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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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Trends in pharmacy regulation

• New laws in most states now allow pharmacists to dispense emergency opioid overdose reversal treatment, and pharmacists in some states have direct authority to prescribe and sell naloxone to consumers. 
• Under parts of the Drug Supply Chain Security Act coming into effect in 2020, pharmacists will be responsible for checking product tracing documentation.
• As of April 2019, 13 states and D.C. allow pharmacists to prescribe hormonal contraceptives after receiving proper training.

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Update on Veterinary Nurse Initiative

The National Association of Veterinary Technicians of America has undertaken an initiative to standardize credentialing requirements, scope of practice, and use of the title Registered Veterinary Nurse. Some recent bills are moving the initiative forward. A bill to approve the title change has passed in the Ohio House and is under consideration in the Senate. Title change bills have been considered in Indiana and Georgia, and Oklahoma will soon be conducting  review of its veterinary practice act.

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Arizona considers bill to disclose non-provided medical services

A bill proposed in Arizona would require healthcare providers to disclose which medical services or products they will not provide due to religious beliefs. A current state law allows practitioners to decline to provide services that violate their "sincerely held religious beliefs." The proposed bill would require practitioners to provide a list of all legal drugs and services within their scope that they will not provide.

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