Legislators receive many proposals each session to expand or narrow health care scopes of practice. Scopes of practice define services licensed professionals may legally provide. The review process is time-consuming, and stakeholders are often polarized. Like many states, Oregon has no clear process for evaluating these requests. Legislators, striving to uphold public safety, face challenges when responding to requests, and counter-requests are common. In response to interest from Oregon Legislative Health Care Committees, Oregon Consensus conducted an assessment and convened the Scope of Practice Advisory Group from 2007-2009 to recommend improvements to the process.
Results
A group of volunteer stakeholders met for four facilitated sessions and further explored issues through online surveys. They achieved consensus in recommending a legislatively-funded pilot for processing scope change requests using recommended parameters, including:
- Limit 2009 session pilot to human health-related issues
- Base decisions on 37 criterion that include:
- Problem and evidence of public health benefit
- Impact on health care access, delivery, and costs
- Evidence-based review, including patient safety risk-benefit analyses
- Availability of education, testing, and regulation
- Advantages and disadvantages of overlapping scopes of practice
- Require all scope requests to utilize a template that uniformly articulates issues for consideration.
- Have Senator Monnes-Anderson and Representative Greenlick select several scope requests based on proposed criteria, and utilize an impartial process to bring stakeholders together to complete templates and report to the legislator.
- Have pilot participants and the Scope of Practice Work Grop report to the Legislature within six months of adjournment regarding pilot effectiveness.
Participants
OR Academy of Family Physicians; Peace Health; Willamette Dental Group; OR Podiatric Medical Association; OR Optometric Physicians Association; Kaiser Foundation Health Plan of the Northwest; OR Association for Hospitals and Health Systems; OR Nurses Association; OR Association of Naturopathic Physicians; OR Medical Association; OR Board of Massage Therapists; OR Assoc. of Orthopedists, OR American College of Cardiologists, OR Ambulatory Surgery Center; OR Society of Clinical Social Workers; OR Dental Association; OR Academy of Ophthalmology; OR Medical Board; OR State Ambulance Association; OR State Board of Nursing; Nurse Practitioners of OR; OR Psychological Association; OR Society of Anesthesiologists; Occupational Therapy Association of OR; OR Psychiatric Association; OR Speech Language Hearing Association; OR Speech-Language Hearing Association; OR Board of Examiners for Speech Pathology and Audiology; OR Doctors of Chiropractic; OR Board of Psychologist Examiners; OR Chapter American College of Nurse Midwives; OR Physical Therapy Association; Chiropractic Association of OR; OR Board of Pharmacy; OR Orthotic and Prosthetic Association; National Alliance on Mental Illness (NAMI); OR Veterinary Medical Association; OR Federation of Nursing and Health Professionals; CareOregon; The ODS Companies; Osteopathic Physicians and Surgeons of OR; OR Association of Nurse Anesthetists
Meeting Information
June 2008 Meeting
September 2008 Meeting
October 2008 Meeting
November 2008 Meeting
Additional Project Documents
- Project Roster
- Budget Summary
- Presentation to Legislature
- Final Report and Recommendations to the Legislature
Project Lead
Laurel Singer
Director
Oregon Consensus
Hatfield School of Government
Portland State University
(503) 725-9070
consensus@pdx.edu
Facilitator
Sam Imperati, Institute for Conflict Management
