Legislative Changes to Scope of Practice

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Legislative Changes to Scope of Practice

• Kathy Apple, RN, MS, CAENCSBN

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Legislative Angst
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Why Now?

• Professions share skills or procedures
• Decrease in unique scopes of practice
• Practice evolves
• Access to safe competent care

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Interdisciplinary Effort

• Association of Social Work Boards (ASWB)
• Donna DeAngelis, LICSW, ACSW, Executive
  Director
• Federation of State Boards of Physical Therapy
  (FSBPT)
• William A. Hatherill, CEO
• Barbara J. Safriet, Public Member and Associate
  Dean and Lecturer in Law, Yale Law School
• Federation of State Medical Boards (FSMB)
• Lisa Robin, Vice-President, Leadership and
  Legislative Services
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• National Board for Certification in Occupational
  Therapy (NBCOT)
• Paul Grace, MS, CAE, President/CEO
• National Council of State Boards of Nursing
  (NCSBN)
• Kathy Apple, MS, RN, Executive Director
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• National Association of Boards of Pharmacy
  (NABP)
• Carmen A. Catizone, MS, RPh, DPh, Executive
  Director/Secretary

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• Legislative Considerations for Assessing Changes
  in Healthcare ProfessionsScopes of Practice

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Purpose

• Promote better consumer care across professions
  and competent providers
• Improve access to care
• Recognize the inevitability of overlapping scopes
  of practice

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Heart of Regulation

• Ensure that the public is protected from
  unscrupulous, incompetent and unethical
  practitioners
• Offer some assurance to the public that the
  regulated individual is competent to provide
  certain services in a safe and effective manner
• Provide a means by which individuals who fail to
  comply with the professions standards can be
  disciplined, including the revocation of licenses

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Foundational Basis

• An established history of the practice scope
  within the profession
• Education and training
• Supporting evidence
• Appropriate regulatory environment

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Define Scope of Practice

• The rules, the regulations, and the
  boundaries within which a fully qualified
  practitioner, with substantial and appropriate
  training, knowledge, and experience may practice
  in a field of medicine or surgery, or other
  specifically defined field. Such practice is also
  governed by requirements for continuing education
  and professional accountability

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Assumptions

• The purpose of regulation, public protection,
  should have top priority in scope of practice
  decisions, rather than professional self-interest.

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Assumptions

• Changes in scope of practice are inherent in
  our current healthcare system.

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Assumptions

• Collaboration between healthcare providers
  should be the professional norm.

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Assumptions

• Overlap among professions is necessary.

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Assumptions

• Practice acts should require licensees to
  demonstrate that they have the requisite
  training and competence to provide a service

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Basis for Decisions to Changes in Scope of
Practice

• Historical
• Education Training
• Evidence
• Regulatory Environment

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Collaboration and Cooperation
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Questions

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