This bill removes the requirement that a psychiatric clinical nurse specialist must be supervised by a physician to write prescriptions and order tests and therapeutics. The supervisory requirement would be removed only after a two-year period of supervision of the psychiatric clinical nurse specialist by a physician, a nurse practitioner or a psychiatric clinical nurse specialist in independent practice.

If passed, this legislation would add the critical perspectives of a registered nurse and a public health expert focused on eliminating healthcare disparities to the Commonwealth’s Health Policy Commission, the independent state agency that shapes policy and tracks cost-control measures across our public health and healthcare sectors. In February of 2019, State Auditor Suzanne M. Bump appointed Barbara Blakeney, an experienced public health nurse, to the HPC. With this appointment, Auditor Bump took a critical step in recognizing the important perspective nurses in leadership can bring to our healthcare system. This bill will ensure that professional nurses have permanent representation on the HPC so that we can continue to benefit from their insights and contributions on improving health care in the Commonwealth. 

This bill removes the requirement that a psychiatric clinical nurse specialist must be supervised by a physician to write prescriptions and order tests and therapeutics. The supervisory requirement would be removed only after a two-year period of supervision of the psychiatric clinical nurse specialist by a physician, a nurse practitioner or a psychiatric clinical nurse specialist in independent practice.

This legislation would remove the mandate of physician supervision for the prescriptive practice and retrospective review of prescriptions already written for patients by Certified Registered Nurse Anesthetists (CRNAs). It would also eliminate restrictive time limitations on issuing prescriptions for CRNAs.

This legislation requires insurers to pay nurse midwives the same as physicians for the same services. Nurse-Midwives are Advanced Practice Nurses. According to Massachusetts law and the Board of Registration in Nursing, they are also considered independent practitioners, and do not have to work under the supervision of physicians.  Making reimbursement more equitable will enable nurse-midwives to expand their services in many under-served areas of the state. 

The legislation gives Psychiatric Clinical Nurse Specialists the same authority that Nurse Practitioners currently have to sign certain patient health documents. Both Psychiatric Clinical Nurse Specialists and Nurse Practitioners are Advanced Practice Registered Nurses according to Massachusetts law and the Board of Registration in Nursing. Signatory authority will help make patient care more efficient and accessible.

This legislation would establish a Nursing Advisory Board which will create a neutral environment for discussion of issues facing the nursing workforce of Massachusetts, and serve as a think tank to produce research for long-term planning and strategic policy development in the nursing field. The 8 Board Members would represent all areas of nursing and the Board may seek public and private grant money to fund its research endeavors.

This bill would establish a 17 member Commission on nurse staffing in hospitals located within the Executive Office of Health and Human Services. The Commission would review and make recommendations regarding best nurse staffing practices designed to improve the patient care environment, quality outcomes, and nurse satisfaction.

This legislation authorizes Massachusetts to join the list of 20+ states that have adopted the Nurse Licensure Compact (NLC). The NLC abides by a mutual recognition model of nurse licensure that allows a nurse to have one license in his/her state of residency and to practice in other states, subject to each state's practice law and regulation. This bill enhances the state’s efforts to respond to the changing landscape of health care delivery, permits qualified nurses to care for patients across the health care continuum, allows for better emergency preparedness and more rapid staff response in times of disaster.