Although physicians in the state are asking for a veto, Connecticut Gov. Dannel Malloy is expected to sign a bill
giving advanced-practice registered nurses the ability to practice independently after a three-year collaboration period with a state-licensed physician.
Allowing nurse practitioners to practice independently has become a popular cause in state legislatures, as lawmakers attempt to deal with access issues created by primary-care
physician shortages, as well as increased consumer demand spurred by the expansion of Medicaid and private insurance coverage under the Patient Protection and Affordable Care Act
The Connecticut bill, entitled “An Act Concerning the Governor's Recommendations to Improve Access to Health Care,” was approved 110-35 by the Connecticut House of Representatives April 28 and passed earlier this month in the state Senate. It will take effect July 1.
“Although the availability of primary care providers in Connecticut is greater than the national average, access to primary care can be challenging in some communities,” Malloy said in a news release
. “This bill increases access to primary care across Connecticut by allowing advanced-practice registered nurses to do more of what they do so well—evaluating, screening, physical examinations and management of many routine medical conditions such as hypertension, diabetes, and asthma.”
In addition to diagnosing and management services, the bill allows independent APRNs to “prescribe, dispense and administer medical therapeutics, corrective measures and drugs.”
The Connecticut State Medical Society argues that the bill will further fragment care and lacks a “truth in advertising,” or transparency provision, requiring providers to tell patients if they have a doctorate of medicine degree.
“When a patient meets 'Dr. Smith,' there is no language requiring Dr. Smith to identify himself or herself as a Doctor of Nursing,” the medical society said in a news release
The American Association of Nurse Practitioners praised the Connecticut legislature for passing the bill, but also criticized the requirement for APRNs with new Connecticut licenses to first collaborate with a licensed physician for three years.
The physician-collaboration requirement “for both new nurse practitioners and those new to Connecticut will limit the state's ability to recruit and retain enough nurse practitioners to meet the growing needs of its patient population, especially those in medically underserved communities,” Angela Golden and Kenneth Miller, co-presidents of the association said in a news release. “Other nearby states with more favorable regulatory environments—where nurse practitioners can serve patients without worrying that they'll be forced to stop offering care because of issues with their mandated collaborator—may prove to be more attractive places to live and work.”
Earlier this month, a similar bill was enacted in New York
, while another was vetoed by Nebraska Gov. Dave Heineman who said in his veto message
that bill “goes too far too quickly” in granting nurse practitioners authority to practice independently.
In Florida, an omnibus healthcare bill—that includes provisions on telemedicine and allowing NPs to practice independently and prescribe controlled substances—passed the state House of Representatives April 25 and is being considered by the state Senate.Follow Andis Robeznieks on Twitter: @MHARobeznieks