May 29, 2018

South Carolina, Maryland Pass Laws Increasing People’s Access to Nurse-Provided Care

South Carolina and Maryland are the latest states to pass laws increasing people’s access to the high-quality care provided by advanced practice registered nurses (APRNs). Earlier this month, Gov. Henry McMaster signed S.345 into law, easing consumer access to nurse practitioners in the Palmetto state. In Maryland, Gov. Larry Hogan signed HB 863, modernizing laws that govern consumer access to the state’s certified registered nurse anesthetists (CRNAs).

In South Carolina, nurse practitioners will still be required to maintain a contract with a physician, but beginning July 1, physicians can contract with more nurse practitioners at a time, increasing the cap on the number of nurse practitioners. The bill also removes a distance limitation tied to the physician’s location. In addition, nurse practitioners will be allowed to prescribe more of the medications that they are educated and trained to prescribe. While the new law does not grant nurse practitioners the ability to practice to the full extent of their education and training, it marks a step in the right direction. It is expected to improve consumers’ access to health care, especially in rural areas where few physicians practice.

“Better access to health care at a lower cost is a clear win for all South Carolinians,” wrote the bill’s sponsor, State Sen. Tom Davis, an op-ed in The Island Packet.

High rates of obesity, diabetes, cancer, and cardiovascular disease are prevalent in South Carolina. Nineteen of the state’s 46 counties have 10 of fewer family physicians, and one county has no physicians at all.

A diverse coalition of organizations supported the bill, including AARP South Carolina, the South Carolina Hospital Association, the New Morning Foundation, Michelin, the Carolinas Center, the South Carolina Medical Association, the South Carolina Academy of Family Physicians, the South Carolina Nurses Association, CVS Pharmacy, the South Carolina Department of Mental Health, Community Medical Clinic of Kershaw County, Eau Claire Cooperative Health Centers, and the Free Medical Clinic.

In Maryland, where nurse practitioners are already able to practice fully, a new law will lift barriers on CRNAs by removing a burdensome requirement that CRNAs maintain a written contract with a physician. The Maryland Association of Nurse Anesthetists (MANA), who championed the bill, noted that: “CRNAs strive to provide high-quality, modern anesthesia care to patients. Our certification laws should be modern, too.”

In a letter praising the new law, MANA’s President Shawn Seifert, MS, CRNA, thanked the bill’s many supporters, which included “allies in patient and professional interest groups.” The bill was co-sponsored by Delegate Bonnie Cullison and Senator Joan Carter Conway.

With these changes, South Carolina and Maryland join the ranks of a growing number of states lifting restrictions on APRNs in order to give people greater access to the care provided by highly skilled nurses. State laws govern the practice of each of the four types of APRNs: nurse practitioners, clinical nurse specialists, CRNAs, and certified nurse-midwives. In many states, APRNs can do everything they are educated and trained to do, but in some states outdated and unduly restrictive laws keep them from contributing all they can to meet America’s health and wellness needs. In 2017 alone, legislatures in more than 20 states passed laws lifting restrictions.

Note: The Campaign is closely watching states’ efforts to modernize these laws and will be reporting on the progress made in the months to come. If you are working to remove barriers to APRN practice and care and would like guidance or assistance with your efforts, please contact us