Episode 7: 11/6/25-Full Practice Authority (FPA) Legislative Update

This episode is a legislative update as of 11/06/25 for Full Practice Authority (FPA) for Michigan Nurse Practitioners (NPs) with Michigan Council of Nurse Practitioners' (MICNP) Legislative Committee Chair, Naila Russell. The updates for legislation will continue to change. As the voice of NPs in Michigan, we promise to continue to publish updates in our strive for FPA! Stay tuned for further updates!

Theme music

• Keyboard, Bass: Clementine Kanfom
• Guitar: Tyler McDonald
• Drums: Andrew Padfield
• Mixed, Mastered: Andrew Padfield

Michigan Council of Nurse Practitioners (MICNP): Website

Find us on:

• LinkedIn
• Instagram
• Facebook
• Buzzsprout: Podcast Episodes

Transcript

Rachel Hetzner (00:07)
Welcome to the MICNP podcast. I'm Rachel Hetzner, your president-elect. Join us as we bring you the latest insights, discussions, and expert perspectives on the evolving role of nurse practitioners in Michigan and beyond.

Jen McConnell (00:21)
Hosted by the Michigan Council of Nurse Practitioners, MICNP this podcast is your go-to resource for advocacy, education, and professional growth. Whether you're a student, a seasoned NP, or a healthcare leader, we're here to keep you informed, inspired, and connected. Each episode will explore critical topics in clinical practice, healthcare policy, legislative updates, and professional development, all tailored to the unique needs of Michigan NPs.

Tune in as we amplify the voice of nurse practitioners and work together to shape the future of healthcare. Subscribe now and stay tuned for expert conversations, legislative updates, and the latest in NP practice in Michigan.

Justin Hooks (00:56)

This material is provided for entertainment, general information, and educational purposes only, and is not intended to provide medical, legal, or professional advice. Nothing in this presentation, discussion, or material should be interpreted as establishing a client, provider, attorney, client, or other professional relationship. The views expressed by the speakers, guests, participants, and vendors are their own and do not necessarily reflect those of MICNP Additionally, references to any specific products, services, organizations, or third-party entities do not constitute an endorsement or recommendation by MICNP. No representation or warranty is made regarding the accuracy, completeness, or reliability of the information provided. MICNP expressly disclaims any liability for any direct, indirect, incidental, or consequential damages arising from the use of or reliance on the information provided. Participants and members of the audience should always consult their own healthcare providers, legal counsel, financial advisors, or professional advisors and qualified professionals for questions and advice. Any reliance on the information presented is solely at your own risk.

Rachel Hetzner (01:43)
Welcome to the MICNP Podcast where we have Naila Russell, Legislative Chair of MICNP with us today. Welcome back, Naila.

Justin Hooks (01:50)
Yay, welcome back, Naila!

Rachel Hetzner (01:52)
We have enjoyed having you share these updates with our listeners. We really appreciate all of your hard work that you and your committee are doing. I am Rachel Hetzner, President-Elect for Michigan Council of Nurse Practitioners and co-host of the MICNP Podcast.

Justin Hooks (02:07)
Hi everyone, I'm Justin, chair of the education committee for MICNP and the other co-host of the podcast.

Jen McConnell (02:13)
Hi, I'm Jen McConnell, PR and Marketing Chair for MICNP and Producer, Stand and Co-host of the MICNP Podcast.

Rachel Hetzner (02:20)
Okay, so where do we start? There's a lot of updates to share, right, Naila?

Naila Russell (02:24)
Yeah, I think the most exciting thing that's happened is that yesterday, November 5th, there was a committee vote. And so our bill was passed out of the House Health Policy Committee, which is truly a huge step in the process. You know, if we don't get a committee, obviously, it's kind of just dead on arrival.

Rep. Preston was a staunch, sponsor and really made sure that he checked in with all the other representatives. We've been making sure that we had all the votes that we needed. And finally, everything that we've been waiting for, that vote. So it was exciting. It was stressful, but.

I did get to be in the room and see it happen. getting that passed was huge. So now we're just on to the next thing, which is the rules committee.

Justin Hooks (03:05)

Yeah, that's really amazing. Now, when you talk about that it passed, how did it pass Because I saw the update, it passed by flying colors, right?

Naila Russell (03:21)
Yeah, it did. And so it was bipartisan, which is huge, especially with all the political gainsmanship that we see in today's politics. yeah, everybody who was there was a yes, except for one person was a no, and then one representative passed. So resounding support, which was really great despite some ⁓

distractions from the peanut gallery. I don't know if anybody watched, you could hear someone shouting from the audience about, I don't know, beating against the bill. Thankfully, the legislators didn't listen and that that's just not even a factor.

Rachel Hetzner (03:59)
Is that what was going on? I didn't hear, but I heard him calling order and someone was shouting.

Naila Russell (04:05)
Yes.

