Nurse Practitioner Full Practice Authority Act of 2015 SB 723/ HB 999
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7/5/15.  What do YOU need to know about the recently passed "Certified Nurse Practitioners – Authority to Practice” legislation in Maryland?

The FPA legislation repealed the attestation and adds a requirement for new applicants for certification (an applicant who has never been certified in Maryland or any other state) to name a mentor on their application for certification as a nurse practitioner.

The mentor is defined as a physician or nurse practitioner licensed in Maryland who has three or more years of clinical practice experience, and who will be available for advice, consultation, and collaboration, as needed, for 18 months beginning on the date an application is received by the Board of Nursing.

5/12/15:  Governor Larry Hogan signs the Certified Nurse Practitioners – Authority to Practice

4/13/15:  The Maryland General Assembly has PASSED FULL PRACTICE AUTHORITY for NPs in Maryland!!! It will be signed by Governor Larry Hogan within the month! WAY TO GO NPAM!! ‪#‎FullPracticeAuthority

Saturday 4/11/15 Update  #2 (2:15pm)
SB 723 was released from Rules AND received a crossover vote from HGO, meaning it will be on 2nd Reader in the House Monday morning when they go in.

We have every indication that they will be able to flip to 3rd reader within hours and finish it up before midnight.  We won't count a single chicken before it's hatched!

The House bill (HB 999) came out of Rules this morning but didn't get a vote this afternoon by EHEA. So it's now a step behind and we'll have to see what happens on Monday to it.

Saturday 4/11/15 Update
Both bills have passed 3rd read in their original chambers and have crossed over to the opposite chambers, but we're in Rules Committees.

HB 999 is currently in Senate Rules.
SB 723 is currently in House Rules.

Both were supposed to be released today (4/11/15), but the Senate was on the floor from 10 am-4:30pm yesterday and then did not have committee or Rules meetings. The House was on the floor from 10am-3pm, took a break and went back in at 7pm but did not have committee or Rules meeting.

That means we lost a day. However, the Senate has announced that they will be back on the floor today (4/11/15) at 10am, which means that our lobbyists will be right there with them asking to have a Rules meeting to release our bill. As of this update, we don't yet know if the House will be in today.

Process steps that need to be completed:
HB 999 needs to be released by Senate Rules, then go to the Senate floor for a 2nd and a 3rd Reader vote, then make it back to the House for concurrence.

SB 723 needs to be released by House Rules, then go to the House floor for a 2nd and 3rd Reader vote, then make it back to the House for concurrence.

WE have been assured that it will be released by Rules, but it's all timing now. It doesn't matter which bill makes it first, whichever makes it back to their original chamber first by midnight on Monday, gets to go to the Governor for signature.

Friday 4/10/15 Update
Both bills have passed over into the opposite Chambers and are now in the Rules Committee. We anticipate legislators working tomorrow (Saturday).   

Wednesday 4/8/10 Update

HB 999 – passed 3rd Reader on the House Floor (139-1)
Next Steps: will go over to the Senate for a Senate Committee Vote in EHEA. Then 2nd reader and 3rd Reader on the Senate Floor.  Last step is to come back to the House for a concurrence and it’s done.

SB 723 – passed 2nd Reader on the Senate Floor (not vote count, 2nd Reader is a "pass through vote)
Next Steps: will go to 3rd Reader on the Senate Floor tomorrow (4/9/15). Then it will go to the House for an HGO Committee Vote, then 2nd and 3rd Reader on the House Floor.  Last step is to come back to the Senate for a concurrence and it’s done


The Certified Nurse Practitioners – Authority to Practice Bill HB 999 has been voted out of the House Committee. We need you to CALL YOUR LEGISLATORS and urge them to VOTE YES on HB 999 when it comes to the House of Delegates for a full vote! We approved two minor amendments and are in favor of the final bill. One amendment requires a new nurse practitioner to identify a mentor (NP or physician) for their first 18 months of practice (no approval or signatures required). The other amendment just adds "consult and collaborate” to the description of what an NP does

"Practice as a nurse practitioner" means to independently CONSULT AND COLLABORATE WITH, OR REFER an individual to, an appropriate licensed physician or ANY other health care provider AS NEEDED.

This addition DOES NOT IMPOSE consultation and collaboration in order to practice or to obtain a license.

2 Simple Steps

1. Use and put in your address in to get all of your elected officials. Remember, you are calling all of the State Delegates listed for your district; they are the last official(s) listed (not Federal or MD Senator) because the bill is going to the Maryland House right away. Click on their names to get their office phone numbers.

