(1) Background: Veterans access to healthcare has be a major issue nationwide. In order to take care of our growing Veteran population the Veterans Health Administration has proposed that all Advanced Practice Registered Nurses (APRNs) and Physician Assistants have full practice authority. APRNs include Certified Registered Nurse Anesthetists, Nurse Practitioners, Nurse Midwives, and Clinical Nurse Specialists. This change to the nursing handbook is supported by Senate bill 2279 (The Veterans Health Care Staffing Improvement Act) and House bill 1247 (Improving Veterans Access to Quality Care Act). Allowing APRNs and Physician Assistants full practice authority will allow the Veterans Health Administration to deliver care to Veterans in an efficient manner while maintaining safety and preserving a high quality of care. This legislation will also allow for a single policy across the Veterans Health Administration in regard to scope of practice for APRNs and Physicians Assistants. The current policy varies by state and in some instances severely limits the scope of practice for APRNs and Physicians Assistants which is both inefficient and financially irresponsible.

(2) Current Stance: The National Guard Association of the United States has come out with a memorandum against Senate bill 2279, specifically full practice authority for Certified Registered Nurse Anesthetists.

(3) Impact of not supporting Senate bill 2279 and House Bill 1247: Veterans will continue to suffer from an inefficient and ineffective healthcare policy. The VA healthcare system will continue to define the role of the Advanced Practice Registered Nurses and Physician Assistants by state law rather than institutional policy.

(4) Recommendation: The South Dakota Officers Association discussed the issue at length at the yearly conference and as a group unanimously moved to support Senate bill 2279 and House bill 1247 in an effort to streamline care, provide high quality care, and allow for a single policy throughout the Veterans Health Administration. Our support in this matter is consistent with the policy of the U.S. Armed Forces which already recognizes APRNs to their full practice authority, with the recommendations of the Institute of Medicine, and with the recommendations of the congressionally mandated Independent Assessment of the U.S. Department of Veterans Affairs (Fall 2015). The resolution committee, on behalf to the officer's association of South Dakota, recommends the current memorandum be rescinded and replaced with language in full support of Senate bill 2279 and House bill 1247.