The
Massachusetts Medical Society wishes to be recorded in opposition to H.1730/S.1157.
These identical bills would remove the existing statutory framework underlying
the relationship between physicians and psychiatric nurse practitioners and
would allow psychiatric nurse mental health clinical specialists to issue
written prescriptions and order and interpret tests.
This
legislation provides no public protections or standards to replace the legal
basis for the functioning team approach to collaborative and supervisory
relationships among psychiatric nurses and physicians which has served the
Commonwealth so well over the years.
The
Massachusetts Medical Society urges the legislature not to expose the public,
particularly our most vulnerable patients, to the independent practice of
individuals with minimal training and no oversight whatsoever. A team-based
approach to health care, under the supervision of a physician is the gold
standard of care and there is no need to change that requirement for psychiatric
nurse mental health clinical specialists.
Any
consideration of independent practice for psychiatric nurse mental health
clinical specialists must address the lack of public protections required of
nursing. Nurse practitioners are not subject to the public protections the
legislature has created for the practice of medicine by physicians. Nurse
practitioners do not have profiles listing their education, residency, specialties
and history of discipline, criminal convictions or malpractice payments. They
are not required to have professional liability coverage. They are not subject
to mandatory continuing education requirements in specific areas as are physicians.
They do not have requirements regarding electronic medical records and a host
of other legislative mandates which apply to physicians.
For the
reasons noted above, the MMS also wishes to be recorded in opposition to
H.1731, An Act Providing Signature Authority for Psychiatric
Nurse Mental Health Clinical Nurse Specialists. This bill would allow psychiatric nurse mental
health clinical specialists to sign documents which currently require the
signature of a physician or nurse practitioner; and would further strike the
following language which the MMS believes to be important patient protection
provisions: “Nothing in this section
shall be construed to expand the scope of practice of nurse practitioners. This
section shall not be construed to preclude the development of mutually agreed
upon guidelines between the nurse practitioner and supervising physician under
section 80E.”
The MMS
urges the Committee on Mental Health, Substance Use and Recovery to reject H.1730/S.1157
and H.1731 and to report these bills out of committee ought not to pass.
