On April 10, 2020, the Board of Nursing and Board of Medical Examiners issued a joint order significantly loosening the APRN Practice Agreement and PA Scope of Practice Guidelines for certain specific circumstances in an effort to prepare for the surge of COVID-19 patients. 

Specifically, the Boards are suspending enforcement of the requirement that APRNs and or PAs practicing in the Hospital enter into written practice agreements or written scope of practice guidelines with a specific collaborating or supervising physician. Hospital is defined as a hospital’s Emergency Department, Intensive Care Unit, inpatient hospital floors, as well as a hospital’s long-term care and hospice facilities. 

The following conditions apply, however, to the suspended enforcement:  

• Hospitals currently experiencing (or expect to experience) a need to assign APRNs and or PAs who do not currently practice in the Hospital to practice in the Hospital due to a surge in COVID-19 patients, may submit the following information (“Staffing Plan”) for review and approval by the Board of Nursing or Board of Medical Examiners (as applicable) in lieu of a practice agreement or scope of practice guideline:
  • A List of all APRNs and/or PAs currently practicing, or who may practice, in the Hospital during the public health emergency – including each APRN’s and PA’s current practice setting and collaborating/supervising physician. 
  • List of all physicians who currently practicing, or may practice, in the Hospital during the declared public health emergency. 
  • A proposed plan to ensure appropriate physician collaboration/supervision with APRNs and PAs who will practice in the Hospital. 
• Upon the Board’s written approval of the Staffing Plan, APRNs and PAs may practice in accordance with the terms of the approved Staffing Plan without submitting any additional documentation to the Boards subject to the following: 
  • In addition to the practice agreements and scope of practice guidelines under which they currently practice – APRNs and PAs in Hospital may practice pursuant to the pre-approved practice agreements and scopes of practice guidelines (included in the Board’s order) relevant to the areas of the hospital in which they are practicing. 
  • However, an APRN or PA may not perform any task for which he/she does not have the proper education, training, and experience to perform (even if such tasks are included in the pre-approved practice agreements and scopes of practice). 
  • Physicians in charge of the areas of the hospital in which the APRNs/PAs are practicing are responsible for ensuring that those APRNs/PAs receive appropriate collaboration and/or supervision by the physicians working in each unit and shall be personally available to APRNs and PAs for collaboration and/or supervision. Hospital must maintain a list of individual physicians responsible for collaborating/supervising an APR/ PA during each shift. 

The order is available for review here.