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ACNM Policy Update - 2/24/2014

1.  Notable State Developments, Kentucky, Hawaii, Ohio, Florida
2.  Other State Developments, Colorado, Georgia, Kansas, Mississippi, Nebraska, New Mexico, Ohio, South Dakota, Virginia

1.  Notable State Developments

Success in Kentucky
Kentucky S.7 removes the requirement for a written collaborative agreement to prescribe non-scheduled legend drugs (CAPA-NS). After four years of prescribing in collaboration with a physician, APRNs will no longer be required to maintain the CAPA-NS. An agreement will still be needed for controlled substances. The bill was signed into law on February 13.

Home Birth Victory in Hawaii
The Hawaii affiliate has spent the past month working tirelessly to defeat S.2569, a home birth bill that would have required all OOH CNMs to obtain a secondary layer of licensure from the Board of Medicine and inappropriately truncated CNM scope of practice, among other things. On February 13, a Senate committee recommended that a task force be convened to study the multiple issues raised by the Hawaii Affiliate and their supporters during the hearing in lieu of passing the bill out of committee. The affiliate will have the opportunity to appoint members to the task force, which will be convened by July 1 and must release recommendations to the legislature prior to the beginning of the 2015 session.

Birth Certificate Bill Advances in Ohio
As of February 12, House Bill 95 has passed out of both chambers to clarify in Ohio law that CNMs may sign birth certificates. Though CNMs have been signing birth certificates for more than 30 years and the Ohio Department of Health Office of Vital Statistics has accepted nurse midwife-signed documents, CNMs have never had the express authority in the law to do so. Recently two Ohio hospitals have gone so far as to no longer allow their Certified Nurse-Midwives to sign birth certificates.  H.95 clarifies that the physician or CNM in attendance shall provide the medical information required by the certificate and certify to the facts of birth within 72 hours after the birth.

Independent Practice in Florida?
On February 18, the House Select Committee on Workforce Innovation approved a large bill that would create a mechanism for independent practice for APRNs. The bill establishes two levels of APRN registration – advanced practice registered nurses and independent advanced practice registered nurses. Independent status could be gained by demonstrating full-time practice in any U.S. jurisdiction as an APRN for at least three years immediately preceding the application, no record of disciplinary action in the previous five years, and completion of a graduate level course in pharmacology. In addition to the standard APRN scope of practice recognized by Florida law, independent APRNs could also admit, manage the care of, and discharge patients from health care facilities without physician supervision.

2.  Other State Developments

Colorado H.1117 would establish the Premature Birth Commission to develop preventive strategies and to strengthen existing evidence-based approaches to reduce the state’s preterm birth rate. The bill passed the House on February 17.

Georgia H.971 is a truth in advertising bill that would require CNMs and other providers to wear a name tag that conspicuously states the license the practitioner holds, in addition to placing a sign in all office settings with the same information that is “visible and apparent” to all patients. The bill was introduced on February 10.

Kansas H. 2685 would authorize independent prescriptive authority for CNMs and specifically recognize CNMs as primary care providers and leaders of health care teams, among other things. Initial APRN licensees would not have independent prescriptive authority until after they complete a 2000 hour transition to practice program in collaboration with an independent APRN or physician. It was introduced on February 13.A bill in

Mississippi that would have deleted the requirement that advanced practice registered nurses must practice within a collaborative or consultative relationship with a physician or dentist has died in committee.

Nebraska L.76 establishes the Healthcare Transparency Act. A committee will be appointed to provide objective analysis of health care costs and quality, promote transparency for health care consumers, and facilitate the reporting of health care and health quality data, in the hopes of providing for the facilitation of value-based, cost-effective purchasing of health care services by public and private purchasers and consumers. The bill was signed into law on Feb. 13. The

New Mexico House passed a legislative memorial which requests that the Secretary of Health convene a task force to identify statutory provisions that create obstacles to the ability of nurse practitioners, nurse-midwives and physician assistants to function at their full scopes of practice.

Ohio H.139 states that CNMs and other advanced practice nurses may admit patients to the hospital if they have a standard care arrangement with a physician who is a member of the medical staff, the patient will be under the medical supervision of the collaborating physician, and the hospital has granted the CNM admitting privileges and appropriate credentials. The bill was signed into law on February 18.

South Dakota S.30 implements the Advanced Practice Registered Nurse (APRN) credential. It was signed into law on February 10.

Virginia H.580 clarifies that active-duty military personnel are exempt from state licensure requirements when providing care at public and private health care facilities. The bill became law on February 20.

Should you have questions about any of these issues, please contact your Affiliate legislative chair or president, who can be identified using this map.  Alternatively, you can contact Cara Kinzelman, ACNM's Manager of State Government Affairs at [email protected] or 240-485-1841.  



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