Independent Practice Q&A
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With the passing of HB 607 (Independent Practice) on March 11, 2020 there have been numerous questions sent in for clarification.  We know everyone has questions so we hope this page will provide some of the answers.  If you have a question that is not answered here, please feel free to email us at contact@flanp.org

July 1, 2020 Update:  The Board of Nursing has posted this announcement with the appointments made to the Council on Advanced Practice Registered Nurse Autonomous Practice.

June 23, 2020 Update:  NetCE has offered our members with a discounted rate to complete the needed CE requirements for independent practice (pharmacology and differential diagnosis) as well as your annual renewal.  If you are a member, please sign in and visit this page to view the list of courses which meet the Independent Practice CE criteria.  If you are not a member, you can go to NetCE direct to review full course list.  

June 10, 2020 Update: The Florida Board of Nursing (BON) issued a statement today providing more details on the rule making process for HB 607.  Here are a few additional points made:

  • The registration application for autonomous APRNs will be available after it has been adopted by rule, which is anticipated to take approximately 90 days.
  • The Board also voted to define “primary care practice” to include “health promotion, disease prevention, health maintenance, counselling, patient education, and diagnosis and treatment of acute and chronic illnesses in a variety of healthcare settings”. This definition will also move through the rule making adoption process prior to becoming effective.

To read the full statement by the Board of Nursing, click here.

 

The BON had their bi-monthly meeting this past Friday, June 5, 2020 to discuss among many agenda items, rule making and implementation of HB 607 as it relates to Autonomous Practice for APRNs (NP and CNM per HB 607). A bulleted summary of their rule making decisions is provided below.

  • An application which is termed a registration form by the BON will be available July 1st. They ask that you DO NOT submit any attestations or CE reports before the application is available as there will be nobody tracking such information ahead of the July 1st date. The application form will be free and made available by the BON on their website.
  • Educational equivalency was discussed as it related to the 3 graduate credit hour courses in pharmacology and differential diagnosis. In accordance with the understanding that 1 graduate credit hour = 15 CE credits, an equivalency was voted that an APRN can submit evidence of 45 CE credits in pharmacology and 45 CE credits in differential Diagnosis completed within the last 5 years to fulfill the statutory requirement of the two 3 credit courses.
  • CE Providers for the 45/45 CE equivalency was discussed and voted upon too. Any CE provider that has been authorized by the BON previously to provide CE or national associations or organizations empowered to accredit nursing CE are approved. For nurse practitioners, this would mean that CE accredited by ANCC or AANP are authorized.  FLANP will be working to see if we can partner with some of these providers to provide discounts to our members; we will update our members with this information soon.
  • Differential Diagnosis specification of CE was discussed in that many courses may not be entitled “Differential Diagnosis of X.” To satisfy that requirement when submitting the differential diagnosis CE is that course descriptions may be used to show that the differential diagnosis of conditions are met. For this reason, we recommended keeping a log of your CE or track your CE so as to have it readily available if applying for autonomous practice.
  • A One Time CE requirement is what the 3/3 graduate credit or the 45/45 CE stipulation is. This means that once it is satisfied it WILL NOT need to be completed with each subsequent license renewal, but these must have been completed in the last 5 years.
  • Malpractice / Liability Insurance limits were clarified in that an APRN who seeks autonomous practice must meet the limits specified in the statute and NOT IN ADDITION TO the BON’s current limit attestation.
  • Faculty Credit or credit for teaching nursing courses WILL NOT BE allowed in place of the education requirement for graduate / CE credit. This means that there will be no credit that can be supplemented by precepting or teaching a course even if that course is pharmacology or differential diagnosis / health assessment.

Your elected leadership will continue to track any and all developments as they occur and make that information available to you. If you have any questions, don’t hesitate to send them to contact@flanp.org.

