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Committee hears broad support for removing APRN standard care arrangement to expand access
Summary
Advocates told the Senate Health Committee that removing Ohio's standard care arrangement for advanced practice registered nurses (after 2,000 hours of practice) would reduce administrative cost and expand access to primary care, especially for seniors and rural patients; opponents' concerns about oversight were addressed by proponents citing board regulation and certification.
The Senate Health Committee on Tuesday heard extensive sponsor and stakeholder testimony in favor of Senate Bill 258, which would retire the state-mandated standard care arrangement (SCA) for advanced practice registered nurses (APRNs) who have completed 2,000 hours of practice.
Angela Hoff of National Church Residences told the committee the SCA ‘‘limits practice, delays care and does not enhance safety,’’ and said her organization pays collaborating physicians as much as $4,000 per month to satisfy the requirement. Hoff said those payments and contractual burdens reduce the number of APRNs organizations can hire and restrict services for frail older adults and homebound patients.
Supporters from independent and pediatric practices described practical barriers created by the SCA. Terri Gerthaus, a board-certified pediatric nurse practitioner who operates an independent pediatric practice, said the physician named in her agreement has never visited her clinic and that the contract imposes administrative costs and risk to continuity: ‘‘It simply removes an outdated requirement that no longer reflects how health care is delivered in Ohio,’’ she said.
Representatives of APRN groups told the committee the SCA is an administrative arrangement rather than a clinical residency or supervision model. Summer Davis and Mandy Cafasso of the Ohio Association of Advanced Practice Nurses testified that removing the SCA for experienced APRNs would not expand licensure or scope but would improve timely access and workforce stability while retaining oversight by the Ohio Board of Nursing.
Committee members asked witnesses about particulars, including how the 2,000-hour threshold would operate and whether practitioners would be grandfathered. Witnesses acknowledged questions remain about implementation details (for example, how grandfathering and verification of hours would be handled) and said staff work would be needed to finalize statutory language.
No formal amendments or votes on the bill occurred at the hearing; the committee limited testimony to three minutes per witness. Proponents urged the committee to move the bill forward to ease administrative barriers and increase primary care availability in underserved and rural communities.
The committee will decide next procedural steps; supporters said they are prepared to provide additional drafting suggestions to address verification and oversight questions raised during questioning.
