F. STRATEGIES FOR WORKING WITH STATE APC REGULATORY BOARDS
Many activists and health care providers are familiar with their political representatives and the
processes of their state government. Surprisingly, however, few have an understanding of who
serves on their state’s regulatory boards, how members are appointed, the boards’ decisionmaking
procedures, or how these boards can influence the practice of abortion by APCs. State
health professional politics can be as contentious as abortion politics which often includes the
relationships between licensing boards and professional organizations. Understanding regulatory
board functions as well as the roles of the board members is essential to advocating for
policies and change around scope of practice, and is a critical component of making sure that
clinicians who are providing or plan to provide abortion care have full understanding of what
could happen if their practice is challenged.
Although issues tend to come and go, often the same people remain in leadership positions.
Thus, learning to work with the people on the state regulatory boards makes a lot of sense. To
develop good relationships, APCs should create strategies to increase the opportunities for communication,
education, and cooperation. Traditionally, regulatory boards are underfunded, understaffed,
and hassled by many licensure-driven tasks. Many boards have great latitude in how
they draft regulatory language that practitioners may have to live with for a long time. Many
complex issues are currently before them that will affect CNM, NP or PA practice in the future.
Here are some proactive approaches for clinicians and their professional organizations who
want to advocate for scope of practice changes generally and/or advance abortion practice in
particular. See also Figure IV.3 on “getting to know your state regulatory board” strategies.
- Volunteer to help your board, especially to serve on committees, by providing education and information about how any new regulations will affect your practice. Developing a better understanding of the issues or limitations that affect both the public and health professional groups can only help them do what they do best—focus on the patient.
- Learn about board processes; what are the mechanisms the board uses to regulate and advance scope of practice.
- Attend a Board public meeting to observe the process in action and initiate the acquaintance of board members and colleagues from around the state.
- Obtain the minutes from public meetings; in many states they are available online.
- Talk with colleagues who have been investigated for a scope of practice complaint or who have petitioned the board to advance their scope of practice.
Individual clinicians as members of their state professional organizations will have the most
influence in working with their respective licensing boards. Leaders of the professional associations
are likely to be the most knowledgeable about Board processes and in many cases are
active members of licensing board committees or are involved in making recommendations for
regulatory board appointments to the state legislature or governor. See Section III.G for how
professional organizations can effectively work with state regulatory boards.
In doing this kind of research, preparation and relationship-building, individual clinicians
(as members of their professional organizations) and their allies are not only able to move
forward with confidence in providing abortion care, but they also show members of the regulatory
board that they are committed to abortion care as a scope of practice issue and not just a
political hot potato or headline-grabber. Too often, regulatory boards have been ignored
by activist groups who favor the legislative process, and it takes a shift in perspective for
advocates to begin working hand in hand with healthcare providers toward goals that are truly
pro-professional and pro-patient. Building relationships, educating members of the regulatory
board about the barriers to access and the safety of abortion, offering oneself up as a resource
when questions arise, and showing interest in the goals of the regulatory board and colleagues
in various fields can go a long way toward building goodwill and open lines of communication
prior to meeting over a challenge, when emotions may run high.
FIGURE IV.3
Getting to Know Your State’s Professional Regulatory Boards
- It is never too early (or too late!) to do some research on the members of the state licensing boards
that have authority for regulating medical, nursing or midwifery practice in one’s state. Some questions
to ask when doing research on these members:
- Who lives in rural communities and who lives in urban communities? Both of these groups may understand access issues in different ways and may be eager to learn how APCs are providing care to patients in their area.
- Are there members of the Board with whom you have mutual interests, mutual acquaintances, or mutual experiences that can be used as entrée to getting to know each other and discussing issues of reproductive health access generally, or specifically access to abortion care in your state?
- Who appointed the members? What have the members’ stances been on other decisions regarding reproductive health care or issues deemed “controversial” (such as end-of-life care)?