regarding the bill for NPs in California. Interesting how the CNA and CBRN are opposed to it along with CMA.

Here it is:

Good Morning PA ******,

Thank you for contacting the CAPA office. We are aware of the proposed legislation AB 890: Nurse practitioners: scope of practice: practice without standardized procedures. The bill would grant specific new privileges to NPs, but it does not grant full independent practice. CAPA is working with a lobbyist in Sacramento to monitor the bill. We have been informed that the California Medical Association (CMA), the California Nurses Association (CNA), and the California Board of Registered Nursing are in opposition of this bill.

CAPA leaders are currently devising an outreach/awareness plan to educate medical professionals, such as those who hire PAs, about the PA profession and the defining differences between PAs and NPs. The PA profession was created to be a part of team-based care, and CAPA is working to ensure that the PA profession continues to play a pivotal role for healthcare within the team.

We hope this information helps and if you have any questions, please let us know.

We thank you for your continued support of CAPA and hope you have a great day!

-ok, apparently it is not full independence for them either. Will try to get more specifics when I have time to read the bill. Alright folks let's keep fighting back. I'm certain some ppl believe they aren't doing enough but State societies do look out for us as much as they can but are hamstrung. Please support your state chapters and AAPA.

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NP and nursing organizations are opposed to this bill because it actually adds regulation to NP practice.  It is not FPA.  The current version of the bill moves NPs away from core principles and national standards for NP regulation.  As amended, the bill moves NP regulation out of the Board of Registered Nursing, creates a new regulatory board that includes physician oversight, regulates NPs by setting, and establishes new barriers.

[Joelseff]

NP and nursing organizations are opposed to this bill because it actually adds regulation to NP practice.  It is not FPA.  The current version of the bill moves NPs away from core principles and national standards for NP regulation.  As amended, the bill moves NP regulation out of the Board of Registered Nursing, creates a new regulatory board that includes physician oversight, regulates NPs by setting, and establishes new barriers.

Thanks for clarifying that. It makes sense. This is the impression I got about the bill after CAPA emailed me and after reading the changes of the bill, it would still place NPs under physician oversight at a board level while on a practice level, NPs would be able to have removed collaboration. But why is CANP supporting it? Are they taking the compromise like we had to last year?

 

https://canpweb.org/advocacy/grassroots-resource-center/

 

 

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[surgblumm]

I am hearing many echoes of the past with a much bleaker vision of the future of our profession due to the large increase of NPs, their independent status in many states and their ability to work independent of physicians. The only big hope that I see for PAs is telemedicine and we need to be the top  providers here. The increase in litigation for NPs due to schools on the internet and lack of experience is the only thing that may change our future. I don't wish them misfortune but I do wish us well.

[PACali]

On 2/24/2020 at 5:57 PM, surgblumm said:

I am hearing many echoes of the past with a much bleaker vision of the future of our profession due to the large increase of NPs, their independent status in many states and their ability to work independent of physicians. The only big hope that I see for PAs is telemedicine and we need to be the top  providers here. The increase in litigation for NPs due to schools on the internet and lack of experience is the only thing that may change our future. I don't wish them misfortune but I do wish us well.

I always have a feeling when something good happens to the NPs, we PAs get left out. But when something bad happens, we all get group together. I definitely don't want the NP to fail.   

I think as a profession, we need to have the mindset that NP will eventually get Full Practice Authority in all 50 states, but what we are going to do about it. Our goal is to make the PA profession better each year. The time will come for NP Full Practice Authority in all 50 states, just matter of when.   

[Kaepora]

On 2/24/2020 at 11:24 AM, Joelseff said:

Thanks for clarifying that. It makes sense. This is the impression I got about the bill after CAPA emailed me and after reading the changes of the bill, it would still place NPs under physician oversight at a board level while on a practice level, NPs would be able to have removed collaboration. But why is CANP supporting it? Are they taking the compromise like we had to last year?

 

https://canpweb.org/advocacy/grassroots-resource-center/

 

 

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Yeah, I think they are of the mindset that baby steps are still forward progress, while the other organizations are thinking more "go big or go home".  

[Joelseff]

Yeah, I think they are of the mindset that baby steps are still forward progress, while the other organizations are thinking more "go big or go home".  

You would think California would be more apt to allow this but I suppose there is pressure from the physician groups and likely other stakeholders so a lot of compromises have to be made.

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[rookiejay]

On 2/24/2020 at 5:57 PM, surgblumm said:

I am hearing many echoes of the past with a much bleaker vision of the future of our profession due to the large increase of NPs, their independent status in many states and their ability to work independent of physicians. The only big hope that I see for PAs is telemedicine and we need to be the top  providers here. The increase in litigation for NPs due to schools on the internet and lack of experience is the only thing that may change our future. I don't wish them misfortune but I do wish us well.

We need someone to approach the government NOW with this Virus so we can help. Restrictions need to be lifted. 

[ProSpectre]

42 minutes ago, rookiejay said:

We need someone to approach the government NOW with this Virus so we can help. Restrictions need to be lifted. 

Why not you? Are you in California?

I'm across the country, but I'm happy to write an email to senators or representatives in any state to support a PA cause. I wrote last week to the senator in Florida who helped shoot down PA involvement on the HB607 there. However, we need PAs in California to lead the charge since they're going to have the most influential voice as constituents there. 

Edited March 20, 2020 by ProSpectre

[Lexapro]

Hmmm. I'm choosing to bump this old thread instead of starting a new one. I'm very surprised to see that the bill appears to have passed both the house and senate. and now it's up to the governor to sign. It's been quite amended but still, pretty shocked to see that independent practice might actually happen for NPs in CA.

 

https://californiahealthline.org/news/long-fought-nurse-practitioner-independence-bill-heads-to-newsom/

Edited September 1, 2020 by Lexapro

[MediMike]

Oof. There goes the neighborhood.

[turnedintoamartian]

Will physicians refuse to supervise NPs for the required 3 years as push back? 

[MediMike]

6 minutes ago, turnedintoamartian said:

Will physicians refuse to supervise NPs for the required 3 years as push back? 

Of course not. They will likely be required to by whatever large healthcare entity they work for.  This approach could work if there were still large number of private practices out there but not these days...plus who would give up the cash cow of $5-$15k/year?

[PACali]

7 hours ago, Lexapro said:

Hmmm. I'm choosing to bump this old thread instead of starting a new one. I'm very surprised to see that the bill appears to have passed both the house and senate. and now it's up to the governor to sign. It's been quite amended but still, pretty shocked to see that independent practice might actually happen for NPs in CA.

 

https://californiahealthline.org/news/long-fought-nurse-practitioner-independence-bill-heads-to-newsom/

Thank you for bumping this, I was going to make a new one. 

I am not surprised at all. I knew this is going to happened, it happened all 22 other states. Why not CA? CA nurses are loaded with $$ too. 

This is not the time to feel bad. We really need to make a big swing and stop being "afraid". California PA should really piggyback on this, especially in the Covid era.