Legislative and Regulatory Toolkit

Starter Kit for Impacting Change at the Government Level: How to Work with Your State Legislators and Regulators

Resources to assist you in advocating for key issues on the state and federal level.

Table of Contents

1. Introduction – Download

2. How to Use the Tool Kit for Impacting Change – Download

3.Guide to Media Advocacy

• Legislative Fact Sheets-Updated
  • Guide to Meeting with Congressional and State Representatives
  • Guide to Developing Legislation for CNS Practice
  • Other resources on legislation
    • APRN Handbook for Legislators
    • NCSBN’s Changes in Healthcare Professions’ Scope of Practice, Legislative Considerations
    • FAQ for Consumers on Scope of Practice CAC
• State Regulations Fact Sheets-Updated
  • Guide to Participating in the Regulatory Process
  • Guide to Getting Appointed to the BON
  • Guide Media Advocacy
• FAQs on Consensus Model
  • FAQ APRN Consensus Model LACE
  • FAQ APRN Consensus Model NACNS

4. Model Legislation and Regulations for Scope of Practice and Prescriptive Authority

• Oregon Regulation for CNS
  See grandfather language on page three
• Oregon Regulation for CNS Prescriptive Authority
• Indiana Nurse Practice Act – One example of regulations that has worked in state.
• Pennsylvania Legislation for CNS
  See Section 8.5, however, it is best to not include national certification as a requirement, since this does not exist for all CNSs at this time.
• Pennsylvania Regulations for CNS
  See Certification Requirements for language on certifying CNSs who are not eligible for national certification exam

5. Resources

• IOM Reports on Nursing-Updated
  • The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity (2021)
    • NACNS Response
  • Assessing Progress on the Institute of Medicine Report-The Future of Nursing (2016)
  • Robert Wood Johnson Foundation’s Campaign for Action
    • Check your state’s efforts; example: https://campaignforaction.org/state/new-jersey/
• National Council of State Boards of Nursing (NCSBN)
  • Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education
    • FAQ
    • Video
    • APRN maps
      • CNS Independent Practice map
      • CNS Independent Prescribing map
  • APRN Model Act and Rules
    • Grandfathering guidelines
    • Examples of successful legislation (with links to law & regs)
      • Oregon
      • Indiana
      • Pennsylvania
      • Minnesota
      • Maryland
  • Reading list
• National Association of Clinical Nurse Specialists
  • Position Statements
    • APRN Consensus Model Implementation (2012)
    • Prescriptive Privilege for the Clinical Nurse Specialist
  • Legislative and Regulatory update
    • Ray MM & Mitttelstadt. Prescriptive Authority and Independent Practice Progress for the Clinical Nurse Specialist-Changes since 2010. Clinical Nurse Specialist, 2016; Sept/October: 302-303.

6. Articles

• Christopher, M.A. et al. (2015) Advocacy for vulnerable patients: How grassroots organizations can influence health policy. The American Journal of Nursing, 115 (3) p. 66-69. Retrieved from http://journals.lww.com/ajnonline/Abstract/2015/03000/Advocacy_for_Vulnerable_Patients___How_Grassroots.32.aspx.
• Davidson, S. et al (2001). Statutory and Regulatory Recognition for Clinical Nurse Specialists in Oregon. Clinical Nurse Specialist 15(6), p. 276-283.
  Although old, it provides ideas for working with regulators.
• Hansen-Turton, T., Ritter, A. & Valdez, B. (2009). Developing Alliances: How Advanced Practice Nurses Became Part of the Prescription for Pennsylvania, Policy Politics Nursing Practice 10(7), p. 7-15.
  http://ppn.sagepub.com/content/10/1/7.abstract
• Hartigan, C. (2011). APRN Regulation: The Licensure-Certification Interface. AACN Advanced Critical Care, 22(1), p. 50-65.
  History of licensure and certification
  http://www.nursingcenter.com/library/static.asp?pageid=1130715
• Hudspeth, R. (2011). Changes for the Valuable Clinical Nurse Specialist. Nurse Administrator Quarterly 35(3), p. 282-284.
  http://www.nursingcenter.com/library/JournalArticle.asp?Article_ID=1181756
• Lyon, B. L. (2003). Advanced Practice Registered Nurse Compact A Call to Action With a Primer on the Regulation of CNS Practice. Clinical Nurse Specialist, 17(4), p. 185-187.
  Note: Although written in 2003 it is still relevant and a good explanation of the impact of the APRN consensus model on the CNS and what can be done.
• Ponto, J., Sabo, J., Fitzgerald, M. & Wilson, D. (2002). Operationalizing APRN Legislation, Clinical Nurse Specialist 16(5), p. 263-269.
• Tabak, R. G. et al. (2015). Accessing evidence to inform public health policy: a study to enhance advocacy.  Public Health, 129 (6) p. 698-704.  Retrieved from http://journals.lww.com/ajnonline/Abstract/2015/03000/Advocacy_for_Vulnerable_Patients___How_Grassroots.32.aspx