The American Association of Nurse Practitioners (AANP) just wrapped up its 2023 Health Policy Conference in Washington, DC, where attendees were updated on legislative issues affecting NP practice. Issues such as decreasing federal barriers to care, the APRN Compact, and the push for full practice authority were discussed. Clinical Advisor spoke with AANP President April Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, for a debriefing on the conference. 

Q: What are the key takeaways from the 2023 Health Policy Conference?

Dr Kapu: It was a power-packed few days. We had wonderful guest speakers, including several NPs working in health policy. And we were very pleased to be joined by Virginia Congresswoman Jen Kiggans, the first NP elected to Congress. The agenda kept us all up to date on what happens in DC and how legislation affecting NPs and other clinicians moves through the legislative process. Many NPs were able to meet with their members of Congress on The Hill to talk about issues that impact the patients they serve.

April Kapu AANP
AANP President Dr April Kapu

Right now, a major push is to remove barriers for patients seeking care from NPs. Outdated laws need to be modernized such as those pertaining to prescribing therapeutic shoes for patients with diabetes under Medicare programs. Currently, patients with diabetes need to be referred to a physician who can order therapeutic shoes, which can delay care. This is something that falls within NPs’ education and clinical training and by updating these laws patients will get care in a more timely manner from their chosen health care provider. Other examples are being able to order and supervise cardiac and pulmonary rehabilitation, refer patients for medical nutrition therapy, certify and recertify a patient’s terminal illness for hospice eligibility, and perform all mandatory examinations in skilled nursing facilities.

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On January 30, 2023, HR 618 the Improving Access to Workers’ Compensation for Injured Federal Workers Act was introduced in both the US Senate and House of Representatives by Senators Brown (D, Ohio) and Collins (R, Maine) and Representatives Walberg (R, Michigan) and Courtney (D, Connecticut). The bill would ensure federal workers receive access to high-quality health care for work-related injuries from their chosen health care provider.

Q: Can you update us on the development of an ARPN Compact?

Dr Kapu: The APRN Compact is not in effect and AANP, along with other state and national nursing associations, continue to work to secure revisions. There are outstanding concerns and lessons from the pandemic that need to be incorporated before an APRN Compact moves forward. Simultaneous to those discussions within the broad nursing community, we are seeing individual states take action to streamline licensure and modernize telehealth policies. Modernizing both telehealth and licensure policy are critical elements in addressing workforce and access to care issues.

Q: Why is it important for NPs to seek public office?  

Dr Kapu: NPs have a long history of public service. Many of the first NPs began their nursing careers as community and public health nurses. The skills that NPs use to obtain comprehensive assessments and create holistic management plans are transferable to public office and health care administration. Nurse practitioners should seek public office to bring their unique perspective to the policy-making process. It is critically important to understand how policy made in both state capitols and the US Capitol will impact the delivery of care as well as patient access to care in our country. Congresswoman Kiggans (R, Virgina) is the first NP elected to congress. Her success is motivating and inspirational — this is something that we can do and we need more nurses and NPs in public office so that we can share our perspectives.

Q: Can you update us on states pushing for full practice authority?  

Dr Kapu: In the last 2 years, 4 states have adopted full practice authority (FPA) and many others retired outdated bureaucracy that delayed and interfered with care. Twenty-six states, DC, and 2 territories have enacted FPA, and patients in more than half of the country have full and direct access to NP care. Several states have legislative proposals for FPA under consideration including Indiana, North Carolina, and New Jersey. These legislative efforts have broad bipartisan support and a diverse group of stakeholders working to adopt FPA. We expect more to be introduced in the coming weeks.

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