Arkansas Senate Health Committee Advances "Scope of Practice" And Pharmacist Bills

Mar 16, 2021

Sen. David Wallace, R-Leachville, (right) presents his bill to the Public Health, Welfare and Labor committee.
Credit Arkansas Senate

An Arkansas Senate committee voted to advance a series of bills Monday concerning medical practice in the state.

By a vote of 5-2 on each, the Senate Public Health, Welfare and Labor committee advanced two "scope of practice," bills to the full Senate. 

House Bill 1254, which the committee discussed first, allows for advanced practice registered nurses, or APRNs, to attend to Medicaid patients without the need of a referral. Under the legislation, the state’s Medicaid program would be able to recognize an APRN as a primary care provider. 

Several Arkansans in the medical field testified against the legislation, including Dr. Bala Simon, who spoke on both himself and the Arkansas Academy of Family Physicians. 

"This bill affects the most impoverished in this state, the Medicaid population," Simon said. "We know that a lot of Medicaid patients have complex medical conditions." 

In closing for his bill, Rep. Jeff Wardlaw, R-Hermitage, spoke on the change the legislation would make. 

"It only remove[s] the referral process to see a Medicaid patient. They can already see the Blue Cross Blue Shield patients. They can already see the private insurance patients. That’s all this bill does now. We amended everything else out of the bill," Wardlaw said.

The committee also spent over an hour debating House Bill 1198, which removes supervision requirements for certified registered nurse anesthetists.

Under the legislation, the definition of "practice of certified registered nurse anesthesia," would be amended to remove the current requirement of a certified nurse to receive supervision from a licensed physician, dentist or other person “lawfully entitled to order anesthesia." Instead, the term “in consultation with” would replace the supervision requirement. 

In speaking on the bill, Sen. David Wallace, R-Leachville, said the change will allow medical facilities to "choose the model of anesthesia that’s right for them."

"This bill does not create a pathway for full prescriptive authority, as stated by the opposition. There [are] other current bills, as we’ve seen today that consider that, but this bill does not do that," Wallace said.

Dr. Kevin Spence, an anesthesiologist who practices in Arkansas, spoke against the legislation.

"When we start talking about supervision, it’s a duty of a physician to supervise the care of a patient. That’s what we do. We diagnose and we treat and we supervise your care. You come to me, you and I have a relationship and I’m supervising you and you know I’m going to take care of you from start to finish," Spence said. "It’s my duty. It’s what I do. This law takes away that duty. It takes it away from me."

Both bills now go to the Senate where, if passed, they will then go to the governor.

The committee also voted to advanced a series of bills expanding the scope of what pharmacists in Arkansas can do. 

By a voice vote, members advanced both House Bill 1134 as well as House Bill 1135, both presented by Rep. Justin Boyd, R-Fort Smith.  

Under House Bill 1134, pharmacists in the state would be able to prescribe, administer, deliver or dispense medication that would treat any adverse reactions to vaccines and immunizations. It also allows pharmacists to prescribe vaccines and immunizations to anyone aged three or older. 

In presenting his bill, Boyd spoke on the extra requirements concerning patients between the ages of three and six.

"The pharmacist must, with the exception of flu and COVID[-19] vaccines, participate in the Vaccine for Children program and recommend a well-child check to a pediatrician or other licensed primary care provider at least once a year," Boyd said. 

No one from the public spoke for or against the bill. The committee passed it, with no dissenting votes heard. 

The committee also passed House Bill 1135, which according to the legislation, would allow pharmacy technicians to administer vaccines and immunizations, "if delegated to do so by a supervising pharmacist." That bill also passed by a voice vote, with no dissenting votes heard.