For 45 years the Arizona Nurses Association (AzNA) has successfully lobbied for changes in statutes and rules which have enlarged the scope of practice for nurse practitioners and other APRNs and enhanced their standing in the healthcare community.
For 45 years the Arizona Nurses Association (AzNA) has successfully lobbied for changes in statutes and rules which have enlarged the scope of practice for nurse practitioners and other APRNs and enhanced their standing in the healthcare community.
April 30, 2021
AzNA staff and AzNA members led by AzNA lobbyist Kathy Busby have been hard at work at the AZ Legislature over the past several months. Their efforts resulted on the passage of three important bills.
Legislative Tracking for the current or most recent Arizona Legislative Session.
AzNA and AzNPC/AzNA Chapter 9 have successfully lobbied for decades for changes in statutes and rules which have enlarged the scope of practice and provided consistent advancement of our role in the state. We enjoy the privilege of being licensed independent professionals with full prescribing authority directly as a result of the advocacy efforts of AzNA and its members. In addition to pursuing advocacy activities related to AzNA’s Legislative Agenda (which includes nursing education, public health and access to the care) lobbying on behalf of APRN-related legislation normally represents 20-75% of the lobbying program depending on the year.
Outlined below is a listing of legislation AzNA successfully pursued in Arizona.
| 1974 | · Statute defined Nurse Practitioner in an extended role. Audrey Rath, RN, MSN, NP, practice consultant for the AZ State Board of Nursing was instrumental in developing the language for APRN rules. The Audrey Rath scholarship is awarded annually by AZNPC, an AzNA Chapter. |
| 1982 | · Defined and protected the title “Registered Nurse Practitioner” |
| · Removed language that limited prescribing and dispensing drugs | |
| 1990 | · Updated 3rd party reimbursement law to include certified nurse practitioners, certified nurse midwives, certified nurse anesthetists. |
| 1992 | · Removal of physician board approval of nursing practice and NP prescribing rules |
| 1993 | · Authorization of nurse practitioners as primary care providers in the AHCCCS system |
| · Authorization for the Board of Nursing to certify Clinical Nurse Specialists | |
| 1995 | · Authorization for Board of Nursing (not the medical profession) to determine additional acts of professional nursing and the meaning of collaboration requirements |
| 2001 | · Extension to 4 years, loan repayment program for underserved areas including Nurse Practitioners |
| 2002 | · Changed definition of NP to conform to national standards |
| · Allowed issuance of temporary NP certificate | |
| · Removed NP requirement for consultation by MD or DO | |
| · Added Clinical Nurse Specialists to nurse practice act | |
| 2003 | · Creation of protection against retaliatory action by a health care institution when a health care professional reports violations of professional standards or threats to patients |
| 2004 | · Amendment of Vital Records statutes to authorize properly educated Nurse Practitioners to sign death certificates |
| 2005 | · Added enhanced criteria for testifying experts in malpractice cases |
| 2006 | · Prevented expansion of scope for non-nurse midwives |
| 2007 | · Nurse Practitioner (80-page) Omnibus Bill-Amendment of 45 statutes to extend the statutory duties limited to physicians to nurse practitioners. These changes extended over 12 subjects of the Arizona Revised Statutes and included: authority to complete pre-adoption certificates, performing physical and immunization requirements for students and completing certifications for insurance purposes, jury duty and handicapped plates. |
| 2008 | · Added APRN with experience as an infection control practitioner to Infection Prevention Control Advisory Committee |
| 2009 | · Included prescribing APRN to Immunizations and Vaccines Advisory Committee to recommend protocols and education requirements for pharmacists administering immunizations |
| 2010 | · Expanded the statutory role of Psychiatric Mental Health Nurse Practitioners in court-ordered treatment and evaluation |
| 2011 | · Included NPs as a provider authorized to enter into protocol-based drug therapy agreements with pharmacists |
| 2012 | · Expansion of scope of CRNA to include issuance of medication orders, ordering and evaluating diagnostic tests and preparing anesthesia plans |
| 2013 | · Expansion of Medicaid to 133% of the Federal Poverty Level (FPL) |
| 2014 | · Added NP to state-wide Vaccine Study Committee |
| 2015 | · Included NP authorization to provide opiate antagonist order for EMT’s |
| · Increased potential loan repayment amounts for Medically Underserved Area providers, including NPs | |
| 2016 | · Amended statutes to authorize NPs to prescribe and dispense opioid antagonists to at risk individuals |
| 2017 | · Created separate statutory titles for NPs and Nurse Midwives; removed “collaboration” from practice statutes |
| · Enlarged CRNA prescribing authority to assure DEA numbers | |
| 2018 | · Added NPs with advanced pain certification as medical directors at pain clinics |
| · Added NPs to list of prescribers who may issue epinephrine standing orders for schools | |
| 2019 | · Expansion of Clinical Nurse Specialist (CNS)scope - granted prescriptive authority |
| · Added NPs to list of providers allowed to contract with patients for services outside of insurance coverage | |
| · Included NPs in exemption for certain dispensaries or first aid stations in a business when supervised by physician or NP (Related to Pain Management Clinics) | |
| · Added CNM to Advisory Committee on Maternal Fatalities and Morbidity | |
| 2021 | · Modified the definition of a licensed mental health professional as it relates to traumatic event counseling to include Mental Health NPs and Psychiatrics CNSs |
| · Allowed healthcare providers to use telehealth as a vehicle for a patient visit and still get reimbursed by commercial insurers at the same rate as an in-person visit | |
| · Added NPs and CNSs to list of providers who can order home health care for Medicaid patients | |
| · Required health profession regulatory boards to promote preceptorship awareness | |
| 2023 | · Allowed physicians, APRNs, and PAs working in a hospital more than 50 miles from a 24-hour pharmacy to dispense 12-hour supplies of an opioid to patients with acute illnesses or injuries |
| · Expanded the type of health professionals who may conduct an evaluation for use in a judicial commitment proceeding in counties with a population of less than 500,000 to include mental health nurse practitioners and PAs with psychiatric expertise· | |
| · Mandated clinical review criteria and requirements for exception requests for health care insurers that implement step therapy protocol for prescription drugs | |
| 2024 | · Allowed CNMs and PAs to enter into a collaborative agreement with pharmacists to provide care for patients |
| · Expanded DD coverage to infants and toddlers with developmental delays | |
| · Expanded the definition of emergency services which commercial insurers will be required to use, preventing insurers from denying claims in settings and situations when the provider believes the patient condition is emergent and does not need authorization to treat |
