ADVANCED PRACTICE REGISTERED NURSE                                              H.B. 5400 (H-2):

                                                                                                    SUMMARY OF BILL

                                                                                      REPORTED FROM COMMITTEE

House Bill 5400 (Substitute H-2 as reported without amendment)

Sponsor:  Representative Ken Yonker

House Committee:  Health Policy

Senate Committee:  Health Policy

CONTENT

The bill would amend the Public Health Code to include provisions regarding an advanced practice registered nurse (A.P.R.N.) and a clinical nurse specialist (CNS). The bill would do the following:

-- Include clinical nurse specialist among the health profession specialty fields for which the Michigan Board of Nursing may grant a specialty certification.

-- Define "advanced practice registered nurse" as a registered professional nurse who has been granted a certification in one of the specialty fields (nurse midwifery, nurse anesthetist, nurse practioner, or CNS).

-- Authorize an A.P.R.N. to prescribe a nonscheduled prescription drug and, under the delegation of a physician, a controlled substance.

-- Allow an A.P.R.N. to order, receive, and dispense a complementary starter dose drug without delegation from a physician, and, as a delegated act, order, receive, and dispense a complementary starter dose of a controlled substance.

-- Allow an A.P.R.N. to make calls or go on rounds.

-- Authorize an A.P.R.N. to refer patients to a speech-language pathologist and a physical therapist.

-- Include an A.P.R.N. in the definition of "prescriber".

-- Refer to an A.P.R.N., in addition to a physician and a physician's assistant to whom a physician has delegated the performance of medical care services, in provisions regarding a policy a health facility or agency must adopt describing the rights and responsibilities of patients or residents.

-- Require the Board of Nursing to include a CNS.

-- Include a CNS among the designated professionals eligible for the State's essential health provider loan repayment program.

-- Add a reference to a CNS in a requirement that a health professional notify and counsel both applicants for a marriage license if one tests positive for HIV.

The bill also would increase fees as described below.

MCL 333.2701 et al.                                                      Legislative Analyst:  Julie Cassidy

FISCAL IMPACT

The bill would have a likely positive fiscal impact on the Bureau of Professional Licensing (BPL) within the Department of Licensing and Regulatory Affairs (LARA). The bill would increase license fees for nurses from $30 per year to $60 per year, and increase the application processing fee from $24 to $75. According to data from a reporting requirement in the annual budget bill for LARA, the BPL typically processes about 83,500 license renewals in a given year, and about 10,500 initial licensure applications. The proposed fee increases would

increase annual revenue to the Health Professions Regulatory Fund attributable to nurse license fees by about $5.0 million per year, after taking into account estimates for the number of other licenses that would remain unaffected by the bill (temporary and limited).

Over the last few years, the cost of regulating the nursing profession has exceeded revenue by about $4.5 million to $4.9 million each year. Under the bill, the shortfall between license fees attributable to the nursing profession and regulatory costs would be significantly reduced.

Finally, the bill would result in some increased costs to the BPL due to changes in the scope of practice for certain types of nurses. The amount of these increased costs is unknown, but would be offset by increases in license fees, at the very least.

Date Completed:  12-7-16                                                     Fiscal Analyst:  Josh Sefton

This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent.