October 8, The Honorable Jerry Moran U.S. Senate 361A Russell Senate Office Building Washington, DC Dear Senator Moran:

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October 8, 2013 The Honorable Jerry Moran U.S. Senate 361A Russell Senate Office Building Washington, DC 20510 Dear Senator Moran: On behalf of the 39 undersigned organizations representing the Nursing Community, we thank you for introducing the Protecting Access to Rural Therapy Services (PARTS) Act (S. 1143). Collectively, the Nursing Community represents nearly one million Registered Nurses, Advanced Practice Registered Nurses (APRNs), nurse executives, nursing students, nursing faculty, and nurse researchers. Our organizations are committed to improving the health and health care of our nation by collaborating to support advancements in nursing education and practice. The Nursing Community supports this legislation which would allow certain outpatient therapeutic and diagnostic services to be provided under general supervision, rather than direct supervision, of a physician or certain non-physician practitioner. The bill includes in its definition of non-physician practitioner the four APRN roles (nurse practitioner, certified registered nurse anesthetist, certified nurse-midwife, and clinical nurse specialist). As providers of high-quality care for rural communities, the PARTS Act supports these clinicians to practice to the full scope of their education and training as defined by state law. Moreover, by eliminating the Center for Medicare & Medicaid Services current requirement that non-physician providers must be under direct supervision at the time services are furnished, the bill helps address the demand for these critical services in rural areas, and in particular when a health provider shortage is present. The Nursing Community commends this legislation s effort to support APRN practice and ensure some of our nation s most vulnerable patients receive the services they need in a timely manner. If our organizations can be of any assistance, please contact convener of the Nursing Community Dr. Suzanne Miyamoto, at Smiyamoto@aacn.nche.edu or 202-463-6930, ext. 247. Sincerely, Academy of Medical-Surgical Nurses American Academy of Ambulatory Care Nursing American Academy of Nursing American Assembly for Men in Nursing American Association of Colleges of Nursing

American Association of Nurse Anesthetists American Association of Nurse Practitioners American College of Nurse-Midwives American Nurses Association American Organization of Nurse Executives American Psychiatric Nurses Association American Society for Pain Management Nursing American Society of PeriAnesthesia Nurses Association of Community Health Nursing Educators Association of Nurses in AIDS Care Association of perioperative Registered Nurses Association of Public Health Nurses Association of Women's Health, Obstetric and Neonatal Nurses Commissioned Officers Association of the U.S. Public Health Service Dermatology Nurses' Association Gerontological Advanced Practice Nurses Association Hospice and Palliative Nurses Association Infusion Nurses Society International Nurses Society on Addictions International Society of Psychiatric Nurses National American Arab Nurses Association National Association of Clinical Nurse Specialists National Association of Nurse Practitioners in Women's Health National Association of Pediatric Nurse Practitioners National Association of School Nurses National Gerontological Nursing Association National Nursing Centers Consortium National Organization for Associate Degree Nursing National Organization of Nurse Practitioner Faculties Nurses Organization of Veterans Affairs Oncology Nursing Society Preventive Cardiovascular Nurses Association Public Health Nursing Section, American Public Health Association The Quad Council of Public Health Nursing Organizations

October 8, 2013 The Honorable John Thune U.S. Senate 405 Hart Senate Office Building Constitution Ave. and 2nd St. NE Washington, DC 20510 Dear Senator Thune: On behalf of the 39 undersigned organizations representing the Nursing Community, we thank you for introducing the Protecting Access to Rural Therapy Services (PARTS) Act (S. 1143). Collectively, the Nursing Community represents nearly one million Registered Nurses, Advanced Practice Registered Nurses (APRNs), nurse executives, nursing students, nursing faculty, and nurse researchers. Our organizations are committed to improving the health and health care of our nation by collaborating to support advancements in nursing education and practice. The Nursing Community supports this legislation which would allow certain outpatient therapeutic and diagnostic services to be provided under general supervision, rather than direct supervision, of a physician or certain non-physician practitioner. The bill includes in its definition of non-physician practitioner the four APRN roles (nurse practitioner, certified registered nurse anesthetist, certified nurse-midwife, and clinical nurse specialist). As providers of high-quality care for rural communities, the PARTS Act supports these clinicians to practice to the full scope of their education and training as defined by state law. Moreover, by eliminating the Center for Medicare & Medicaid Services current requirement that non-physician providers must be under direct supervision at the time services are furnished, the bill helps address the demand for these critical services in rural areas, and in particular when a health provider shortage is present. The Nursing Community commends this legislation s effort to support APRN practice and ensure some of our nation s most vulnerable patients receive the services they need in a timely manner. If our organizations can be of any assistance, please contact convener of the Nursing Community Dr. Suzanne Miyamoto, at Smiyamoto@aacn.nche.edu or 202-463-6930, ext. 247. Sincerely, Academy of Medical-Surgical Nurses American Academy of Ambulatory Care Nursing American Academy of Nursing American Assembly for Men in Nursing

American Association of Colleges of Nursing American Association of Nurse Anesthetists American Association of Nurse Practitioners American College of Nurse-Midwives American Nurses Association American Organization of Nurse Executives American Psychiatric Nurses Association American Society for Pain Management Nursing American Society of PeriAnesthesia Nurses Association of Community Health Nursing Educators Association of Nurses in AIDS Care Association of perioperative Registered Nurses Association of Public Health Nurses Association of Women's Health, Obstetric and Neonatal Nurses Commissioned Officers Association of the U.S. Public Health Service Dermatology Nurses' Association Gerontological Advanced Practice Nurses Association Hospice and Palliative Nurses Association Infusion Nurses Society International Nurses Society on Addictions International Society of Psychiatric Nurses National American Arab Nurses Association National Association of Clinical Nurse Specialists National Association of Nurse Practitioners in Women's Health National Association of Pediatric Nurse Practitioners National Association of School Nurses National Gerontological Nursing Association National Nursing Centers Consortium National Organization for Associate Degree Nursing National Organization of Nurse Practitioner Faculties Nurses Organization of Veterans Affairs Oncology Nursing Society Preventive Cardiovascular Nurses Association Public Health Nursing Section, American Public Health Association The Quad Council of Public Health Nursing Organizations

October 8, 2013 The Honorable Jon Tester U.S. Senate 706 Hart Senate Office Building 2nd and C Streets, N.E. Washington, DC 20510 Dear Senator Tester: On behalf of the 39 undersigned organizations representing the Nursing Community, we thank you for introducing the Protecting Access to Rural Therapy Services (PARTS) Act (S. 1143). Collectively, the Nursing Community represents nearly one million Registered Nurses, Advanced Practice Registered Nurses (APRNs), nurse executives, nursing students, nursing faculty, and nurse researchers. Our organizations are committed to improving the health and health care of our nation by collaborating to support advancements in nursing education and practice. The Nursing Community supports this legislation which would allow certain outpatient therapeutic and diagnostic services to be provided under general supervision, rather than direct supervision, of a physician or certain non-physician practitioner. The bill includes in its definition of non-physician practitioner the four APRN roles (nurse practitioner, certified registered nurse anesthetist, certified nurse-midwife, and clinical nurse specialist). As providers of high-quality care for rural communities, the PARTS Act supports these clinicians to practice to the full scope of their education and training as defined by state law. Moreover, by eliminating the Center for Medicare & Medicaid Services current requirement that non-physician providers must be under direct supervision at the time services are furnished, the bill helps address the demand for these critical services in rural areas, and in particular when a health provider shortage is present. The Nursing Community commends this legislation s effort to support APRN practice and ensure some of our nation s most vulnerable patients receive the services they need in a timely manner. If our organizations can be of any assistance, please contact convener of the Nursing Community Dr. Suzanne Miyamoto, at Smiyamoto@aacn.nche.edu or 202-463-6930, ext. 247. Sincerely, Academy of Medical-Surgical Nurses American Academy of Ambulatory Care Nursing American Academy of Nursing American Assembly for Men in Nursing

American Association of Colleges of Nursing American Association of Nurse Anesthetists American Association of Nurse Practitioners American College of Nurse-Midwives American Nurses Association American Organization of Nurse Executives American Psychiatric Nurses Association American Society for Pain Management Nursing American Society of PeriAnesthesia Nurses Association of Community Health Nursing Educators Association of Nurses in AIDS Care Association of perioperative Registered Nurses Association of Public Health Nurses Association of Women's Health, Obstetric and Neonatal Nurses Commissioned Officers Association of the U.S. Public Health Service Dermatology Nurses' Association Gerontological Advanced Practice Nurses Association Hospice and Palliative Nurses Association Infusion Nurses Society International Nurses Society on Addictions International Society of Psychiatric Nurses National American Arab Nurses Association National Association of Clinical Nurse Specialists National Association of Nurse Practitioners in Women's Health National Association of Pediatric Nurse Practitioners National Association of School Nurses National Gerontological Nursing Association National Nursing Centers Consortium National Organization for Associate Degree Nursing National Organization of Nurse Practitioner Faculties Nurses Organization of Veterans Affairs Oncology Nursing Society Preventive Cardiovascular Nurses Association Public Health Nursing Section, American Public Health Association The Quad Council of Public Health Nursing Organizations