1. TRANSITIONS to PRACTICE
Christine Armstrong, MSN, CNP

2. What’s Next You chose a certification exam.
You joined a professional organization.
AACN/AANP
You apply to take the exam online.
Submit transcripts electronically.
Wait (patiently) for your OK to test.

3. While you wait… You apply for your APRN License
APRN Modernization Bill went into effect April 4, 2017.
You only need to apply for APRN license.
OBN site states that all applications and payments must be on line.
Can apply before you graduate and before you test. OBN will keep on file for 1 year.

4. Application Ohio Board of Nursing web site. Apply on Line
Pay fees on line.
Submit Electronic Transcripts to the OBN
As there is no CTP or CTP externship, the Board will be paying close attention to your 45 hours of Pharmacology in the last 5 years.

5. Application
The Certifying Agency must submit your test results directly to the Board.
There is no fee to submit results to Board.
New law states that you will then be granted a license as an APRN.
You will be designated a CNP, CRNA, CNM, CNS with automatic prescriptive authority with licensure. Lucky Ducks!

6. Congratulations! You passed your certification exam.
You have been granted a License to Practice as an APRN.
You have to be an RN to be an APRN.
DO NOT let your RN license lapse as it voids your APRN.
Leads to talking to the Board of Nursing.

7. Practice Compensation for services rendered. Contract negotiation.
Malpractice Insurance.
National Provider Number.
DEA number.
Medicare Number.
Medicaid Number.

8. SCA Standard Care Arrangement
Written, formal guide for planning and evaluating a patient’s health care that is developed by a collaborating physician/s and an APRN.
All APRN’s must have SCA even if not Prescribing per Modernization Bill.
Must submit to OBN within 30 days of practice or change in collaborator.

9. APRN Modernization Collaborating now 5 APRN’s to one Physician.
Collaborating Physician/s: SCA with APRN and is continuously available to communicate with APRN in person or with technology.
Psych NP can now collaborate with Psychiatrist or Primary Care Physician.

10. National Provider Identification
NPI number is a 10 digit numeric identifier to be used on claim forms submitted to payors.
Must have it to bill for services.
Medicare, Medicaid and private insurances.
Must update when changing practices.
Must have NPI to Apply for Medicare and Medicaid number.

11. Schedule II Need to have a DEA number to Prescribe Schedule II
DEA $ Employer cover cost?
Need to inform OBN of DEA number.
OARRS Registration.

12. Medicare Number
Internet-based Provider Enrolment, Chain and Ownership System.
PECOS
Submit the current version of the Medicare enrollment application (CMS-855)
Submit the correct application for your provider to the Medicare contactor servicing your state. (Palmetto)

13. Medicaid Number Apply on Line
Check list of documentation you need to even start application on line.
MITTS.
Must have NPI before you can apply.
Can apply for Medicare and Medicaid simultaneously.

14. Practice Professional organizations. AANP OAAPN NEONP
Mentorship/Preceptorship.
Pay it Forward.

15. Nurse Practitioner History
Early 1960’s PCP recruited RN’s with clinical expertise and began collaborating to provide Primary Care.
1965 Loretta Ford and Dr. Silver founded the first NP program at the University of Colorado.
1967 first Master’s Program for NP and Ohio was using NP’s in Public Health

16. Nurse Practitioner History
By 1979 there were 15,000 NP programs in the US.
Ohio, especially Northeast Ohio, had a high number of programs.
Marymount Hospital, Lutheran Hospital and St. Joseph’s Hospital in Lorain, Ohio
1980 Northeast Ohio Nurse Practitioner Group was founded.

17. Nurse Practitioner History
Goal of NEONP was to organize for NP’s.
Legislation for certification and licensure.
Fought to be recognized as a health care provider.
Out of NEONP, founding members went on to establish OAAPN.
This brought together all Advanced Practice. CNS, CNP, Midwife, CRNA

18. Nurse Practitioner History
1997 Title Protection: gave NP’s the right to be paid for their Advanced Practice by Insurance Companies.
2000 Ohio was the last State to obtain Prescriptive Authority.
2008 APRN could prescribe Schedule II
2017 APRN Modernization Act, removed some limits on practice.

19. Practice
Questions???