At Crossover, a look at EM-impacted bills
Current Virginia law requires hospitals to have a licensed physician on call, though not necessarily physically present and on the premises in the ER. Virginia law should ensure there is a physician physically present in the ER at all times, which is a standard these bills — introduced by VACEP — would achieve.
The latest: The Senate bill passed unanimously, 38-0, and now moves to the House. This is VACEP’s priority legislation for 2024 and we thank the patrons for carrying it.
Virginia nurse practitioners are seeking to expand their scope of practice and gain autonomous practice.
VACEP fights this battle most every year, and wants to keep clinical training for NPs at the current Virginia standard: five years (9,000 supervised hours) before independent practice. Physicians are not allowed to practice without supervision after they graduate from medical school. They need to complete at least a three-year, 10,000 to 15,000 hour residency. We believe the standard should be the same for our NP colleagues before they are allowed to practice alone.
The latest: The original bill would have lowered the five-year training requirement to two years, or 3,600 hours. The identical bills would have allowed those NPs to lead patient care teams, too.
A compromise was struck to remove the language regarding leading teams in exchange for increasing the training requirement to three years. In doing so, the Medical Society of Virginia removed opposition to the bill.
VACEP was the only specialty medical group to continue to oppose bill and push for the existing five-year standard. Emergency physician and VACEP member Lauren Webb, MD, spoke last week in opposition to HB 971, which passed the Health and Human Services committee and was read in the House.
Certified registered nurse anesthetists (CRNAs) want to eliminate a requirement that they practice under supervision of a licensed doctor of medicine, osteopathy, podiatry, or dentistry and instead practice “in consultation with” those physicians.
The latest: The bill is moving forward. VACEP is also supporting Senate Bill 33 (Locke), which would clarify that CRNAs be supervised by a licensed physician who is present during an operation or procedure. The bill would convene a work group of relevant stakeholders to evaluate and make recommendations to increase the anesthesia provider workforce in the Commonwealth.
Advanced Practice Registered NurseS CONTINUE UNDER JOINT BOARDS
HB 978 (Willett) and SB 351 (Boysko)
Currently, professions of advanced practice registered nurses and licensed certified midwives are licensed and jointly overseen by the Board of Medicine and the Board of Nursing. The bill would abolish the joint board and put all oversight under the Board of Nursing only.
Abolishing the joint board in Virginia would allow these practitioners to become part of the APRN Compact, which gives APRNs one multistate license with the ability to practice in all compact states.
The Compact requires those providers to be governed solely by a Board of Nursing. The compact supersedes all other state law regarding scope of practice and allows practice after only one year of training.
The latest: The bills were continued to 2025 and are done for the year.
A BILL THAT WOULD MAKE ED BOARDING crisis EVEN WORSE
The bill would allow state psychiatric hospitals to delay admission of an individual under a temporary detention order (TDO) until the hospital has determined the person does not have potentially life-threatening medical needs that require immediate evaluation and treatment but the facility is incapable of providing. The bill is a recommendation of the Joint Legislative Audit and Review Commission and the Behavioral Health Commission.
The latest: If a state psychiatric hospital is given such power, patients could be kept in the ER even longer under a TDO, worsening an already bad boarding crisis. The bill is opposed by VACEP, the Virginia Hospital & Healthcare Association, and the Virginia Sheriff’s Association.
MEDICAL MALPRACTICE CAPs remain
The latest: A bill to eliminate the cap on the recovery in actions against healthcare providers for medical malpractice in cases where the patient is age 10 or younger was defeated this week. Here’s a news story on the issue.
Have a look at all the bills VACEP is tracking in the 2024 General Assembly.
