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After heated debate, board approves most out‑of‑state NP programs for clinical placements, removes one large request for verification
Summary
Following extended discussion and dozens of public comments from California and out‑of‑state educators, the BRN approved multiple non‑California nurse practitioner programs to place students in California clinical settings; the board removed ASC/Post University from the motion pending verification of its current in‑state enrollment figures.
The Board of Registered Nursing approved a slate of non‑California nurse practitioner (NP) education programs to place students in clinical practice settings in California after extended discussion of clinical capacity, program oversight and data gaps.
Maryann McCarthy, supervising nursing education consultant, presented five years of program data and regulatory context for item 8.3, noting that since the board began approving out‑of‑state NP clinical placements in August 2020 the number of approved out‑of‑state programs has grown rapidly. "After todayif the approval is placed, we will have 50 out‑of‑state nurse practitioner programs to our 35 in‑state nurse practitioner programs," McCarthy said, summarizing staff calculations and specialty‑by‑specialty student counts that drove board members' concerns.
California program directors and clinical placement coordinators urged restraint in approvals. Don Dam, clinical placement coordinator at the University of San Diego, said approving additional out‑of‑state clinical placements "will allow external entities to displace our students" and described competitive pressure that can delay graduation when clinical sites are scarce. Multiple speakers from in‑state programs said they do not pay preceptors and that unaffiliated out‑of‑state arrangements can circumvent local consortium processes.
Representatives of several out‑of‑state programs, including American Sentinel/Post University and Chamberlain, pushed back, saying their programs comply with federal placement requirements and that they do not pay preceptors. Kimberly Narude (representing American Sentinel/Post University) told the board, "We do not pay for preceptors," and said the numbers in the packet included projected enrollments rather than students currently placed in California.
Board members considered options including limiting enrollments, deferring approvals until more data are available, or approving under current regulatory authority and revisiting approvals if evidence of harm emerges. David Lawler moved to approve the programs and the enrollment figures listed in the agenda table; board member Allison Cormack seconded. A friendly amendment was accepted to remove ASC/Post University from the motion until staff could verify whether the numbers in the packet reflected current in‑state enrollment or aspirational projections. On a roll‑call vote the motion (as amended) passed with all members present voting yes.
What the vote does and does not do: Under existing regulations (CCR 1486) many out‑of‑state NP applicants meet approval criteria; the board lacks a prescriptive statutory limit for NP clinical placements comparable to the one that governs pre‑licensure programs, so staff and several board members said regulatory changes and better data collection (a statewide placement database/consortium) will be necessary to manage growth consistently.
Next steps: Staff will verify applicant enrollment numbers where projections appear uncertain, report back on data collection plans and work with partner agencies on potential regulatory updates. Board members said they expect continued public comment and more detailed data before future approvals or adjustments.