Somebody was shouting. So while Representative Preston was presenting, the amendments and his reasons for supporting the bill, the person was like, that's bad evidence. And was just being kind of rowdy. it was kind of funny, though, because first they had to take a vote to basically accept the amendment. So the sub change of the bill.

And that went through, everybody voted yes to accept the sub change. And that's when the person stood up and was like, you've just set healthcare back 50 years and was screaming. But it was comical because again, all they had done at that point was accept the sub change. So he was totally out of line in so many ways. And then the chair had to call the order and the man left.

But then they actually voted so he wasn't even there for like what it what it voted and got passed at a committee. But yeah, that's what happened.

Justin Hooks (04:53)
Wow.

Rachel Hetzner (04:58)
So we still have a ways to go. Can you explain more about how it has to go to the rules committee now as a stop to stop there and then it goes to the full house floor? What's going on with that?

Naila Russell (05:10)
Right.

Yeah, so this is more of a procedural step because obviously our practice is governed by LARA and the Board of Nursing where we have the rules that oversee our practice. The Rules Committee just takes a look at everything from a regulatory perspective and make sure that there aren't any red flags. And, you know, there shouldn't be any red flags because we have been

working this bill, from the beginning and working very closely with the bill directors and LARA and all the other reps to make sure that we got all the technical things then to make sure the bill does what it's supposed to do, that there's no confusion about anything. So it's a really well constructed bill. And basically, this should be procedural, I will say.

that we are going to hope that that is all that happens during the rules committee hearing. It sounds like some of the opposition groups would like to relitigate things in front of the rules committee, but that is not the role of the rules committee. The rules committee does not relitigate the merits of the bill. They look at it from a regulatory standpoint.

Rachel Hetzner (06:15)
Yeah, that makes sense.

Justin Hooks (06:16)
I just learned something. I learned something every time I hear you speak and you get me more eager to get involved in your committee. Let me tell you, I know Rachel's a part of your committee and I'm definitely going to come to your meeting at the end of this month your legislative committee meeting. So I would tell everyone, please do that. And besides the emails that we received from MICNP, there was one

I missed, I do have to watch it now that you said the heckling part. I definitely will watch that now and for our members to do that. But you sent out a really good email to all the members and I really appreciate it because you put the contact for our own personal representative and then you sent out another email

about all of our state reps and who we should email What I wanted to see is, you stress to our members and listeners how important it is to reach out to them? And when I go back and think of reaching out, I think of the app, the Five Calls. And it encouraged people, instead of just emailing, to call your elected officials daily. What do you think would work, in your opinion?

Naila Russell (07:21)
Yeah, it's such a fine line and we have to be strategic about timing. So obviously these calls to action come out when we know that there's going to be hearings and votes and things like that. But at the same time, we have to remain vigilant and reach out enough that this doesn't fall off of the radars of our legislators. So we try to be very strategic about when we say call email.

But in the interim, building that relationship, like you said, is really, really essential. The legislators hear from opposition on a regular basis, and they need to hear from us too. So while we got voted out of committee, like I said, there's still a lot of work that needs to be done, and all of our members have to remain vigilant, engaged. I hope that them seeing that our members seeing this momentum, like we've gotten this vote finally.

or moving forward will really get people invigorated again in a way where they were getting a little apathetic. So yes, those relationships are important. Look for the calls to action. I definitely, if I need you to reach out to your specific legislator, like you said, I try to curate those emails so it's easy for you.

Jen McConnell (08:33)
We had legislative talks during our most recent conference that received very positive feedback, including Rachel's strategic advocacy and your legislative update. So Rachel, can you share some of the highlights from your session and tips for others to get involved?

Rachel Hetzner (08:49)
Yeah, I would say the main thing, the most impactful thing is to build those relationships, like Naila said, continue to call your legislators, especially now that we have that momentum going. A lot of people say, what is the MICNP Board doing to get this legislation passed? And I've said over and over again that the MICNP Board in and of itself cannot get.

this legislation passed. It is on every nurse practitioner in the state of Michigan to reach out to your legislators, reach out to everyone that you know, articulate what you do every day, and just interact with them, build those relationships, and just keep having those conversations.

Justin Hooks (09:29)
That's really important. So, Naila, can you explain, we have more than one bill going on right now. What's the difference between both of them?

Naila Russell (09:37)
Yeah, so we have House Bill 4399 That's the one that just got voted out of committee. And we also cross filed it in the Senate with Senate Bill 268. So they started out essentially being identical to one another, but House Bill 4399 has been amended along the way. As I said, we've been spending a lot of time refining it, making it exactly what it needs to be, being good, you know, thought partners and just making sure like

we're getting what we need, but stakeholders see that we are entering into this in good faith, right. And so a lot of updates were made. That's why the committee had to adopt the sub change, they voted to do that. And then they voted to move it forward. So basically, House Bill 4399 looks a little different than Senate Bill 268. However,

the Senate is taking the lead from the House on this one. And so essentially when House Bill 4399 passes the House, it will get sent to the Senate and then they can take up that version. If they would like to, you know, also amend or asks for some different things, there is always that opportunity for that to happen. I think that, Senator Erwin, the bill sponsor on the Senate side is fully aware of what's been happening on the House side. And so I don't anticipate there really being any

changes that are thrown on from the Senate perspective, but you just never know. Amendments can be proposed at any time. So that's the difference right now, but we were really strategic to start off in the House because we knew that we had a really favorable chair. We knew that we had really good dynamics in the House with the makeup of the representatives.

