The DuPage County Health Department received a Model Practice Award from the National Association of County and City Health Officials (NACCHO).
Celebrating local health departments that develop programs demonstrating exemplary and replicable best practices in response to a critical local public health need, the Model Practice Award recognized the DuPage Narcan Program (DNP).
Created in 2013 in response to a striking increase in heroin-related deaths in DuPage County, the DNP is the first county-wide overdose prevention program in Illinois to be approved by the Division of Alcoholism and Substance Abuse (DASA). Narcan, also known as naloxone, reverses the effects of heroin and other opioids when administered.
"The Model Practice Award is a confirmation of our commitment to developing responsive and innovative public health programs that improve the health of local residents," said Karen Ayala, Executive Director.
With a focus on health departments that have built strong alliances with partners in order to bridge the gap between clinical medicine and population health, DuPage County Health Department was also awarded the "Silver Local Health Department of the Year" by NACCHO.
The Illinois State Medical Society prevented the Illinois Society for Advanced Practice Nursing (ISAPN) from moving its top priority this year i.e., to allow APRNs to practice completely independent of a physician. After numerous negotiating sessions and intense advocacy from physicians throughout Illinois an agreement has been reached on this topic.
ISAPN introduced legislation that would have granted APRNs full independent practice, including full prescriptive authority, after completing additional clinical training under the supervision of either another APRN or physician. ISMS opposed this legislation.
There is strong support within the Illinois legislature for bills that would grant APRNs independent practice. Instead of voting against us, legislators asked ISMS to draft an alternative.
ISMS offered alternative language that was eventually accepted by the APRNs. Our language:
Maintains the requirement that APRNs have a written collaborative agreement, unless the APRN receives substantial post-graduate training under the direct supervision of a physician (4,000 clinical training and 250 hours in additional educational/training components). The physician then must sign a written attestation confirming that the training was completed.
Does not change current practice within a hospital setting; APRNs must still be recommended for credentialing by the hospital medical staff.
Requires APRNs to maintain a formalized relationship with a physician that must be noted in the state’s prescription monitoring program (PMP) if that APRN wishes to prescribe schedule II opioids and benzodiazepines. The opioids to be prescribed must be specifically noted in the PMP and APRNs and the consulting physician must meet at least monthly to discuss the patient’s care.
Says that APRNs are prohibited from administering opiates via injection. APRNs are also prohibited from performing operative surgery.
Prohibits APRNs from advertising as “Dr.,” which is extremely misleading to patients. APRNs who have doctorate degrees must tell patients that they are not medical doctors or physicians.
Makes clear that CRNAs are not included in the agreement; nothing changes as to how CRNAs currently must practice.
In most other states, advanced practice nurses already have full practice authority to diagnose and treat patients including full prescriptive authority. Some 24 states and the District of Columbia don't require any physician involvement for APRNs to diagnose, treat, or prescribe. In addition to those, eight states allow APRNs to diagnose and treat independently but require physician involvement for APRNs to prescribe.
ISMS physicians are committed to ensuring that care is centered on each patient’s needs and that each patient receives high-quality care by a well-trained team of professionals. These important provisions will be amended to HB 313 in the Senate this week. We would not have been able to make these important changes without all of your assistance.
AND URGE A THEM TO VOTE NO ON SENATE BILL 642
INDEPENDENT PRACTICE FOR ADVANCED PRACTICE NURSES
The Illinois Society for Advanced Practice Nursing has introduced and is lobbying for Senate Bill 642, which would remove the requirement that most APNs (does not include CRNAs) practicing outside of a hospital or ASTC maintain a collaborative agreement with a physician. Attached to this alert is our position paper, which has been distributed to every legislator.
Legislators asked ISMS to try to negotiate with the APNs. ISMS offered alternative language that would have provided for greater independence for APNs after meeting additional education and training requirements, but still would have a required a written practice agreement with a physician for prescriptions of Schedule II opioids and benzodiazepines as these drugs are extremely dangerous and highly abused. The ISMS alternative would have also prohibited from APNs from advertising as “Dr.,” which is extremely misleading to patients. The APNs rejected the proposal. They believe they should practice without any restrictions.
This bill would allow advanced practice nurses to provide the same level of care, completely independent from any physician collaboration, as family physicians, pediatricians, obstetricians, and other specialists.
Under their bill, APNs gain full prescriptive authority, including dangerous Schedule II drugs like opioids and benzodiazepines, without any physician input. This is not in the best interest of patients, particularly those who suffer from multiple medical conditions or require specialty care.
Allowing non-physician practitioners to expand their scope of practice through legislation rather than through education and training is not good public policy for improving access to quality care.
APNs will argue that they can fill a health care void in areas that suffer from physician shortages. This is not true. Research shows that in states where nurses practice independently, physicians and nurses continue to work in the same areas. Allowing the independent practice of APNs will not help solve the problem of health professional shortages in rural areas.
ISMS physicians are committed to ensuring that care is centered on each patient’s needs and that each patient receives high-quality care by a well-trained team of professionals. The APNs walked away from negotiations with ISMS. Please take time to contact your legislators and urge them to reject full independent practice for APNs. Urge them to vote NO on SB 642.
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