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A Comparison of Changes in the Professional Practice of Nurse Practitioners, Physician Assistants, and Certified Nurse Midwives:  1992 and 2000

This page: Appendix A.  Project Advisory Committee | Appendix B.  Professional Organizations | Appendix C.  Original Index Calculations

Appendix A.

Project Advisory Committee

Richard A. Cooper, MD
Director, Health Policy Institute
Medical College of Wisconsin
8701 Watertown Plank Road
Milwaukee, WI 53226

Antonio Furino, PhD
Professor of Economic and Director
Center for Health Economics and Policy
University of Texas, HSC at San Antonio
7703 Floyd Curl Drive, Mail Code 7907
San Antonio, TX 78229-3900

Tim Henderson
Director, Primary Care Resource Center
National Conference of State Legislatures
444 North Capitol Street, Suite 515
Washington, DC 20001

L. Gary Hart, PhD
Director, WWAMI Health Workforce Center
Roosevelt Way, NE  Suite 308
University of Washington
Seattle, WA 98195-4795

Thomas R. Konrad, PhD
Director, Program on Health Professions
Sheps Center for Health Services
725 Airport Road, CB 7590, Suite 210
Chapel Hill, NC 27599-7165

Linda Lacey
Associate Director
North Carolina Center for Nursing
222 North Person Street
Raleigh, NC 27601

Kevin Marvelle
VP, Data Systems and Analysis
American Academy of Physician Assistants
950 North Washington Street
Alexandria, VA 22314-1552

Eileen T. O’Grady, PhD, RN, NP
Policy Liaison
American College of Nurse Practitioners
503 Capitol Court, NE, #300
Washington, DC 20002

Joyce Roberts, CNM, PhD
President
American College of Nurse-Midwives (ACNM)
818 Connecticut Avenue, NW  Suite 900
Washington, DC 20006

Hollis Russinof, MUPP
Center Manager and Policy Analyst
Illinois Center for Health Workforce Studies
850 West Jackson Blvd, Suite 400
Chicago, IL  60607

Edward Sekscenski
Health Care Financing Administration
Susan Skillman
Deputy Director, WWAMI Health Workforce Center
Roosevelt Way, NE  Suite 308
University of Washington
Seattle, WA 98195-4795

Joanne Spetz
Research Fellow
Center for the Health Professions
545 Edinburgh Street
San Mateo, CA  94402

Staff

Edward S. Salsberg
Executive Director
Center for Health Workforce Studies
School of Public Health, University at Albany
One University Place, Suite 200
Rensselaer, NY 12144-3456

Paul Wing
Deputy Director
Center for Health Workforce Studies
School of Public Health, University at Albany
One University Place, Suite 200
Rensselaer, NY 12144-3456

Margaret Langelier
Senior Research Associate
Center for Health Workforce Studies
School of Public Health, University at Albany
One University Place, Suite 200
Rensselaer, NY 12144-3456

Emily Slocum
Graduate Research Assistant
Center for Health Workforce Studies
School of Public Health, University at Albany
One University Place, Suite 200
Rensselaer, NY 12144-3456

HRSA Project Officer

Louis A. Kuta
Economist and Project Officer
National Center for Health Workforce Analysis
Health Resources and Services Administration
5600 Fishers Lane, Suite 8-55
Rockville, MD 20857

Appendix B.  Professional Organizations

This appendix lists the professional organizations related to NPs, PAs, and CNMs contacted as part of this study.

Professional Organizations

The professional organizations that credential and represent Nurse Practitioners, Certified Nurse Midwives and Physician Assistants are:

Nurse Practitioners

Nurse Midwives

  • American College of Nurse Midwives
  • American College of Nurse Midwives (ACNM) Certification Council Inc. (ACC)
  • ACNM Division of Accreditation for CNMs and CMs
  • North American Registry of Midwives (NARM) for CPMs
  • American College of Nurse-Midwives Certification Council
Physician Assistants
  • American Academy of Physician Assistants

Appendix C.  Original Index Calculations

This appendix contains a table that documents the detailed calculations used to compute the practice environment indices for the three professions for each of the 50 States plus the District of Columbia. It includes the following subsections:

  • NPs
  • PAs
  • CNMs

NPs

The original practice environment index developed by Sekscenski et al for 1992 was based on a number of specific criteria and point allocations reflecting the then current practice environment for the profession. The specific criteria and point allocations used in creating the index are presented below.

Legal Status (Maximum = 20)

License or Title Recognition = 6.

Practice Defined by the Board of Nursing = 7.

No Supervision by Physician = 7.

