Legislatures around the country are redefining the rules of practice for several health care professions. What health professionals can do in their professional practice is dependent on each health professionals’ scope of practice, which is defined by state boards of medicine, boards of nursing, etc., often with the guidance or instruction (via statute) of the state’s legislature.
Non-physician practitioners increasingly render services autonomously, particularly in rural and underserved areas, to make up for provider shortages. State legislators and other state health policymakers consider a broad range of issues related to scope of practice, including supervision requirements, prescriptive authority and other requirements for practice.
A new ScopeofPracticePolicy.org website provides policymakers with information on laws that govern the scope of practice for nurse practitioners, physician assistants, dental hygienists and dental therapists across the country. This new website includes 11 interactive maps and a legislative database that tracks scope of practice bills in all 50 states.
State legislatures consider many aspects of a health care professional’s practice. These include the ability to prescribe, dispense and/or administer drugs, to sign evaluations and/or certifications (such as death certificates), to allow admitting or clinical privileges at a health care facility, how health professionals can be addressed and what information they must wear on their badge, how they are reimbursed, whether they can independently run a health clinic, how they can maintain licensure, where they can practice, which regulatory board oversees them and whether to create or abolish other medical boards, the ability of health professionals to advertise and what that advertisement can or cannot look like, as well as other standards of practice.
NCSL’s resources outline policy options for Meeting the Primary Care Needs of Rural America. Primary care access in rural areas is a growing concern driven by demographic trends. Physician supply in rural areas remains low, compared to non-rural areas of the country. According to the Health Resources and Services Administration, only about 11 percent of the nation’s physicians work in rural areas, despite having nearly 20 percent of the population. Moreover, physicians who practice in rural areas often serve large geographic areas that require long travel times. These areas also often have a shortage of hospitals and other health care facilities. Demographic shifts, such as the aging rural physician workforce and the growth in the rural elderly and near-elderly populations will increase demand for primary care services. Legislative strategies to meet this increased demand include redefining or expanding the scope and standards of practice for non-physician practitioners.
NCSL's Scope of Practice Legislative Tracking Archive
This database contains legislation from 2011, 2012 and 2013 legislative sessions, including enacted, pending and failed bills and resolutions. Bills can be searched by state, topic, keyword, status, and/or primary sponsor. It was updated regularly through June 30, 2013 and remains free to all web users. As of June 30, 2013, this database is no longer actively maintained and will be retained online only as an archive.
The ScopeofPracticePolicy.org website database tracks bills related to nurse practitioners, physician assistants, dental hygienists and dental therapists.