Analysis of Nursing Regulations, HIPAA, and Policy in Colorado

This report analyzes the regulatory landscape of nursing in Colorado, focusing on the Colorado Board of Nursing and its functions, including licensure and governance. It explores the impact of the Health Insurance Portability and Accountability Act (HIPAA) on healthcare access, patient data privacy, and electronic records. The report also examines the Colorado Nurse Practice Act (NPA), its influence on nursing scope of practice, and its effect on healthcare costs and access. Furthermore, it discusses Rule 950, which addresses the physician's role in prescriptive authority for advanced practice nurses, and the implications of these regulations on the advanced nurse's role. The analysis references key legislation, regulations, and professional organizations to provide a comprehensive overview of nursing practice and healthcare policy in Colorado.

Policy and advocacy for
improving population health.
Presenter

Differences between a board of nursing
and a professional nurse association
board of nursing professional nurse association
It designation is within a specific state Its designation can be state, national or
international
Seeks to promote public and welfare of the
public
Seeks to improve nursing through education,
advocacy, research and leadership
This is public and is run by the state It is private requiring professional
membership
Focused more service delivery to the public Helps in political advocacy professional
development of nurses
Falls under the National Council of State
Boards of Nursing (NCSBN)
Fall under the American Nurses Association

Colorado Board of Nursing
• State BON are regulated by the NCSBN (Milstead & Short, 2019).
• Geographic distribution- designated within the state of Colorado.
• Academic credentials- To qualify to be on the board, one must be a registered
nurse with the state of Colorado (Colorado Board of Nursing, 2020).
• Practice positions- The following are membership positions, 1 Board
president, 1 elect president, 1 treasurer, 7 directors.
• Licensure status of members of the board- the Colorado BON offers Nurse
Licensure Compact to its members (Colorado Board of Nursing, 2020)..
• The members of the board are elected by fellow registered nurses who are
members of the body.

Licensing requirements
• Graduate of a professional school of nursing with a degree in
any field of nursing.
• Must have taken and passed the NCLEX-RN exam (Nursing
Licensure.org, 2020).
• For out of state RNs, they will need to provide license
verification from the initial state of licensure.
• They must also have practiced for two years in the previous
state of origin (Nursing Licensure.org, 2020).

Federal regulation for healthcare- Health
Insurance Portability and Accountability Act
(HIPAA) of 1996
• Protects American workers who have lost jobs or change from one job
to another (American Nurses Association, 2018).
• It allows workers to apply for health insurance plan in any healthcare
provider (HIPAA, 2020).
• It preserves state laws and protects workers from insurance rights.
• HIPAA applies to verbal, written, and electronic patient records
• Seeks to protect healthcare consumers from data breaches where
electronic records are used (Laureate Education, 2018).

Changes in HIPAA in the last five years
• HIPAA has recently changed to focus more on electronic records
and patient safety.
• This change was driven by the need for protecting patient
information.
• It focusses on following areas
• Privacy of health information
• Security of electronic records
• Administrative simplification
• Insurance portability

How HIPPA influences delivery to
healthcare and access
• HIPPAA sets regulations in healthcare that influence access.
• It sets standards that allow ease of access to healthcare through
ensuring that all employees are protected (Institute of
Medicine, 2010).
• HIPPAA has an impact on access to Healthcare information
since it requires sharing of data with patients.
• Shared data ensures that there is increased access to patient
which is a way of auditing healthcare information (Gasper,
2020).

State regulation related to general nurse scope of
practice- Colorado Revised Statutes 2019, Title 12,
Professions and Occupations, Article 255, Nurses
• The act provides a framework for safe practice within the
state (Laureate Education, 2018).
• It limits the scope of practice for registered nurses like opioid
limitations (Colorado Nurses Association, 2019).
• It defines the practice levels within different nursing scopes
like registered nurse and advanced practice nurse (Neff,Yoon,
Steiner, Bumbach, Everhart & Harman, 2018).
• It defines the relevant charges and fines that are related to
practice.

Colorado Nurse Practice Act
• The Act grants authority to the Colorado BON to regulate the
practice by enforcing the law,
• It defines the educational program standards that govern
nursing within the state(Russell, 2017).
• They set the scope of practice and the standards that need to
be followed by nurses.
• It sets grounds for disciplinary actions for members who
violate the statute limitations of practice(Russell, 2017).

How NPA influence delivery cost and
access to healthcare.
• The NPA sets standards of practice that define how nurses meet the
needs of patients.
• It sets the scope of practice, regulations and ethical concerns that have
to be upheld by nurses (Russell, 2017).
• It sets curriculum requirements for nurses through the BON to
determine the quality of nursing education.
• By defining the scope of nursing it ensures that nurses only work in
roles that they are qualified (Russell, 2017).
• It empowers the Nurse association to raise any issues of concern within
the nursing environment.

Rule 950 -The physician’s role in prescriptive
authority for advanced practice nurses
• This provided under Sections 12-36-106.4(4)(a) and 24-4-
103 of the Colorado Revised Statutes.
• Sets requirements for physicians to support advanced practice
nurses in prescriptive authority.
• Sets scope of prescriptive practice for advanced nurses.
• The regulation recognizes the changing role of the Advanced
practice Nurse.

How the regulation influence the advanced
nurse’s role
• The regulation sets the requirements for one to qualify as an
advanced registered nurse.
• It sets the relationship between nurses and medical
practitioners like physicians.
• It defines the prescriptive scope of advanced nurses within
the state.
• The regulation sets requirements for advanced practice nurses
and the regulation that govern their practice.

References
• American Nurses Association. (2020). Welcome to the American Nurses
Association. Retrieved from American Nurses Association:
https://www.nursingworld.org/ana/
• American Nurses Association. (2018). Chapter 4, “Government Response:
Regulation” (pp. 57–84). Retrieved September 20, 2018, from
http://www.nursingworld.org
• Colorado Board of Nursing. (2020). Colorado Board of Nursing. Retrieved
from Colorado : https://ncsbn.org/Colorado.htm
• ColoradoMedicalBoard. (2010). RULE 950 -The Physician’s Role in Prescriptive
Authority for ADvanced Practice Nurses. Colorado Medical Board.
• Colorado Nurses Association. (2019). Colorado Revised Statutes 2019 Title
12 Professions and Occupations Article 255. Colorado Nurses Association

• Gasper, P. M. (2020). The Impact of Federal Regulations on Health Care
Operations. Annals of Health Law, 19(1), 249-254.
• HIPAA. (2020). Summary of the HIPAA Privacy Rule. Retrieved from
HIPAA : https://www.hhs.gov/hipaa/for- professionals/privacy/laws-
regulations/index.html
• InstituteofMedicine. (2010). Chapter 2: The Value and Importance of
Health Information Privacy. Washington : National Academies Press.
• Laureate Education (Producer). (2018). The Regulatory Process [Video
file]. Baltimore, MD: Author.
• Laureate Education (Producer). (2018). The Regulatory Process [Video file].
Baltimore
• Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s
guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

• Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D.,
& Harman J. S. (2018). The impact of nurse practitioner regulations on
population access to care. Nursing Outlook, 66(4), 379–385.
• NCSBN. (2020). The world leader in nursing regulatory
knowledge. Retrieved from National Council of State Boards of
Nursing: https://www.ncsbn.org/index.htm
• Nursing Licensure.org. (2020). Nursing Licensure Requirements
in Colorado. Retrieved from NursingLicensure.org: https://
www.nursinglicensure.org/state/nursing-license- colorado.html
• Russell, K. A. (2017). Nurse Practice Acts Guide and Govern:
Update 2017. Journal of Nursing Regulation, 8(3), 18-26.