Committee defers Arkansas APRN independent-practice rules after lawmakers raise concerns about added requirements

A joint presentation by the state Board of Nursing and State Medical Board on a chapter implementing independent (full) practice authority for advanced practice registered nurses (APRNs) drew sustained scrutiny and was deferred for further work.

Board staff and the medical board explained the chapter implements Act 412 and establishes procedures, qualifications and fees for applicants seeking independent practice. Committee members objected to several committee-drafted qualifications the boards had included: a requirement to submit three letters of recommendation and an affidavit to verify practice for applicants coming from states that do not require collaborative practice agreements.

"They added the qualification submission of 3 letters of recommendation," a medical-board or nursing-board representative said when asked what the committee had added. Representative Gonzales asked whether letters of recommendation were redundant with other documentary proofs of practice and said the extra steps might exceed legislative intent and create unequal standards for in-state versus out-of-state practitioners. Board staff acknowledged the requirement could need refinement and suggested the committee could tweak language in future sessions.

Lawmakers pressed whether the rules would create barriers or otherwise alter statutory thresholds, and whether the committee could receive clearer written explanations of how the boards implemented public comments. Given those unresolved concerns, the committee agreed to defer the item to its next monthly meeting so staff and the sponsoring legislators could discuss changes.

The committee also earlier passed a separate motion requiring that agencies stop using the generic response "comment taken under advisement" without a written explanation when such responses appear in rule summaries; the motion requires written clarifications before rules advance to the Rules/ALC process.

Next steps: The boards will consult with legislators and stakeholder groups and return with clarified language and written responses to public comments before the next committee meeting.