A new state law that takes effect July 1 could increase access to healthcare for patients who see nurse practitioners.

 

The new law eliminates joint promulgation for certified nurse practitioners. Currently both the Board of Nursing and the Board of Medical Licensure must jointly approve any new regulations pertaining to nurse practitioners. Mississippi was one of only four states still having to answer at some level to two boards.

 

Under the terms of House Bill 1260, the regulation of nurse practitioners will fall under the sole purview of the Board of Nursing, instead of sharing the role with the Board of Medical Licensure.

 

"We worked with the Mississippi Board of Nursing on this bill so that nurse practitioner regulations would be solely under the Board of Nursing," said Ricki Garrett, PhD, executive director of the Mississippi Nurses Association. "The association believes that nurses should be regulated by nurses. We now join most other states in sole regulation of nursing."

 

What this means to patients is that the Board of Nursing can have a more streamlined process for adopting up-to-date standards for nurse practitioners, and as the practice changes, the regulations can more readily follow those changes.

 

Adoption of this law also provides some risk to the nurse practitioner practice, Garrett said.

 

In the past, say nurse practitioner proponents, the Board of Medical Licensure has attempted to restrict the number of nurse practitioners that a physician can collaborate with. In some rural counties, there are simply not enough physicians who collaborate with nurse practitioners, thus restricting the number can affect access to healthcare.

 

"Although we're aware that the Board of Medical Licensure might use this as a means to limit the number of nurse practitioners that a physician can collaborate with, or might also try to put other restrictive provisions in their regulations regarding collaborating physicians, we still believe that it is best for the nurse practitioner practice to be solely regulated by the Board of Nursing," said Garrett.

 

State Rep. Mary Coleman, a Democrat representing Hinds and Madison counties since 1994, authored the bill. State Rep. John Hines, Sr., a Democrat representing Washington County since 2001, co-authored the bill. Coleman and Hines both sit on the House Public Health and Human Services Committee.

 

"The bill also has a reverter clause, so that if we have problems as a result of the bill, at the end of the year, we can ask that the law revert back to its original status," explained Garrett.

 

The new legislation also deletes the requirement for supervision by a licensed physician for insurance reimbursement, and defines the term, qualifications for licensure, and practice requirements of "advance practice registered nurse" for the Nursing Practice Law.

 

"The passage of HB 1260 allows Mississippi nurse practitioners to join 47 other states that are currently regulated by their state nursing boards," said Jackie Williams, NP, MNA director of advanced practice. "It's an exciting time for nurse practitioners, and we're hopeful that this streamlined process will ultimately allow for increased healthcare access for the residents of Mississippi."

 

Mississippi has more than 2,000 nurse practitioners, including many that represent the only healthcare providers available to patients in rural pockets of the state. The role of the nurse practitioner is not to assist a physician, but rather to provide primary healthcare to patients.

 

A problem that has exacerbated the relationship between nurse practitioners and other healthcare providers over the years, say industry watchers, is that as more and more nurse practitioners find opportunities to buy their own clinics, or work in clinics and are not under the direct "collaboration" of a physician, the Board of Medical Licensure has restricted these practices. 

 

The American College of Physicians Policy Monograph 2009: Nurse Practitioners in Primary Care, states that "collaboration is defined as ongoing interdisciplinary communication regarding the care of individuals and populations of patients in order to promote quality and cost-effective care."

 

It also states: "collaboration among physicians and nurse practitioners can occur during both face-to-face encounters and electronically through the use of technology, including telephone, e-mail, telehealth and electronic health records" and suggests: "licensing and certification exams for nurse practitioners should be developed by the discipline of nursing, based on standardized training involved in graduating from advance practice nursing program and scope of practice statures and regulations."

 

The position paper does not suggest restricting the number of nurse practitioners with which a physician may collaborate. 

 

"The Mississippi Nurses Association will continue to monitor the actions of the Board of Medical Licensure to ensure that regulations for the physicians do not affect and restrict the practice of nurse practitioners who are providing valuable access to healthcare to many Mississippians," Garrett said.