Senate Passes Bill to Expand Scope of Practice During COVID-19 Emergency

Press Release from Senate President Spilka’s Office:

BOSTON (3/26/20) – Today, the Massachusetts Senate passed legislation to expand the scope of practice for certain health care professionals for the duration of the COVID-19 public health emergency. This bill removes barriers to immediate care by granting certain health care professionals the authority to work at the top of their license, education and training to ensure that our health care system can meet the increased demand it’s currently seeing due to the coronavirus outbreak. 

One of the biggest challenges COVID-19 presents to the health care system is its impact on the workforce. Expanding health care providers’ capacity to safely provide care is essential to addressing the pandemic while also responding to other demands on the system. Executive Orders from Governor Baker have already expanded access to telehealth and eased restrictions on credentialing of health care professionals. 

This bill, An Act ensuring access to qualified health professionals, builds on these actions and provides another level of workforce expansion that health care facilities desperately need. It enables advanced practice registered nurses and pharmacists to provide services that will ease the strain on other health care workers and increase access to treatment throughout the system. 

“The Senate stands ready to help the people of Massachusetts during this public health emergency, and expanding access to health care for residents while working to support the members of our state’s health care infrastructure is a top priority,” said Senate President Karen E. Spilka (D-Ashland).  “I am grateful for the thoughtful work that Senator Cindy Friedman has done in this area so that the Senate can act quickly to help our health care system when needed. I’d also like to thank the entire Senate for its willingness to work quickly to pass this necessary legislation.”

“The passage of this vitally important piece of legislation is critical to bolstering our healthcare workforce and helping our healthcare system during this public health crisis,” said Senator Michael J. Rodrigues (D-Westport), Chair of the Senate Committee on Ways and Means. “Thank you to Senator Friedman for her hard work and thank you to our heroic healthcare workers who are going above and beyond to keep us safe in these incredibly difficult times.”

“We’ve heard loud and clear from the health care provider community that they need their professionals working at the top of their license in order to manage the increased demand that the coronavirus outbreak has brought on our health care system,” said Senator Cindy F. Friedman (D-Arlington), co-chair of the Joint Committee on Health Care Financing. “This bill allows health care professionals, advanced practice registered nurses in particular, to work at the height of their training and education, maximizing safe and efficient care delivery and increasing access to care for all those in need. I’d like to thank the Senate President and Chair Rodrigues for their leadership on this issue and for their continued commitment to increasing access to critical care as we address this public health emergency.”

“The Senate is taking swift action to respond to emerging needs throughout the Commonwealth that are both urgent and vital,” said Senate Minority Leader Bruce Tarr (R- Gloucester). “By expanding the ability of trained medical professionals to practice, we tap into tremendous human resources to respond to growing human needs.”

This bill authorizes certified nurse practitioners, nurse midwives, nurse anesthetists, and psychiatric mental health clinical nurse specialists to practice independently and issue written prescriptions and medication as well as order tests and therapeutics. The bill limits this practice authority to nurses with two or more years of supervised practice, unless the Board of Registration in Nursing determines that a reduced supervised practice requirement is necessary to increase access to these nurses during the current state of emergency.

In addition, the legislation grants advanced practice registered nurses the authority to admit patients to mental health facilities for care and to restrain patients in cases where failure to do would create the likelihood of serious harm. 

The bill also enables pharmacists to better coordinate with health care teams and engage in a broad range of patient services beyond filling prescriptions. These services can include conducting health and wellness tests, managing chronic diseases, performing medication management, and administering immunizations. 

Allowing pharmacists to provide medication management to patients will decrease the caseloads of physicians and nurse practitioners and reduce the burden on the overall health care system.

“We have long been supportive of proposals that allow nurse practitioners to practice to the full extent of their education and training—particularly as a means for expanding access to critical primary and behavioral health care for residents across the Commonwealth,” said James W. Hunt, Jr., President & CEO of the Massachusetts League of Community Health Centers. “As we continue to combat this pandemic, we will need rapid mobilization of all health care professionals to not only help mitigate its spread and treat those impacted by it, but to continue to provide high-quality care for the patients that rely on community health centers each and every day.”  

Finally, the legislation limits these scope of practice expansions to 90 days after the end of the COVID-19 state of emergency. This time limitation enables the state to manage this unprecedented demand on our health care system by allowing health care providers to work to the full extent of their training and licensure, maximizing the work that all types of health care professionals can safely provide. This immediate workforce expansion will help meet the needs of patients during this public health crisis.

The bill now moves to the House of Representatives for consideration.

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