An Act Improving the Quality of

   Health Care and Reducing Costs

                     (SB 1079/ HB 2009)

 

        Toolbox for Grassroots 

            Legislative Action 

                          
  
Background:
  
Despite our advanced education and training and years of patient outcome data that supports
the quality and cost effectiveness of the care we provide, nurse practitioners (NPs) and certified registered nurse anesthetists (CRNAs) in Massachusetts are bound by a practice act that creates barriers and increases costs rather than enhances quality care and patient access.
 
With the goal of breaking down these barriers and improving access to cost-effective high 
quality health care, the MCNP along with the Massachusetts Association of Nurse Anesthetists (MANA) filed (SB 1079 /HB 2009) An Act Improving the Quality of Health Care and Reducing Costs.
  
This legislation proposes language changes that will allow nurse practitioners and certified registered nurse anesthetists to practice to the full extent of their education and training by removing physician oversight of prescriptive practice, eliminating mandated collaborative practice agreements, and giving the Board of Registration in Nursing sole authority for regulating APN practice. These changes are consistent with the recommendations cited in the Institute of Medicine's Future of Nursing Report and supported by the National Council of State Boards of Nursing, the National Governors Association, the Federal Trade Commission, and many other specialty organizations.
  
Goals of An Act Improving the Quality of Health Care and Reducing Costs:  

1.  Remove the mandate of supervision by physicians for the prescriptive practice of

     the NP and CRNA

2.  Remove the mandate for collaborative practice agreements with a physician

3.  Provide the sole authority for the regulation of NPs and CRNAs to the Board of

     Registration in Nursing

4.  Remove restrictive time limitations on writing prescriptions for the CRNA
5.  Update the Nurse Practice Act to reflect that NPs and CRNAs not only order tests
     and therapeutics, but also interpret them in order to best treat the patients
 
This legislation is not intended to expand the scope of advanced nursing practice or change the way we care for our patients, rather support statutory and regulatory changes that will remove restrictive and antiquated practice requirements. Echoed in the slogan for our legislative campaign, we will be "Changing the Language .... Not the Care."
 
What Will Change with the Legislation?
NPs and CRNAs will be able to:
*  Practice to the full extent of their education and training.
*  Practice without mandatory collaborative practice agreements that dictate
   what they "may do" versus what they are educated and trained to do.
*  Prescribe medications without artificial regulatory requirements.

*  Be credited for the care they actually provide which will allow for transparency

   related to patient outcomes and cost savings.

*  Be regulated by the Board of Registration in Nursing and NOT jointly with the Board
   of Registration in Medicine.
*  Develop innovative practice models without imposed financial practice agreements.
*  Improve access to value based, quality, safe, and cost-effective health care for the citizens
   of the Commonwealth.
 
What Will Not Change with the Legislation?

NPs and CRNAs will continue to:

*  Provide high quality, safe health care.

*  Consult and collaborate with other health care professionals to meet needs of their patients.
*  Obtain advanced education and training.
*  Meet state requirements for National NP Certification.
*  Practice in and be employed by health care institutions and group practices.
  
Helpful Handouts and Links:
  
Click on the links below to read the Full Language of the Bills:
SB 1079       HB 2009
  
  
  
Click Here to Find Your Legislators.    
  
Click Here for a List of the Members of the Joint Committee on Public Heath 
Sample Letter to Your Legislators:
  
Dear (insert your legislator's name) 
  
As your constituent and a nurse practitioner (NP) who cares for patients in the Commonwealth, I am writing to ask you for your support of (SB 1079 / HB 2009), An Act Improving the Quality of Health Care and Reducing Costs. The bill will soon be heard before the Joint Committee on Public Health, and I ask that you and your fellow legislators support the favorable release of this bill, which will increase patient access and enhance the quality of health care for our patients.
  
An Act Improving the Quality of Health Care and Reducing Costs will modernize the Massachusetts advanced practice nursing statutes by proposing statutory and regulatory changes that allow advanced practice registered nurses (APRN) to practice to the full extent of their education and training. Specifically, the bill will remove the requirement for physician oversight of NP and Certified Registered Nurse Anesthetist (CRNA) prescriptive practice, remove the mandate for collaborative practice agreements, and remove the Massachusetts Board of Registration in Medicine's (BORM) oversight of the Massachusetts Board of Registration in Nursing (BORN). These changes are consistent with the recommendations cited in the Institute of Medicine's Future of Nursing Report and supported by the National Council of State Boards of Nursing, the National Governors Association, the Federal Trade Commission, and many other specialty organizations.
  
As you may be aware, nurse practitioners and other APRNs are expert clinicians with graduate degrees and licensed by the Board of Registration in Nursing to practice in an expanded role. Despite our advanced education and training and significant outcomes data that support the quality and cost effectiveness of the care we provide, NP's in Massachusetts are restricted by a practice act that creates barriers rather than enhances quality care and patient access. There is no evidence that these antiquated barriers enhance patient safety, add value or decrease the cost of care.
  
The Rand Report: Controlling Health Care Spending in Massachusetts, cited a potential $8.4 billion dollar in savings over the next 10 years in Massachusetts by allowing NP's to practice to the full extent of their education and training (2009).
  
I would welcome the opportunity to meet with you and share more information about the many roles and contributions of nurse practitioners and how they enhance the health and wellness of the citizens of the Commonwealth.
  
I look forward to hearing back from you and thank you in advance for your support of this legislation and the 7000 nurse practitioners across the state.
  
Sincerely,
  
  
Your name, address, phone number