A rules and regulations change that could be completed soon in Vermont would provide independent practice status to NPs and increase patients' access to primary care.
In the state's 2007 legislative session, the Vermont Nurse Practitioners Association (VNPA) provided testimony to the House and Senate health committees for the purpose of educating and advocating for NPs. Based on the testimony, the Legislature passed Act 71, which will help ensure health care reform. One section of the act called for a study of whether the collaborative practice requirement for NP practice should continue. The law noted that NPs "might serve a greater role as primary care providers who provide essential chronic care management."
A multidisciplinary task force made several recommendations to the Vermont Board of Nursing (BON) after the act was passed. These included recommendations to eliminate the requirement for NPs to have a written signed collaborative agreement with a physician, to require an NP appointee to the BON and to create a mentor-mentee program for new graduate NPs.
Jennifer Laurent, NP, president of the VNPA, told ADVANCE that the House Health Committee endorsed the recommendations. "The House Health Committee sent a letter to the BON asking them to expeditiously move forward with removing the [requirement for a] practice agreement," she said. A majority of the task force agreed that the collaborative practice requirement should be ended.
After these recommendations were made, Laurent met with Mary Botter, executive director of the Vermont BON, to discuss removing the collaborative practice requirement. Botter requested that an NP advisory group be formed to make recommendations to the BON as to how the change would occur. The BON would then accept or reject the advisory board's recommendations, then present final recommendations to a professional operations committee.
In addition to seeking comments on collaborative practice, the advisory board will continue to meet to provide guidance on NP issues in Vermont and to make comments on all changes recommended by the task force, including practice by new graduate nurse practitioners. The advisory board will address whether new graduates will be able to automatically practice or must first complete an internship.
"Because the climate is really hot right now, and the primary care shortage is all over the papers and all over Congress, [Botter] and VNPA agree that we need to move. People have had enough of not being able to get care," Laurent said.