2. Please call and say the following (you may speak to the legislative aide):

"Hello, my name is ______, and I'm a Nurse Practitioner in your district. I'm calling because an important piece of legislation is headed to the House floor and I'd like to urge you to VOTE YES on HB 999 which will allow nurse practitioners in Maryland to practice to the fullest extent of their statutory authority, and it also creates a mentorship role for new graduates entering the workforce in Maryland."

You can offer to supply more information if needed, and thank them for their time and consideration of a yes vote.

And you're done! You have now made yourself part of the NPAM team trying to support your profession and your Full Practice Authority! 




Introduction to Nurse Practitioner Full Practice Authority Act
The Nurse Practitioner Association of Maryland (NPAM) is pleased to announce the launch of our 2015 Legislative Agenda: Certified Nurse Practitioners – Authority to Practice SB 723/HB 999.

NPAM will be partnering with the Maryland Academy of Advanced Practice Clinicians (MAAPC) to introduce legislation in the Maryland General Assembly in January 2015 to repeal the attestation requirement!  This legislation is supported by the Maryland Board of Nursing, the Maryland Nurses Association, and the Maryland DHMH/

Please join us with your support and participation as we move toward Full Practice Authority.

NPAM will keep you informed of all legislation and regulations that impact your practice.

Hearing Dates Set
Full Practice Authority Act of 2015--hearings set in House and Senate!

The hearing dates for testimony in the Maryland General Assembly are as follows:
Tuesday, March 10, 2015 at 1pm--Health and Government Operations Committee (House)
Wednesday, March 18, 2015 at 1pm--Education, Health, and Environmental Affairs Committee (Senate)
Please collect those letters of support from colleagues (click here for template. If possible, copy and paste on to letterhead) and fax them back to the NPAM lobbyist's office 410-268-0844 ASAP! 

NPAM Testimony in favor of HB 999/SB 723 March 10, 2015/March 18, 2015
Letter of Support from AANP
Julie Stanik-Hutt Testimony
Julie Worcester Testimony
Veronice Gutchell Testimony

This page will serve as your landing page for all things NP Full Practice Authority 2015 SB 723/ HB 999.  We will post resources and links that will be useful for individuals to use to help with this initiative.

Letter templates have been disabled pending hearing outcome 3/27/15  (Click to download)

Letter of support to Maryland legislators.  This template can be used by you and by physicians, practice managers and administrators, other health care colleagues and stakeholders, as well as patients, essentially anybody who supports the NP Practice Authority Act 2015 SB 723/ HB 999.   Use this letter as a template, but if you have specific anecdotal information that would strengthen your letter, please include that as well.  Please collect these letters and fax or mail to the NPAM office (F:  410-772-7915).  These letters will be presented together so VOLUME COUNTS!

Stakeholder Letter
.   Use this letter as a resource to explain succinctly our legislation to physicians, practice managers and administrators, other health care colleagues and stakeholders, as well as patients.Do not fax this letter to the NPAM office. After explaining the legislation, present the letter of support (above), for signature(s) and return that signed to letter of support to the NPAM office.  

PDFs (click to download)

AANP Key Messages
AANP Key Legislative Message
AANP NP Graphic
Maryland NP Talking Points

Articles (PDFs)
Oliver, Pennington, Revelle, Rantz.   Impact of nurse practitioners on health outcomes
of Medicare and Medicaid patients

Authors examined for a statistically significant relationship between the level of APRN practice (full,reduced, or restricted) allowed and results of recent nationwide, state level analyses of Medicare or Medicare-Medicaid beneficiaries.   Results indicate that obstacles to full scope of APRN practice  have the potential to negatively impact our nation’s health. 

American Academy of Nursing: Improving health and health care systems with advanced
practice registered nurse practice in acute and critical care settings
Advanced practice registered nurses (APRNs) working in acute care settings are well
positioned and well prepared to reduce health care costs while improving access, addressing health systems issues, and providing high-quality care

Buerhaus, DesRoches, Dittus & Donelan   Practice characteristics of primary care nurse practitioners and physicians 
Significant differences in demographic and practice characteristics exist between PCNPs and PCMDs. Whether working independently or with  PCMDs, increasing the number of PCNPs can be expected to expand access to primary care, particularly for vulnerable populations, and for those gaining access to health insurance through the ACA


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