A new bill was just pre-filed in the Indiana House of Representatives for the 2019 legislative session. If passed, this would grant nurse practitioners and other advanced practice registered nurses (APRNs) independent practice after meeting certain requirements. This would make Indiana the latest state to join a nationwide trend of allowing APRNs more freedom to practice without the oversight or supervision of a physician. The bill, known as HB1097, can be read in full here. Bill HB1097 has been referred to the Committee on Public Health for initial discussion.
Currently APRNs must practice under the supervision of a physician, dentist, podiatrist, or optometrist as embodied in a written “practice agreement.” If passed HB1097 would allow APRNs who have prescriptive authority to be granted the ability to practice without a “practice agreement” if they meet four criteria. Those criteria are: (1) have already worked under a practice agreement overseen by a practitioner for one year; (2) the overseeing practitioner has been licensed in Indiana for at least five years; (3) the overseeing practitioner has reviewed at least 5% of the NPs prescriptive charts; and (4) that the APRN submits an attestation to the Board of Nursing of having completed the one-year practice agreement. APRNs who have completed those 4 four steps gain an “I” notation (for independent) on their prescriptive license number and would then be able to practice without needing to enter into a practice agreement.
This period of supervised practice is similar to how APRNs in other states qualify for independent practice. What is unique about this proposed bill is that it includes advanced practice registered nurses in the definition of “practitioners” who may oversee the practice agreements of other APRNs. In most other states that require APRNs to work under a practice agreement the supervising practitioner is always a physician or similar high-level licensee. This would create the currently unusual circumstance where an APRN who has independent practice could be overseeing practice agreements with other newer non-independent APRNs.
We will be monitoring this bill as it advances in the Indiana legislative process this year. If you have specific questions or comments on HB1097 you may contact Representative Ron Bacon, the Bill’s sponsor, at his webpage.