ANA-Ohio Supports House Bill 508 – Removing the Standard Care Agreement
ANA-Ohio Supports HB 508—Position Statement
The ANA-Ohio Board of Directors voted to formally support HB 508, a bill that would enable Ohio’s advanced practice registered nurses (APRNs) to practice without a standard care agreement (SCA) entered into with a collaborating physician. The bill was introduced on October 8, 2025, by Representatives Jennifer Gross (R-West Chester) and Rachel Baker (D-Cincinnati) both APRNs. It was referred to the House Medicaid Committee where hearings began on October 21st.
ANA-Ohio believes supporting removal of an outdated practice restriction that has made it difficult for APRNs to be the asset they must be in Ohio and elsewhere is long overdue and in the best interest of all Ohioans.
Historical Background
Ohio’s recognition of APRNs can best be described as incremental. The state first recognized advanced practice registered nurses in 1993, when the General Assembly approved two pilot programs that authorized APRNs to practice (including prescriptive authority) with limited patient populations. In 1996, APRNs were recognized statewide, but they did not have authority to prescribe medications. Prescriptive authority was added to Ohio law in 2000; however, that authority was tied to an inclusionary formulary that required all allowable drugs to be listed on a cumbersome formulary. In 2017, prescriptive authority was still tied to a formulary, but it was an exclusionary formulary that allowed APRNs’ authority to more readily meet the prescription drug needs of their patients.
While many changes have been approved, one more practice limitation remains part of the state’s law. Currently, in order to practice in Ohio, APRNs must enter into and maintain a standard care agreement (SCA) with a collaborating physician, and the requirement never ends for APRNs. In other words, for the entirety of an APRN’s practice life, they cannot render the care they are educated, licensed, certified, and authorized to provide unless they have the SCA. If the physician leaves practice or decides they no longer wish to be a party to the agreement, the APRN’s authority to practice as an advanced practice nurse ceases until they can find another collaborating physician. This effectively sidelines the APRN and often leaves patients without the means to obtain the care they need.
What is a standard care agreement?
The phrase “standard care agreement” or SCA arises frequently in conjunction with HB 508, so it is important to understand what an SCA actually is. An SCA is a written formal guide between an APRN and a collaborating physician who (with some exceptions) is practicing in a specialty that is the same as or similar to the nurse’s nursing specialty. These guides must address administrative matters such as coverage for the parties in cases of planned, unexpected, or emergency absences; a process to resolve disagreements; criteria for referral of a patient; and a process for obtaining a consultation. Because this agreement, under current law, is crucial to an APRN’s practice, if someone decides to no longer serve as a collaborating physician, the APRN must be notified immediately, and the nurse must notify the Board of Nursing. If a new collaborating physician cannot be found within 120 days of the board’s notification, the APRN must cease practicing, potentially leaving patients to fend for themselves. (Sources: Section 4723.431 Ohio Rev. Code and Rule 4723-8-01 Ohio Admin. Code).
What’s in HB 508?
The bill is simple, and its passage would allow Ohio to join 30 other states that have eliminated unnecessary restrictions such as the SCA. In recognition of the concerns expressed by some, the bill provides that the SCA requirement will be retained until the APRN completes 5,000 hours of clinical practice with a provider. An APRN may maintain an SCA for longer than 5,000 hours if the APRN chooses to do so.
What HB 508 does NOT do?
The requirements for licensure as an APRN by the board of nursing are not affected by HB 508. APRNs must still earn an advanced degree from an accredited college or university, pass a national certification examination, and practice in accordance with practice standards established by the Board of Nursing and national professional nursing practice organizations. APRNs are also subject to disciplinary action if they fail to practice in accordance with Ohio’s relevant law, rules, and regulations. Finally, the scope of practice for APRNs remains unchanged by HB 508.
Conclusion:
Passage of HB 508 will allow APRNs to fully utilize their skills and expertise to help address the shortfalls affecting the delivery of essential care to Ohioans. HB 508 removes an outdated practice restriction that has made it difficult for APRNs to be the asset they must be in Ohio and elsewhere. ANA-Ohio believes that Ohio cannot afford to underutilize or otherwise limit qualified care providers now or in the future if we hope to provide Ohioans with the accessible, affordable, quality health care they need and deserve.
*Approved by the ANA-Ohio Board of Directors on November 10, 2025.
