Health Policy Paper
Health Policy Paper
My topic is on Massachusetts senate Bill S.2796 (191) and House Bill H4871 – An Act Putting Patient First
I support the bill senate bill to permanently remove practice restrictions for nurse practitioners and allow them full practice authority.
Instructions:
Select a House of Representatives or Senate bill (national or state level), either currently in process or one that has been passed within the last year that impacts mental health care operations, advanced practice nursing, or mental health care financing. (Include the name of the bill: e.g., H.R. 4909 (115th): Stop School Violence Act of 2018. Note if the bill is federal or state level legislation and indicate the state, if applicable. Also note if the bill was passed and the date, if in committee [house or senate], or if awaiting the president’s signature).
Discuss your support or opposition of the Bill based on policy, legal, and ethical considerations. Consider the nursing practice act in your state and other state-level documents pertaining to practice, the Social Policy Statement of the American Nurses Association. Consider funding of the bill and who should pay, if applicable.
Discuss how the bill impacts, or will impact, the role of the nurse practitioner. Discuss the impact on health care quality and outcomes.
Health Policy Paper
The bill under review is at the state level, the Massachusetts Senate Bill S.2796 (191) – An Act Putting Patients First. The bill seeks to control the cost of health care and improve access within the state by setting caps on the non-contracted commercial rates for emergency and nonemergency medical services, and expanding the scope of practice for nurses. The bill ensures that the state government, through a commission, retains control over the health insurance industry by making certain that the contracted rates for private and public payers rates are appropriate for covering care costs. In addition, the bill seeks to expand the scope of practice for nurses, specifically psychiatric nurse mental health specialists, nurse anesthetists, and nurse practitioners, by permitting them to practice independently for as long as they meet certain training and education standards. Passing the bill would ensure that the licensure of advanced practice nurses is not contingent on oversight by the state medical board or contracts with physicians (The General Court of the Commonwealth of Massachusetts, 2020).
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The bill was introduced into the Senate on 25th June 2020 and passed on the same day. The bill was introduced to the House on 9th July 2020 and is current before the Committee of Conference with discussions ongoing about amendments to the bill (The General Court of the Commonwealth of Massachusetts, 2020). Health Policy Paper
The bill makes sense from a policy, legal and ethical perspective and should be supported. Firstly, the bill makes sense from a policy perspective by leveraging the education, experience and skills of nurses. Advanced practice nurses have the capacity to independently evaluate and diagnose patients, order and interpret diagnostic tests, and initiate and manage medications. Assigning advances practice nurses this authority is important for addressing the health care personnel shortages. With more nurses capable of practicing independently, there would be greater access to health care for the state residents. Secondly, the bill makes legal sense. There are states that allow nurses to have full practice authority and this creates inconsistencies. Across the USA, the requirements for advances practice nurses’ education, board certification and program accreditation are consistent with the national states. However, these national standards are inconsistent with the state practices and laws thereby creating significant challenges for nurses, health care delivery and patients. The bill helps to address the legal inconsistency by ensuring that the state standards of practice match the national standards. Thirdly, the bill makes ethical sense. Research studies indicate that states with limited nurses’ practice authority experience health disparities as the number of medical personnel is limited so that rural areas remain underserved. Passing the bill is likely to see more nurses serving independently in underserved and rural areas thereby addressing the existing disparities while meeting the higher care safety and quality standards (Buppert, 2018).
The bill seeks to ensure that nurses have full practice authority. This implies that nurses’ roles would be revised, and they would be allowed to independently evaluate and diagnose patients, order and interpret diagnostic tests, and initiate and manage medications. In fact, the bill would allow nurses practicing within the state to use their full complement of experience, skills, knowledge and education to provide basic and comprehensive primary care services (Bose et al., 2017).
There is a case for allowing nurses to have full practice authority in the state. Firstly, this helps with protecting the choices of patients. It provides more primary care options so that patients are able to see the health care provider of their choosing. It helps with facilitating patient-centered health care by eliminating the anti-competitive licensing restrictions that restrict nurses who are capable of independent practice. Secondly, the bill helps in reducing health care costs. Full practice authority ensures that services are not duplicated and billing costs associated with physician oversight of nurse practitioner services are eliminated. In fact, it reduces the unnecessary repetition of care services, office visits and orders. Thirdly, it improves the efficiency of care delivery and streamlines services by providing patients with direct and full access to nurse practitioner services at their point of care. This removes care delays. Finally, the bill improves access to health care, an issue of concern in rural and underserved urban areas. Full practice authority ensures that a primary care provider is likely to be working in an underserved and rural area (Zaccagnini & White, 2017).
It is clear that the discussed bill seeks to ensure that nurse practitioners can provide patients within the state with direct and full access to all the health care services that they are equipped to provide. Certainly, if nurses are equipped to practice independently within the state, then there would be an assurance of more primary care providers. With the bill, the state residents can be assured of their choices as patients being protected, decreased costs, streamlined and improve care efficiency, and improved care access.
References
Bose, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. American Academy of Nursing on Policy, 65(6), 761-765. https://doi.org/10.1016/j.outlook.2017.10.002
Buppert, C. (2018). Nurse Practitioner’s Business Practice and Legal Guide (6th ed.). Jones & Bartlett Learning, LLC.
The General Court of the Commonwealth of Massachusetts (2020). Bill S.2796, 191st (Current), An Act Putting Patients First. https://malegislature.gov/Bills/191/S2796
Zaccagnini, M., & White, K. (Eds.) (2017). The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing (3rd ed.). Jones & Bartlett Learning, LLC. Health Policy Paper
