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Another state grants NP independence NY


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https://thefacts.com/ap/business/article_390a55dd-9457-5ae9-9209-8e7084a85094.html

 

 

AUSTIN, Texas, April 11, 2022 /PRNewswire/ -- When New York Gov. Kathy Hochul signed the state budget into law, it secured improved health care access for residents in the state. New York joins 24 other states, the District of Columbia and two U.S. territories in adopting Full Practice Authority (FPA) legislation. The legislative action enables nurse practitioners (NPs) to provide the full scope of services they are educated and clinically trained to provide. The American Association of Nurse Practitioners® (AANP) commends Gov. Hochul and the New York Legislature for modernizing nursing licensure law and positioning New York for a healthier future.

"New York has taken a critical step forward in our country, increasing access to vital health care services. New Yorkers will now have full and direct access to the comprehensive care NPs provide," said April N. Kapu, DNP, APRN, ACNP- BC, FAANP, FCCM, FAAN, president of AANP. "Over the past two years, New York has waived unnecessary and outdated laws limiting access to health care. AANP applauds the state legislature and Gov. Hochul for recognizing that these provisions need to continue. These changes will help New York attract and retain nurse practitioners and provide New Yorkers better access to quality care," said Kapu.

 

FPA is the authorization of NPs to evaluate patients; diagnose, order and interpret diagnostic tests; initiate and manage treatments; and prescribe medications, all under the exclusive licensure authority of the state board of nursing. This framework eliminates unnecessary, outdated regulatory barriers that prevent patients from accessing these vital care services directly from NPs. Leading health policy experts like the National Academy of Medicine have long recommended that states adopt such legislation to improve health care access and outcomes.

"As the 25th state with Full Practice Authority, New York joins an expanding list of states acting to retire outdated laws that have needlessly constrained their health care workforce and limited patient access to care," said Jon Fanning, MS, CAE, CNED, chief executive officer of AANP. "This is a no-cost, no-delay solution to strengthening health care for the nation. Decades of research show that states with Full Practice Authority are better positioned to improve access to care, grow their workforce and address health care disparities, while delivering quality health outcomes for patients. We look forward to more states following suit."

NPs deliver high-quality health care in more than 1 billion patient visits each year. As of April 2022, there are more than 355,000 licensed NPs in the U.S. providing care in communities of all sizes across the nation. Recently, U.S. News and World Report ranked the NP role first on its 2022 Best Health Care Jobs list.

 

The American Association of Nurse Practitioners® (AANP) is the largest professional membership organization for nurse practitioners (NPs) of all specialties. It represents the interests of the more than 355,000 licensed NPs in the U.S. AANP provides legislative leadership at the local, state and national levels, advancing health policy; promoting excellence in practice, education and research; and establishing standards that best serve NPs' patients and other health care consumers. To locate an NP in your community, visit npfinder.com. For more information about NPs, visit aanp.org.

SOURCE American Association of Nurse Practitioners

 

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The most interesting thing in this article, which I suspect is a gross misrepresentation of the facts, willfully is that that is over a billion visits by NP per year.  This means that each and every NP would need to be seeing 55 patients a day for every week of the year.  I have seen many many admin type RN with NP behind their names that do not ever touch a patient, and then TNTC new grads that have never worked as an NP.   

 

Seems like the misrepresentations just keep growing.

 

 

I am happy for the NP and hope that some day PA are afforded the same flexibility and professional responsibility.

 

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I knew NPs in the VA were LIPs but today I found out that, because they are LIPs, they are required to carry the same patient panel numbers as a physician. Guess who is going to be the VAs preferred provider? The one who has to be supervised and carries 75% of a physicians panel or the one who carries 100% and does the work for about half of what a physician gets paid?

 

 

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1 hour ago, sas5814 said:

I knew NPs in the VA were LIPs but today I found out that, because they are LIPs, they are required to carry the same patient panel numbers as a physician. Guess who is going to be the VAs preferred provider? The one who has to be supervised and carries 75% of a physicians panel or the one who carries 100% and does the work for about half of what a physician gets paid?

 

 

unless the VA drastically under works their MD/DO this will cause complete failure/burnout for most NPs

It is only with a varied background and 20 years of experience that I can keep up with the docs in productivity. No way no how can a NP <5 years and likely < 10 years even come close to a doc and provide good care.  The extra hand holding time and implementation of "advanced nursing theory" takes time and they don't have any of the that...

