(a)
(1)
Notwithstanding any other law, a nurse practitioner may perform the functions specified in subdivision (c) pursuant to that subdivision, in a setting or organization specified in paragraph (2) pursuant to that paragraph, if the nurse practitioner has successfully satisfied the following requirements:
(A)
Passed a national nurse practitioner board certification examination and, if applicable, any supplemental examination developed pursuant to paragraph (4) of subdivision (a) of Section 2837.105.
(B)
Holds a certification as a nurse practitioner from a national certifying body accredited by the
National Commission for Certifying Agencies or the American Board of Nursing Specialties and recognized by the board.
(C)
Provides documentation that educational training was consistent with standards established by the board pursuant to Section 2836 and any applicable regulations as they specifically relate to requirements for clinical practice hours. Online educational programs that do not include mandatory clinical hours shall not meet this requirement.
(D)
Has completed a transition to practice in California of a minimum of three full-time equivalent years of practice or 4600 hours. A nurse practitioner who has been practicing as a nurse practitioner in direct patient care for a minimum of three full-time equivalent years or 4,600 hours within the last five years, as
indicated on the application, may be deemed to have satisfied this requirement. For purposes of this subparagraph:
(i)
Proof of completion of one transition to practice shall be provided to the board, on a form prescribed by the board, as an attestation from either a licensed physician and surgeon, a certified nurse practitioner practicing pursuant to this section, or a certified nurse practitioner practicing pursuant to Section 2837.104.
(ii)
A licensed physician and surgeon or a certified nurse practitioner who attests to the completion of a transition to practice is not required to specialize in the same category as the applicant pursuant to Section 2836.
(iii)
A licensed physician and surgeon or a certified nurse practitioner
practicing pursuant to this section or Section 2837.104 who attests to the completion of a transition to practice is not required to verify competence, clinical expertise, or any other standards related to the practice of the applicant and shall only attest to the completion of the transition to practice, as defined in Section 2837.101.
(iv)
A licensed physician and surgeon or a certified nurse practitioner practicing pursuant to this section or Section 2837.104 who attests to the completion of a transition to practice shall not be subject to civil, criminal, administrative, disciplinary, employment, credentialing, professional discipline, contractual liability, or medical staff action, sanction, or penalty or other liability for providing an attestation or refusing to provide an attestation pursuant to this section unless the attestation was
produced fraudulently.
(2)
A nurse practitioner who meets all of the requirements of paragraph (1) may practice, including, but not limited to, performing the functions authorized pursuant to subdivision (c), in one of the following settings or organizations in which one or more physicians and surgeons practice with the nurse practitioner without standardized procedures:
(A)
A clinic, as defined in Section 1200 of the Health and Safety Code.
(B)
A health facility, as defined in Section 1250 of the Health and Safety Code, except for the following:
(i)
A correctional treatment center, as defined in paragraph (1) of subdivision (j) of Section 1250 of the Health
and Safety Code.
(ii)
A state hospital, as defined in Section 4100 of the Welfare and Institutions Code.
(C)
A facility described in Chapter 2.5 (commencing with Section 1440) of Division 2 of the Health and Safety Code.
(D)
A medical group practice, including a professional medical corporation, as defined in Section 2406, another form of corporation controlled by physicians and surgeons, a medical partnership, a medical foundation exempt from licensure, or another lawfully organized group of physicians and surgeons that provides health care services.
(E)
A home health agency, as defined in Section 1727 of the Health and Safety Code.
(F)
A hospice facility licensed pursuant to Chapter 8.5 (commencing with Section 1745) of Division 2 of the Health and Safety Code.
(3)
In health care agencies that have governing bodies, as defined in Division 5 of Title 22 of the California Code of Regulations, including, but not limited to, Sections 70701 and 70703 of Title 22 of the California Code of Regulations, the following apply:
(A)
A nurse practitioner shall adhere to all applicable bylaws.
(B)
A nurse practitioner shall be eligible to serve on medical staff and hospital committees.
(C)
A nurse practitioner shall be eligible to attend
meetings of the department to which the nurse practitioner is assigned. A nurse practitioner shall not vote at department, division, or other meetings unless the vote is regarding the determination of nurse practitioner privileges with the organization, peer review of nurse practitioner clinical practice, whether a licensee’s employment is in the best interest of the communities served by a hospital pursuant to Section 2401, or the vote is otherwise allowed by the applicable bylaws.
(b)
An entity described in subparagraphs (A) to (F), inclusive, of paragraph (2) of subdivision (a) shall not interfere with, control, or otherwise direct the professional judgment of a nurse practitioner functioning pursuant to this section in a manner prohibited by Section 2400 or any other law.
(c)
In addition to any other practices authorized by law, a nurse practitioner who meets the requirements of paragraph (1) of subdivision (a) may perform the following functions without standardized procedures in accordance with their education and training:
(1)
Conduct an advanced assessment.
(2)
(A)
Order, perform, and interpret diagnostic procedures.
(B)
For radiologic procedures, a nurse practitioner can order diagnostic procedures and utilize the findings or results in treating the patient. A nurse practitioner may perform or interpret clinical laboratory procedures that they are permitted to perform under Section 1206 and under the federal Clinical Laboratory Improvement Act
(CLIA).
(3)
Establish primary and differential diagnoses.
(4)
Prescribe, order, administer, dispense, procure, and furnish therapeutic measures, including, but not limited to, the following:
(A)
Diagnose, prescribe, and institute therapy or referrals of patients to health care agencies, health care providers, and community resources.
(B)
Prescribe, administer, dispense, and furnish pharmacological agents, including over-the-counter, legend, and controlled substances.
(C)
Plan and initiate a therapeutic regimen that includes ordering and prescribing nonpharmacological interventions, including, but not
limited to, durable medical equipment, medical devices, nutrition, blood and blood products, and diagnostic and supportive services, including, but not limited to, home health care, hospice, and physical and occupational therapy.
(5)
After performing a physical examination, certify disability pursuant to Section 2708 of the Unemployment Insurance Code.
(6)
Delegate tasks to a medical assistant pursuant to Sections 1206.5, 2069, 2070, and 2071, and Article 2 (commencing with Section 1366) of Chapter 3 of Division 13 of Title 16 of the California Code of Regulations.
(d)
A nurse practitioner practicing under this section and not working under standardized procedures shall inform all new patients in a language understandable
to the patient that a nurse practitioner is not a physician and surgeon.
(e)
A nurse practitioner shall not be required to tell a patient the patient has a right to see a physician and surgeon.
(f)
A nurse practitioner practicing under this section and not working under standardized procedures shall post a notice in a conspicuous location accessible to public view that the nurse practitioner is regulated by the Board of Registered Nursing. The notice shall include the board’s telephone number and the internet website where the nurse practitioner’s license may be checked and complaints against the nurse practitioner may be made.
(g)
A nurse practitioner shall refer a patient to a physician and surgeon or other licensed
health care provider if a situation or condition of a patient is beyond the scope of the education and training of the nurse practitioner.
(h)
A nurse practitioner practicing under this section shall have professional liability insurance appropriate for the practice setting.
(i)
Any health care setting operated by the Department of Corrections and Rehabilitation is exempt from this section.
