This is an update provided by the American Nurses Association regarding the Department of Veterans Affairs (VA), Veterans Health Administration (VHA) consideration of a policy to allow advanced practice registered nurses (APRNs) to practice to the full extent of their education and training. You can read the VA news release on the topic here. The 60-day public comment period on the proposed rule will end on or about July 24, 2016. We seek your assistance to ensure that the VA receives an overwhelming number of supportive comments to this rule. Below is more information about the rule and detailed steps on how you can provide public comments.

Background:

With 98,000 nurses on staff, the VA is the largest employer of nurses. These nurses represent the VA’s largest health care profession and provide high quality comprehensive care to over 8.3 million Veterans annually. Currently, APRNs must follow the laws of the state in which they are licensed regardless of the laws in the state where their employing health center is located. ANA has been active in efforts to ensure that this new regulation supports implementation of federal supremacy for APRN practice within the VHA. VA is proposing to exercise Federal preemption of State nursing licensure laws to the extent that such State laws conflict with the full practice authority granted to VA APRNs. Such a proposal would preempt the laws and regulations in states that impose inconsistent physician oversight of APRN practice (with the exception of certain limits on the authority to prescribe controlled substances, which are mandated by the Controlled Substances Act).

The VHA’s proposed regulation leads the way for APRN’s to practice to the full extent of their education and training.  The proposal:

• Would amend VA’s medical regulations to permit full practice authority for all four advanced practice registered nurses (APRNs) roles when they are acting within the scope of their VA employment
• States that APRNs are authorized to provide primary health care and other related health care services to the full extent of their education, training, and certification, without the clinical supervision or mandatory collaboration of physicians
• Defines full practice authority as “the authority of an APRN to provide services . . . without the clinical oversight of a physician, regardless of State or local law restrictions, when that APRN is working within the scope of their VA employment”
• Explicitly states that the rule would preempt conflicting State law (“To achieve important Federal interests, including but not limited to the ability to provide the same comprehensive care to veterans in all States under 38 U.S.C. 7301. This section preempts conflicting State and local laws relating to the practice of APRNs when such APRNs are working within the scope of their VA employment. Any State or local law, or regulation pursuant to such law, is without any force or effect on, and State or local governments have no legal authority to enforce them in relation to this section or decisions made by VA under this section.”)

• Describes services that can be provided by an APRN with full practice authority and the qualifications for the APRN roles
• Comments will be due on or about July 24, 2016 — 60 days following publication in the Federal Register (scheduled for May 25th)

It is critical that the VA hears from ANA Members…What can you do?

During the public comment period which ends on or about July 24th, we need your help by submitting supportive comments to the VHA underscoring the important role that ALL APRNs play in providing access to high-quality care to Veterans at VHA facilities in your state and expressing why this rule will facilitate timely delivery of care to our nation’s veterans.

Please visit http://bit.ly/1sunDmXto submit a public comment today.

Thank you for taking the time to submit a thoughtful, timely comment