NPs with 2+ years experience – Apply for autonomous practice or re-enter a practice agreement by July 1

Beginning July 1, NPs with at least two years of clinical experience are eligible to apply for autonomous practice licensure, thanks to the success of House Bill 1737. Assuming the state of emergency ends on June 30 as Governor Northam has indicated, this means Virginia’s NPs will no longer be able to practice without a practice agreement or autonomous practice licensure as of July 1. If you have at least two years of clinical experience (equivalent to 3,600 hours), you have two options –

• Apply for autonomous practice licensure
• Re-enter a practice agreement

If you have at least five years of practice experience, please submit your autonomous practice application now.

For NPs with 2+ years experience, although we are waiting for the Board of Nursing to update the autonomous practice application, we encourage you to begin collecting information now. The BON has indicated it will begin accepting applications on June 15, which is important for NPs who will not have a practice agreement in place on July 1. The BON has also indicated it will provide an updated application by mid-June which will be available on the BON website.

While autonomous practice may not benefit you in your current job, applying for this licensure shows your commitment to the NP profession and provides you with flexibility for the future. Legislators will be reviewing these numbers during this fall’s Joint Board Study and considering this information when evaluating future legislation including VCNP’s 2022 bill.

Frequently-asked questions

Is the 2-year regulation temporary?

Although HB 1737 has a re-enactment clause that means the bill will expire July 1, 2022, VCNP plans to introduce legislation during the 2022 General Assembly session to make the 2+ year requirement permanent. It’s important for NPs who are eligible to apply for autonomous practice as soon as possible to show legislators how desirable this licensure is to Virginia’s NPs.

What if I’ve ended my practice agreement but haven’t submitted my autonomous practice application?

Virginia Code section 54.1-2957(G) allows NPs to continue to practice for up to 60 days upon meeting certain criteria: “In the event a physician who is serving as a patient care team physician dies, becomes disabled, retires from active practice, surrenders his license or has it suspended or revoked by the Board, or relocates his practice such that he is no longer able to serve, and a nurse practitioner is unable to enter into a new practice agreement with another patient care team physician, the nurse practitioner may continue to practice upon notification to the designee or his alternate of the Boards and receipt of such notification. Such nurse practitioner may continue to treat patients without a patient care team physician for an initial period not to exceed 60 days, provided the nurse practitioner continues to prescribe only those drugs previously authorized by the practice agreement with such physician and to have access to appropriate input from appropriate health care providers in complex clinical cases and patient emergencies and for referrals. The designee or his alternate of the Boards shall grant permission for the nurse practitioner to continue practice under this subsection for another 60 days, provided the nurse practitioner provides evidence of efforts made to secure another patient care team physician and of access to physician input.”

What does the autonomous practice application entail?

The process is fairly simple and includes submitting the following information with your application –

• Application with required $100 fee
• Current NP license in good standing (if out of state)
• Evidence of current national professional certification
• Evidence of 2 years full time clinical experience (at least 1,800 hours per year for total of 3,600 hours)

What if I can’t get my collaborating physician to sign the attestation?

In the event you are unable to get the required signature(s), you can provide other evidence to attest to your years of practice. Other evidence includes official records of employment, military service, Medicaid/Medicare reimbursement or other similar records verifying full-time clinical practice in the role category as a licensed/certified nurse practitioner.

I don’t have plans to open my own practice, and my hospital system is still figuring out how to manage NPs with autonomous practice. Why should I apply?

As we’ve learned over the last 14 months, the future is unpredictable. Autonomous practice gives you flexibility for the future and allows you to volunteer without a practice agreement. We’ve also heard from NPs with autonomous practice licensure who have been able to take on second jobs during the pandemic without needing a practice agreement. Finally, it’s important for NPs who are eligible to apply to show legislators how desirable this licensure is to Virginia’s NPs. Legislators will be looking at autonomous practice numbers this fall as they consider future legislation including VCNP’s 2022 bill.

What if I have questions or need assistance completing my application?

Contact vcnp@vcnp.net, and we’ll connect you with a VCNP member to guide you through the application process.