The head of the Wisconsin Board of Nursing resigned from his post two months early in protest of Gov. Tony Evers' veto of a bill that would have expanded the scope of authority for registered nurses.
Dr. Peter Kallio submitted his resignation letter to Evers and Department of Safety and Professional Services Secretary Dawn Crim last week. WisPolitics first reported the news on Tuesday.
"This veto appeared politically motivated to appease a small group of doctors who want to dictate nursing practice and that, unfortunately, makes this Board of Nursing ineffective," Kallio wrote.
The legislation would have created a system to allow registered nurses to be licensed by the state board of nursing as advanced practice registered nurses, or APRNs. Under the bill, APRNs would have been authorized to prescribe medication, delegate some tasks to other clinically trained health care workers and use the title “A.P.R.N.”
The proposal would have generally allowed an APRN to practice advanced practice registered nursing without a written collaborative agreement with a physician or being supervised by a doctor, but would have required an APRN to consult or collaborate with a physician (or refer the patient) if a patient’s needs exceeded the APRN’s expertise.
Supporters said it would help expand affordable, high-quality health care, while a coalition of physician groups warned it could detract from the quality of care patients are used to in Wisconsin.
Evers rejected the bill last month, writing in his veto message that the legislation did not address some of the issues raised by some medical professionals throughout the legislative process.
"I am … vetoing this bill in its entirety because I object to altering current licensure standards for APRNs, allowing practices functionally equivalent to those of physicians or potentially omitting physicians from a patient's care altogether notwithstanding significant differences in required education, training, and expertise," Evers wrote.
A joint statement from the American College of Nurse-Midwives (WI Affiliate), Wisconsin Association of Clinical Nurse Specialists, Wisconsin Association of Nurse Anesthetists and the Wisconsin Nurses Association expressed "shock and disappointment" at the governor's decision.
Wisconsin Nurses Association executive director Gina Dennik-Champion said in a statement that the legislation would have given more patients access to "quality, safe and accessible health care."
Groups including the Wisconsin Medical Society, the American Medical Society and the American Society of Anesthesiologists supported Evers' veto.
Mark Grapentine, chief policy and advocacy officer for the Wisconsin Medical Society, said when the bill was proposed that it would move Wisconsin away from its " physician-led, team-based care system," which has led the state's health care system to consistently rank "near or at the top of the country for quality."
"This bill would have confused the roles of physicians and nurses and actively dismantled the care team model that makes Wisconsin a leader in patient care by allowing nurse anesthetists with far less education and training than physicians to provide anesthesia care and pain management without physician oversight," said ASA president Dr. Randall M. Clark, in a statement.
The bill passed the Legislature with bipartisan support. About two dozen states have “full practice” authority for APRNs.
Kallio, who was appointed to the nursing board by former Republican Gov. Scott Walker in 2018 and reappointed by Evers in 2019, wrote that the governor's veto "will discourage current nurses from moving towards an advanced practice degree, which further erodes access to care.
"Current advanced practice nurses will move to states where they can practice to the full extent of their scope," Kallio wrote.
Kallio's term on the nursing board was set to end in July. He also resigned from his position on the state's Controlled Substances Board.