CLEAR

Scope of practice after the pandemic

This article highlights some of the healthcare scope of practice changes that have been or are being allowed in response to the coronavirus pandemic. The article considers how these changes should be handled post-pandemic, noting the effect on healthcare practitioners' job satisfaction and professional well-being, as well as telehealth and patient access to care. The article urges an evidence-based approach to future decisions about scope of practice and clear communication of the evidence for the decisions in order to mitigate perceptions of unfairness.

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Massachusetts introduces bill for telehealth and scope of practice expansion

The Patients First Act introduced in the Massachusetts Legislature would make telehealth services permanently available to patients by requiring insurance carriers to cover services, including services through audio-only telephone calls. The bill would also expand the scope of practice of registered nurse practitioners, nurse anesthetists, and psychiatric nurse mental health specialists to allow independent practice if training and initial supervision requirements are met. A new license would also be created for "dental therapists."

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Highlighting pharmacy changes in Canada

This article highlights regulatory changes to pharmacy practice in Canada in response to COVID-19. Examples include changes in scope of practice for pharmacists to administer vaccines and other medications, extended prescribing authority, and e-prescribing.

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Health policy researcher calls for making changes permanent

A health policy researcher with the Dartmouth Institute for Health Policy and Clinical Practice calls for some state actions and changes to the healthcare system in response to COVID-19 to be "boundless and permanent." In this article, he focuses on deregulatory trends in healthcare policy: reciprocity of occupational licenses, relaxing requirements for inactive licensees to return to practice, expanding scope of practice, lifting telemedicine regulations, and temporarily suspending continuing education requirements.

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States expand scope of practice to respond to COVID-19

Many states are expanding the scope of practice of nurses and physician assistants to aid in responding to the COVID-19 emergency. Here are examples from a few states.

New Jersey's governor has issued an executive order that removes physician oversight requirements for advanced nurse practitioners and physician assistants and allows them to prescribe controlled dangerous substances independently.

An order in Massachusetts allows nurse practitioners, nurse anesthetists, midwives, and psychiatric nurse specialists with two years supervised practice to now independently give physicals and prescribe medications.

Michigan's governor signed an executive order to temporarily allow qualified physician assistants, nurses, and other healthcare practitioners to treat COVID-19 patients.

Many states are taking similar measures.

Manitoba proposes new limited legal practitioners

Proposed changes to the Legal Profession Act of Manitoba would create a new profession, limited legal practitioners, who could perform specific legal services in areas that "pose no risk to the public." The Law Society of Manitoba would determine requirements and scope of practice for these limited practitioners.

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Ontario: changes to controlled act of psychotherapy for nurses

Following the December 2017 proclamation of psychotherapy as a controlled act under Ontario's Regulated Health Professions Act, new amendments are in effect for nurses. Registered nurses and registered practical nurses can independently initiate the act of psychotherapy if they have the requisite knowledge to determine if the procedure is warranted and to perform the procedure safely, effectively and ethically.  They must also accept accountability for determining if the patient's condition warrants the procedure.

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Arizona pilot project for licensed legal advocates

A two-year pilot project in Arizona will create the credential licensed legal advocate. Nonlawyers with the license will be able to provide legal advice related to protective orders, divorce, child custody, consumer protection and housing. A similar pilot project creates the legal document preparer program to allow nonlawyers to prepare legal documents for people who experienced domestic violence.

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Idaho considers optometrist scope of practice

The Optometric Physician Licensing Act being considered in Idaho would expand optometrist scope of practice to perform three in-office laser procedures that currently can only be performed by ophthalmologists. The Bureau of Occupational Licenses has concluded that optometrists do meet minimum training standards to perform the procedures. The bill would require optometrists to perform at least five supervised procedures before being eligible for the expanded scope of practice.

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New Jersey legislature strikes down APRN scope of practice bill

The "Consumer Access to Health Care Act" has been voted down in the New Jersey legislature. The bill would have allowed Advanced Practice Registered Nurses with proper training to prescribe medication without a physician.

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