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1 hour ago, ventana said:

unless the VA drastically under works their MD/DO this will cause complete failure/burnout for most NPs

It is only with a varied background and 20 years of experience that I can keep up with the docs in productivity. No way no how can a NP <5 years and likely < 10 years even come close to a doc and provide good care.  The extra hand holding time and implementation of "advanced nursing theory" takes time and they don't have any of the that...

but now you are thinking long term and practically. That won't work here...

you have to think of how much money you are saving by having a new grad NP carry the exact same pt load as the medical director! What a brilliant money saving plan!

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my local CBOC and local hospital have literally no idea about things like this

As a 20 yr PA I have been trying to get hired by VA about 15 years.  They always had "someone out of the area" they hired, or a new grad that they paid for schooling that they had to hire.  What it has turned into is a revolving door for providers.  12-24 months and another one bites the dust.  That means every 1-4 visits you have a brand new provider.  I finally gave up and will not be applying again.   So sad..... Veteran of the USAF, carrying a disability rating, firewall 5's on almost all my reviews, amazing references, DFAAPA, not a single smudge on my record yet they don't even consider me as the local candidate.    Yup they are not overly well run.....

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Unfortunately this is a win, win for NP again... Now how much longer for the state of CA to have NP with full practice independence ?  Now guess who will be hired and who don't . The PA profession will be dying slowly but surely. It is not our fault, the NP career was created to take over our jobs and because of their strong board they perfection our profession with the full practice autonomy, which is the key for us to be in the same position, but it is Not going to happen for us because we are Assistants. I am worry because I am in the middle of my profession and very uncertain of what is in the horizon for us PA's...

still, I am in complete disagreement to  give NP full medical independent practice , because they are NOT Doctors and I can expect to see lots of medical malpractice in the near future , I hope they are prepare for that. 

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1 hour ago, Rose66 said:

Unfortunately this is a win, win for NP again... Now how much longer for the state of CA to have NP with full practice independence ?  Now guess who will be hired and who don't . The PA profession will be dying slowly but surely. It is not our fault, the NP career was created to take over our jobs and because of their strong board they perfection our profession with the full practice autonomy, which is the key for us to be in the same position, but it is Not going to happen for us because we are Assistants. I am worry because I am in the middle of my profession and very uncertain of what is in the horizon for us PA's...

still, I am in complete disagreement to  give NP full medical independent practice , because they are NOT Doctors and I can expect to see lots of medical malpractice in the near future , I hope they are prepare for that. 

CA did pass independence for NPs effective 2023

I see PAs commenting that they don’t agree with NPs independence.. literally nobody cares 

NPs have had independence forever.. there’s no more lawsuits for them; in fact they have much lower malpractice premiums than PAs (who mind you also need med malpractice for their SP)

 

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13 hours ago, iconic said:

CA did pass independence for NPs effective 2023

I see PAs commenting that they don’t agree with NPs independence.. literally nobody cares 

NPs have had independence forever.. there’s no more lawsuits for them; in fact they have much lower malpractice premiums than PAs (who mind you also need med malpractice for their SP)

 

I can see this changing 

as they establish their “independence” they will get sued more (old folks no but new grads are dangerous).  Free market will figure it out.  Problem is that they are likely to drag us down too.  

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Any idea if the NYSSPA is going to do anything about this? The state has been operating (pretty much the entire time) without a supervision requirement since the pandemic started. I imagine, like elsewhere, this has been done safely. This unique situation has continued with two different governors. NY is a big state with thousands of PAs. Right now, the provision is just extended on a monthly basis. Time to make it permanent. I'm getting tired of the "we don't want independence" argument. Look at how our PA colleagues in Maine, North Dakota, Utah, etc did it, some with varying levels of collaboration/independence. We can play graba$$ all day and bash the NPs, their education, rotation experience, etc. Nevertheless, they have the backbone to get things done and not worry about pissing off others. Whatever changes we make will infuriate someone; that's life. The future depends on job availability. Personally, I'll be looking at states that actually have a good practice environment and not stuck in the past. NY, time to move forward.

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4 hours ago, sas5814 said:

This profession is dead. It just hasn't figured out where to lay down.

I lay this at the feet of our leadership for the last 2o years and, in particular, the AAPA HOD which has its collective head so far up its butt it couldn't begin to see the future.

I would say the last 2 years at least the BOD has tried with all their might. I lay this squarely at the feet of the state elected AAPA HOD of the last 20 years, but especially the last 5.

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15 minutes ago, dream2pa said:

 I know one NP who will start lecturing in medical school in California . Where do we stand ? Still attached to SPs by their umbilical cord . 

Lots of PAs teach med students and residents as well. This isn't as big a deal as it sounds like. 

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