Expanding Authority for APRNs
Evidence-based Research
Advanced Practice Medical Nurses (APRNs) conducting evidence-based research and delivering healthcare services in New York require access to confidential client data, state-issued information, and collaborative practice protocols. The Health Insurance Portability & Accountability Act (HIPPA) provides additional mandatory requirements protecting client personal health information. APRNs consider these measures when assessing client needs and prescribing medications.
Before determining appropriate medications for prescription, APRNs discover the authority necessary to make healthcare recommendations by interpreting language present in authorizing statues and regulations. The Affordable Care Act mandates specific modifications to health law in New York pertaining to authority for prescribing medication. APRNs must demonstrate authority by including the prescriber’s title and state-issued Rx #, as well as information regarding collaborative practice protocols.
Affordable Care Act
Affordable Care Act changes the way APRNs receive authority to prescribe controlled substances. Critics of new healthcare reform measures assert the Affordable Care Act presents challenges for APRNs to deliver primary care services. Practitioners in New York possess limitations on length of supply and refill authority specific to individual substances. New state regulations requiring articulation within protocols for particular substances exist in addition to federal DEA registration. Schedule IIs, including anabolic steroids and benzodiazepines, must be written on official prescription forms to show distinction between other medications.
New Laws
Recent state legislation provides New York APRNs with authority to prescribe medications without the presence of a physician. APRNs must first go through a transition period during which recommendations for prescriptions occur under a physician’s observation. The most recent state budget includes a provision allowing APRNs to prescribe medications independently after 3,600 practicum hours. New York, Minnesota and Connecticut represent the first states to adopt provisions removing physician oversight after the transition period.
While expanding APRN authority provides patients to greater access to healthcare, one of the most challenging obstacles remains physician compensation. Within the 16 states and the District of Columbia where healthcare reform legislation exists, annuals salaries for physicians remain stagnant according to research by the Bureau of Labor Statistics. Health labor associations show concern regarding the value of the primary care physician’s role amid new policy changes.
