History of the Nurse Practitioner Association of Maryland

The Nurse Practitioner Association of Maryland is the unifying voice for all NPs within the state.  The organization provides consistency and expertise in guiding the profession.  It also provides information and serves as an advocate for those outside the NP role.  In this position, NPAM is able to accomplish as a group what individual NPs cannot, thereby decreasing the barriers to practice and expanding the NP role.

The nurse practitioner role developed in 1965 following the successful piloting of the MS level Pediatric Nurse Practitioner Program at the University of Colorado by nursing faculty member Dr. Loretta Ford and her physician colleague Dr. Henry K Silver.  Many NP programs were subsequently developed at both the continuing education and MS degree level.

The first NP program in Maryland was a 9 month Adult NP certificate program followed by a 1 year internship that was first implemented in 1973.    It was not until 1976 that the initial students were admitted into the first Masters Level Adult NP Program at the University of Maryland with a class of 4 students.  Other continuing education programs were established at other hospitals and schools within the next few years. 

 Dr Loretta Ford 
                                                                                  
  Gaining Recognition for NPs in Maryland

Nurse practitioners in Maryland recognized quickly that they would need to amend the state Nurse Practice Act if they were to be able to practice.  The Maryland State Nurses Association (MNA) was then representing nurse practitioners who joined their Primary Care Special Interest Council.  The first attempt to pass enabling legislation was successful, however the rules and regulations were never agreed to because the NPs refused to allow the term "supervision" to be used in the regulations to describe their relationship with physicians.  The legislation expired because of the failure to get regulations passed and requited new legislation to be passed.  This new legislation described a collaborative relationship between NPs and physicians.  Other legislation was required to guarantee reimbursement for services.  While the MNA lobbyist had been instrumental in representing NPs and helping see legislation passed, their mandate to represent all nurses in Maryland diluted their ability to represent NPs exclusively.  It became clear that NPs must have some sort of organization of their own.  

NPAM became an independent professional organization in 1992.  The decision to form an independent organization was motivated by the desire to better meet the needs of NPs in solving complex issues that are unique to Nurse Practitioners.  These issues, including legislation, scope of practice and reimbursement, are still relevant today.

NPAM Today

The membership of NPAM is divided in geographic districts across the state. Each district is lead by a district director who is elected every two years and is allowed to serve six consecutive years according to NPAM bylaws.  NPAM currently has membership of over 600 members and is divided into 9 regional districts where special educational and networking activities are held.  Members may attend district meetings either near their homes or sites of employment. 

The Board of Directors of NPAM has always been composed of volunteers.  The Board consists of a President; Past President; President-Elect; Secretary; Treasurer; Legislative Chairperson; Conference Chairperson and the District Directors.  The Board positions are elected with the exception of the Legislative and Conference Chairpersons which are appointed positions.  As NPAM began to grow, a management company was hired in the mid 1990's to assist with these calls and the many administrative duties necessary for running a professional organization. The current management company is Nurse Practitioner Alternatives, Inc.

 
Picture: The 2008--2009 Board of Directors:  In back:  Jane Kapustin Past President; Diana Heffner, President; Bonnie Bock, Secretary;  In front:  Dominique Ashen, Treasurer and Sandi Nettina, President Elect.

A Lobbyist has been a critical part of the history of NPAM.  Since 1992 William Pitcher, Esquire has been the lobbyist for NPAM and has represented the interests of all nurse practitioners in Annapolis.  He is also the legal counsel for NPAM.  In 2001 Mr. Pitcher guided NPAM in passing legislation that allows Nurse Practitioners to be named to the provider panels of HMO's.  In 2007 legislation was passed designating the appointment of an Advanced Practice Nurse to the Maryland Board of Nursing. In 2008 legislation was passed enabling Nurse Practitioners to sign birth and death certificates; sign Advanced Directives; and sign applications for Handicapped License tags—all tasks that had previously been carried out by physicians but which lie well within the domain of primary care nurse practitioners.

NPAM has been able to offer professional continuing education for many of the district meetings over the last few years.  Beginning in 2002 NPAM provided exceptional continuing education opportunities for members and other NPs in Maryland and surrounding states through the Mid-Atlantic Regional Conference for Nurse Practitioners (MARC-NP).  In 2008 NPAM offered two Mini-Marc conferences.  These were high quality single day conferences held in two different areas of the state with a focus on Sports Medicine.

NPAM is recognized nationally as an active, successful and dynamite organization.  The organization's work to pass legislative statutes to authorize NP practice and reimbursement have served as model legislation for NPs in other states to follow.  The use of professional lobbyists and association managers have increased both the sophistication of the NP representation, and have expanded the benefits that can be provided to members.  The professional organization is able to advocate for its members and all other NPs in Maryland and achieve results that no single members would be able to do.

As with any professional organization, the power of the organization's message is increased when the membership numbers are the largest.  Thus, NPAM has a great desire to have all NPs within Maryland belong to this organization.  We invite nonmembers to contact us to discuss how they may become involved.