Politics and health care collide in new Senate bill


Two years ago Senate Bill 471 died a quiet death in the Senate Health & Human Resources committee. It was a bill to allow advanced practice registered nurses (APRNs) to practice to the full extent of the scope for which they are trained and educated. Sen. Ron Stollings, D-Boone, a physician who chaired the committee at the time, refused to put the bill on the committee’s agenda. It was killed by the political maneuver of a single individual with no consideration of the legislative process.

History stands to repeat itself. Introduced this session, SB 379 is sponsored by Sen. Bob Beach (D-Monongalia) and cosponsored by eight senators, including Senate President Jeff Kessler, D-Marshall.

It has the exact language of its predecessor bill allowing APRNs to practice fully. Sen. Stollings, still the HHR committee’s chair, explicitly states he has no intention of placing the bill on the agenda.

He is using a misconstrued interpretation of a law passed last session that amended WV Code section 31-1A relating to regulating and expanding the scope of professions in West Virginia. However, that law does not apply if a legislator introduces bills having impact on a profession, as in this case.

His argument is also invalid because SB 379 would not expand the scope of practice for APRNs, nor change the way in which APRNs are regulated. National education standards and certification requirements define the scope of practice for APRNs and in West Virginia currently, the law impedes our ability to practice at the scope for which we are trained. This bill would not expand scope; it would merely let us practice at our scope.

Sixteen states and the District of Columbia allow practice autonomy for APRNs. At least 12 other states have current bills that would do the same. There is strong support for advancing such laws from numerous organizations, including, among others, the Institute of Medicine, the American Association of Retired People, the Robert Woods Johnson Foundation, the National Governor’s Association and the Federal Trade Commission (FTC).

The FTC provided testimony to the West Virginia legislature during the 2012 interim sessions recommending legislation to allow full practice to APRNs saying doing so could improve access to primary care services, lower health care costs and increase consumer options.

Their testimony indicates current restrictions add no protection to the public and serve only to limit competition. (Full FTC report at

And there’s the real story. There are some so concerned about competition that they will go to great lengths to preserve their monopoly, regardless if doing so hurts West Virginians. On Jan. 1, West Virginia stands to gain at least 125,000 additional insured residents under the Affordable Care Act. There are not enough primary care physicians to efficiently tend to those currently insured. The newly insured are going to find insurance makes them no better off because timely appointments are unavailable.

I am increasingly jaded watching one individual dictate, based upon his personal opinion, what is best for the health care industry and people of West Virginia by attempting to kill SB 379 without debate or consideration. Not naive to the political process, I have long known the comparison of law-making to sausage-making one’s happier if not seeing it done. But with the wellness of my fellow West Virginians at stake, who with the current health care system have nearly the worst health in the nation, the process has become more than distasteful; it’s tragic.

Toni DiChiacchio

Family Nurse Practitioner

Health Thru Care