HB607-Independent practice for APRN's- Clarification

Dear NPCPBC Members, 

There have been many emails, texts and questions regarding the implementation of HB607-Independent practice for APRN's. It is important to clarify and provide you with some understanding regarding the changes that will be needed if you decide to apply to be an APRN-IP. First of all, we are awaiting final rules to be established by the Board of Nursing (BON) and they will determine how the criteria of the bill will be implemented for APRN-IP. The BON will establish a new Council on Advanced Practice Registered Nurse Autonomous Practice that will include 9 individuals members consisting of: 

• 2 members appointed by the chair of the Board of Medicine 
• 2 members appointed by the chair of the Board of Osteopathic Medicine 
• 4 members appointed by the Board of Nursing (BON) who are APRNs
• The State Surgeon General, or a designee who shall serve as the chair of the Council 

Currently you are under a protocol with a physician and that WILL NOT change if you decide to continue to practice that way and not go for independent practice. An example would be if you are close to retirement and do not want to meet the criteria and choose to stay the way you are--in a protocol with the physician. 

APRN Independent Practice will only be in primary care--this is inclusive of family medicine, general pediatrics, general internal medicine.    

You may not apply for APRN-IP if you are practicing:

1.  In a specialty such as Cardiology, Rheumatology, Infectious Disease, Nephrology, Urology, Allergy/Immunology, Oncology, etc. All specialties are ineligible.
2. as an Acute Care NP
3. as a Psychiatric NP

This bill is not inclusive of CRNA's, CNS's, or PA's. 

An APRN or CNM seeking to be licensed to be an independent APRN will need to meet the following guidelines:

1. 3,000 hours of clinical practice hours, which may include clinical instructional hours, within the 5 years immediately preceding the application request
2. Completion of 3 graduate-level semester hours, or the equivalent, in differential diagnosis within the 5 years immediately preceding the application request
3. Completion of 3 graduate-level semester hours, or the equivalent, in pharmacology within the 5 years immediately preceding the application request
4. Must obtain and maintain professional liability coverage (malpractice insurance) in the amount of at least 100k per claim / 300k aggregate or obtain and maintain an irrevocable letter of credit in the amount of at least 100k per claim / 300k aggregate
5. CNMs must have a written patient transfer agreement with a hospital and a written referral agreement with a physician to engage in nurse midwifery.

If you have an APRN-IP license you will be granted signature authority which includes being able to sign death certificates, admission and discharge documents from a facility, Baker Act involuntary examination, and other documents otherwise required by law to be provided by a physician. You may not sign for medical marijuana.

 If you practice in a shortage area as an APRN-IP you will be eligible for student loan repayment of $15,000 a year from the Department of Health.

You will be required to complete an additional 10 hours of CE for license renewal in addition to what is now required.