Jump to content

California's AB 890 Signed Into Law


Recommended Posts

Sadly, this isn't always the case. Although a lot of surgeons I've met think highly of PAs, I can't tell you how many physicians I've also spoken to that didn't know the difference in training and practice laws of PAs and NPs. Hell, most didn't even know NPs can work independently. The look of surprise on their face when I broke some of this stuff down is concerning. Most just thought NPs are trying to be fake doctors and both PAs and NPs are just "mid-levels." I still remember one cardiologist who was trying to hire an NP because he thought PAs couldn't see patients on their own and always had to have the physician present. That's what he thought supervision meant. [emoji849]
Just did an ER f/u on a pt of mine. She was sent to ED by me for AMS and possible stroke. I spoke with the ED doc... I told him I was "the PA" at my office. In the note I was referred to as "The primary care NP" and "the PA" in so many sections of the report and even in the same paragraph. [emoji2359]

Sent from my SM-G975U using Tapatalk

Link to comment
Share on other sites

27 minutes ago, Kaepora said:

Governor Gavin Newsom signed AB 890 into law today.

AB 890 allows NPs to work without physician supervision, removing the supervisory requirement in existing law.

Good god Almighty. It has happened.  My worst professional fears have come true.  We have lost California...

My advice:

1.  Pay off your student loans ASAP even if it means living like a homeless person.

2.  Get ready to look for work for half of what PA's made before.

3.  Get with AAPA and CAPA and scream that we need parity with NP's.

4.  Pray, because this does not end well for us assistants.

Link to comment
Share on other sites

1 hour ago, ventana said:

calling AAPA

 

Largest state in the union (are they the biggest in pop?) just gave lesser trained NP's independence.....

time to take the gloves off and get us there!!!

congrats to NP for winning the PR war and making everyone think they are the same as docs..... ugh  (face slap)

Yes, and it's not even close.

Link to comment
Share on other sites

1 hour ago, iconic said:

And we are still debating whether we are Associates *shrug*

Sadly, we are not debating anything right now.  We are in a terminal holding pattern waiting for AAPA to make their decree....in November.

Whether they leave us Assistants or recommend the change to Associates, the fact is...we have now lost California.  If you go back through my old posts, I said a few years ago that if we lose California, we lose the whole ballgame.  Now other states will follow our country's most populous state and authorize full independent practice, except maybe Texas.  That is a death nail for us.  It's just so freaking tragic that many of us could see this coming from a mile away, yet clung to "assistant" or "associate".   At this point, we deserve our fate.

  • Like 1
Link to comment
Share on other sites

I just got this from CAPA:

 

CAPA Addresses Passage of Nurse Practitioner Legislation
 
Today, CAPA congratulates California’s Nurse Practitioners (NPs) and the California Association for Nurse Practitioners (CANP) on Governor Newsom signing Assembly Bill 890 (AB 890) last night.
 
Like the CAPA-sponsored Senate Bill 697 (SB 697) from last year, AB 890 offers NPs new opportunities to practice with a degree of autonomy in California that they have never enjoyed before. Knowing what a battle it was to push SB 697 through, CAPA knows that AB 890 did not come easy. CAPA tips its hat to NPs and CANP.
 
As we applaud the NPs success, CAPA also wants to spotlight the implications of such an event for you and the PA profession. What the passage of AB 890 underscores is how far PAs have to go to secure our livelihoods and our role in an ever-changing healthcare environment.
 
We recognize that politics and advocacy isn’t for everyone.But, everything you do, your professional dignity, and every dollar you earn can be traced back to a
word in a law that was passed in Sacramento.
 
For those who believe that successfully protecting the PA profession will simply “be handled” by CAPA, AAPA, and other PA organizations, we must respectfully inform you, that is a misconception.
 
To protect and advance the future of California PAs, the blunt truth is that CAPA needs many more PAs to make just a couple small, personal commitments to their profession. Otherwise, any effort CAPA makes on your behalf fizzles and will not be taken seriously.
 
CAPA asks you to help us, yourselves and other PAs change the tide of the profession by making PAs a strong, united voice. An organization that is 13,000 members strong is difficult for Sacramento to ignore.
 
Through SB 697, CAPA advanced and secured the present for you. But what about your future? That will be up to you. What are you waiting for? Join CAPA today, make PAs impossible to ignore, and tell us how you want to contribute to CAPA SPEAKS!
  • Like 1
  • Upvote 2
Link to comment
Share on other sites

  • Moderator
53 minutes ago, Cideous said:

I just got this from CAPA:

 

CAPA Addresses Passage of Nurse Practitioner Legislation
 
Today, CAPA congratulates California’s Nurse Practitioners (NPs) and the California Association for Nurse Practitioners (CANP) on Governor Newsom signing Assembly Bill 890 (AB 890) last night.
 
