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Board hears that out‑of‑state NP programs are straining California clinical placements
Summary
Board staff told the California Board of Registered Nursing that more than 60 out‑of‑state nurse‑practitioner programs currently provide clinical placements in California while roughly 30 in‑state programs exist, raising concerns from in‑state programs about access to preceptors and clinical sites; staff will collect detailed in‑state enrollment and clinical placement data for further review.
The California Board of Registered Nursing was told Nov. 19 that out‑of‑state nurse‑practitioner programs are placing unusually large numbers of California students into clinical sites, and board members agreed staff should gather more concrete in‑state data before considering regulatory changes.
Executive Officer Loretta Melby said the board has approved more than 60 out‑of‑state programs to provide clinicals in California compared with about 30 in‑state programs, and several out‑of‑state institutions report hundreds of California students. Melby pointed to examples including Chamberlain and large online programs that have dozens or hundreds of California enrollees and said the board is still “in discovery” about how many out‑of‑state programs are operating clinically in California.
Why it matters: board members and in‑state nursing educators say competition for preceptor placements and clinical rotations can impair the ability of California‑based programs to graduate nurses on schedule. ‘‘We have half as many in‑state nurse‑practitioner programs as out‑of‑state programs,’’ Melby said, adding that some out‑of‑state programs have paid arrangements or other resources not available to pre‑licensure programs.
Staff response and next steps: Melby said the board does not have statutory authority to limit an out‑of‑state school’s overall enrollment in its home state, but it does have authority to approve or deny an out‑of‑state program’s use of California clinical sites under existing regulations (Cal. Code Regs., tit. 16, § 1486 and related guidance). She told the board staff will collect and publish enrollment figures for California‑based NP programs and continue outreach so the Education and Licensing Committee can weigh effects on clinical capacity.
Board members called for more time to digest the data and asked staff to return the issue to the Education Licensing Committee. ‘‘We need the numbers for our in‑state programs so we can understand the whole set,’’ board member Allison Cormack said. Melby said supervising nurse‑education consultants are assembling that information and the board may re‑agendaize the topic for the committee in February.
Public comment: CRNA and NP stakeholder groups attended and urged the board to both protect in‑state program capacity and recognize that many California residents seek convenient out‑of‑state didactic options while still relying on California clinical sites.
What's next: staff will assemble a comprehensive report on in‑state program enrollment, clinical‑placement usage and the list of out‑of‑state programs that currently bring California students for clinicals; the Education Licensing Committee is scheduled to revisit the topic in February.
