April 25, 2018 the Honorable Jim Wood Member, California State

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April 25, 2018 The Honorable Jim Wood Member, California State Assembly State Capitol, Room 6005 Sacramento, CA 95814 RE: Assembly Bill 890 – SUPPORT As Amended April 22, 2019 Dear Assembly Member Wood: On behalf of the Rural County Representatives of California (RCRC), I am pleased to offer our support for your Assembly Bill 890, which would allow Nurse Practitioners (NPs) that meet specified requirements to practice independently and without physician and surgeon supervision. RCRC is an association of thirty-six rural California counties, and the RCRC Board of Directors is comprised of elected supervisors from each of those member counties. Currently, California is one of twenty-eight states that requires NPs to practice under the supervision of a licensed physician and surgeon. While there are no definitive rules regarding the physical proximity of a physician to an NP, many medical services, such as ordering and interpreting diagnostic procedures, certifying disability, and prescribing, administering, and dispensing controlled substances, require a physician’s oversight and authorization. AB 890 allows a licensed NP to practice without physician supervision in limited practice settings. Additionally this bill creates the Advanced Practice Registered Nursing Board (Board), and authorizes an NP certified by that Board that has obtained an advanced nursing degree and has meet specified experience requirements, to provide services outside of the limited practice settings. California has a significant shortage of health service providers in underserved and rural areas, and many children and adults face significant challenges accessing quality services. We believe AB 890 will help bridge the access gap by allowing NPs to provide full healthcare services in areas where physician care is unfeasible. 1215 K Street, Suite 1650, Sacramento, CA 95814 | www.rcrcnet.org | 916.447.4806 | Fax: 916.448.3154 ALPINE AMADOR BUTTE CALAVERAS COLUSA DEL NORTE EL DORADO GLENN HUMBOLDT IMPERIAL INYO LAKE LASSEN MADERA MARIPOSA MENDOCINO MERCED MODOC MONO NAPA NEVADA PLACER PLUMAS SAN BENITO SAN LUIS OBISPO SHASTA SIERRA SISKIYOU SONOMA SUTTER TEHAMA TRINITY TULARE TUOLUMNE YOLO YUBA The Honorable Jim Wood Assembly Bill 890 April 25, 2019 Page 2 For the above reasons, RCRC supports your AB 890. If you should have any questions or concerns regarding RCRC’s position, please do not hesitate to contact me at [email protected] or (916) 447-4806. Sincerely, TRACY RHINE Legislative Advocate cc: The Honorable Anna Caballero, Member of the State Senate The Honorable Jerry Hill, Member of the State Senate The Honorable Connie Leyva, Member of the State Senate The Honorable Jeff Stone, Member of the State Senate The Honorable Susan Eggman, Member of the State Assembly The Honorable James Gallagher, Member of the State Assembly The Honorable Mike Gipson, Member of the State Assembly The Honorable Cecilia Aguiar-Curry, Member of the State Assembly The Honorable Laura Friedman, Member of the State Assembly Members of the Assembly Appropriations Committee Consultant, Assembly Appropriations Committee Ellen Cesaretti, Consultant, Assembly Republican Caucus .

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