California committee defers approval of multiple out‑of‑state nurse practitioner clinical requests for further review

The Education and Licensing Committee of the California Board of Registered Nursing on Oct. 22 voted to defer consideration of multiple requests by out‑of‑state nurse practitioner programs to place California‑licensed registered nurses in clinical practicums in California.

The committee voted to refer the item to the next committee meeting scheduled for February 2026 and asked staff to present an informational briefing at the November full board meeting on the approval process and potential impacts on in‑state programs. "We will defer taking action on this approval of these out of state nurse practitioner programs," the committee recorded as the motion and subsequent second; the committee chair and both committee members voted yes.

Why it matters: Committee members said they are concerned that large numbers of California‑licensed RNs enrolled in out‑of‑state NP programs could create clinical placement impaction for California NP students and sought clearer, program‑level enrollment data and documentation of current clinical activity. Board staff said some large programs already have hundreds of California RN students doing clinicals and that many programs are coming into formal compliance only since the board began a review process in 2019.

Discussion and evidence: Mary Anne McCarthy, supervising nursing education consultant and liaison to the committee, described the regulatory framework for approving out‑of‑state NP clinical placements and distinguished those programs from prelicensure programs that must be physically based in California. Laurie Melby, the board's executive officer, showed a roster of previously approved out‑of‑state programs and the number of California students each program reported; she cited examples including Chamberlain (601 family nurse practitioner students reported in state), Post University (requests totaling more than 600 students in various NP tracks), Simmons University (367 FNP students reported), University of Saint Augustine (400 FNP students reported) and others.

Committee members asked whether the board has authority to limit how many students an out‑of‑state program may place in California. Reza Pejuhesh, legal counsel, said the regulation the staff cited ("1486") requires prior board approval for programs requesting clinical placements in California and that criteria apply to that approval; he also said he would look more closely at any statutory authority over enrollment numbers. McCarthy and Melby pointed the panel to the California Code of Regulations provision the staff relies on and to board practice that any program bringing students into California must obtain prior board authorization.

Committee members requested these specific items before the board acts: documentation that the numbers reported are current (not historic or cumulative), a breakdown of how many of the reported students are California residents and how many are currently placed in California clinicals, and contemporaneous clinical‑site collaboration forms that show which local hospitals and clinics are committed to receiving additional students and whether those sites already host students from other programs.

Public comment and next steps: Representatives of California state universities and other programs said they are already experiencing difficulty finding preceptors and clinical sites and that they support further review. Michelle Pereira of Stanislaus State University and Jessica Padilla of Loma Linda University told the committee their programs face the same clinical‑site competition described by committee members.

The committee chair and members unanimously approved the motion to defer and to request a staff presentation to the full board in November and a return to the committee in February 2026 with the additional documentation. Staff said they will request that specific out‑of‑state programs appear at the board meeting if committee members want to question program representatives directly.

The committee did not adopt any enrollment limits or other conditions at this meeting; instead it ordered more documentary evidence and a fuller briefing for the full board.