Reimbursement (Maximum = 40)

Mandated Payment = 20. [This was understood to mean any required payment to Nurse Practitioners by Medicare, Medicaid, Workers Compensation, or private payer.]

Services Covered = 0 – 10. [Particularly favorable environments were awarded 10 points, while somewhat favorable environments were awarded 5 points]

Medicaid % Pay = 0 – 10. [This was computed by multiplying the percent of physician reimbursement rate x 10. Thus NP reimbursement at 80 percent of physician rate received a score of 8.]

Prescriptive Authority (Maximum = 40)

Full Authority = 40. [This was defined as prescriptive authority for Schedule II-V controlled substances and legend drugs.]

Partial Authority = 10 – 30. [Schedule III-V and legend drugs was valued at 30 points. Schedule IV-V and legend drugs was valued at 20 points. Legend drugs only was awarded 10 points.]

No Authority = 0.

The details of the point allocations for each of the fifty States and the District of Columbia can be found below.

Table C-1 Professional Practice Index Scoring Criteria Original Scoring System for NPs for 2000
Scoring Category Score Optimal Score AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN
Legal Status
License or Title Recognition
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
Practice Defined by Board of Nursing
7
7
7
7
7
7
7
7
7
7
7
7
7
7
7
No Supervision by Physician
7
7
7
7
7
7
7
7
7
7
7
7
7
7
7
7
Subtotals Legal
20
13
20
20
20
20
20
20
20
13
20
13
13
20
20
20
Reimbursement
Mandate Payment
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Services Covered
0-10
10
10
5
10
10
10
10
10
10
10
10
7
10
Medicaid % Pay x 10
10
10
10
8
6
8
10
10
10
10
8
9
7.5
8.5
10
8.5
Subtotals Reimbursement
40
20
33
36
28
20
40
40
40
20
38
29
37.5
38.5
37
38.5
Prescriptive Authority
Full Authority
40
40
40
40
40
40
40
40
40
40
Partial Authority
1-39
10
30
30
10
10
10
30
No Authority
0
Subtotals Prescriptive Authority
40
10
40
40
30
30
40
40
40
40
10
10
10
40
30
40
TOTAL
100
43
93
96
78
70
100
100
100
73
68
52
60.5
98.5
87
98.5
 
Table C-1, continued Professional Practice Index Scoring Criteria Original Scoring System for NPs for 2000
Scoring Category Score Optimal Score IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH
Legal Status
License or Title Recognition
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
Practice Defined by Board of Nursing
7
7
7
7
7
7
7
7
7
7
7
7
7
7
7
No Supervision by Physician
7
7
7
7
7
7
7
7
7
7
7
7
7
7
Subtotals Legal
20
20
20
20
14
20
13
6
13
20
20
20
20
13
20
20
Reimbursement
Mandate Payment
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Services Covered
0-10
10
10
7
10
10
10
10
10
10
10
10
10
10
0
10
10
Medicaid % Pay x 10
10
10
8
8
7.5
8
10
10
10
10
9
9
10
8.5
10
8
10
Subtotals Reimbursement
40
38
35
37.5
38
40
40
40
40
39
39
40
38.5
30
38
40
Prescriptive Authority
Full Authority
40
40
40
40
40
40
40
Partial Authority
1-39
35
10
10
30
10
10
10
35
10
35
No Authority
0
Subtotals Prescriptive Authority
40
40
35
10
10
30
40
40
10
40
10
10
40
35
10
35
TOTAL
100
98
90
67.5
62
90
93
86
63
99
69
70
98.5
78
68
95
 
Table C-1, continued Professional Practice Index Scoring Criteria Original Scoring System for NPs for 2000
Scoring Category Score Optimal Score NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT
Legal Status
License or Title Recognition
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
Practice defined by Board of Nursing
7
7
7
7
7
7
7
7
7
7
7
7
7
No Supervision by Physician
7
7
7
7
7
7
7
7
7
7
7
7
7
Subtotals Legal
20
20
20
13
13
20
20
13
20
6
20
13
13
7
20
20
Reimbursement
Mandate Payment
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Services Covered
0-10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
Medicaid % Pay x 10
10
10
9.5
9
10
10
8
10
9
10
10
8
8
9
10
7
10
Subtotals Reimbursement
40
39.5
39
40
40
38
40
19
40
40
38
28
39
40
37
40
Prescriptive Authority
Full Authority
40
40
40
40
40
40
40
40
40
40
40
Partial Authority
1-39
20
35
30
30
10
10
No Authority
0
Subtotals Prescriptive Authority
40
20
40
40
35
40
30
30
40
40
40
10
40
40
10
40
TOTAL
100
79.5
99
93
88
98
90
62
100
86
98
51
92
87
67
100
 
