MAFP is excited to share that it has been selected to receive the AAFP Leadership in State Government Advocacy Award for the chapter’s work on advanced practice registered nurse (APRN) scope of practice legislation. This annual award recognizes outstanding chapter contributions to further Family Medicine through legislative accomplishments or initiatives, or the support of public policy efforts. Also winning the award this year are the Colorado, Ohio and Texas Chapters.
MAFP’s efforts centered around House Bill 5400 (H-2) (Public Act 499)—the culmination of years of negotiations around the appropriate scope of practice for APRNs in Michigan. As has been the case in most states, for the past several years, each new legislative session in Michigan saw a new APRN scope of practice bill that would allow APRNs to practice independent of physician delegation and supervision. Senate Bill 68, as introduced on January 29, 2015, by Senate Health Policy Committee Chairman would have done just that. Its introduction unleashed a flurry of meetings among MAFP staff, other physician groups, the bill sponsor, and policy staff. A similar effort was ignited in the House with the introduction of Senate Bill 68’s House companion bill, House Bill 5400, in early 2016.
Ultimately, due to the successful lobbying and grassroots advocacy efforts of the physician community, these bills, as introduced, were never passed into law. Instead, stakeholders went “back to the drawing board” with little to no hope of resurrecting a palatable bill. House Bill 5400 (H-2) is the comprise no one thought possible, brokered between physicians and nurses in the summer of 2016. The legislation, among other things, defines advanced practice registered nursing in the public health code and broadens some APRN authorities, including allowing APRNs to prescribe nonscheduled drugs autonomously, make calls or go on rounds without restrictions notwithstanding any law or rule to the contrary, and prescribing physical therapy, ordering physical and chemical restraints, and referring for speech pathology services. APRNs are still licensed as registered professional nurses and subject to state law regarding physician delegation.
House Bill 5400 (H-2) saw victory in the Michigan House of Representatives on November 29, 2016, passing by a vote of 102 to 5. It passed out of the Senate on December 14 by a vote of 36 to 1, and was signed into law by Governor Rick Snyder on January 5, 2017.
MAFP will accept the award during the AAFP’s State Legislative Conference in Dallas, Texas, on November 3. The Academy looks forward to sharing our story with other state chapters who are mired in similar debates, and members can look forward to reading more in the winter 2017-2018 issue of Michigan Family Physician.