CHARLESTON, W.Va. -- A legislative audit released Thursday recommended a limited expansion of autonomy for advanced practice registered nurses -- a recommendation that was not well received by the health care professionals.
Last spring, the West Virginia Nurses Association submitted an application for expanded scope of practice for APRNs, registered nurses who have advanced degrees and medical training and are considered mid-level practitioners, equivalent to physician's assistants.
The association is seeking expanded authority for APRNs, including eliminating requirements that each have written collaborative agreements with physicians, and removing restrictions on their ability to prescribe drugs.
In his report to the House Government Organization Committee, legislative auditor Aaron Allred said he found lots of research showing that APRNs can deliver the same quality of care as family practice physicians, but stopped short of recommending full autonomy.
"We couldn't find any research I could base such a recommendation on," he said.
He noted that both the state Medical Association and the state Board of Osteopathic Medicine oppose expanding scope of practice for APRNs.
"That doesn't make it right, but it does show there is disagreement on whether APRNs should practice independently," Allred said.
He also raised concerns about expanding prescribing authority for APRNs to include Schedule II narcotics, given current problems with prescription drug abuse in the state.
"The state currently holds the distinction of having the most drug overdose deaths, the majority of which are from prescription drugs, of any state in the nation," he said.
The audit also recommended that APRNs who wish to practice without a collaborative agreement should be licensed by the state Board of Medicine, a proposal that drew particular objections from APRN representatives.
Angie Nixon, who gave a response on behalf of APRNs, noted, "One profession should not regulate another."
Regarding concerns that expanded prescriptive authority for APRNs could exacerbate prescription drug abuse problems in the state, Nixon noted, "AP nurses can't be responsible for the current abuse of controlled substances."
Advocates of expanding scope of practice for APRNs say it would help address shortages of primary care providers in rural parts of the state, and is needed to provide care for more than 137,000 West Virginians who be added to state Medicaid coverage under the Affordable Care Act.
Reach Phil Kabler at ph...@wvgazette.com or 304-348-1220.