CLEAR

States expand which professionals can provide abortion services

Several states have expanded or are expanding the list of healthcare professionals who can provide abortion services. With the possibility of Roe v. Wade being overturned, lawmakers in Democratic states are concerned that an influx of patients seeking abortion will overwhelm their current capacity. States are moving to allow nurses, midwives, and other non-physician healthcare workers to handle simple and early abortion procedures. States are also budgeting money for training of these providers.

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Changes in scope of practice for advanced practice providers

Several states have recently made changes or rejected changes to scope of practice laws fro nurse practitioners, physician assistants, and pharmacists. Emergency powers and waivers due to the COVID-19 pandemic allowed advanced practice providers to temporarily perform some expanded services. Supporters of expanded scope laws argue for providers to be allowed to practice to the full extent of their education and training, resulting in improved access to care for patients. Opponents of expanded scope cite studies showing that most patients want a physician to be involved in their care and that care provided by advanced practice providers is actually more expensive than care provided by doctors.

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Some states with recent scope of practice changes include

• New York allows nurse practitioners to practice without supervision from a doctor
• Massachusetts expanded the independent practice of physician assistants
• Maryland now allows nurse practitioners, midwives, and physician assistants to perform abortions
• Kansas allows full practice authority for nurse practitioners, read more
• Alabama allows certified registered nurse anesthetists to provide anesthesia services in coordination with a physician, podiatrist or dentist and order certain medications and tests, read more
• Wisconsin's governor vetoed a bill that would have granted independent practice authority to APRNs, read more

 

Expanding pharmacist scope of practice

A Kaiser Health News report details expanded scope of practice for pharmacists across the US. At least 12 states have authorized pharmacists to treat minor illnesses such as urinary tract infections, strep throat, and flu after performing rapid point-of-care tests. The National Alliance of State Pharmacy Associations has also noted more states allowing direct prescribing authority instead of collaborative practice agreements.

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British Columbia considers consolidating legal professional regulators

The Ministry of the Attorney General in British Columbia has announced proposed changes to the regulatory framework for legal professionals. Under the proposal, regulation of lawyers, notaries, and paralegals would be consolidated under a single statute and a single regulator. A new mandate clarifying the duty to protect the public would be established. Scopes of practice would also be updated and clearly defined. Further details of the proposal are under development in consultation with the Law Society of BC, the Society of Notaries Public of BC, and representatives of the paralegal profession.

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Expanded scope of practice for pharmacists

Expanded scope of practice for pharmacists in Florida allows qualified pharmacists to test, screen, and treat minor health conditions and to collaborate with doctors for treating chronic conditions such as asthma and diabetes and prescribing medications.

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A bill passed in the Kansas Senate would allow pharmacists to test for and treat certain conditions such as influenza, strep throat, and urinary tract infections. That bill now moves to the House.

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Pennsylvania court ruling on animal chiropractic

In a case brought before a Pennsylvania Appeals Court, the Court has ruled that animal chiropractic is within the definition of veterinary practice and does fall under the jurisdiction of the Pennsylvania State Board of Veterinary Medicine. The petitioner is a licensed chiropractor but is not a veterinarian, although she has certification in veterinary chiropractic from the International Veterinary Chiropractic Association. The Board ordered that, in order to provide chiropractic care to animals, the practitioner must become a licensed veterinarian or only perform the care under the supervision of a Pennsylvania-licensed veterinarian.

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NABP releases task force reports

The National Association of Boards of Pharmacy's task force on state oversight on drug importation released a report focused on areas of concern for regulating prescription drug importation: supply chain issues, enforcement responsibility, Section 804 Importation Programs, patient safety, and the Drug Supply Chain Security Act. The task force recommends that NABP develop resources for boards to use in educating legislators when an importation bill is being considered, communicate with Canadian pharmacy regulators about NABP programs that can assist with regulatory oversight, and collaborate with other stakeholders to develop consumer education programs as well as educational tools for healthcare providers and regulators.

The Work Group to Consider Extending Waivers [issued during the pandemic] met and recommended changes to the Model State Pharmacy Act to reflect expanded pharmacist scope of practice to administer testing and vaccines, allowed alternatives to in-person counseling, use of remote Automated Pharmacy Systems, and other provisions during unusual public health circumstances or declared emergency.

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Trends in scope of practice expansion

This article from The National Law Review details trends influencing scope of practice expansion for advanced practice providers (APPs). In response to the COVID-19 pandemic, many states granted expanded scope of practice to AAPs to meet demand for healthcare services, and some of those temporary orders have been signed into permanent legislation. The opioid crisis has likewise increased demand for healthcare services, and prescriptive authority of nurse practitioners has been expanded under federal law to include addiction treating drugs. Another increase in demand for health services comes from aging rural populations, with some states allowing independent practice for certain APPs to meet this need.

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APRN scope of practice expansions fail in 8 states

Legislation to expand scope of practice for Advanced Practice Registered Nurses has been approved this year in Delaware and Utah but failed in Florida, Kansas, Kentucky, Louisiana, Maine, Mississippi, Tennessee, and Texas. The American Medical Association has led advocacy efforts against the scope of practice expansions.

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California expands optometrist scope of practice

Two bills signed into law in California expand optometrist scope of practice. Optometrists will be authorized to administer COVID-19 vaccinations and perform COVID testing. The list of allowed drugs and conditions is also expanded to allow optometrists to treat all noncancerous anterior segment conditions, including all types of inflammation and treatment with all antivirals and antifungals. Medical assistants will be allowed to perform subjective refraction procedures.

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