Like the CAPA-sponsored Senate Bill 697 (SB 697) from last year, AB 890 offers NPs new opportunities to practice with a degree of autonomy in California that they have never enjoyed before. Knowing what a battle it was to push SB 697 through, CAPA knows that AB 890 did not come easy. CAPA tips its hat to NPs and CANP.
 
As we applaud the NPs success, CAPA also wants to spotlight the implications of such an event for you and the PA profession. What the passage of AB 890 underscores is how far PAs have to go to secure our livelihoods and our role in an ever-changing healthcare environment.
 
We recognize that politics and advocacy isn’t for everyone.But, everything you do, your professional dignity, and every dollar you earn can be traced back to a
word in a law that was passed in Sacramento.
 
For those who believe that successfully protecting the PA profession will simply “be handled” by CAPA, AAPA, and other PA organizations, we must respectfully inform you, that is a misconception.
 
To protect and advance the future of California PAs, the blunt truth is that CAPA needs many more PAs to make just a couple small, personal commitments to their profession. Otherwise, any effort CAPA makes on your behalf fizzles and will not be taken seriously.
 
CAPA asks you to help us, yourselves and other PAs change the tide of the profession by making PAs a strong, united voice. An organization that is 13,000 members strong is difficult for Sacramento to ignore.
 
Through SB 697, CAPA advanced and secured the present for you. But what about your future? That will be up to you. What are you waiting for? Join CAPA today, make PAs impossible to ignore, and tell us how you want to contribute to CAPA SPEAKS!

Excellent statement.

  • Like 1
  • Upvote 1
Link to comment
Share on other sites

I just got this from CAPA:

 

CAPA Addresses Passage of Nurse Practitioner Legislation
  Today, CAPA congratulates California’s Nurse Practitioners (NPs) and the California Association for Nurse Practitioners (CANP) on Governor Newsom signing Assembly Bill 890 (AB 890) last night.   Like the CAPA-sponsored Senate Bill 697 (SB 697) from last year, AB 890 offers NPs new opportunities to practice with a degree of autonomy in California that they have never enjoyed before. Knowing what a battle it was to push SB 697 through, CAPA knows that AB 890 did not come easy. CAPA tips its hat to NPs and CANP.   As we applaud the NPs success, CAPA also wants to spotlight the implications of such an event for you and the PA profession. What the passage of AB 890 underscores is how far PAs have to go to secure our livelihoods and our role in an ever-changing healthcare environment.   We recognize that politics and advocacy isn’t for everyone.But, everything you do, your professional dignity, and every dollar you earn can be traced back to a word in a law that was passed in Sacramento.   For those who believe that successfully protecting the PA profession will simply “be handled” by CAPA, AAPA, and other PA organizations, we must respectfully inform you, that is a misconception.   To protect and advance the future of California PAs, the blunt truth is that CAPA needs many more PAs to make just a couple small, personal commitments to their profession. Otherwise, any effort CAPA makes on your behalf fizzles and will not be taken seriously.   CAPA asks you to help us, yourselves and other PAs change the tide of the profession by making PAs a strong, united voice. An organization that is 13,000 members strong is difficult for Sacramento to ignore.   Through SB 697, CAPA advanced and secured the present for you. But what about your future? That will be up to you. What are you waiting for? Join CAPA today, make PAs impossible to ignore, and tell us how you want to contribute to CAPA SPEAKS!
READ FULL STATEMENT
I emailed them and crickets... Not even a link to that statement! I guess they're tired of hearing from me... All California PAs NEEDS TO GIVE TO THE PAC! and JOIN FREAKING CAPA! Even then we are outnumbered! But we can be more persistent and tenacious! [emoji34]

 

Sent from my SM-G975U using Tapatalk

 

 

 

  • Upvote 1
Link to comment
Share on other sites

From CAPA about AB890:

 

"WHAT DOES AB 890 ACTUALLY DO FOR NPs?

 

• Creates a new NP-specific Advisory Committee under the Board of Registered Nursing.

• Requires that an NP verbally inform new patients that they are not a physician.

• After certain additional education and experience (4,600 hours) requirements are met, allows NPs practicing alongside

physicians to do so without “standardized procedures.” (“Standardized procedures” refers to specific protocols governing NP

practice).

• After 2023, if an NP has been issued a certification from the Board of Registered Nursing, and met education and experience requirements, they may practice in settings where no physicians are present; but, may only offer specified services.

• Mandates that NPs consult with physicians in many specific circumstances.

• Requires NPs to establish a detailed, written “referral plan” for when they must refer patients to a physician, such as in such common circumstances as when a patient fails to respond to treatments “as predicted”, or does not fit the “commonly accepted” pattern for a disease or disorder."

