Missouri Nurse Winter 2022/2023

The Regulatory Reduction bill has lots of support to move forward during the 2023 session in Missouri. For example, the Better Access, Better Care Coalition has formed to improve the health of Missourians by increasing access to care, reducing costs, maintaining quality, and modernizing regulations. The Better Access, Better Care Coalition consists of the organizations across the state of Missouri that have agreed to support the Regulatory Reduction bill. Additionally, in 2020, the governor of Missouri temporarily allowed the Department of Health and Senior Services (DHSS) and the Department of Commerce and Insurance (DCI) to waive regulations requiring nurse practitioners to practice with a collaborating physician continuously

present for at least a one-month period before practicing in a setting where the collaborating physician is not continuously present. The governor also approved a temporary waiver of the requirement that the collaborating physician, or any other physician designated in the collaborative practice arrangement, review the advanced practice registered nurse’s delivery of health care services through a review of a minimum of 10 percent of the charts every 14 days. These waivers lasted until December 2021. No legal issues related to care provided by nurse practitioners were reported during this reduction in unnecessary oversight of nurse practitioners. Moving forward, it is vital that regulatory restrictions in Missouri

are removed, so nurse practitioners can practice to the full extent of their education and training to improve access and quality of care for Missouri residents, especially those in underserved communities. COVID-19 demonstrated the impact of reducing regulatory restrictions and the benefits of granting full practice authority to nurse practitioners within Missouri. Instead of regressing to pre COVID outdated restrictions, state policymakers should support Senator Nick Schroer and continue the momentum created by the pandemic to permanently eliminate regulatory

barriers for nurse practitioners and improve access to care for Missourians.

References

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American Association of Nurse Practitioners. (2022a). Issues at a glance: Full Practice Authority . American Association of Nurse Practitioners. Retrieved September 5, 2022, from https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief

American Association of Nurse Practitioners. (2022b). State practice environment . American Association of Nurse Practitioners. Retrieved September 5, 2022, from https://www.aanp.org/advocacy/state/state-practice-environment.

Buerhaus, P., Perloff, J., Clarke, S., O’Reilly-Jacob, M., Zolotusky, G., & DesRoches, C. M. (2018). Quality of primary care provided to Medicare beneficiaries by nurse practitioners and physicians. Medical Care, 56(6) , 484-490.

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DePriest, K., D’Aoust, R., Samuel, L., Commodore-Mensah, Y., Hanson, G., & Slade, E. P. (2020). Nurse practitioners’ workforce outcomes under implementation of Full Practice Authority. Nursing Outlook, 68 (4), 459–467. doi.org/10.1016/j.outlook.2020.05.008

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Missouri Division of Professional Registration. (2022). Board of Nursing . Missouri Department of Professional Registration. Retrieved September 3, 2022, from https://pr.mo.gov/nursing-advanced-practice-nursing-collaborative.asp

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Rantz, M., Vogelsmeier, A., Popejoy, L., Canada, K., Galambos, C., Crecelius, C., & Alexander, G. L. (2021). Financial and work-flow benefits of reducing avoidable hospitalizations of nursing home residents. The Journal of Nutrition, Health & Aging, 25 (8), 971–978. doi.org/10.1007/s12603-021-1650-2

Traczynski J, & Udalova V (2018). Nurse practitioner independence, health care utilization, and health out comes. Journal of Health Economics, 58 , 90–109, doi: 10.1016/j.jhealeco.2018.01.001.

Venhuizen T, & Pritchard K (2017). Gov. Daugaard Signs Nurse Practitioner Bill. Retrieved from: https://news.sd.gov/newsitem.aspx?id=21534

Xue Y, Kannan V, Greener E, Smith JA, Brasch J, Johnson BA, & Spetz J (2018). Full scope-of-practice regulation is associated with higher supply of nurse practitioners in rural and primary care health professional shortage counties. Journal of Nursing Regulation, 8 (4), 5–13, doi: 10.1016/S2155-8256(17)30176-X.

24 | The Missouri Nurse :: Winter 2022/2023

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