South Dakota NPs now have full practice authority

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South Dakota
South Dakota

South Dakota has become the 22nd state to authorize nurse practitioners to provide a full scope of services — diagnosing, treating, managing care and prescribing medicines and therapies. The change could affect staffing in assisted living and other types of senior living communities, according to the American Association of Nurse Practitioners.

The state law also applies to nurse midwives.

“There is a need for more healthcare professionals in rural areas of our state,” Gov. Dennis Daugaard, a Republican, said in a statement after signing Senate Bill 61 into law Feb. 23. “This bill will eliminate a hurdle for some nurse practitioners and midwives who want to serve in those high-need communities.”

Previously, NPs and nurse midwives were required to practice under “collaborative agreements” with physicians. Now, they can work independently after practicing 1,040 hours under physician supervision.

The new measure also retires joint South Dakota Board of Nursing and Board of Medicine oversight for NPs. The regulatory changes will save the state more than $71,000 annually in regulatory costs, the AANP said.

The South Dakota Board of Nursing has not set up regulations related to the new law, AANP President Cindy Cooke, DNP, FNP-C, FAANP, told McKnight's Senior Living. Barring a state statute or federal law specific to requirements in assisted living, memory care, continuing care retirement or skilled nursing communities, however, she said, “these settings could experience added flexibility with regards to staffing.”

The new state law, of course, would not supercede federal requirements, Cooke added.

This law, she said, allows these settings to employ or contract with NPs to provide healthcare and serve as primary care providers for residents without the requirement to employ or contract with a physician to meet state nursing licensure requirements. “In other states, the fees saved from paying for such collaborative licensure agreements have provided settings with the ability to redirect those resources toward enhanced patient services,” Cooke said.

South Dakota's law also provides for additional signature recognition on state patient/resident care forms, “which will help decrease unnecessary delays for patients receiving treatment,” she said.

The state last “significantly” considered changing licensure requirements for NPs 15 years ago, Cooke said. Five states — Arkansas, Massachusetts, North Carolina, Oklahoma and Pennsylvania — are considering granting NPs full practice authority and if they do would join 21 states and the District of Columbia, according to the AANP.

“The case for modernizing licensure for NPs has over 50 years for research behind it,” Cooke said. “That is why more and more states are supporting the safe, high-quality and cost-effective care NPs provide their patients.”

Federal legislation, S. 445, also known as the Home Health Care Planning Improvement Act, was introduced in late February by Sens. Susan Collins (R-ME) and Ben Cardin (D-MD) and would enable NPs, physician assistants, clinical nurse specialists and certified nurse midwives to order home health services for Medicare beneficiaries, Cooke noted. Currently, only physicians can do that.

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