 

 

 

Still... I would prefer that to the restrictions we got. They say they will be working more "to advance the PA profession in California" whatever that means... But they DO NEED EVERY CALIFORNIA PA ON BOARD!

 

I've been a member of CAPA since I graduated even before joining AAPA (I only joined AAPA relatively recently when the rust came off their joints and they started doing more for PAs) and have been giving to the PACs. I doubled it this year!

 

So if you are a California PA and this is worrying you or pisses you off... YOU NEED TO JOIN (if you haven't yet) CAPA and GIVE MONEY TO THE PACs (Give more if you can!)

 

More from CAPA: https://www.capanet.org/ab890/

 

Sent from my SM-G975U using Tapatalk

 

 

 

 

 

 

  • Upvote 2
Link to comment
Share on other sites

14 hours ago, Joelseff said:

From CAPA about AB890:

 

"WHAT DOES AB 890 ACTUALLY DO FOR NPs?

 

• Creates a new NP-specific Advisory Committee under the Board of Registered Nursing.

• Requires that an NP verbally inform new patients that they are not a physician.

• After certain additional education and experience (4,600 hours) requirements are met, allows NPs practicing alongside

physicians to do so without “standardized procedures.” (“Standardized procedures” refers to specific protocols governing NP

practice).

• After 2023, if an NP has been issued a certification from the Board of Registered Nursing, and met education and experience requirements, they may practice in settings where no physicians are present; but, may only offer specified services.

• Mandates that NPs consult with physicians in many specific circumstances.

• Requires NPs to establish a detailed, written “referral plan” for when they must refer patients to a physician, such as in such common circumstances as when a patient fails to respond to treatments “as predicted”, or does not fit the “commonly accepted” pattern for a disease or disorder."

 

 

 

Still... I would prefer that to the restrictions we got. They say they will be working more "to advance the PA profession in California" whatever that means... But they DO NEED EVERY CALIFORNIA PA ON BOARD!

 

I've been a member of CAPA since I graduated even before joining AAPA (I only joined AAPA relatively recently when the rust came off their joints and they started doing more for PAs) and have been giving to the PACs. I doubled it this year!

 

So if you are a California PA and this is worrying you or pisses you off... YOU NEED TO JOIN (if you haven't yet) CAPA and GIVE MONEY TO THE PACs (Give more if you can!)

 

More from CAPA: https://www.capanet.org/ab890/

 

Sent from my SM-G975U using Tapatalk

 

 

 

 

 

 

Agreed. I'm a member of and donated to both my state board and AAPA. I have been a member of both since I was eligible to be a student member, but just now started donating last year. 

  • Like 1
  • Upvote 1
Link to comment
Share on other sites

On 9/30/2020 at 1:33 PM, Cideous said:

Sadly, we are not debating anything right now.  We are in a terminal holding pattern waiting for AAPA to make their decree....in November.

Whether they leave us Assistants or recommend the change to Associates, the fact is...we have now lost California.  If you go back through my old posts, I said a few years ago that if we lose California, we lose the whole ballgame.  Now other states will follow our country's most populous state and authorize full independent practice, except maybe Texas.  That is a death nail for us.  It's just so freaking tragic that many of us could see this coming from a mile away, yet clung to "assistant" or "associate".   At this point, we deserve our fate.

On the same page but I'm optimistic. I am not surprised at all the CANP got FPA or however they want to call it. I will say just matter of the time all NP will have some degree of FPA, at least have less restrictions than the PAs. In a way, sadly or luckily the NPs are the one push the PA profession forward. Without the NP we wouldn't be talking about optimal team practice or SB 697 Practice parity. I think its time for CAPA to push for the next partice parity and we have to swing bigger this time. 

Link to comment
Share on other sites

  • 2 weeks later...
22 minutes ago, Cideous said:

4D1A154C-9DD7-4DE4-A865-494F92F25D5C_1_105_c.thumb.jpeg.14a18c93e4e5f0d4cdc4d81ab318249b.jpeg

Haha, while NP’s are shooting for the stars, to many PA’s and AAPA are afraid to climb more than a small mountain for the professions future.  PA goal, in the future, may need  to be more about being on par, with RN. Assistant or Associate will never gain equal ground with NP. 

Link to comment
Share on other sites

  • 6 months later...

AB 890 will accelerate the PA movement towards increasing practice autonomy. Untoward Statements by some PA’s doesn’t help the cause.  “Lesser trained providers” will not help facilitate or promote a positive milieu, not to mention the statement is regressive and further divides PA’s and NP’s. There is evidence that NP’s are “lesser trained” to the contrary. 

The fact of the matter is that PA’s are yet able to practice independently without the collaboration or supervision of an MD or DO.

