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Nurse practitioner bill passes House, moves over to Senate

CHARLESTON, W.Va. — Advanced practice registered nurses are another step closer to having “full practice authority” in the state after a bill was passed out of the House on Saturday.

H.B. 4334 allows APRNs that meet certain requirements to evaluate, diagnose and treat patients outside of a collaborative partnership with physicians after two years.

A major reason for the bipartisan support is the prospect of improving health care in the state’s under-served rural counties, where some studies have shown that full practice authority in other states increased access for residents in similar counties by 70 percent.

“We’re not tying to take anything away from the doctors, I have immense respect for all of the doctors and they do a super job,” Del. Woody Ireland (R – Ritchie, 07) said. “They can’t be available seven days a week, 24 hours a day, 365. So if we can provide that opportunity to save a few lives, we need to take that into consideration.”

However, opponents of the bill are skeptical that the legislation will improve health care as promoted, with one delegate believing the issue lies with other government regulations.

“With the electronic medical records and all the other things you have to comply with, it’s very difficult for anyone with anyone with any type of certification to go out to these areas now and practice independently and stay viable in areas that don’t have much population,” Matthew Rohrbach (R – Cabell, 17), a practicing Gastroenterology doctor in Huntington said.

Opponents also fear that with full practice authority including the ability for APRNs to prescribe Schedule II narcotics to treat pain, the state’s prescription drug abuse crisis will worsen with a few “bad players” taking advantage of the system.

Del. Kelli Sobonya (R – Cabell, 18), one of the bill’s sponsors, explained to the body that there are systems currently in place to monitor prescribing habits.

“All prescribing nurse practitioners in West Virginia are monitored by the West Virginia Controlled Substance Monitoring program facilitated by the Board of Pharmacy. So, irregular prescribing patterns would be flagged and reviewed, and they would be referred to law enforcement or the licensing board.”

There are approximately 2000 APRNs in the state, 860 of those would meet the requirements to have prescriptive authority and 70 percent of that number would have a licence from the DEA to prescribe Scheduled II drugs, according to the WV Nurses Association.

Through the bill’s two committee stops and on the floor, amendments were proposed to alter the legislation in ways that kept some of the restrictions for APRNs in place or extended some of the process.

Proponents of the bill looked at how the legislation has performed in the 21 states, plus Washington D.C. that have implemented full practice authority and believe it would work as proposed.

“This is not a new idea, this isn’t something that needs studied further,” lead sponsor Amy Summers (R – Taylor, 49) said. “Iowa has allowed full practice authority for 33 years, Alaska 28 years, New Mexico 20 years. No state has ever repealed full practice authority once it was given.”

With the 72-20 vote in favor of the bill Saturday, it now head to the senate.

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