Abortion: authorized procedures.

Section 2725.4(e)(2): The requirement for nurse practitioners and certified nurse-midwives performing procedural abortions beyond the first trimester to establish written consultation, collaboration, referral, and transfer procedures was narrowed. The old text triggered this requirement for 'complex cases and cases with complications, conditions, or emergencies' in addition to cases beyond their scope. The enrolled version removes those explicit triggers, leaving only 'cases that require care that is beyond the scope of their education, training, and experience.'

The legislative counsel's digest was updated to match the cleaned-up statutory language, removing the reference to 'complex cases and under other specified circumstances' and replacing it with 'as specified, in cases that require care that is beyond the scope of their education, training, and experience.'

Formatting changes throughout: removal of amendment history headers, line numbers, and page markers; addition of final enrolled bill elements including passage dates (Assembly and Senate both August 25, 2026), signature blocks for the Chief Clerk of the Assembly, Secretary of the Senate, Private Secretary of the Governor, and a Governor approval line.

The consultation, collaboration, referral, and transfer-of-care requirement now applies only when a nurse practitioner or certified nurse-midwife performs a procedural abortion beyond the first trimester. First-trimester procedural abortions by these providers are no longer subject to this requirement.

When the consultation requirement does apply (beyond first trimester), the provider must now establish, maintain, AND follow written procedures that delineate the parameters for consultation, collaboration, referral, and transfer of care - a stronger obligation than the prior 'establish and maintain procedures' language.

Three specific compliance mechanisms are added: (A) policies and protocols mutually agreed upon by a physician and surgeon, (B) standardized procedures developed in compliance with subdivision (c) of Section 2725, or (C) policies and protocols developed by an organized health care system in collaboration with a physician and surgeon.

Terminology corrections throughout: 'nurse midwife' changed to 'nurse-midwife', 'Board-approved' changed to 'board-approved', and header formatting fixes (e.g., 'Assembly Member Members' to 'Assembly Members').

Removed the first trimester limitation: nurse practitioners, certified nurse-midwives, and physician assistants may now perform abortions at any stage of pregnancy, not just the first trimester, provided they hold a valid license or certificate authorizing them to do so.

Removed the entire Section 1 amending Business and Professions Code Section 14101 (business good will), which was a nonsubstantive change unrelated to the bill's primary purpose.

Removed Section 3502.4(f), which had prohibited interpreting the physician assistant provisions to authorize performing abortion by aspiration techniques after the first trimester. No replacement restriction was added for physician assistants.

Replaced 'abortion by aspiration techniques' with 'procedural abortion' throughout the bill, broadening the scope beyond aspiration to encompass other procedural methods.

New Section 2725.4(e)(2) requires a nurse practitioner or certified nurse-midwife performing a procedural abortion to establish and maintain procedures for consultation, collaboration, referral, and transfer of care to a physician and surgeon in complex cases and cases with complications, conditions, or emergencies beyond their scope of education, training, and experience.

Section 2725.4(g) now states the section shall not be interpreted to authorize performing an abortion in a manner not authorized by Sections 2725, 2746.5, 2837.103, and 2837.104, replacing the prior first trimester limitation with a scope-of-practice guardrail.

Fiscal committee vote changed from 'no' to 'yes,' indicating the bill now carries a fiscal impact or state-mandated local program cost.

The bill's scope expanded from a single nonsubstantive edit to Section 14101 (business good will) to also amend Sections 2253, 2725.4, and 3502.4 of the Business and Professions Code, covering physician, nurse practitioner, certified nurse-midwife, and physician assistant abortion authority.

The first trimester restriction is retained specifically for nurse practitioners, certified nurse-midwives (Section 2725.4(g)), and physician assistants (Section 3502.4(f)) performing aspiration techniques, meaning the trimester removal applies only to physicians under Section 2253.

Section 2253(b)(2) removes the 'in the first trimester of pregnancy' limitation for persons holding valid licenses under the Medical Practice Act, Osteopathic Act, Nursing Practice Act, or Physician Assistant Practice Act who perform abortions by medication or aspiration techniques. Physicians can now perform these procedures beyond the first trimester.

New Section 2253(a) makes failure to comply with the Reproductive Privacy Act (Health and Safety Code Section 123460 et seq.) constitute unprofessional conduct for physicians and surgeons.

New Section 2253(d) prohibits the Medical Board and Osteopathic Medical Board from suspending or revoking a physician's certificate solely for performing an abortion in accordance with law and the Reproductive Privacy Act.

New Section 2253(e) prohibits boards from denying licensure or disciplining a California-licensed physician who was disciplined or convicted in another state solely for performing an abortion there, overriding several existing disciplinary provisions.

New immunity provisions in Sections 2725.4(f) and 3502.4(e) protect persons who evaluate clinical competency of NPs, CNMs, or PAs from punishment, civil liability, or denial of rights or privileges.

Sections 2725.4 and 3502.4 rename 'abortion by aspiration techniques' to 'procedural abortion' throughout, broadening the terminology used in training requirements for nurse practitioners, certified nurse-midwives, and physician assistants.

New training sources added for NPs, CNMs, and PAs: competency-based training protocols from Health Workforce Pilot Project No. 171 (now Department of Health Care Access and Information), and clinic or hospital-based clinical competency evaluation provided by a physician, NP, CNM, or PA who has performed the procedure themselves.

New provisions in Sections 2725.4(h) and 3502.4(f) specify that exclusively online or simulation-based training programs without mandatory clinical hours involving direct patient care do not meet the clinical training requirements.

The fiscal committee answer changed from 'no' to 'yes,' indicating the amended bill now has a state fiscal impact, likely due to expanded board oversight and training program administration.