Senate panel OKs expansion of nurses' role

Lansing — Michigan nurses could play a larger role in delivering primary care under legislation the Senate Health Policy Committee approved Tuesday.

If adopted by the Legislature and signed into law by Gov. Rick Snyder, advanced practice registered nurses, also called nurse practitioners, would be allowed to write prescriptions for patients. Physician oversight would be required for the nurse's first five years of practice, and to prescribe any Schedule II or Schedule III medications.

The Michigan Council of Nurse Practitioners has sought full practice authority for its 5,400 members, saying highly trained nurses can improve access to care in regions of the state that have too few physicians. Doctors initially opposed the legislation because it would give authority to nurses which, they argue, should be restricted to physicians with higher levels of education and training.

Chairman Mike Shirkey, R-Clark Lake, said Tuesday the committee listened to the concerns of physicians as well as nurses. The substitute version of Senate Bill 68 was approved with eight amendments.

The final version clarifies that practical nurses must have permission from at least one physician to prescribe Schedule II or Schedule III drugs.

Schedule II drugs, such as morphine and Oxycodone, have a high potential for abuse that may lead to severe psychological or physical dependence. Schedule III medications, such as Tylenol with codeine, may lead to moderate physical dependence but high psychological dependence.

Another change says the statute does not require increased reimbursement by insurers for services rendered by an advanced practice nurse.

"We listened to everybody's concerns, and to the extent we could ... contemplated and included those concerns," Shirkey said. "They may not like the current version, but they would not deny what I just said."

Olivia McLaughlin, executive director of the Michigan Council of Nurse Practitioners, said the bill is "encouraging."

"While the bill that has moved out of committee does not address all of the concerns we have as advanced practice registered nurses, we are encouraged we will be able to work with the bill's sponsor to hopefully reach legislation that will ultimately benefit patients and health care professionals in Michigan," McLaughlin wrote in an email to The News.

The approved version also earned tentative praise from the Michigan State Medical Society.

The medical group "is pleased with the direction the bill is heading," said spokesman Kevin McFatridge. "We still need to refine some areas of the bill, but overall we appreciate the due diligence by Sen. Shirkey and the committee."

kbouffard@detroitnews.com