2019 brings new regulations for Virginia nurse practitioners, many of whom no longer need a cooperation agreement to practice in the Commonwealth. House Bill 793, the Independent Practice Act NP and related emergency regulations passed by Governor Ralph Northam and published by the Joint Nursing and Medical Councils, came into force on January 7, 2019. The new law, codified under Virginia Code § 54.1-2957, reforms the scope of practice (SOP) and allows qualified NPs to practice independently.1 Abolishing the career-long cooperation agreement with a physician is a significant change in public policy that is expected to increase the capacity of basic nursing NPs throughout the state. Background To the policy changeThe shortage of health workers has become a growing political problem due to the growing demand for primary health services in the context of the current and projected shortage of medical personnel. The new Independent Practice of NPs Act falls short of the Full Practice Authority (FPA) as defined by the American Association of Nurse Practitioners (AANP) – “state practice and licensing laws that allow NPs to assess patients; diagnose, order and interpret diagnostic tests; and the initiation and management of treatments, including the prescription of drugs and controlled substances, under the exclusive licensing authority of the State Board of Nursing6 – because the Virginia State Licensing Authority remains subordinate to the Joint Board of Nursing and Medicine and because autonomy is not granted immediately after licensing, but after a while. This is a complete extension of SOPs for Virginia IPs and, at the same time, a step-by-step towards modernizing POS laws and regulations. Qualifications for IP`s Self-Licensure To be eligible for a license to practice independently in Virginia, the NP must have five years of full-time experience in clinical practice and submit a certificate from the cooperating physician to the Board of Nursing (BON). Practical clinical experience is described as the provision of postgraduate health care directly to patients, which unfortunately excludes administrative and faculty teaching time. The five-year full-time equivalent is based on a 36-hour week and is defined as 1,800 hours per year for a total of 9,000 hours.6 Applications for certificate/admission for self-employment are available on the BON website. The application requires the signature of the physician(s) on the patient care team, which confirms: 1) the physician has worked as an employee of the NP in accordance with a practice agreement;2) the physician practices regularly with a patient population and in an area of practice for which the PI is certified and authorized; and (3) The period of time with the NP in accordance with the practical agreement. A flat fee of $100 per certification category in which the PI is authorized and certified is required.
After verifying that the requirements are met, a new “licence for autonomous practices” is issued, and the NP can practice independently. Find out why the common business practices of healthcare companies are often very different – and how you can protect your own. So far, however, it has not decided to derogate from regulations that require medical surveillance. At a news conference Friday, Northam said he and the state health department “would be interested” in hearing from nurses who have struggled during the coronavirus outbreak. Nurses may prescribe substances from Controlled Lists II to VI without a cooperation agreement if certain conditions are met. Tal Code §54.1-2957.01(A) A. There are alternatives depending on when someone was originally authorized. It is specified in Regulation 18 VAC 90 -30 -105 for NPs and there are additional requirements for NPs with prescriptive authority, which can be found in 18 VAC 90-40-55. You can access it from our website dhp.virginia.gov and then go to the Nursing Council.
Jenks already had a contract with a private health clinic in Pulaski County, but said she was recently discharged because the volume of patients had declined in recent weeks. And while Jenks has a standalone license — making it easier for her to find work in other areas and treat patients independently — most nurses should find a new, cooperating doctor. Before the authority to practice independently is authorized, NPs must complete five years of full-time clinical experience as a registered nurse under a practice agreement with a physician. PAH Code §54.1-2957 E. The Medical and Nursing Councils may grant an applicant a licence by confirmation to practise as a nurse if the applicant has been licensed as a nurse under the laws of another state and the applicant meets the qualifications for admission required of nurses to the Commonwealth in accordance with the regulations of the councils. A nurse licensed by confirmation may practise without a practice agreement with a physician on the patient care team under Subdivision I if such an application provides the boards with a certificate attesting that the applicant has completed the equivalent of at least five years of full-time clinical experience as determined by the boards, in accordance with the laws of the state, in which the nurse was licensed. 1. A description of the nurse`s regulatory authority within the framework and practice of the nurse permitted by law. As Virginia continues to struggle with a growing number of COVID-19 cases, nurses are seeking an exemption from regulations, many of which still require practicing under medical supervision. One.
Except for Subdivision E of this Division, a nurse with the authority to prescribe may prescribe only under the written or electronic practice agreement with a physician on the patient care team. F. Pending the outcome of the next national specialty examination, boards may jointly grant temporary admission to nurses. Northam has relaxed some testing requirements for nurses waiting during the pandemic. In March, he waived certain admission requirements that allowed nurses to practice temporarily pending their review by the board of directors or receiving their results. D. Medical and nursing committees shall jointly adopt rules establishing cooperation and consultation between physicians and nurses working in patient care teams, including the development and regular review and revision of a written or electronic practice agreement; guidelines for availability and ongoing communication that define consultation between the cooperating parties and the patient; and regular joint evaluation of the services provided. The modalities of practice include provisions for (i) regular review of medical records, visits to the place where health care is provided in the manner and frequency determined by the nurse and physician of the patient care team, and (ii) contributions from appropriate health care providers in complex clinical cases and patient emergencies, as well as for cross-references….