Questions & Answers (Last updated 6/10/2020)

  • When can I complete the application?  Where do I find it?  The Registration Form will  not be available until AFTER July 1, 2020; it will be available on the Board of Nursing website and we will also post it on our site here as soon as it is posted.  APRNs do not automatically assume independent practice when the law takes effect on July 1st.  The Board of Nursing asks that no one sends in any prior information as they can not predetermine if you are eligible for the independent practice license.
  • Are ALL nurse practitioners able to practice independently?  Unfortunately no.  Nurse Practitioners who are issued a licensed to practice autonomously/independently, must engage in such practice only in primary practice, including family medicine, general pediatrics, and general internal medicine, as defined by board rule.  Certified Nurse Midwives (CNM) are also able to practice independently.  
  • Why weren't other groups/specialties included?  They were included in the original version of HB 607.  As the legislative process moved forward the bill was amended and approved by both the House and the Senate. FLANP continuously advocated for the original version of the bill throughout the 2020 session.  In some ways we won the battle and in some ways we lost.  The good news is now that we have a start and have gained support of the House and Senate, we will have a little easier time advocating for other groups/specialties in the future.  This is on our agenda for the next session!
  • Can I apply now to practice independently?  Unfortunately no.  The law does not go into effect until July 1, 2020.  The registration form will be posted sometime AFTER July 1 on the Board of Nursing website as well as on this page.
  • With the passage of the Independent practice bill, are we now able to sign DNR's, terminal condition forms, etc.?  Once the law takes effect on July 1, 2020 AND the APRN license with independent practice is successfully issued, the NP is granted signature authority which includes the Baker Act involuntary examination, signing death certificates, admitting/discharging patients from a facility and “provide a signature, certification, stamp, verification, affidavit, or endorsement that is otherwise required by law to be provided by a physician (except for medical cannabis)".
  • I graduated over 5 years ago but the new law will be requiring a completion of 3 graduate-level semester hours in differential diagnosis and the completion of 3 graduate-level semester hours in pharmacology, do I have to go back to school? This was discussed at the Board Of Nursing Meeting on June 5th, in accordance with the understanding that 1 graduate credit hour = 15 CE credits, an equivalency was voted that an APRN can submit evidence of 45 CE credits in pharmacology and 45 CE credits in differential Diagnosis completed in last 5 years to fulfill the statutory requirement of the two 3 credit courses. 
  • What is your advice for obtaining the necessary 3 hours of CEU in differential diagnosis and pharmacology?  Do you think it will be offered online prior to July when the law becomes active?  CE Providers for the 45/45 CE equivalency was discussed and voted upon too. Any CE provider that has been authorized by the BON previously to provide CE or national associations or organizations empowered to accredit nursing CE are approved. For nurse practitioners, this would mean that CE accredited by ANCC or AANP are authorized.  We are working to see if we can partner with some of these providers to provide discounts to our members; we will update our members with this information soon.
  • How will this impact our ability to be providers on health insurance plans without a collaborating physician?  This law doesn’t supersede CMS policies so we will get what we have been getting. It made it so insurance companies can’t force patients to see an NP over a physician and can’t discriminate against NPs ONLY BECAUSE they are NPs.
  • Since CMS is Federal- will we still need to get a physician signature on 485s and Home Health Care orders?  As of April 30th, CMS issued an interim final rule that permanently implements section 3708 of the CARES Act, retroactively effective on March 1, 2020.  Please visit our CARES Act page for more information.
  • Will we be able to sign home health certifications, and will we be able to prescribe schedule II drugs longer than 7 days at a time with independent practice?  These are 2 separate questions.  As of April 30th, CMS issued an interim final rule that permanently implements section 3708 of the CARES Act, retroactively effective March 1, 2020.  Visit our CARES Act page for more information. The DEA legislation is also enshrined in other statutes and that applies until otherwise changed. 

 

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  • Florida Association of Nurse Practitioners, Inc.
  • PO Box 602
    Lake Helen, FL 32744
  • 850.363.3627
  • contact@flanp.org

Vision Statement

Florida Association of Nurse Practitioners will be the leading Florida Nurse Practitioner professional organization advocating for patient centered health care. The organization will increase knowledge on healthcare policy pertaining to Nurse Practitioner practice and patient centered health care; and will remove barriers to Nurse Practitioner practice to gain access to quality health care for Floridians.