Senate legislation is looking to empower nurse practitioners across the Veterans Affairs Department to practice independently of physicians, regardless of laws in individual states. The goal is to mitigate physician shortages and reduce patient wait times that have been plaguing the VA.
The provision would allow nurse practitioners—including midwives and mental healthcare clinical nurse specialists—to prescribe some drugs and treat patients without a supervising physician.
Maryland last month became the 21st state to allow nurse practitioners these privileges. The remaining states require them to have a collaborative agreement with a physician.
In comments read during a Wednesday hearing on the bill, called the Frontlines to Lifelines Act of 2015 and sponsored by Sen. Mark Kirk (R-Ill.), organizations either supported the measure or remained neutral.
The American Medical Association has not yet taken a position but the American Association of Nurse Practitioners fully supports the measure.
Diane Zumatto, national legislative director for the veterans organization AMVETS, submitted comments saying this would maximize the use of nonphysician medical personnel.
Complaints of long wait times at VA hospitals and outpatient clinics across the U.S. and an attempted cover-up led to the resignation of VA Secretary Eric Shinseki and prompted lawmakers to pass VA healthcare reforms, including relaxing a rule that allowed veterans to get private care paid for by the government.
During Wednesday's hearing on the bill, Sen. Jerry Moran (R-Kan.) noted with relief that the Colmery-O'Neil VA Medical Center in Topeka would be getting the physicians it needed to reopen its emergency department, which has been closed since Jan. 31, 2014.
"The current policy of limiting nurse practitioner practice in the VHA impairs veterans' access to care, risks lengthening delays in healthcare delivery, increases healthcare costs, and fails to promote patient safety," AANP President-elect Cindy Cooke said in a news release. "We urge Congress to advance this bill—a zero-cost, zero-delay, zero-risk solution—that will immediately bring improvements in care to the brave men and women who have served their country."
The Senate bill would also expand a pilot program where “intermediate-care technicians” practicing within the Defense Department would get priority placement at VA healthcare facilities that have the longest wait times.
The Defense Department would be required to transfer to the VA the credentialing data of its former clinicians hired by the VA.
A bill before the House also aims at addressing personnel shortages. That bill would allow certified registered nurse anesthetists to practice independently.