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CALL TO ACTION -- HB 287 Stuck in the Senate HHS Committee

Posted 7 months ago by Melissa J Hinton

Dear Nurse Practitioners and Followers,
House Bill 287 was heard in the Senate Health and Human Services Committee this morning (scroll to HB 287 in the agenda to view the video). Excellent testimony was provided by UNP and NPs across the state. Significant medical society opposition in the form of emails to committee members last night and public comment that questions the safety of NP-provided care was also heard by the committee. No vote was taken today though there was committee discussion about what might be done to get the bill to the Senate Floor for final vote before the session ends in 1 week.
Current Status:
Senators on the committee requested that UNP meet with UMA, as in the past, to see if there was language that could address the physician and Senator concerns. Negotiations and additional conversations are underway. Please know that UNP is interested in language that will support NP practice, not diminish it. We will continue to press forward with the same intent; remove the C&R without losing any practice authority. 
Action You Can Take:
We are asking you to reach out to the Senate Health and Human Services Committee members to ask them to pass HB 287 in order to get to the Senate. UMA members have been contacting your senators....they need to hear from YOU instead! 
Again, please remain courteous, professional, and patient-focused. Hearing from individual NPs makes a difference in how committee members view this legislation. Talk about your patients, your positive patient-outcomes, and your safe opiate prescribing practices. Please feel free to speak to the issues that the committee discussed today which primarily focuses on opiate safety:
1. UMA says NPs only have 2 years of training and don't have enough experience to prescribe safely.
FACT: Nurse Practitioners have a total of 5-8 years of clinical-based education with an average of 15,000-20,000 clinical and experience hours at the bedside, and advanced pharmacology/opiate training. Current data from DOPL shows that Utah NPs consistenly have a proven track record of safe opioid prescribing.
2. UMA says that NEW NPs are not ready to prescribe opiates and need physician (or seasoned APRN) guidance.
FACT: NPs are trained in their program specialty for immediate practice out of school, have PROVEN competency, and must pass boards to be prepared to practice. Yes, we all need mentoring, but even as a new NP, we know how to establish a mentorship, seek guidance, and find resources based on the years of training at the bedside and graduate-level research. Additionally, any NP colleague is willing to provide transition-to-practice support WITHOUT a signature form, as will many physicians.
3. UMA suggests that NPs need an established contact that can help them with consult or referral for complex cases.
FACT: We are trained to refer to specialty practices when appropriate. We talk with various providers throughout the day in which conferencing about a patient is natural and inherent to all medical providers. NPs should not be required to get a signature to communicate with a colleague.
4. UMA says that during the opioid epidemic, the state must be vigilant not to "relax" NP law.
FACT: ALL Utah NPs can already practice without a C&R except in the 2 situations. "Relaxing" our statute has already been test-driven with demonstration of years of safe prescribing data.
  • Pain Management practices would actually provide safer patient outcomes than pain patients in primary care. Pain management provides aggressive monitoring as part of daily practice. 
  • NPs have remarkably low malpractice rates (nationally and in the state) and have NO disciplinary actions from DOPL in 2020. We are already monitored by the DEA, the state DOPL, and the Board of Nursing, all of which eclipse the C&R.
UMA's claims are clinically and statistically unfounded nationally and in Utah.
The Utah Nurse Practitioner Association continues to work with Utah Medical Association on language recommended by the Senate Health and Human Services Committee. UNP is invested in safe patient care as well as solutions to the opiate epidemic, which includes the rigourous patient monitoring provided in pain management clinics.

Please send a message to the committee before it reconvenes on Monday for vote. A text message will be more effective. A phone conversation is the best. Please also send your message to your own senator in anticipation that we will pass the committee on Monday (link to "participate virtually" at 4 pm) and will get the vote on the floor.
Sente Health and Human Services Committee members (blue link will provide more contact information):
A Reminder on What This Bill Does:
In our existing statute, NPs cannot own or operate a pain management clinic without a career-long C&R form, even though NPs who are employed by phsyicians to provide the exact same care do not require a C&R (pain management clinics provide rigorous patient monitoring and compliance with CDC guidelines and state CSD requirements in prescribing). Utah law also requires NPs licensed less than one year or 2,000 hours to practice with a C&R in order to prescribe Schedule II controlled substances. HB 287 will retire the C&R as introduced.
Currently 14 states, D.C. and 2 U.S. territories do not require any consultation and referral plans prior to authorizing NPs to prescribe medication. Most of these are our neighboring western states where this licensure model has been in place for decades with improved opiate outcomes.
Thank you for taking a role in removing unnecessary barriers between NPs and their patients. We will update you of developments as they occur.
Melissa Hinton, President UNP
Julie Balk, Legislative Co-Chair
Lee Moss, Legislative Co-Chair
Representative Doug Welton, HB 287 Sponsor