CHARLESTON, W.Va. — After passing the House with bi-partisan support Saturday, a bill that would grant advanced practice registered nurses “full practice authority” has been sent to the first of two committee stops in the Senate.
H.B. 4334, which allows APRNs to practice the full extent of their training without a collaborative partnership with physicians after two years, must first go through the Senate Committee on Health and Human Resources before heading to Government Organization.
Dr. Brad Henry, a Charleston-based physician against the bill, and Jason Huffman, a proponent of the bill with Americans for Prosperity, each made their case on Tuesday’s MetroNews “Talkline.”
A point of contention physicians choosing to voice their opposition have made is that the legislation is unnecessary because APRNs currently have the ability to start their own practice, as long as there is a collaborative partnership with physicians in place.
“We want to see quality medicine,” Dr. Henry said. “If we can move toward something that has a mentorship, that has oversight, so an APRN just can’t come off the street and start practicing. We don’t wanna just have more care, we want to have quality care.”
The education of an APRN consists of a four-year degree, plus a masters, according to the WV Nurses Association.
Any APRN wanting to practice on their own would then be required to complete “at least two years of practice in a collaborative relationship with a qualified collaborating health care professional: Provided, That this requirement does not apply to those nurses who have been granted prescriptive authority more than two years prior…”
Looking at APRNs from a business standpoint, Huffman likened physicians dictating the terms in which they could practice, to solar panel companies running the Mine Safety and Health Administration.
“You don’t want the competition governing how you’re operating as an entrepreneur, it’s innately a conflict of interest,” he said. “You’ve seen businesses, these young entrepreneurs, these APRNs that are being shut down because doctors refuse to sign a piece of government paperwork that would allow them to continue their practice.”
Another major concern for those opposing the bill is the possibility of adding more prescribers with APRNs having prescriptive authority would exacerbate Schedule II prescription drug abuse in the state.
“If you’re not checking with your Board of Pharmacy regularly, which is not mandated at this point, it’s recommended, that you could go from nurse-to nurse-to nurse or nurse-to doctor-to doctor. It could happen either way,” Henry said.
The WV Nurses Association estimates there would be approximately 602 APRNs in the state with the ability to prescribe Scheduled II drugs.
Without definitive evidence to show APRNs with prescriptive authority contributes to drug abuse or not, Huffman said it was disingenuous to believe they would distribute drugs “willy nilly” and is the reason H.B. 4334 took what he described as a conservative approach in granting authority.
“With the limited structure of how the APRNs would be able to prescribe, I think that does take into account the possibility and negates it, nips it in the bud, so to speak.”
In its current form, APRNs would be allowed to prescribe 72 hours worth of a Schedule II drug with no refill, 30 days worth of a Schedule III drug with no refill and 30 days of an ADD drug with no refill.
Proponents of the bill have said it will allow APRNs to set up shop in rural areas where the populations are underserved. However, Dr. Henry does not believe that’s what will transpire if the bill passes.
“We can craft a bill that benefits West Virginia, this one doesn’t do that,” he said. “It doesn’t incentivize people to go to underserved areas.”
H.B. 4334 was not listed on the agenda for the Senate’s 1 p.m. meeting Tuesday afternoon.