1999 State Legislative Trends

Advanced Practice Registered Nurses (12/30/99)

[Click here for larger version of map. File size: 28K]

Advanced Practice Registered Nurse Legislation Establishing definitions, scopes of practice, prescriptive authority, reimbursement and hospital privileges describe just a few of the 85 APRN-related bills surfacing in 1999. Building upon the experiences of KY (1996) AL, NM, OK, RI (1997) and GA and TN (1998) , NJ passed a law to allow NPs and CNSs to order and prescribe controlled substances; the new KS law permits prescribing but not dispensing; NV allows APNs to possess and administer controlled substances. AR now allows certain APRNs to distribute starter doses of drugs and VA, along with MO (1998), will allow NPs to dispense samples. NM passed, only to be vetoed by the Governor, prescriptive authority for NPs and CNSs. CRNAs received prescriptive authority in IL and IN; a similar bill was considered in MO. Mandated data collection on CRNAs and midwives was signed by the Governor in MD. The other major category for legislation is defining APRNs or scopes of practice. In SD, NP and nurse midwife functions are now specified by law. A new law in SD allows NPs and midwives to sign health certificates, while in MT, APRNs can now make recommendations on disability parking permits. New in UT, APRN specialists in mental health can be considered mental health therapists. MN and TX have new legislation that defines APRNs in statute; a similar bill was considered in PA. Reimbursement became a reality for APNs under workers' comp in WY and for mental health specialists under mental illness coverage in MT. These states join MO, which passed required reimbursement in 1998. Reimbursement-related provisions died in FL, but were approved in HI, ME, and MN. Other significant new statutes include clinical privileges for APRNs in IA, inclusion of APRNs in the term "provider" under the Patient Freedom of Information Act in ID, the permanent setting of physician-to-NP ratios for prescriptive services in VA, and the addition of APNs to the referral source for physical therapy in WY.

Advanced Practice issue of the Online Journal of Issues in Nursing

1999 State Legislative Trends main page