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Why Nurses and Other Health Care Practitioners Oppose HB 699 / SB 1216

HB 699 (by Rep. Negron) and SB 1216 (by Sen. Peaden) would grant sweeping new powers to the Board of Medicine and Board of Osteopathic Medicine to regulate the practice of all health care practitioners in all practice settings, including hospitals, nursing homes, ambulatory surgery centers, rehabilitation facilities, health departments, clinics and offices.  The bills require the Board of Medicine and Board of Osteopathic to adopt rules on how any “licensed health care practitioner” must be supervised whenever they are not working under the direct, on-site supervision of an MD or DO.

Who does the bill apply to?  Section 456.001(4), Florida Statutes, defines “health care practitioner” to include:

• Acupuncturists (Chapter 457)
• Physician Assistants (Chapters 458 & 459)
• Chiropractors (Chapter 460)
• Podiatrists (Chapter 461)
• Naturopaths (Chapter 462)
• Optometrists (Chapter 463)
• Registered Nurses (Chapter 464)
• Licensed Practical Nurses (Chapter 464)
• Advanced Registered Nurse Practitioners (Chapter 464)
• Certified Registered Nurse Anesthetists (Chapter 464)
• Certified Nurse Midwives (Chapter 464)
• Pharmacists (Chapter 465)
• Dentists (Chapter 466)
• Speech Pathologists (Chapter 468, Part I)
• Nursing Home Administrators (Chapter 468, Part II)
• Occupational Therapists (Chapter 468, Part III)
• Respiratory Therapists (Chapter 468, Part V)
• Dieticians and Nutritionists (Chapter 468, Part X)
• Athletic Trainers (Chapter 468, Part XIII)
• Electrologists (Chapter 478)
• Massage Therapists (Chapter 480)
• Clinical Laboratory Personnel (Chapter 483, Part III)
• Medical Physicists (Chapter 483, Part IV)
• Physical Therapists (Chapter 486)
• Psychologists (Chapter 490)
• Marriage and Family Therapists (Chapter 491)
• Mental Health Counselors (Chapter 491)
• Clinical Social Workers (Chapter 491)

ALL THE ABOVE HEALTH CARE PRACTITIONERS COULD BE IMPACTED BY THIS LEGISLATION IF THEY PROVIDE SERVICES WITHOUT DIRECT, ON-SITE SUPERVISION OF AN M.D. OR D.O.

This legislation is not needed!   There is no compelling evidence to show that the way licensed health care practitioners now practice is causing harm to patients or other problems.  Each licensed practitioner has a licensing board that ensures licensees practice within the parameters established by the legislature, and takes disciplinary action against those who do not.

In the case of advanced registered nurse practitioners (ARNPs – including Nurse Practitioners, Certified Registered Nurse Anesthetists and Certified Nurse Midwives), there already exists a Joint Committee of the Boards of Nursing and Medicine.  The Joint Committee sets standards for protocols and supervision of ARNPs.  HB 699 and SB 1216 would allow the medical boards to override the policies of the Joint Committee, and set their own supervision requirements.  Current law provides for input from both physicians and nurses on the Joint Committee.  It does not make sense to give the power to determine how ARNPs are supervised to the medical boards alone, where nurses are not represented.

This bill is not about patient safety, it is all about the power of organized medicine.  Most health care facilities rely on a wide range of licensed health care practitioners to provide reliable, affordable and safe medical services, because it is not feasible for every patient in Florida to see a MD or DO physician for every medical problem.  Numerous studies have shown that the care provided by nurses and other non-physician providers is safe, effective and economical. There is no reason to allow the medical boards to control or limit the services now provided by other practitioners.

This legislation will restrict access to health care and drive up health care costs across the state.  It will limit treatment options for patients who reside in areas where non-physician health care practitioners now provide critically needed health care services.

According to the bills, the rules of the medical boards “must include, but need not be limited to” the following:

• the percentage of time the supervising physician spends directly supervising the licensed health care practitioners;
• standards for adequate supervision, including the distance of the licensed health care practitioner from the supervising physician;
• the number of each type of licensed health care practitioner which a supervising physician may supervise.

The rulemaking powers granted to the medical boards under HB 699 and SB 1216 would usurp the authority of the Board of Nursing, the Joint Committee and the boards of every other health care profession to regulate the practice of their own licensees.

FLORIDA DOES NOT NEED TO GIVE THE MEDICAL BOARDS MORE POWER OVER OTHER HEALTH CARE PROVIDERS.
VOTE “NO” ON HB 699 / SB 1216