NU507 M1 Restrictions of roles of Nurse Pracitioners and APNs in certain states

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Purdue University Globle 

NU507 Promoting Optimal Models and Systems for Health Care Delivery

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NU507 M1 Restrictions of roles of Nurse Pracitioners and APNs in certain states

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7811 Holly Springs Road
Hernando, MS 38632

Senator Cindy Hyde-Smith
702 Hart Senate Office Building
Washington, DC 20510

Dear Senator Hyde-Smith,

I am writing to discuss the current Advanced Practice Nurse (APN) practice regulations outlined in Section 73-15-5 of the Mississippi Code of 1972 and to advocate for policy changes that would improve healthcare access throughout Mississippi. According to the current legislation, Advanced Practice Nurses are authorized to diagnose, treat, and manage medical conditions; however, they are required to practice under a collaborative relationship with a licensed physician in the state of Mississippi.

Additionally, Section 73-15-20 of the Mississippi Code of 1972 requires Advanced Practice Nurses to complete 3,600 transition-to-practice hours before becoming eligible for exemption from the physician collaboration requirement. The policy also requires APNs to notify the Mississippi Board of Nursing of any changes involving their collaborating physician. Failure to report these changes may result in restrictions on the APN’s ability to practice (Mississippi Legislature, 2020).

Need for Policy Change

Mississippi remains one of the few states in the United States that does not provide Nurse Practitioners (NPs) with full practice authority. Under the current regulations, Nurse Practitioners must maintain a collaborative agreement with a physician. This agreement requires the collaborating physician to conduct periodic chart reviews, including random audits of up to 20 patient records, and meet with the Nurse Practitioner at least once every quarter (Mississippi Center for Public Policy, 2020).

Although Nurse Practitioners may become exempt from this requirement after completing 3,600 clinical practice hours, the current restriction creates unnecessary barriers to healthcare delivery. Research has demonstrated that Nurse Practitioners provide safe, high-quality care comparable to physicians. Studies have shown that NP patient outcomes are equivalent to, and in some cases better than, those achieved by physicians (Mississippi Center for Public Policy, 2020).

NU507 M1 Restrictions of roles of Nurse Pracitioners and APNs in certain states

This issue is particularly important in Mississippi due to the state’s large rural population and healthcare access challenges. Many rural communities experience shortages of primary care providers, and low-income populations often face significant barriers to receiving timely medical care. Nurse Practitioners can help address these shortages because they provide cost-effective, high-quality healthcare services and can expand access in underserved communities.

The National Conference of State Legislatures (2011) projected a national shortage of approximately 21,000 primary care physicians by 2015. Additionally, approximately 30% of rural primary care providers were approaching retirement age, creating an increased demand for alternative healthcare providers. Rural communities require thousands of additional primary care providers to meet existing healthcare needs, and Nurse Practitioners can play an essential role in closing this gap (National Conference of State Legislatures, 2011).

Proposed Policy Change

The proposed policy change is to remove the 3,600-hour physician collaboration requirement for Nurse Practitioners in Mississippi. Eliminating this requirement would allow qualified Nurse Practitioners to practice independently after completing their education and clinical training, enabling them to provide healthcare services where they are needed most.

Granting full practice authority would allow Nurse Practitioners to diagnose, treat, prescribe medications, and manage patient care without unnecessary administrative restrictions. This change could significantly improve healthcare access, particularly in rural areas where physician shortages are most severe.

Currently, 22 states allow Nurse Practitioners to practice independently without physician supervision or mandatory collaboration agreements. These states include Alaska, Arizona, Colorado, Connecticut, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, and Wyoming (Maryville University, 2020).

Expanding Nurse Practitioner autonomy in Mississippi would align the state with evidence-based healthcare policies implemented across the country and would strengthen the healthcare workforce.

Cost Implications of the Proposed Policy Change

Removing the physician collaboration requirement could provide significant financial benefits for Mississippi’s healthcare system. Under the current policy, Nurse Practitioners are required to maintain collaborative agreements with physicians during their transition-to-practice period. These collaborating physicians must be located within a 75-mile radius of the Nurse Practitioner’s practice location and are compensated for reviewing charts, attending meetings, and providing consultation services when necessary.

The cost of physician collaboration agreements creates additional expenses that may indirectly affect healthcare organizations and patients. According to the Mississippi Center for Public Policy (2020), collaborating physicians may charge approximately $74 per day or a flat monthly fee of around $2,250.

A Nurse Practitioner working approximately 40 hours per week would require about 22 months to complete the required 3,600 transition hours. Using a monthly collaboration fee of $2,250, the total cost associated with physician collaboration could reach approximately $49,500 during this period. Eliminating this requirement could allow healthcare organizations to redirect these resources toward expanding services, hiring additional providers, and improving patient access.

Role of Nurses as Change Agents

Nurses have an essential role as healthcare advocates and change agents. Nurse Practitioners represent an advanced level of nursing practice that combines clinical expertise, leadership, and patient advocacy. By pursuing advanced education and expanding their scope of practice, Nurse Practitioners demonstrate their commitment to improving healthcare outcomes and addressing community needs.

Nurses are consistently recognized as one of the most trusted healthcare professions, making them strong advocates for patients and communities. Nurse leaders can contribute to healthcare policy changes by identifying problems, gathering evidence, participating in strategic planning, implementing solutions, and evaluating outcomes.

As a Registered Nurse and Nurse Practitioner student, I support House Bill 613, which aims to increase Nurse Practitioner autonomy and improve healthcare access throughout Mississippi. Allowing Nurse Practitioners to practice to the full extent of their education and training would strengthen the healthcare system and benefit patients across the state.

Conclusion

The shortage of physicians and healthcare providers continues to create significant challenges in Mississippi, especially within rural communities. Expanding Nurse Practitioner practice authority would provide an effective solution by increasing access to qualified healthcare professionals while maintaining quality and safety standards.

Removing the requirement for Nurse Practitioners to complete 3,600 collaborative practice hours with a physician would allow them to serve patients more efficiently and address healthcare disparities throughout the state.

Thank you for taking the time to consider this proposed policy change and its potential benefits for Mississippi residents. Increasing Nurse Practitioner autonomy has the potential to improve healthcare accessibility, reduce unnecessary costs, and strengthen healthcare delivery throughout the state.

Sincerely,

______, BSN

References

Mississippi Center for Public Policy. (2020). Expanding access to healthcare through nurse practitioner independence. https://www.mspolicy.org

Mississippi Legislature. (2020). Mississippi Code of 1972: Nursing practice laws and regulations. https://law.justia.com/codes/mississippi/

National Conference of State Legislatures. (2011). The primary care workforce: A critical challenge. https://www.ncsl.org

NU507 M1 Restrictions of roles of Nurse Pracitioners and APNs in certain states

Maryville University. (2020). States with full practice authority for nurse practitioners. https://www.maryville.edu