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State regulators urge removal of blanket physician‑consult requirement from S.163 on APRN scope
Summary
Deputy Secretary Lauren Hibbert and Office of Professional Regulation staff urged the committee to remove a provision in S.163 that would mandate physician consultation for APRNs in all interactions, arguing APRNs practice independently in Vermont and mandatory universal consultation is unnecessary and burdensome.
Legislative staff and regulators asked the Senate Health & Welfare committee to remove a proposed blanket consultation requirement for advanced practice registered nurses (APRNs) from S.163.
Lauren Hibbert, Deputy Secretary of State, introduced Office of Professional Regulation staff and said the state recognizes APRNs’ independent practice: "APRNs have independent practice...we're one of 27 states" that allow independent APRN practice after full credentialing. Hibbert and OPR staff argued that APRNs routinely collaborate when clinically necessary but that the bill’s current language would mandate collaboration on every interaction rather than when the APRN's scope or clinical judgment requires it.
OPR staff (on the record as Jen Cola) said collaboration is a common and enforceable professional obligation when clinicians step outside their scope, but that statutory language requiring consultation for every interaction would be seen as a backward step nationally and could discourage APRNs from practicing in Vermont. "We're just not asking that this bill doesn't have this restrictive language in it because it will be seen...as a step backwards," the OPR representative said.
Committee members pressed whether hospitals could still impose their own bylaws restricting practice; OPR said such employer‑level restrictions are a marketplace decision and outside the board’s jurisdiction. Lawmakers said they will resume markup on S.163 at a later session and invited further technical input from OPR and hospitals.
What happens next: committee indicated it will continue markup work on S.163 and requested clarifying language from OPR and stakeholders.
