Bill Summary for Bill Number SB15-197

Date: 04/02/2015

Final
BILL SUMMARY for SB15-197

HOUSE COMMITTEE ON HEALTH, INSURANCE, & ENVIRONMENT

Votes: View-->	Action Taken:
Refer Senate Bill 15-197 to the Committee of the W	PASS

02:33 PM -- SB 15-197

Representative Willet and Representative Fields presented Senate Bill 15-197. The bill makes several changes regarding the prescriptive authority of advanced practice nurses (APNs). Specifically, the bill:

• eliminates the 1,800 hours of preceptorship required for an APN to achieve provisional prescriptive authority and instead allows an APN to gain provisional prescriptive authority upon graduation and passage of the certification examination;
• reduces the hours of the prescribing mentorship required for an APN to gain full prescriptive authority from 1,800 hours to 1,000 hours;
• allows an APN to complete a prescribing mentorship under the supervision of an APN with full prescriptive authority in his or her same area of practice;
• allows an APN to communicate with his or her mentor remotely in real time, although email is excluded from the allowable forms of communication; and
• specifies that provisional prescriptive authority expires after three years if a mentorship is not completed.

The bill sponsors showed a video of a news story concerning APNs.

02:43 PM -- Dr. Jana Faragher, representing herself, testified remotely in support of the bill. She discussed being a nurse practitioner in a rural community. Dr. Faragher answered questions about her education, her practice, the bill, and her ability to obtain prescriptive authority.

02:54 PM -- Barbara Kelley, Department of Regulatory Agencies, testified in support of the bill. She discussed the Nurse Physician Advisory Task Force for Colorado Healthcare (NPATCH) review of the current requirements for APNs to obtain prescriptive authority. Director Kelley answered questions about the current requirements for an APN to obtain full prescriptive authority.

03:00 PM -- Douglas Warnecke, NPATCH, testified in support of the bill. He discussed the process utilized in preparing the NPATCH's Final Report and Recommendations on the Requirements for Advanced Practice Registered Nurses Seeking Prescriptive Authority dated November 10, 2014.

03:01 PM -- Dr. Sue Townsend, NPATCH, testified in support of the bill. She discussed how the current requirements for APNs to obtain prescriptive authority were established and how the proposed requirements in bill were determined.

03:04 PM

Mr. Warnecke answered questions about the bill. In response to a question, Mr. Warnecke and Dr. Townsend discussed the difficulties of finding preceptors in rural areas. Dr. Townsend and Mr. Warnecke answered questions about the Senate amendments to the bill.

03:10 PM -- Dr. Amy Silva-Smith, representing the University of Colorado system, testified in support of the bill. She discussed the educational process for nurses to become APNs and the access to care that APNs provide.

03:16 PM -- Dr. Margaret Hughes, AARP, testified in support of the bill. She discussed the shortage of primary care practitioners and the current requirements for APNs to obtain full prescriptive authority.

03:21 PM -- Aubrey Hill, Colorado Coalition for the Medically Underserved, testified in support of the bill. She discussed the limited access to health care in certain parts of Colorado.

03:24 PM -- Dr. Barry Martin, Colorado Community Health Network, testified in support of the bill. He discussed his experience working with APNs. Representative Fields discussed Dr. Martin's work in Aurora.

03:28 PM -- Dr. Mary Ciambelli, Colorado Nurses Association, testified in support of the bill. She discussed how the bill will help remove barriers for APNs from obtaining prescriptive authority. Dr. Ciambelli answered questions about how the bill will help increase the health care workforce in Colorado.

03:33 PM -- Jacob Weinstein, representing himself, testified in support of the bill. He discussed his educational and professional experience. He shared his personal experience of not being able to find employment without prescriptive authority and how he cannot obtain prescriptive authority without employment. He discussed the other states that allow independent prescriptive authority for APNs.

03:38 PM -- Molly Harris, representing herself, testified in support of the bill. She discussed her educational and professional experience in nursing. She discussed the primary care providers shortage and the difficulties for APNs to find employment in Colorado. She referenced a 2010 Colorado Health Institute study focusing on APNs.

03:43 PM -- Lee Anne Merrifield, Colorado Behavioral Healthcare Council, testified in support of the bill. She relayed statistics about providing care to people with mental health needs. She stated that APNs are leaving the state or not coming to Colorado due to the current requirements.

03:47 PM -- Charlotte Yanakopolous-Veath, Colorado Behavioral Healthcare Council, testified in support of the bill. She discussed the costs to health care organizations caused by the current 3,600 hour requirement for an APN to obtain full prescriptive authority. She discussed the health care workforce shortage.

03:52 PM -- Beccy Finn, representing herself, testified in support of the bill. She stated the bill does not change the scope of practice for APNs. She shared her professional and educational experience as a nurse working to obtaining her APN degree.

03:56 PM -- Heather Dunham, representing herself, testified in support of the bill.

03:57 PM -- Melissa Bosworth, Colorado Rural Health Center, testified in support of the bill. She provided two handouts (Attachments A and B) to the committee members. She discussed the Colorado Provider Recruitment Program, which focuses on expanding the primary care workforce throughout Colorado's rural communities, and shared statistics about rural health care providers.

150402 AttachA.pdf

150402 AttachB.pdf

04:00 PM -- Kelly Gallegos, San Luis Valley Health, testified in support of the bill. She discussed the difficulties in recruiting APNs due to the current prescriptive authority requirements.

04:03 PM -- Denise Clark, Mt. San Rafael Hospital, testified in support of the bill. She discussed how the bill will allow APNs to mentor APNs. She relayed health statistics about Las Animas County. She discussed APNs leaving the state after receiving their education and training in Colorado. Representative Joshi discussed being a preceptor.

04:09 PM -- Deanna Tolman, ClinicNet, testified in support of the bill. She shared her experience operating a health clinic. Ms. Tolman answered questions about the training for nurses related to prescribing authority.

04:14 PM -- Gail Finley, Colorado Hospital Association, testified in support of the bill.

04:15 PM -- Candace Deyerling, representing herself, testified in support of the bill.

04:16 PM -- Dr. Shawn Elliott, representing herself, testified in support of the bill. She explained that she works as a part-time pediatric nurse practitioner in Alamosa, averaging eight hours a week. She noted that at this rate, it would take her seven years to obtain prescriptive authority under the current statutes.

04:20 PM -- Lauren Larson, Department of Regulatory Agencies, testified in support of the bill. She discussed the data in the handout comparing disciplinary actions in other states against APNs with independent prescriptive authority (Attachment C).

150402 AttachC.pdf

04:22 PM

Representative Fields described the process leading to the bill. Committee members commented on the bill.


BILL:	SB15-197
TIME:	04:28:13 PM
MOVED:	Landgraf
MOTION:	Refer Senate Bill 15-197 to the Committee of the Whole. The motion passed on a vote of 13-0.
SECONDED:	Sias
		VOTE
	Brown	Yes
	Esgar	Yes
	Humphrey	Yes
	Joshi	Yes
	Landgraf	Yes
	Lontine	Yes
	Mitsch Bush	Yes
	Primavera	Yes
	Ransom	Yes
	Ryden	Yes
	Sias	Yes
	Ginal	Yes
	McCann	Yes

Final YES: 13 NO: 0 EXC: 0 ABS: 0 FINAL ACTION: PASS

04:29 PM

The committee recessed.