A state legislative committee held a vote last week on a bill that would allow nurse practitioners in Maine to practice the functional and legal equivalent of medicine immediately after graduating from nurse practitioner school.

The Joint Committee on Health Coverage, Insurance and Financial Services held a second work session (i.e, debate) on LD 295, the so-called “Act To Repeal Restrictions That Prohibit Certain Advanced Practice Registered Nurses from Providing Essential Health Care Services.”

The bill, proposed by Maine Nurse Practitioner Association would eliminate the following language from Maine’s Nursing Practice Act:

“A certified nurse practitioner who qualifies as an advanced practice registered nurse must practice, for at least 24 months, under the supervision of a licensed physician or a supervising nurse practitioner or must be employed by a clinic or hospital that has a medical director who is a licensed physician.  The certified nurse practitioner shall submit written evidence to the board upon completion of the required clinical experience.”

The bill has been covered in a number of recent Maine Medicine Weekly Update E-newsletters:

Urge Your State Legislators To Oppose The Elimination of Training for Nurse Practitioners (Feb 19) 

Committee Delays Debate on Bill to Eliminate Nurse Practitioner Training (Feb 26) 

CALL TO ACTION: Committee Strongly Considering Elimination of Nurse Practitioner Training (Mar 5) 

APRN Training & Supervision: “Laws are Like Sausages. Better Not to See Them Being Made” (Mar 12)

The advocacy response and outreach by countless MMA members proved effective as a majority of the committee voted against the original bill. The in person vote on the bill was 6-5 against passing the bill with 2 absent, however, those two votes were filed shortly after the meeting with the final vote being 7-6 against LD 295.

Legislators that voted along with the Maine Medical Association position AGAINST the bill:

Representative Poppy.Arford@legislature.maine.gov

Brunswick

Representative Mark.Blier@legislature.maine.gov

Limington / Standish (Part) / Buxton (Part) / Limerick (Part)

Representative Jonathan.Connor@legislature.maine.gov 

Lewiston

Representative Richard.Evans@legislature.maine.gov

Atkinson/ Brownville/ Dover-Foxcroft/ Lake View/ Medford/ Milo/ Orneville Township

Representative Gina.Melaragno@legislature.maine.gov

Auburn

Representative Joshua.Morris@legislature.maine.gov

Leeds/ Turner/ Livermore (Part)

Representative Tracy.Quint@legislature.maine.gov

Amity/ Bancroft/ Benedicta Township/ Cary/ Glenwood/ Haynesville/ Hodgdon/ Houlton/ Macwahoc/ Orient/ Reed/ Weston/ Molunkus Township/ Silver Ridge Township/ South Aroostook

Committee members who voted to remove any supervision and training for newly graduated nurse practitioners:

CHAIR: Senator Heather.Sanborn@legislature.maine.gov

Westbrook and part of Portland

CHAIR: Representative Denise.Tepler@legislature.maine.gov

Topsham

Senator Trey.Stewart@Legislature.maine.gov

Numerous towns in Aroostook County

Senator Stacy.Brenner@legislature.maine.gov

Scarborough (Part)/Gorham

Representative Heidi.Brooks@legislature.maine.gov 

Lewiston 

Representative Kristi.Mathieson@legislature.maine.gov 

Kittery 

We try to only to identify party affiliation on legislative policy matters (as with budget discussions) when there is an obvious split whether it be completely partisan or if only one party is unified. In this case, the Democrats on the committee split their vote with five voting to completely remove the supervision along with one Republican senator to allow newly graduated NPs to practice independently immediately upon graduating NP school without any supervision or additional training. Three Democrats voted with the four other Republicans on the committee to oppose the dangerous bill.

We urge members to reach out to legislators on the committee to either thank them for their vote to ensure effective and safe patient care in Maine or reach out to legislators that supported the bill to thank them for their consideration of a very contentious issue and urge them to reconsider their vote on the original bill when it goes to the state House or state Senate for a full vote.

Regardless of committee votes each bill moves for consideration by the full House and Senate in Maine.

Unlike many other states where a vote to kill a bill in committee normally ends the process, in Maine, bills are voted on the motions “Ought to Pass,” “Ought Not to Pass,” “Ought to Pass as Amended,” etc… The final vote on LD 295 was 7-6 against “Ought to Pass.”

We are uncertain when the bill will be released from committee and sent for floor votes. It will go first to the House. We are quite confident it will not be done soon, practically and procedurally; however we will keep a close eye and send out an urgent member wide call to action should we hear differently.

While many MMA members directly contacted their  legislators as constituents and reached out to members of the committee regardless of whether you were their constituent, the following MMA members submitted formal online testimony opposed to the bill. Their comments can be read by clicking on each name:

Adele Carroll, D.O.

Senator Ned Claxton

Norma Dreyfus M.D.

Gregory Feero M.D.

Renee Faye-LeBlanc, M.D.

Lesley M. Fernow M.D.

Kevin Fickenscher M.D.

Brandon Giberson, D.O.

Maroulla Gleaton, M.D.

Deborah Hagler, M.D.

James L Madara, M.D. (AMA)

Representative Patricia Hymanson

Phyllidia Ku-Ruth, M.D.

Amy Madden, M.D.

David McDermott, M.D.

Jay Mullen, M.D.

Saul Levin, M.D. (American Psychiatric Association)

David Schenk, M.D.

Kristin N. Smith, M.D.

Elisabeth Wilson, M.D.

As is the case with many bills before the Maine Legislature, for some reason not all formal testimony submissions make it online. To those that also submitted formal testimony that have reached out to us, thank you! Please let us know if we missed recognizing you or if you know of a colleague that submitted formal testimony. MMA leadership greatly appreciates your steadfast advocacy and urges you to stay on guard with us as we keep a close eye, and both ears open on the progress of this important legislation moving forward.

For more detailed information on the bill, the process, the votes, or any other questions, comments, or concerns on this or any other legislative matter please reach out directly to MMA Director of Communications and Government Affairs, Dan Morin at dmorin@mainemed.com or by phone at 207-480-4199