Independent Practice for California's Nurse Practitioners More Urgent After Roe vs. Wade Decision
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THE CHCF WEEKLY
August 2, 2022
In 2020, California created a pathway for nurse practitioners (NPs) to treat patients independently (without supervision from a physician), which was intended to help address the state’s provider shortage. This takes on new significance since the Supreme Court overturned Roe v. Wade. California lawmakers are considering legislation to clarify that independent NPs can perform aspiration abortions without physician supervision, thereby increasing capacity to provide abortions as women travel here from states where it is no longer available.
California has yet to establish how much experience and physician mentorship an NP must have before being allowed to practice independently. This is referred to as the transition-to-practice period – or TTP. The legislature is proposing a TTP period of three full-time equivalent years or 4,600 hours — one of the most robust TTP periods in the country, a new CHCF analysis finds. The bill would allow NPs who have met the TTP criteria to start practicing independently in 2023.
Dr. Christine Henneberg, an abortion provider in California, shared a physician’s perspective on the role of NPs in increasing access to high-quality abortion care in the face of increased demand.
Of the 30 states (plus Washington, DC) that allow NP independent practice, 16 have no TTP period and 8 have a TTP period of 2,400 hours or less.
From the Blog
Heather Stringer Researchers partner with community-based organizations to reach homebound, older adults at risk of severe illness from COVID-19. |
Anne Sunderland A conversation with Christine Henneberg — physician, abortion care provider, author, and mother. |
Recent Releases
In the Health Affairs Forefront, CHCF's Kathryn Phillips describes California's progress investing in primary care, including important actions by DHCS, Covered California, CalPERs, and the California legislature. Leaders from Maryland and Nebraska share experiences from their states.
With support from CHCF, Mathematica explores the opportunities and challenges of expanding psychiatry graduate medical education in California. The brief includes case studies of new psychiatry residency programs at Charles R. Drew University College of Medicine and Kaiser Permanente Northern California.
Upcoming Events
There has been scant focus on one of the biggest drivers of structural racism in health care: how doctors and hospitals are paid. In this webinar hosted by the USC Center for Health Journalism, experts will highlight the ways good incentives can produce bad outcomes for specific groups.
The 10th Annual Telehealth Summit, The Golden State for Telehealth: What's Next for California hosted by the California Telehealth Resource Center will be held virtually from August 9-10. Connect with and learn from decisionmakers in health care organizations at different levels of telehealth implementation and integration. Scholarships are available. Use code CHCF2022Scholar.
Stories That Caught Our Attention
- The US Physician Shortage Is Only Going to Get Worse. Here Are Potential Solutions (Time)
The types of shortages and poor access to care that have been common in rural and underserved urban areas for the past few decades will become more common nationwide. Related: See this CHCF update on actions California is taking to implement the recommendations of the California Future Health Workforce Commission.
- Because of Texas Abortion Law, Her Wanted Pregnancy Became a Medical Nightmare (NPR)
New, untested abortion bans have made doctors unsure about treating some pregnancy complications, which has led to life-threatening delays and trapped families in a limbo of grief and helplessness.
- California Health Care Providers Must Join Statewide Data Sharing Agreement by 2024 (Foley & Lardner)
Confidentiality laws that have long limited permissible disclosures of health information must now be considered alongside a new regime of rules designed to prevent obstruction of legitimate access to health information. Related: The president and CEO of CHCF explains why the new health data exchange is so important in this San Francisco Chronicle op-ed reprinted by CHCF.
- Doctors’ New Tool to Treat Homeless People: A Medical Clinic in a Van (Los Angeles Times – paywall)
Some Los Angeles health centers are expanding medical teams treating people experiencing homelessness with vans and RVs equipped with medical chairs, equipment, and lab space to offer patients a more professional and private setting. Related: Read an article in The CHCF Blog to learn about a program in Los Angeles that provides health care to people experiencing homelessness where they are.
- Virtual Mental Health Increasingly Important for Younger and Hispanic Populations, Data Show (MedCity News)
While 92% of consumers said virtual care adds convenience when choosing a primary care provider, those accessing virtual mental health care had different responses to how convenient/private it was based on age and race, CVS Health data showed. Related: This recent publication from the National Council for Mental Wellbeing highlights innovations in telehealth for behavioral health care. It was developed specifically for mental health and substance use disorder treatment providers.
- To Retain Nurses and Other Staffers, Hospitals Are Opening Child Care Centers (California Healthline)
People are leaving the health care industry because they are not able to balance work and life, one expert says. Related: In an interview with The CHCF Blog, a UCSF workforce expert says retirements in nursing and other health care fields will cause problems for at least five years.
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