United States: Primary Care Practice Officially Defined In Florida For APRNs Practicing Autonomously

Overview

As many providers in Florida are aware, House Bill 607 (the "Bill"), which was passed in February of last year, gives certain APRNs in Florida the ability to practice autonomously. The only catch is that they must work in primary practice. When the Bill was initially passed, there was question as to what was exactly considered primary care, absent a definition from the Florida Board of Nursing. However, as of February 25, 2021, "primary care practice" has officially been defined.

Florida Administrative Code 64B9-4.001

Florida Statute 464.0123, which sets forth the requirements for APRN autonomous practice, states, "[a]n advanced practice registered nurse who is registered under this section may engage in autonomous practice only in primary care practice, including family medicine, general pediatrics, and general internal medicine, as defined by board rule."

However, the Board of Nursing had not yet provided such a definition when the statute was passed, leaving APRN's confused as to whether they qualified for an autonomous practice license. In February, primary care was defined in Florida Administrative Code 64B9-4.001(12) as including, "physical and mental health promotion, assessment, evaluation, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses, inclusive of behavioral and mental health conditions." While this definition also encompasses mental health treatment, in addition to family medicine and general medicine, anything involving specialty care will still require a collaborative agreement.¹

In Practice

The Florida Association of Nurse Practitioners further explains when an APRN's practice is considered primary care and when it is not. For example, administering Botox may be considered primary care if the provider is using it for migraines in a primary care setting, while administering it in a MedSpa or using it for wrinkle treatment outside of a primary care setting would not be considered primary care and would require the APRN to practice pursuant to a collaboration agreement.²

Conclusion

It is important to note that even if an APRN is working in a primary care setting and offering primary care to their patients, they may not practice autonomously until they have applied for an autonomous license and have been approved.

Footnotes

1 Florida Association of Nurse Practitioners, Autonomous Practice Q&A, (Feb. 22, 2021) https://www.flanp.org/page/AutonomousPractice.

2 Id.

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