HB 793 has passed the General Assembly, but the joint Boards of Nursing and Medicine are now seeking public comment on the enactment of regulations to implement the bill until 11:59 p.m. on May 4, 2018. HB 793 is legislation to authorize nurse practitioners who meet certain qualifications to practice without a practice agreement with a patient care team physician.
We have the opportunity to provide input on how regulations should be written. In order for the regulations to be implemented in the best favor of NPs, we need you to write a comment today. Topics that need to be commented on for consideration in adoption of regulations will be:
- Equivalence of at least five years of full-time clinical experience
- Routine practice in a practice area included within the category for which the NP was certified and licensed
- Requirement of an attestation of practice
- Fee associated with submission of attestation and issuance of autonomous designation
- Acceptance of “other evidence” demonstrating that the applicant met the requirements
- Endorsement of experience in other states
- Unprofessional conduct – falsification of attestation
Note that the Boards are seeking public comment on the topics above. HB 793 has been signed into law – therefore, the Boards are NOT seeking public comment on changes to the legislation itself.
CLICK HERE to post a comment on the Virginia Regulatory Town Hall site. You may also email Ms. Elaine Yeatts directly: firstname.lastname@example.org. Please comment if you haven’t already and reach out to your colleagues asking them to do the same. Contact your region’s GR chair with questions.
TEMPLATE FOR PUBLIC COMMENTARY POST
Thank you for the opportunity to provide public comment. I have been a nurse practitioner (NP) for ___ years practicing in ________ setting in ________ county/city. Completion of graduate education and national board certification deem that I am a competent clinician. Please keep this in mind as rules are being promulgated.
Use any of the recommended talking points below to add to the template. NOTE: it is important that you personalize the talking points using your own words.
- The five-year equivalent requirement creates a costly bottleneck to building provider workforce and equitable distribution in primary care delivery for underserved and vulnerable populations. Unduly burdensome regulations on top of this requirement will result in additional bottlenecks compromising access to care.
- NPs already pay fees associated with RN, NP, and prescribing licenses. Any additional fees associated with submission of attestation and issuance of autonomous designation should not create a financial barrier for qualified NPs to practice.
- Acceptance of “other evidence” demonstrating that the applicant has met the requirements must be broadly interpreted. We ask that the Joint boards issue a guidance document listing examples of supporting evidence that they would take into consideration. Office administrators, health system administrators, and credentialing documents should all be accepted as evidence that an applicant has met the necessary requirements.
- The Boards should credit applicants by endorsement for all of their time employed and licensed in other states towards calculating their clinical experience requirement for practicing without a practice agreement.
- NPs in any state or working for U.S. Armed Forces, U.S. Veterans Administration or the Public Health Service should be able to submit evidence that the five-year full-time equivalent collaborative requirements have been met with signature from employer, physician, practice administrator, etc.
- There is no demonstrated need for additional requirements on the attestation in order to protect the public beyond what is listed in HB 793. The attestation should be used to document clinical experience under a sworn statement that this information is accurate and meets the requirements of the law.
- Most, if not all, states requiring attestation of transitional clinical hours are not overly prescriptive in what they require in their regulations or on their attestation forms. Therefore, in Virginia it should not be necessary to further define what is meant by “the patient care team physician routinely practiced with a patient population and in a practice area included within the category for which the nurse practitioner was certified and licensed.”
- Both the NP and the patient care team physician should be held to disciplinary standards for providing falsified documentation to the Boards.