OLR Bill Analysis
AN ACT CONCERNING THE GOVERNOR'S RECOMMENDATIONS TO IMPROVE ACCESS TO HEALTH CARE.
This bill allows advanced practice registered nurses (APRNs) who have been licensed in Connecticut for at least three years to practice independently without needing to collaborate with physicians. Current law requires APRNs to work in collaboration with a physician, including having a written agreement regarding the APRN's prescriptive authority.
The bill also makes technical and conforming changes.
By law, nurse anesthetists (one category of APRNs) must work under a physician's direction. Under current law, certified nurse anesthetists can prescribe and administer medication during surgery only if the physician medically directing the prescriptive activity is physically present in the facility where the surgery is taking place. It is unclear if this restriction continues to apply under the bill to such nurse anesthetists who have been licensed for three years.
EFFECTIVE DATE: July 1, 2014
APRN COLLABORATION WITH PHYSICIANS
Under the bill, the current requirement for an APRN to work in collaboration with a physician applies for the first three years after the APRN becomes licensed in the state. After that, collaboration is optional, and APRNs can practice independently. The bill also specifically permits APRNs licensed at least three years to collaborate with other licensed health care providers.
By law, collaboration is defined as a mutually agreed upon relationship between an APRN and a physician whose education, training, or relevant experience is related to the APRN's work. The collaboration must address (1) a reasonable and appropriate level of consultation and referral, (2) patient coverage in the APRN's absence, (3) methods to review patient outcomes and disclose the relationship to the patient, and (4) what schedule II and III controlled substances the APRN can prescribe. (APRNs can also prescribe schedule IV and V controlled substances.)
Public Health Committee
Joint Favorable Substitute