May 29, 2014
Minnesota Lawmakers Approve APRN Initiative
On May 13, Minnesota Senate file 511 became law (Chapter 235) removing existing requirements for Advanced Practice Registered Nurses (APRNs) to practice within the relationship of a physician. Under the language, collaborative management will no longer be required of nurse anesthetists providing anesthesia care.
The Minnesota Society of Anesthesiologists (MSA) fought the measure from its inception with a coalition of physician groups including the state medical society, family physicians, pain physicians, and others. The political dynamics of the legislature, weighed heavily by the state’s rural geography and a vocal state school of nursing, eventually prevailed and patient safety was substituted with an “access to care” law.
To the frustration of the nurse anesthetists seeking pain medicine authority, several patient safety provisions were included in the final language. The language includes the following requirements:
--Collaboration with a physician for nonsurgical acute and chronic pain medicine
--Written prescribing agreements for treatment of chronic pain medicine symptoms
--Setting limitations for nonsurgical pain medicine services – must be performed in the same licensed health care setting as the collaborating physician
Additionally, the new law prohibits nurse anesthetists from interpreting CTs, MRIs, PETs, nuclear scans, and mammography. These provisions of the new law go into effect January 1, 2015.
In a separate legislative measure (Chapter 312), MSA successfully passed language directing the Minnesota Department of Health (MDH) to collect data on pain medicine procedures in the state. Specifically, the Commissioner of Health must gather the types and numbers of pain medicine procedures performed in the previous 36 months, the kinds of professionals performing the procedures, and the location/facility type where such procedures are performed. The Commissioner must submit a report with the compiled data to specified lawmakers in the House and Senate by January 15, 2015.