Our APRN State of Consensus 48 endorsing nursing organizations55 states and jurisdictions252,000 APRNs

The Campaign for APRN Consensus is 71% of the way towards our goal!

The education and oversight of APRNsMaterials that assist in evaluating an individual’s care Individual training and preparationCase logs/Practice Profiles/Peer Review Graduate education in a role and populationPerformance Indicators/quality measures National advanced certification in a role and populationNPDB Specialty training and certification State Prescription database Maintenance of certificationsPatient Satisfaction Professional development &FPPE/OPPE [TJC] Continuing educationIncident reports Professional SocietiesComplaints /claims Evidence based careAwards Outcomes analysis Board oversight Professional PortfolioPerformance Review

Public Regulation, Public Protection Access

Licensure Accreditation

Certification Education

CNP

CNSCNM

CRNA

Not all APRNs are regulated by Boards of Nursing

• Nebraska has an APRN Board• Boards of Nursing may be under umbrella

Boards• Some BONs are under a Board of Health or

Board of Medicine or some APRN roles are regulated or co-regulated by a BOH or BOME

titlero

le

license

education

certi

fication

practice

prescribing

0102030405060708090

100

% with all points without

APRN Major Elements of Consensus by 2015All four roles…

titlero

le

license

education

certi

fication

practice

prescribing

0102030405060708090

100

% with any points without

APRN Major Elements of Consensus by 2015Points for any role…

Title: APRNClinical nurse specialist

Certified nurse practitionerCertified nurse midwife

Certified registered nurse anesthetist

What is in a name?

APRN Title

43210

18

352

New Map Points in Areas other than Practice and Prescribing Autonomy

Who needs to get this done?

Title AL, AK, AS, CO, DE,FL, IL, IN, IA,MI, NH (CNS), NJ, NY, NC, OR, PA, SD, TN, VA, WA, WI

Roles AS (CNS), FL (CNS) , IN (CRNA), MS (CNS), NH (CNS), NY (CRNA), PA (CNM, CRNA), VA (CNS), WA (CNS)

Education CA (CRNA), IN (CNP), NH (CNS), NY (CRNA, CNS), PA (CRNA, CNM), SD (CRNA), WA (CNS)

Certification CA (CNS, CNM, CNP), IN (CNP, CNS), KS, MS (CNS), NH (CNS), NY (CRNA, CNS, CNP), PA (CNM, CRNA), WA (CNS),

Licensure AL, AK, AZ, CA, CO, DC, FL, GA, IN, MD, MA, MI, MS, MO, NH (CNS), NJ, NY (CRNA,CNS), NC, OH, PA, TN, VA (CNS), WA (CNS), WY

APRN Roles:Clinical nurse specialist

Certified nurse practitionerCertified nurse midwife

Certified registered nurse anesthetist

Roles Recognition

four threetwoonenone

48

61

License RN + APRNLevels of regulatory statusCertificationRecognitionLicensure

2nd License

43210

16

30

1 1

7

RN + APRN License

Education

Completion of graduate level or post graduate level education in an APRN role

Education

43210

50

48

2

CertificationNational, advanced certification in a role and population that includes wellness content and embeds gerontology content in the adult roles

Points for Role Certification

43210

1

2

4

46

21

Let’s talk for just a moment about the concept of ‘grandfathering’

Two categories have to be thought about:–Those who are presently licensed in

the state–Those who may wish to endorse into a

new state.

Autonomous Practice

No written requirement for supervision or collaboration or other encumbrance

Points for Autonomous Practice

43210

1

21 18

46 6

Points for Independent PrescribingPoints

43210

30 17

323

IOMFTC

AMA

AAFPASA

Medical

societiesCMS

NGA

AARP

RWJ

Economists

APRNMGMA

The American Academy of Family Physicians

The 2014 Legislative Season

• The focus of APRN supportive bills;Licensure, TitleIndependent practiceIndependent prescribingExpanded functionality in rolesReimbursement

The 2014 Legislative SeasonFederal bills that may pertain to APRNs

• VA APRN• Military• Homecare/primary care• Tele-health and tele-med• Other provider autonomy

New Map Points

2011 2012 2013 2014

Title KS, OK ID, KY, TN, WV AR, AZ, MI, RI IA, KS, PA, FL

Roles IN, OK, VT MD, SC, WV IN, MI, MS, NY, OH, RI

AK**, KS, MN, NY, WA

Education VT WV ID MN, PA, WV

Certification KS, NV, OK, VT WV ID, MN, NY KS, MN, NY, PA

Licensure KS, OK IA, ID, MO, WV HI, MI. MN, MO

HI, IA, KS, MS, NY, SD

Practice autonomy

FL, IA, IL CA, KY, IA, LA, MA, WA

AR, CA, CT, FL, IL, MD, MI, MN, MO, MS,NE, NJ, NV, NY, OH, OR, RI, TX, WV

CT, FL, KS, MA, MI, MN, MO, MS, NE, NY, PA

Prescriptive authority

FL, HI, IL, MA, ND, WA

AL, FL, ID, KY, MA, MO, ND, OH

AL,* AR, CT. IL. KY. MI, MN, MO, MS, NE, NJ, NV, NY, OR, TX, WV

CT, FL, KS, KY, MN, MO, NE, NJ, NY, OK, PA, UT, WI

New Map Points in Areas other than Practice and Prescribing Autonomy

Who needs to get this done?

Title AL, AK, AS, CO, DE,FL, IL, IN, IA,MI, NH (CNS), NJ, NY, NC, OR, PA, SD, TN, VA, WA, WI

Roles AK (CNS) , AS (CNS), FL (CNS) , IN (CRNA), MS (CNS), NH (CNS), NY (CRNA), PA (CNM, CRNA), VA (CNS), WA (CNS)

Education AK (CNS), CA (CRNA), IN (CNP), NH (CNS), NY (CRNA, CNS), PA (CRNA, CNM), SD (CRNA), WA (CNS)

Certification AK (CNS), CA (CNS, CNM, CNP), IN (CNP, CNS), KS, MS (CNS), NH (CNS), NY (CRNA, CNS, CNP), PA (CNM, CRNA), WA (CNS),

LicensureAL, AK, AZ, CA, CO, DC, FL, GA, IN, MD, MA, MI, MS, MO, NH (CNS), NJ, NY (CRNA,CNS), NC, OH, PA, TN, VA (CNS), WA (CNS), WY

APRN Legislative Efforts

What haven’t we attempted that maybe we should?

“The future is going to be different in healthcare. But how soon is that

future going to get here? That is the only question”

Mark McClellan, to RWJ/AARP September 17, 2014