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AANP gives thumbs down to Nebraska veto of NP practice bill

Thursday April 24, 2014
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The American Association of Nurse Practitioners expressed disappointment at the veto of a bill that would have provided Nebraska residents with full and direct access to nurse practitioner services.

AANP Co-presidents Angie Golden, RN, DNP, FNP-C, FAANP, and Ken Miller, RN, PhD, CFNP, FAAN, stated that the veto was a missed opportunity to improve the efficiency of the state’s healthcare workforce.

“The American Association of Nurse Practitioners is extremely disheartened that Nebraskans will continue to face challenges accessing care from their nurse practitioner workforce due to outdated state regulations,” Golden and Miller said, according to a news release. “A majority of counties in Nebraska face primary care and mental health provider shortages, a problem this bill would have addressed with zero cost to taxpayers and zero delay.”

The bill, which passed Nebraska’s unicameral Senate by a vote of 43-0, would have ended Nebraska’s mandated physician involvement in NP practice, retiring the requirement for a career-long collaborative agreement, and would have required NPs to complete 2,000 hours of supervised practice. NPs with less than 2,000 hours of practice the ability would have been allowed to collaborate with experienced NPs.

Gov. Dave Heineman wrote: “In the future, there will be a shift toward additional independence for nurse practitioners as is proposed in [Legislative Bill] 916. However, the bill as presented to me goes too far too quickly.

“I discussed this bill at length with [the state’s] chief medical officer and we agree that adequate clinical experience is necessary for patient safety. If LB 916 had required approximately 4,000 hours of clinical experience, I would have signed it into law but I must consider the bill as presented. It is my hope that the nurse practitioners and physicians will work together and present a joint recommendation for the legislature and the next governor that balances patient access and safety.”

Golden and Miller said citing the need for NPs to have more clinical experience “is inconsistent with decades of independent research showing that nurse practitioners provide high-quality, safe, cost-effective care with these bureaucratic requirements. The bill the governor vetoed is in fact more restrictive than the laws already in place in 13 of the 17 U.S. states, plus the District of Columbia, that allow patients full and direct access to all nurse practitioner services.”

“Exacerbating the problem for Nebraskans is the risk that many nurse practitioners will leave the state for more favorable regulatory environments, where they can serve patients without the fear of their practice suddenly shuttering because of issues with their mandated collaborator. New Mexico has already launched a marketing campaign to recruit nurse practitioners from neighboring states. More may very well follow suit as healthcare workforce challenges become increasingly severe.”

Golden and Miller noted that the veto runs contrary to recommendations from the National Governors Association and the National Conference of State Legislatures, as well as leading policy organizations such as The Institute of Medicine.

LB 916: http://nebraskalegislature.gov/FloorDocs/103/PDF/Intro/LB916.pdf

AANP state-by-state guide to NPs’ scope of practice: www.aanp.org/legislation-regulation/state-legislation-regulation/state-practice-environment


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