Students Libby Willmore (left), Charlie Rowberry (center), and Julie Palmieri (right) lobbying at the state capitol.
By Quincey Taylor
When you think of a House of Representatives or a state legislature, what kind of people do you imagine there? Perhaps middle-aged men in tailored suits? Well, first year BYU graduate nursing students Libby Willmore, Charlie Rowberry, and Julie Palmieri are breaking that stereotype. These students were not afraid to stand up and work towards making changes that will directly affect them after graduation.
These motivated students had the chance to assist associate professor Dr. Beth Luthy – who is also the Legislative Chair for the Utah Association of Nurse Practitioners – in lobbying House Bill 336 in the Utah State Legislature. Getting a bill passed is a long and difficult process, but these students were up to the challenge as they were led by their stalwart professor.
Why was House Bill 336 created?
A nurse practitioner’s scope of practice, or what they’re allowed to do, is dictated by every individual state. There are no national guidelines or regulations. As a result, some states choose to allow NPs to practice full authority within the NP scope of practice, while other states extremely limit what NPs can do. Many times these restrictive states require by law for NPs to be under the direction of a physician at all times.
Utah’s laws fall somewhere in the middle of these two extremes. For example, when NPs in Utah graduate, they are subject to the Consultation and Referral Plan (CRP) which requires them to be under the direction of a physician for the first two years or 2,000 hours of practice when prescribing controlled substances.
When a physician opts to be responsible for an NP, he signs a mandated document that many physicians charge NPs thousands of dollars to receive.
While originally written to more closely regulate the prescriptions of opiates and other dangerous substances, these laws have evolved to a rule that ties the hands of newly graduated nurse practitioners and requires them to pay thousands of dollars for a piece of paper that likely will sit in a filing cabinet until they reach two years of practice or 2,000 clinical hours, whichever comes first.
This was also a problem because nurses could easily avoid these charges if they simply chose to move to a state that doesn’t require them, thus driving nurses away from Utah practices.
What happened when House Bill 336 was implemented?
After working with legislators and coming to a common agreement, HB 336 was passed. The law was changed to require newly graduated NPs to have a CRP only for the first year or 2,000 hours of practice if opening their own clinic. They also changed who could give out a CRP mandated document, now allowing other senior NPs in the field to act as their referral.
This will now be friendlier to small practices opened up by nurse practitioners, allowing them to hire employees without the need for physician supervision. They can practice more easily in rural areas where there might not be a surplus of physicians.
Changing the law will also save new NPs thousands of dollars they might have paid to physicians in past years.
Why were these students interested in participating?
These laws would have affected any nursing student that decided to stay in Utah after graduation. This was something that personally motivated Willmore to get involved. She said she became interested in helping when “Professor Luthy was talking about her work at the capitol building during class and mentioned that she could use some help. I figured that working with law makers to change practice regulations for nurse practitioners will directly affect me when I graduate so I better get in there and help out.”
These students were active participants in Luthy’s legislative committee and personally lobbied to gain support to pass the bill. They dutifully participated, coming up to the capitol multiple times a week during the campaign.
Luthy is so proud of the efforts of these students and says, “All three of those students were fully engaged. Every day they were up at the capitol. They were lobbying. They were attending committee meetings. They testified in committee hearings. I mean, it was completely amazing.” She is looking forward to future developments to progress the cause of nurse practitioners.