From KMS Executive Director Rachelle Colombo:
As we explained in our last newsletter, the implementation process of the recently enacted legislation, HB 2279, regarding APRN practice is likely to be somewhat confusing for all, especially physicians who work with and/or employ APRNs, as well as hospitals, nursing, and other health care facilities and the APRNs themselves. Because the Kansas State Board of Nursing (KSBN) must promulgate regulations to implement the changes contained in the legislation, it requires a complicated, multi-step administrative process that involves several state agencies and review committees. Following is a status report on where things stand as of today, July 1.
Yesterday, the first of the review committees, the State Rules and Regulations Board reviewed and discussed the seven proposed temporary regulations which the KSBN proposed. After lengthy discussion, the Board approved three of the regulations, and did not approve the remaining four proposed regulations. The Board’s action leaves in place, for the time being, the requirement that APRNs must still have a collaborative practice agreement (CPA) with a physician in effect for acts or practices of the APRN that would be considered the practice of medicine, except prescribing drugs and durable medical equipment.
The Board’s action to not approve four of the proposed regulations was in response to testimony presented by KMS that four of the seven regulations went beyond what the APRN legislation authorized. KMS pointed out that while HB 2279 eliminated the need for APRNs to have written prescribing protocols, the remaining portions of the Kansas Nurse Practice Act remain unchanged and thus the APRNs’ authorized scope of practice remains otherwise unchanged. KMS testified that the four regulations in question would have allowed APRNs to practice medicine, which — apart from the prescribing of drugs — the legislation clearly did not authorize. The Board agreed that the four regulations in question appeared to authorize APRNs to practice medicine, which would be beyond what the legislation allowed.
While the objectionable regulations did not go into effect, this issue is far from over. The four proposed temporary regulations which were not approved will be taken up later this month by a second review committee, the legislature’s Joint Committee on Administrative Rules and Regulations, which is scheduled to meet on July 18. It is also possible that the Board of Nursing could revise the four regulations in question and re-file them. In addition, the Kansas State Board of Healing Arts Board has asked the Kansas Attorney General to render an opinion on the extent to which the new law makes changes to APRN practices.
So, while the new law does take effect July 1, at this time, it only eliminates the need for a CPA for prescribing, but for all other acts or practices of the APRN that would be considered the practice of medicine a CPA is still required. Please watch your email for further updates, and check our FAQ on the KMS website for additional details.
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