On Tuesday, April 22, 2014, Governor Dave Heineman vetoed LB 916, which would have eliminated the requirements that nurse practitioners enter into integrated practice agreements with physicians. They would still be required to work collaboratively with physicians and other care providers. The bill would have changed provisions to credentialing and regulation of nurse practitioners as well and would have put into place a transition to practice agreement. In order to practice the nurse practitioner would have needed this transition to practice agreement or had 2,000 hours of practice under such an agreement in order to work in the state.
The bill was introduced by Sen. Sue Crawford of Bellevue. Sen. Crawford stated that studies showed that nurse practitioners “practice in a safe, effective and cost-effective manner in several states.” In testimony given to the Legislature’s Health and Human Services Committee, nurses stated that it can be difficult for nurse practitioners to find physicians with whom they could enter into integrated practice agreements with, especially in rural areas.
In vetoing the bill, Gov. Heineman along with Chief Medical Officer Dr. Joseph Acierno expressed concern for patient safety stating that adequate clinical experience was necessary. Gov. Heineman stated that in the future there would be a time to move forward in giving nurse practitioners additional independence, but LB 916 went too far too quickly. The governor stated had the bill required 4,000 hours of clinical experience he would have signed it.
LaDonna Hart, President of the Nebraska Nurse Practitioners, states that finding a doctor who will sign the needed agreement is becoming harder and harder for nurse practitioners. Other nurse practitioners state that this veto could limit efforts in attracting nurse practitioners to the state. Co-Presidents of the American Association of Nurse Practitioners, Angela Golden and Ken Miller, weighed in on the governor’s veto stating it was a “missed opportunity by the state to allow Nebraska patients to receive full and direct access to nurse practitioners while improving the efficiency of the state’s health care workforce.” They further stated that LB 916 would have addressed the problem of primary care and mental health provider shortages seen in the state had Gov. Heineman signed the bill.