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FNPN Clarifies the outcome of the PMHNP Board of Nursing Declaratory Statement

Posted over 1 year ago by Vicky Stone-Gale

November 7, 2022:

The Florida Nurse Practitioner Network (FNPN) is receiving numerous calls and emails regarding erroneous information that is being disseminated regarding the decision that was made on the declaratory statement of Susan Lynch APRN that was heard by the Board of Nursing on Friday, October 7th. We would like to clear this up for our members and provide transparency regarding this issue.

This decision was not a broad statement regarding scope of practice for autonomous APRNs related to psych and mental health treatment as is being relayed to all PMHNPs in Florida.

  • A declaratory statement ONLY pertains to the petitioner therefore the decision and the vote solely pertains to Susan Lynch and the petition she filed on behalf of herself
  • This decision does not pertain to the entire APRN community or any NP organization or its members
  • If you are being informed that this involves every PMHNP in the state then that is not correct.

 See her petition below:

Lynch, Susan Patricia R.N. 9213048 and A.P.R.N. 9213048 File #1711/304094; References: Sections 464.0123, 394.455, and 893.03, F.S. and Rule 64B9-4.016, F.A.C., regarding whether it is within the scope of practice for an autonomous practice APRN who is a psychiatric and mental health nurse practitioner to provide psychiatric and mental health treatment, including psychotherapy, to patients with psychiatric and mental health conditions. Also, whether it is in the scope of practice for an autonomous practice APRN to prescribe controlled substances defined under Section 893.03(2), F.S. for greater than a seven-day supply, for treatment for psychiatric and mental health conditions. Also, whether the petitioner needs a supervising physician to provide treatment, including psychotherapy, for psychiatric or mental health conditions. Present and sworn in with attorney Susan St. John. A motion was made by Dr. Castillo that it is not within her scope of practice as an autonomous APRN to provide psychiatric and mental health treatment. Motion passed unanimously. The remainder of the petition was continued.

  • Motion to Intervene – Florida Medical Association, Inc., Florida Osteopathic Medical Association, Inc. and Florida Psychiatric Society. Attorney Mary Thomas present. A motion was made by McKeen to grant. Motion passed with Mueller in opposition.

We may all believe that PMHNPs are primary care, and many are trained with primary care courses. As this legislation is written they are not considered as such. Therefore, we need to be respectful of this and abide by the law and try to get a legislative change for inclusion. If we have PMHNPs practicing autonomously in primary care, we will not have positive legislative outcomes moving forward.

We need to remember that the Florida legislators decided this language in HB 607 and not the BON who is required to only enforce the legislation. The BON made their decision based on the law and the BON attorneys are not going to allow the board members to make decisions outside of the law.

Line 989 (1) REGISTRATION.—The board shall register an advanced practice registered nurse as an autonomous advanced practice registered nurse if the applicant demonstrates that he or she meets these the requirements listed which include:

  1. 3000 clinical hours in the 5 years preceding
  2. Hold an unencumbered license in Florida
  3. Maintains malpractice insurance of no less than $100/300K
  4. No discipline in 5 years preceding registration
  5. 3 credit hours or 45 CEs each in Advanced Pharmacology and Differential Diagnosis

 The board did just that, they approved anyone who met the requirements for autonomous practice. They did not have statutory authority to single out NPs and only give out specific autonomous licenses. I do not think some of the NPs in this state understand the statutory requirements of the board or what they can and cannot do. Legislation dictates this.

 The BON was also charged via legislation to define Primary Care, and this went into effect February 25, 2021. The definition is as follows:

Primary care practice – includes physical and mental health promotion, assessment, evaluation, disease prevention, health maintenance, counseling, patient education, diagnosis, and treatment of acute and chronic illnesses, inclusive of behavioral and mental health conditions.

It is the responsibility of all APRNs in the state to know if they can or cannot practice autonomously. You can practice autonomously ONLY if you practice in:

  1. Family Practice
  2. General Internal Medicine
  3. Primary Pediatrics
  4. CNMs must have a transfer agreement

 Please read the BON info page on declaratory statements: 

https://floridasnursing.gov/help-center/request-a-declaratory-statement/

 FNPN will continue to work with other stakeholders and our lobbyist to ensure we are responsible stewards of FNPNs funds and that our actions will not inadvertently result in barriers for other APRN specialties.

 Please do not hesitate to reach out to FNPN if you have further questions or concerns.

 

Vicky Stone-Gale, DNP, APRN, FNP-BC, FAANP, FNAP

First VP of Legislation

vsgalearnp@comcast.net