(tTBA) 2019




 Update -2015 :From Peggy Chapman, MAAPPN Legislative Chair

1)      H 1801, S 1047,  An Act to Increase Access to Mental Health Services

  • This bill is to remove psychiatry MD supervision for CNS’s 
  • currently “in study” in the Joint Committee of Mental Health and Substance Abuse
  • Opposition comes from MPS (Mass Psych Society) – not necessarily the BOM (Board of Medicine).   They withdrew the offer to meet prior to the vote to move it out of Committee.  
  • Rep. Kay Kahn has helped in brokering the bill for MAAPPN


2)      House Bill 1079/SB 2009, An Act Improving Quality of Health Care and Reducing Costs:

  • The Public Health Committee had their executive session 3/18/14 and put the NP-CRNA bill into an “Extension Order” until May 20. 
  • “Extension Order” allows the option to work out compromise language and to keep the bill alive.

Prevailing Legislative Mood:

  • Legislative leadership from the Speaker, Senate President and on down continues to push against these bills  or to promote advancing ANY bills that change current health care laws, since so many mega-laws in health care have been recently passed and have not yet been implemented. They are unsure of the impact still of all of the previous bills they have passed. 
  • Another issue is that the BORN has yet to promulgate the new APRN regulations that reflect the removal of supervision over nurse-midwifery practice (2 years after the law was passed). 


  • Connecticut: April 9, 2014 the Connecticut state Senate voted 25 to 11 Wednesday night to allow nurse practitioners to practice independent of physicians, a controversial concept that has gained traction amid growing concerns about the availability of primary care providers in the state.
  • The proposal, which now goes to the House, originated in Gov. Dannel P. Malloy’s administration, which pitched it as a way to increase access to primary care at lower costs as thousands more state residents gain insurance as part of the federal health law.
  • The bill the Senate passed Wednesday would allow nurse practitioners — also known as advance practice registered nurses, or APRNs — to practice independently, but only after practicing under a collaborative agreement with a doctor for at least three years.
  • New York passed legislation earlier this year allowing NP’s to practice independently after several years of physician supervision.


  • As stated above more pressure will come to bear on Legislative leaders to make sure citizens have access to high quality services


  •  The VA has proposed that all APRNs in their system be designated as independent practitioners.

4)      FTC SUPPORTS INCREASE IN ACCESS TO CARE THROUGH EXCESSIVE PHYSICIAN SUPERVISION REQUIREMENTS.  In March, 2014 the Federal Trade Commission (FTC) published an amazing paper (worth reading)
.“Competition and the Regulation of Advanced Practice Nurses”. This paper cites multiple objections to physician supervision requirements that the FTC reports is limiting patient’s access to care. Though state legislatures are not bound by this paper/opinion it will help in a national way and local way to counter physician objections to nurses practicing independently. A lot of research and prior studies about this issue are cited in the publication.


  • MAAPPN will be refiling a bill again in the new legislative session (approx. Dec. 2014) to request removal of physician supervision for CNS practice. 
  • The NP bill remains active and I will keep you up to date on that bill’s progress.

Respectfully Submitted,

Peggy Chapman, PMHCNS, BC


An Act to Increase Access to Mental Health Services  
This bill would remove the current requirement that physicians supervise psychiatric CNS when they write prescriptions and order tests and therapeutics.
The first committee hearing date (Joint Committee for Mental Health and Substance Abuse) at the State House was on September 10th, 2013.


Positive Aging Act of 2013
The Positive Aging Act of 2013S. 1119, was introduced in the U.S. Senate on June 7, 2013 by Senators Susan Collins (R-Maine) and Barbara Mikulski (D-Maryland).  The bill would improve access to vital mental health care for older adults by supporting the integration of mental health services in primary care and community settings.  Cosponsors are needed for this bipartisan legislation.


An Act to Increase Access to Mental Health Services (H. 1793)
Members are encouraged to support this bill which removes the current requirement that physicians supervise psychiatric nurse mental health clinical specialists when they write prescriptions and order tests and therapeutics
>> Click HERE to View The Bill

Positive Aging Act 2013 (S.1119)
Cosponsors needed to support a bill that would improve the accessibility and quality of mental health services for older Americans
>> Click HERE to Learn More