Legislation Filed in Senate to address APRN scope of practice

The Florida Legislators are rapidly working on Speaker Oliva’s priority of expanding scope of practice for advanced practice registered nurses (APRN) in Florida. HB 607, a Florida House bill which would allow APRNs to practice autonomously has advanced in the Florida House and is presently pending being scheduled to be heard in its final committee. (House Health and Human Services Committee).

On February 17, 2020 a series of amendments was added to an existing Senate bill (SB 1676) that affects APRNs and provides an avenue for autonomous practice with clear limits and hurdles. SB 1676 would allow APRNs to practice autonomously in the primary care setting only, with significant limitations and new educational requirements with oversight by a committee predominantly made up of physicians.

The partial language of the amendment is listed below.

This bill could be the companion bill to HB 607, but would require significant reconciliation.

Section 15 amends the Nurse Practice Act to define an “advanced practice registered nurse – independent practitioner” or “APRN-IP” as an advanced practice registered nurse who is registered under s. 464.0123 to provide primary health care services without a protocol agreement or supervision in primary care health professional shortage areas. The bill defines a “primary care health professional shortage area” as a geographic area, an area having a special population, or a facility with a score of at least 18, as designated and calculated by the Federal Health resources and Services Administration, and which is located in a rural area, as defined by the Federal Office of Rural Health Policy (see section 16). Section 16 creates s. 464.0123, F.S., to establish the Patient Access to Primary Care Pilot Program (Pilot Program) within the Department of Health (DOH). The Pilot Program will provide primary health care services in “primary care health professional shortage areas” by allowing Advanced Practice Registered Nurses (APRN) who meet certain criteria to engage in the autonomous practice of advanced or specialized nursing without the supervision of a physician. The bill creates a nine member Council on Advanced Practice Registered Nurse Independent Practice within the DOH and requires the council to make recommendations on the registration of APRN-IPs and develop proposed rules to regulate the practice of APRN-IPs. All recommendations made by the council must be made by a majority of the members present. Primary Care Certification Examination The bill requires the DOH to approve at least one third party credentialing entity to develop and administer a primary care certification examination for APRN-IPs. Registration The bill requires that APRNs who practice without the supervision of a physician to register with the DOH as an APRN-IP and provide the following:  Proof of experience as an APRN under the direct or indirect supervision of a physician for at least 10,000 hours within the last 6 years;  Certifications and designations recognized and approved by the Board of Nursing, Board of Medicine, Board of Osteopathic Medicine, or the DOH;  APRN education, work, and license history;  Address in which the application will conduct practice;  Criminal and regulatory disciplinary history; and  Proof of professional liability insurance;