Bill for Expanded Practice of CNSs Passes Virginia House

Posted By American Med Spa Association, Friday, February 12, 2021

A Virginia bill that would allow clinical nurse specialists (CNSs) to gain prescriptive authority and broader scope of practice. The bill, which is sponsored by Representative Dawn Adams and is known as House Bill 1747 (HB 1747), recently passed the Virginia House and is currently with the Senate Sub-Committee on Health Professions for further consideration. The status and language of the HB 1747 can be found here.
HB 1747 would restructure Virginia’s current CNS licensing law. Currently CNSs are registered with the Virginia Board of Nursing and are able to provide advanced services, but only within the scope of practice of professional nursing, and they do not have prescriptive authority. HB 1747 would instead make a CNS a type of nurse practitioner who is licensed by both the boards of Medicine and Nursing. Under this new license, they would need to enter a practice agreement with a physician that addresses consultation with the physicians for routine and urgent patient care. The initial CNS licenses granted under this new bill would not include prescriptive authority. However, CNSs would be able to obtain prescriptive authority after completing the qualifications set by board rule.
Currently, nurse practitioners (NPs) can practice without an agreement with a physician after five years of practice. A CNS licensed under this new bill would not be included in that provision. Instead, their practice would be more similar to midwives and anesthetists, who must maintain the physician relationship throughout their careers. The national trend has been moving towards allowing NPs and other advanced practitioners to expand their practice, sometimes with reduced restrictions and supervision requirements. Most of the recent laws have focused on NPs and physician assistants, but other advanced practitioners have also seen some advances. In that regard HB 1747, is in line with current trends.
We will be monitoring HB 1747 as it works its way through Virginia’s legislative process this year. As it has already passed the House, there is clearly some momentum behind it. It remains to be seen if the Senate also treats this bill favorably.