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House of Representatives
Session of 2013 - 2014 Regular Session


Posted: March 1, 2013 03:04 PM
From: Representative Stephen Barrar
To: All House members
Subject: Removal of current barriers to practice and patient care for the Clinical Nurse Specialist
In the near future I plan on introducing a piece of legislation that will remove current barriers to practice and patient care for the Clinical Nurse Specialist. Currently, out dated nurse practice legislation in the Commonwealth places unnecessary barriers on Clinical Nurse Specialists (CNS), which impacts healthcare consumers on numerous levels. A CNS is a registered nurse who has completed an accredited graduate-level or doctoral educational program preparing them for practice and who has also passed a certification exam and are licensed by the State Board of Nursing. CNS’ are classified at a national level as an Advanced Practice Registered Nurse (APRN). APRNs are educationally prepared to assume responsibility and accountability for health promotion and maintenance, as well as assessment, diagnosis, and management of patient problems that include pharmacological and non-pharmacological interventions and should be permitted under state law to practice to the fullest extent of one’s education and clinical preparation.

Currently, 21 states in the nation allow the Clinical Nurse Specialist to practice independently, taking seriously the national recommendations of numerous healthcare affiliated organizations such as the Institute of Medicine (IOM), the American Association of Retired Persons (AARP), the National Council of State Boards of nursing (NCSBN), and the National Governor’s Association (NGA).

APRNs are a unique group of healthcare providers who tend to practice in more rural areas, thus serving the underserved, underinsured and uninsured populations of the Commonwealth. Currently, 22% of our state’s population lives in a federally designated healthcare provider shortage area. Of the 4,761 advanced practice nurses in the Commonwealth, approximately 21% practice in rural settings; however, these APRNs face many barriers to providing care to populations due to restrictive practice laws. It is essential to allow APRNs to practice to the fullest extent of their education in order to provide safe, accessible and cost effective care to the healthcare consumers in the commonwealth.

This legislation addresses these concerns by removing the restrictive practice barriers for Clinical Nurse Specialists and is consistent with nation-wide efforts to remove restrictive practice laws placed upon APRNs.

This legislation is supported by the Pennsylvania State Nurses Association.

Introduced as HB1457