APRN Full Practice Authority Legislation Update
when SB1473 (APRN Full Practice Authority) failed to advance through the legislature, it was decided to move forward with a pared-down, strike-everything amendment to HB2236. This was an effort to remove the “collaboration” language and therefore remove this obstacle to NP/CNM empanelment and reimbursement. As part of the proposal we incorporated language presently found in the Board of Nursing rules regarding when it is appropriate to engage in consultations and make referrals. It is our belief that the language found in HB2236 requires consultation and referrals with physicians only when it is in the best interest of the patient or when the circumstances of the patient are outside the knowledge and experience of the NP/CNM. In our view this would not prevent referrals to other providers if the NP/CNM has the experience and knowledge to exercise the clinical judgment necessary to make an appropriate referral to a non-physician provider. We do not believe that this language mandates that NP/CNMs can only refer and consult with physicians.
Although the language of the strike-everything amendment for HB 2236 has been available for more than two weeks, we have recently been informed by the Executive Director of the State Board of Nursing, that she and their lobbyist believe this language in fact would limit all referrals by NP/CNMs to physicians only. We do not agree with that interpretation but believe that if the Board is going to take that position it creates a handicap to present NP practice which many feel is not outweighed by the removal of both “collaboration” and the present requirement that NPs/CNMs establish a relationship with one or more physicians. We will request that Senator Barto not move the bill forward. This is particularly unfortunate since it probably will contribute to the political obstacles that will complicate future attempts to remove the “collaboration” language and impact efforts on behalf of the consensus model.
For full information regarding the 2016 APRN Full Practice Authority Initiative, please visit the Top Issues Page.
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