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Senate panel opens review of S.163 to add APRNs as attending providers in hospitals
Summary
On Jan. 27 witnesses including the Vermont Nurse Practitioners Association and a nurse midwife told the Senate Health & Welfare Committee S.163 is intended to update statutory language to reflect existing APRN practice in hospitals, improve data capture and support continuity, while OPR recommended removing a clause requiring physician consultation 'at all times'; the committee scheduled follow-up testimony from OPR, the Board of Medical Practice and hospital representatives.
Legislative counsel and clinician witnesses told the Senate Health and Welfare Committee on Jan. 27 that S.163 is intended to align hospital statutes with the existing practice of advanced practice registered nurses (APRNs), but several procedural and liability questions remain.
Jen Harvey of the Office of Legislative Counsel summarized the bill as adding a definition for "advanced practice registered nurse" and inserting APRNs into Vermont’s hospital patient bill of rights and hospital licensure provisions so that an APRN may be listed as the attending provider responsible for coordinating a patient’s care. "This is not a substantive difference," Harvey said of most changes, noting the bill mainly updates gendered language and references to match licensing chapters.
Michelle Wade, president of the Vermont Nurse Practitioners Association, said APRNs already have the education, training and legal authority to admit and attend to patients and described S.163 as a technical cleanup that will improve continuity and data accuracy. "These responsibilities that we do on a daily basis naturally include admitting and attending to our patients," Wade said.
Jade Kaplan of the Vermont affiliate of the American College of Nurse Midwives told the committee that certified nurse midwives currently account for roughly 30–33% of Vermont births and said much prenatal and postpartum care provided by midwives is not captured in currently available data when deliveries are recorded under another clinician’s name. She said clearer statutory language would make that work visible in official data and help plan rural workforce and service needs.
Harvey and the witnesses noted that the Office of Professional Regulation (OPR) asked that one sentence in the bill — "physician consultation and support shall be available to an attending APRN at all times" — be struck because it could be read as narrowing APRN practice. Committee members asked several follow-up questions about how hospital credentialing and bylaws interact with statutory language, the mechanics of an APRN admitting a patient who later requires surgery or ICU care, supervision timelines for independent APRN practice (witnesses cited a transition period of about two years/2,400 hours), and which party bears liability when the named attending is an APRN. Harvey and witnesses agreed that hospital credentialing determines privileges and that the attending-of-record remains administratively responsible; committee staff will seek clarifications from OPR, the Board of Medical Practice, hospitals and insurers.
The committee did not vote on S.163 and said it will schedule additional testimony and provide incoming witnesses with a list of committee questions prior to the next session.