And like I said, the Senate's ready for it to come to them, that we are prepping them. And I think that the dynamics in the Senate are really good too.

Jen McConnell (11:24)
Yeah. So nationally, we know that AANP has a big push for full practice authority, of course, but doesn't the government have a push for states to have full press practice authority for us nurse practitioners?

Naila Russell (11:36)
Yeah, they do, which is really great. One of the positive things that's come out recently as far as NP practice is the federal government, the Centers for Medicare and Medicaid putting out a call for proposals for a rural health transformation proposal or RHGP grant. And that's $50 billion from the federal government to fund rural health initiatives.

So there's a lot of different pieces that the state has to obviously put into their application, but one of the parts of it is related to workforce. And so specifically NP workforce and the government will appraise states based on that AANP full practice authority map. So as many of you know, Michigan is red on that map, which is the most restricted and basically

That means we get zero points on the rubric when it comes to workforce development, where a Green State would have 100 points. So obviously that's huge. Yellow States get 50. But if Michigan can show that they're making progress and that they're committed to achieving full practice authority by 2027, then they will be able to get some allocation of points in that category and remain eligible for the five years of funding. So.

You know, this is a golden opportunity for Michigan to move forward. We've got these two great bills, we've got momentum, and I think that the federal government stance is definitely on our side.

Rachel Hetzner (13:01)
Yeah, I think those grants being there in and of itself is a case in point that this NP full practice authority is going to increase access in the rural and underserved communities. Everyone knows it and now there's funding behind it. So.

Naila, you've worked in a full practice authority state previously. Can you explain the big differences that exist there compared to Michigan?

Naila Russell (13:26)
yeah, I think that in many ways, there's not a lot of differences. we're diagnosing, we're prescribing, we're treating, but then there's those really frustrating differences that we hear about. you know, right before we started recording, we were having a sidebar conversation about providers who are nurse practitioners not

getting their labs that they have ordered. I mean, that is ludicrous. There's nothing in Michigan that's preventing labs from sending the results directly to the ordering NP provider. think about what that means for patients. That is a huge delay in care and treatment. It's getting sent God knows where to a provider who may not know anything about that patient.

and that can cause real patient harm. that doesn't happen in a state that has full practice authority. I think that's one really concrete example.

Justin Hooks (14:15)
That's a good point. So we have nurse practitioner week coming up very soon, November 9th through the 15th. And this year, the theme is trusted voices and proven care. I don't think they could say it any better at this right time in the moment. At MICNP our mission and value statement is to improve the health of all Michigan residents through education, advocacy, and engagement of our wonderful nurse practitioners. How do you think?

we're doing and how do you think full practice authority would elevate our mission?

Naila Russell (14:47)
Well, I definitely think that MICNP as an organization is doing everything that they can to move these priorities forward. the four of us being here, I think it is illustrative of that. I know all of you are working on engagement, Justin, your committee is working, of course, on the education piece, the legislative committee is working on the advocacy piece, and it all goes hand in hand.

I think the organization, despite having challenges like all organizations, is doing a really good job of staying true to our mission and our values. And I hope that members see that and feel that when they listen to our podcast or your podcast. But the engagement piece or the advocacy piece, how does FPA elevate that? I think members are very frustrated and they're sick of the red tape.

like the lab orders, like the delay in getting results, like not being able to call the hospital and get your patient the care that they need. So we need to get there. We are so close. I can feel it. But it's going to just continue to give us a seat at the table because once we've got this behind us, we'll be able to advocate even more. We'll be able to engage even more on other

portions of policy and patient care. And we should be there. Our voices should be heard. We have an incredible lens to bring.

Justin Hooks (16:15)
That's awesome. You said it so well.

Rachel Hetzner (16:18)
Naila it has been an honor to have you as part of our podcast again. We love having you on. You're always welcome here.

Justin Hooks (16:27)
With all good things, it must come to an end. That's a wrap. Stay tuned for more engaging topics, educational opportunities, whether you're a student, seasoned nurse practitioner, or a healthcare leader, we're here to keep you informed, inspired, and connected.

Jen McConnell (16:40)
Tune in as we amplify the voice of nurse practitioners and work together to shape the future of healthcare. Subscribe now and stay tuned for expert conversations, legislative updates, and the latest in NP practice in Michigan. Now, we can't wait for our next episode, I bet you can't either. Trust me, it's coming soon. See you next time.