It’s not a matter of skill, knowledge or capabilities. Many PA’s are unquestionably better practitioners then the physicians they work with. Frankly, it’s a matter of law and the position as a subordinate/assistant.

PAs can never operate their own practice. By law, they are required to work under the direct supervision of a physician or a surgeon. Hence the word assistant. 

NP’s work under an independent license, although hospital bylaws often require supervision or collaboration agreements, although it is not required by law or regulation.  

 Supervision requirements and hospital bylaws do not distinguish between PA’s and NP’s.
Administrators, in their ignorance, applied limitations established by PA law and regulations (PA’s were first in the hospital). PA bylaw precedents were inappropriately applied to NP privileges without regard to differences in law.

Frankly, the bylaw authors didn’t know the difference in regulation and law believing PA and NP regulations are  equal therefore applying equal limitations and rules.

Most hospital administrators and physicians do not distinguish between PA’s and NP’s and assume that the regulations are equal. All of us are “mid-levels”. Even the federal registry refer to us as “mid-levels”:

Only recently, NP’s were allowed and recognized as full voting medical staff members (NP’s can only vote on matters that relate to NP’s and the specialty in which they are credentialed) and allowed to chair committees because of their independent status. 
As a condition of Medicare participation and the requirements to be associated with a MD or DO, PA’s unfortunately do not have the same opportunity (Federal Registry).

The current social-medical environment has afforded opportunities for both PA’s and NP’s never previously imagined. 
Experience, amazing physician mentors and forward thinking legislators will continue to advance both professions to fill the provider void and to benefit vulnerable patients that are hostage to the current medical system. 

 It is discouraging that PA’s and NP’s continue to engage in insecure and infantile rhetoric about who is better. 
We each have an important role that benefit patients and the system. 
 
If we collaborate and support the efforts of each profession, we both win big. 

Physicians are our biggest opponent. They know that the comparative evidence support equal outcomes in care.  I can understand their frustration and have empathy for physicians.  It must suck knowing that there are PA’s and NP’s practicing that are so much better then they could ever be.  
Their arguments for competence are lame and without merit. Don’t misunderstand me, the majority of physicians are amazing practitioners with incredible talent.  As we all know, and is as applicable to us, there are many physicians out there that couldn’t hold water to many PA’s and NP’s and Vice-Versa. 
 It has to be heart felt that there are several studies that show evidence PA’s/NP’s can practice equal too and at a higher level then physicians.  

AB 890 is not a threat to PA’s...it’s a big stepping stone to a brighter future for both professions. I venture to think that AB 890 will make it easier for PA legislation to move forward and pass. It’s hard to believe people don’t see that. Only the few of us that feel threatened make derogatory statements that feel that Armageddon is on the horizon and refuse to see the benefit. 

Thinking your better than another provider shows your insecurity and most likely relates to dangerous practice patterns.  Your probably one of those that think they know it all and doesn’t reach out for questions on difficult cases. Good luck and hope your patients don’t suffer from your arrogance. This is a profession that demands humility, no matter how good you think you are 

Wishing you the best in your practice and life.

 


 

 

 

 


 

 

 

  • Upvote 1
Link to comment
Share on other sites

4 hours ago, IntensivistLife said:

AB 890 is not a threat to PA’s

For the most part I agree with your sentiments. This isn't true because the threat isn't specifically from NPs but from the non-parity in the market. I have been in hundreds of discussions with PA leadership over the years about the practical implications of this difference. 15 years ago it was all about staying in the warm embrace of physicians and being their faithful sidekick because they would always be in charge of medicine. It was only after the ship was mostly below the waves that started to change and it is still changing slowly while we get crowded out of the marketplace. It is just economics.

I have said many times I'm not mad at the NPs...I'm envious of their single minded determination and progress. If we had joined the nurses 20 years ago we would be right there with them. But here we are and we have to do something. All the "hate the nurses" stuff is more a reflection of fear and frustration. I have done it but revamped my attitude.

  • Like 1
  • Upvote 2
Link to comment
Share on other sites

I've said it before, but I wish PAs and NPs could team up and become one sort of shared body - "Advanced Practice Medical Provider" or something of the nature.

Let nursing handle lobbying, marketing, and branding.

Let the PAs handle education standards, testing, and certification.

We could make a hell of a team!

 

On another note, I have noticed a lot of comments about PAs not getting independent practice or even getting kicked off of bills last minute like in Florida. You refer to physicians as an ally and friend, but is it not possible that it is their doing? I sometimes feel the PA profession is the physician natural counter-balance to independent nurse practitioners. It allows them to continue hiring advanced practice providers and padding their bottom line without the "threat" that the person they hire will set up shop down the road and compete. Perhaps it is in the best interest of physicians to keep you all tethered to them.

  • Like 1
  • Upvote 1
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More