To Authorize An Advanced Practice Registered Nurse To Delegate Certain Tasks To Medical Assistants And Other Unlicensed Staff.
Summary
HB1131 authorizes an advanced practice registered nurse (APRN) to delegate certain nursing tasks to qualified, trained healthcare workers who are not otherwise licensed or authorized by state law to perform those tasks. The bill specifically identifies medication and immunization administration, when those tasks do not require specialized judgment as determined by the Arkansas State Board of Nursing, and phlebotomy activities as examples of delegable tasks. It also allows the Board of Nursing to approve additional tasks by rule.
The bill makes clear that the APRN remains responsible for the delegated work and that the unlicensed worker must perform the task under the APRN’s supervision and may not hold themselves out as a licensed nurse or other licensed professional. It further prohibits a person receiving a delegated task from re-delegating it to someone else and bars certified registered nurse anesthetists from delegating anesthesia administration. The Board of Nursing is directed to adopt rules governing delegation, including limits on where medication and immunization administration may occur, patient-condition screening, and training and competency standards.
Impact
HB1131 amends Arkansas Code Title 17, Chapter 87 by adding a new section governing delegation of nursing tasks by APRNs. Its practical effect is to expand the use of medical assistants and other unlicensed staff in clinical settings, while preserving APRN supervision and accountability. The bill also gives the Arkansas State Board of Nursing rulemaking authority to define the scope, conditions, and competency requirements for delegated tasks, which could affect staffing models, workflow, and access to routine services in clinics and other APRN-led practices.
Sentiment
The voting history suggests broad bipartisan support for the bill, with overwhelming majorities in both chambers and only a small number of dissenting votes. The absence of committee transcript material limits insight into detailed debate, but the strong floor votes indicate the measure was generally viewed favorably as a practical workforce and access-to-care bill. The concurrence votes on Senate amendments were also decisive, suggesting the final version remained broadly acceptable to lawmakers.
Contention
The main policy tension in HB1131 is between expanding efficiency and access in clinical practice and maintaining patient safety, professional oversight, and scope-of-practice boundaries. Potential concerns center on allowing unlicensed staff to administer medications, immunizations, and perform phlebotomy, especially in more severe patient situations or outside tightly controlled settings. The bill addresses these concerns by requiring APRN supervision, preserving APRN responsibility, limiting delegation of anesthesia, and directing the Board of Nursing to set training and competency standards.