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Sponsor says removing SCA will expand access without expanding APRN scope; committee questions 2,000‑hour threshold
Summary
Sponsors told the Senate Health Committee that Senate Bill 258 would remove the standard care arrangement (SCA) requirement for APRNs, lowering administrative costs and improving access—especially in rural areas—while leaving APRN scope unchanged; members questioned the choice of a 2,000‑hour threshold and insurance/malpractice implications.
Senate Bill 258, the Better Access to Health Care Act, drew sponsor testimony focused on workforce and access concerns. The bill would eliminate the standard care arrangement (SCA) that requires an APRN to contract with a physician (or podiatrist) for signature and administrative oversight in order to practice. Sponsors told the committee that the change does not expand APRN clinical scope; rather, they said, it removes an outdated administrative cost that disproportionately affects independent and rural APRNs and increases costs for patients.
A sponsor described APRNs as “highly trained professionals” with advanced degrees and national certification and said 28 states and three U.S. territories have adopted similar reforms. The sponsor said eliminating the SCA reduces overhead, could lower patient costs, and help retain APRNs trained in Ohio. The sponsor also noted estimates of a shortage of roughly 1,200 primary‑care physicians affecting 57 of Ohio’s 88 counties as context for the urgency of the bill.
Committee members pressed sponsors on specifics. One member asked how the 2,000‑hour supervised clinical practice threshold was determined; the sponsor said it was "a starting point" without a scientific basis and invited suggestions for adjustment. Other members asked whether malpractice or insurance responsibilities would shift; sponsors said business arrangements determine insurance responsibilities and the bill would not change existing malpractice obligations. Sponsors said they are open to amendments on thresholds and details and emphasized the intent to preserve safety while reducing administrative burdens.
No formal committee vote occurred during this hearing; the chair closed the first hearing on SB 258 after Q&A.
