Practice Barriers and Policy Issues for Florida APNs

Practice Barriers for Florida APNs:

Despite Florida having a Full Practice Authority (FPA) for Nurse Practitioners (NPs), all four APN roles (Nurse Midwife, Nurse Anesthetist, Nurse Practitioner, and Clinical Nurse Specialist) face practice barriers that limit their ability to deliver quality care. Here are some key concerns:

• Physician Supervision Requirements: While NPs have FPA, some hospitals and healthcare systems still require them to have a supervisory agreement with a physician, hindering autonomy.
• Restrictions on Practice Settings: Some APNs, particularly Nurse Midwives, may face limitations on where they can practice (e.g., hospital vs. birthing center).
• Scope of Practice Restrictions: State regulations may limit the types of procedures APNs can perform, even though they are qualified through education and training.
• Reimbursement Parity Issues: Private insurance companies may not reimburse APNs at the same rate as physicians, disincentivizing their services for patients.

Competition and Policy Challenges:

Competition:

• State Level: Physician lobbying groups often advocate for limitations on APN practice, arguing it protects patient safety (despite research showing similar outcomes with APNs).
• National Level: The American Medical Association (AMA) has historically opposed full practice authority for APNs, potentially influencing national policy discussions.

State Lawmakers:

Key Figures:

• Governor Ron DeSantis: Has the power to sign or veto legislation affecting APN practice.
• Representative Colleen Burton (R): Chair of the House Health & Human Services Committee, influential in shaping healthcare bills.
• Senator Lorrane Austicker (R): Chair of the Senate Health Policy Committee, another key figure in healthcare legislation.

Interest Groups:

State Level:

• Florida Nurses Association (FNA): Advocates for expanded APN practice to improve access to care.
• Florida Medical Association (FMA): Represents physicians and may lobby for limitations on APN scope.

National Level:

• American Association of Nurse Anesthetists (AANA): Advocates for full practice authority for nurse anesthetists.
• American College of Nurse-Midwives (ACNM): Advocates for increased access to midwifery care.

Methods for Policy Change:

• Lobbying: APN organizations can lobby legislators to introduce and support bills promoting APN practice.
• Grassroots Efforts: Educating the public and patients about the benefits of APN care can build public support for policy changes.
• Data and Research: Providing evidence demonstrating the safety and effectiveness of APN practice can counter arguments against expanded scope.
• Collaboration: Working with physician groups to find common ground and address potential concerns collaboratively.
• Electoral Politics: Supporting candidates who advocate for expanded APN practice can influence policy outcomes.

Conclusion

While Florida has FPA for NPs, significant barriers still exist for all APNs. Overcoming these barriers requires a multi-pronged approach, including lobbying efforts, public education, research, and collaboration with other healthcare professionals. By advocating for evidence-based policy changes, APNs can improve access to quality care for all Floridians.