Full Practice Authority in Illinois
Full Practice Authority (FPA) in Illinois -- What is it?
According to the American Association of Nurse Practitioners, “Full Practice Authority is the authorization of nurse practitioners (NPs) to evaluate patients, diagnose, order and interpret diagnostic tests and initiate and manage treatments—including prescribing medications—under the exclusive licensure authority of the state board of nursing.” While not all states allow advanced practice registered nurses to have Full Practice Authority, Illinois recently finalized its rules around it, allowing CNPs, CNSs, and CNMs to practice independently with the proper authorization. Read on for ISAPN’s analysis of the pros and cons of Full Practice Authority in Illinois!
Pros of Full Practice Authority
The largest benefit of allowing Full Practice Authority is the increased access to care that it provides. In many parts of the United States -- particularly rural areas -- residents must travel long distances in order to get access to medical care. By allowing advanced practice registered nurses to practice independent of a doctor, the APRNs are more likely to provide healthcare in rural areas.
This benefit has been backed up with data. According to the American Association of Nurse Practitioners, “States that restrict or reduce NPs’ ability to practice according to their abilities through limiting licensure authority are more closely associated with geographic health care disparities, higher chronic disease burden, primary care shortages, higher costs of care and lower standing on national health rankings.”
Beyond these initial benefits, Full Practice Authority also allows for more efficient and less expensive care -- both of which are important to all healthcare seekers!
Cons of Full Practice Authority as implemented in Illinois
While some argue that APRNs are not prepared to practice independently, ISAPN does not agree with this statement. Per the AANP, nurses with Full Practice Authority are “required to meet educational requirements for licensure; maintain national certification; consult and refer to other health care providers, when warranted by patient needs; and remain accountable to the public and the state board of nursing for providing the high standard of care set nationally.” ISAPN believes that the many requirements in place are more than adequate to prepare APRNs to practice with a FPA license.
However in Illinois, several barriers still exist for APRNs. One requirement is that a physician who has collaborated with an APRN must attest that the APRN has practiced with him or her for the required 4000 hours prior to applying for a FPA license. This seems simple enough but some physicians are refusing to sign the attestation thus preventing the APRN from obtaining the license. Also, APRNs with a FPA license must have a consulting physician that they confer with when they prescribe benzodiazepines and Schedule II opioids. The requirement adds an additional barrier to practice and there is no evidence that this does anything to improve patient care or access to care. It does, however, add to the burden of FPA because some physicians refuse to provide this consultation without financial compensation.
ISAPN Advocates for Full Practice Authority
For all of the reasons that have been outlined above, the Illinois Society of Advanced Practice Nursing applauds the state of Illinois for implementing Full Practice Authority and encourages other states to do so. Full Practice Authority not only allows nurses to provide healthcare in areas that would otherwise not have a provider, but the cost and efficiency that results can not be ignored.
Whether you are a doctor, advanced practice registered nurse in training, or member of the public, if you have questions or comments about Full Practice Authority, we would love to hear from you! You can find our contact information here.