Overview of Scope of Practice Initiatives Sheila Abood American Nurses Association
Mar 27, 2015
Overview of Scope
of Practice Initiatives
Sheila AboodAmerican Nurses Association
Scope of Practice Issue Defines each health care providers lawful
sphere of activity Historical context Multiple stakeholders Frequent target of organized medicine Recurring complex issue
Federation of State Medical Boards “Assessing Scope of Practice in Health
Care Delivery: Critical Questions in Assuring Public Access and Safety” (2005)
Questions related to Scope Expansion Resource for Legislators and Regulators Medicine defining scope of health care
providers
AMA Environment
What did the AMA members want? Involvement Advocacy Communication
AMA Priority Issues
Medicare Physician Fee Reform Pay for Performance Medical Liability Reform Medicare Reform Expanding Coverage for the Uninsured Disaster Preparedness
Scope of Practice Partnership What is it doing? Provides financial or in kind support to federation
members facing significant scope of practice issues.
Funds studies: • To determine whether allied health professionals truly fill
health care voids in rural and other underserved areas.• To closely examine the education and training of allied
health professionals and provide this information as a point of comparison for legislators.
Scope of Practice Partnership Serves as an information and advocacy
clearing house for the Federation on scope of practice issues
AMA houses and staffs the partnership and provides a basic level of support
Additional support comes from state and specialty medical societies.
Scope of Practice Partnership Each initiative be it a state-specific concern or a
research study will be considered by the partnership on a case by case basis.
An Executive Committee: • Reviews the issues• Assists in prioritizing scope of practice concerns• Ensures adherence to anti-trust laws• Focuses on maintaining the highest level of cooperation,
coordination, and consensus between Federation members.
Scope of Practice Steering Committee Founding Members Six State Medical Associations
• Massachusetts • New Mexico• Maine• Texas• Colorado• California Now at least 26 state medical associations
Scope of Practice Partnership Six Medical Specialty Organizations
• American Society of Anesthesiologists• American Society of Plastic Surgeons • American Psychiatric Association• American Academy of Orthopedic Surgeons • American Academy of Ophthalmology• American Academy of Otolaryngology-Head
and Neck Surgery.
Scope of Practice Partnership Targeted Groups
Everyone who threatens reimbursement.Medicine Scope of Practice encompasses everything. Medical Specialty Organizations have their own targets.
2005 Texas Resolution 814
Where did it come from? What problem is it trying to address?
2006 Texas Resolution 814 Resolve to study the qualifications, education,
academic requirements, licensure, certification, independent governance, ethical standards, disciplinary processes, and peer review of limited licensure health care providers and limited independent practitioners
Fiscal note- $171,975 Progress report back by June 2006 AMA HOD
2006 American Association of Anesthesiologists Resolution 902 AMA policy that state medical boards shall have
full authority to regulate the practice of medicine by all persons within a state not withstanding claims to the contrary by boards of nursing, mid-level practitioners or other entities (New HOD Policy);
AMA, through the Scope of Practice Partnership, work jointly with state medical boards to assist law enforcement authorities in the prosecution of unlicensed medical practice by limited or mid-level practitioners (Directive to Take Action)
2006 American Association of Anesthesiologists Resolution 902 AMA, through the Scope of Practice Partnership,
immediately embark on a campaign to identify and have elected or appointed to state medical boards physicians (MDs or DOs) who are committed to asserting and exercising their full authority to regulate the practice of medicine by all persons within a state notwithstanding efforts by boards of nursing or other entities that seek to unilaterally redefine their scope of practice into areas that are true medical practice. (Directive to Take Action)
Scope of Practice Partnership How this is playing out……in the states?
Patients First Campaign in Texas Bypassing the Legislature
AMA Scope of Practice Partnership: State Legislation
Legislation introduced in over 30 states attacking SOP of more than 20 health professions: Licensure/Certification/Credentialing General prescriptive authority Authority to prescribe controlled substances Opposition to expanding Scope or Authority Inclusion in health insurance panels
AMA Scope of Practice Partnership: Federal Legislation
Healthcare Truth and Transparency Act seeks to outlaw any act, speech, or practice
conducted by a licensed health care provider who is not a MD, DO, DDS, or DDM that leads patients or the public to believe that the health care practitioner has the same or equivalent education, skills, or training as a physician or dentist
would bring these activities under the purview of the Federal Trade Commission which would be granted the ability to fine health care practitioners up to $10,000 per violation
Introduced in 109th Congress, what’s in store for 110th?
Coalition for Patients’ Rights
Organized by ANA in 2006 Comprised of over 34 associations
representing more than 3 million licensed health care providers
Joint statement released June 2006 “The erroneous assumption that physician organizations should determine what is best for other licensed healthcare professionals is an outdated line of thinking that does not serve today's patients.”
www.patientsrightscoalition.org
Coalition for Patients’ Rights
Coalition for Patients’ Rights
Development of a positive and consistent message and strategy appropriately framed for the targeted audience.
One message or multiple messages?
Coalition for Patients’ Rights
Potential Audiences Nurses Consumers/Patients All Media Payers Employers Business Community Physicians Legislators/Regulators Other Health Care Providers
Coalition for Patients’ Rights
To ensure that patients have access to quality healthcare provided by the full range of licensed health professionals of their choice.
Provider Responsibilities
Know your scope of practice and personal competence.
Be aware of state regulations governing practice.
Stay informed about proposed changes to scope of practice.
Be knowledgeable about employer policy and procedures- They may limit scope but never exceed it.