On April 7, 2025, the Ohio Legislature introduced House Bill 224, a significant piece of legislation aimed at redefining the collaborative practice framework for certified midwives, clinical nurse specialists, certified nurse-midwives, and certified nurse practitioners. This bill seeks to enhance the scope of practice for these healthcare professionals by establishing clearer guidelines for standard care arrangements with physicians and podiatrists.

The primary purpose of House Bill 224 is to facilitate better collaboration between advanced practice nurses and physicians, particularly in specialties that align closely with their training and expertise. The bill stipulates that a collaborating physician or podiatrist must be authorized to practice in Ohio and must specialize in a field that is either the same as or similar to that of the midwife or nurse. Notably, for clinical nurse specialists and nurse practitioners certified in psychiatric-mental health, the bill restricts collaboration to physicians practicing in psychiatry, pediatrics, or primary care.

One of the key provisions of the bill is the requirement for a written standard care arrangement, which must outline criteria for patient referrals between the collaborating healthcare providers. This formalization aims to ensure that patients receive appropriate care while allowing for greater autonomy among advanced practice nurses.

The introduction of House Bill 224 has sparked notable discussions among stakeholders in the healthcare community. Proponents argue that the bill will improve access to care, particularly in underserved areas, by allowing nurse practitioners and midwives to operate more independently while still maintaining necessary oversight from physicians. This could lead to more efficient healthcare delivery, especially in primary care and mental health services.

However, the bill has also faced opposition from some physician groups who express concerns about the potential for reduced oversight and the quality of care. Critics argue that the collaborative model must ensure that patient safety remains a priority and that the complexities of patient care require a physician's involvement in all aspects of treatment.

The implications of House Bill 224 extend beyond immediate healthcare practices. Economically, the bill could alleviate some of the burdens on the healthcare system by enabling more providers to meet patient needs, potentially reducing wait times and costs associated with care. Socially, it may empower advanced practice nurses, enhancing their roles in the healthcare landscape and addressing workforce shortages in critical areas.

As the bill progresses through the legislative process, its outcomes will be closely monitored by healthcare professionals and policymakers alike. The ongoing debates surrounding its provisions will likely shape the future of collaborative healthcare practices in Ohio, with potential ripple effects on patient care and the healthcare workforce across the state.