Table C-1, continued Professional Practice Index Scoring Criteria Original Scoring System for NPs for 2000
Scoring Category Score Optimal Score VT VA WA WV WI WY  
Legal Status
License or Title Recognition
6
6
6
6
6
6
  
Practice Defined by Board of Nursing
7
7
7
7
7
7
7
No Supervision by Physician
7
7
7
7
7
7
7
Subtotals Legal
20
20
20
14
20
20
  
Reimbursement
Mandate Payment
20
20
20
20
20
  
Services Covered
0-10
10
10
10
10
10
10
10
Medicaid % Pay x 10
10
10
10
10
10
10
10
10
Subtotals Reimbursement
40
20
20
40
40
20
40
  
Prescriptive Authority
Full Authority
40
40
40
40
40
 
Partial Authority
1-39
18
35
30
No Authority
0
Subtotals Prescriptive Authority
40
40
18
40
35
40
30
  
TOTAL
100
80
38
100
89
80
90
  

PAs

The original practice environment index developed by Sekscenski et al for 1992 was based on a number of specific criteria and point allocations reflecting the then present practice environment for the profession. The criteria and point allocations used in creating the index are presented below. The detailed point allocations for the 50 States can be found below.

Legal Status (Maximum = 20)

License or Title Recognition = 5.

Professional Practice Regulations = 5.

Practice Under Indirect Physician Supervision = 0 – 10. [On-site supervision = 0; Distance limitations in the regulations = 5; and Indirect supervision with electronic communication = 10.]

Reimbursement (Maximum = 40)

Mandated Payment = 30. [This was assumed to mean any required payment by Medicare, Workers Compensations, Medicaid or third party payer.]

Payment for Services Under Indirect Supervision = 10. [This was determined to be the Medicaid percent times ten.]

Prescriptive Authority (Maximum = 40)

Any authority to Write Prescriptions = 20.

Limited Authority to Order Medications in Inpatient Settings = 0 – 10. This was a subjective category scored according to the variation across the states in the privilege to write scripts in hospitals. If orders for medication must be signed by a physician before execution, for instance, fewer point were awarded. If PAs could write orders for immediate implementation with post review of records, 10 points were awarded.]

Absence of Specific Restrictions = 0 – 10. [This was scored by a review of all restrictions on prescriptive authority. A point was discounted from the full value of 10 for each restriction found.]

Table C-2 Professional Practice Index Scoring Criteria Original Scoring System for PAs for 2000
Scoring Category
Score
Optimal
Score
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
Legal Status
License or Title Recognition
5
5
5
5
5
5
5
0
5
5
5
5
5
5
5
5
5
Scope of Practice Regulations
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Practice Under Physicians Indirect Supervision
0-10
10
10
10
10
10
10
10
9
10
10
8
8
10
10
10
7
 
Subtotals Legal
20
20
20
20
20
20
15
19
20
20
18
18
20
20
20
17
 
Reimbursement
Mandate Payment
30
30
30
30
30
30
30
30
30
0
0
30
30
30
30
30
30
Payment for Services Under Indirect Supervision (if less than physician then %x10)
10
10
10
8.5
10
10
10
10
10
10
0
8
9
10
8.5
10
 
Subtotals Reimbursement
40
40
38.5
40
40
40
40
40
10
0
38
39
40
38.5
30
40
 
Prescriptive Authority
Any Authority to Write Prescriptions
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
0
20
Limited Authority to Order Medications in Inpatient settings
0-10
10
7
10
10
10
10
10
10
10
10
10
10
10
Absence of Specific Restrictions
0-10
10
2
8
9
8
7
10
8
8
9
7
9
9
9
9
 
Subtotals Prescriptive Authority
40
29
38
39
38
37
40
38
38
39
37
39
39
29
9
20
 
TOTAL  
100
89
96.5
99
98
97
95
97
68
59
93
96
99
87.5
59
77
Table C-2, continued Professional Practice Index Scoring Criteria Original Scoring System for PAs for 2000
Scoring Category
Score
Optimal Score
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
Legal Status
License or Title Recognition
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Scope of Practice Regulations
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Practice Under Physicians Indirect Supervision
0-10
10
10
10
10
10
10
10
10
10
10
10
9
10
5
9
8
 
Subtotals Legal
20
20
20
15
20
20
20
20
20
20
20
19
20
15
19
18
 
Reimbursement
Mandate Payment
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
Payment for Services Under Indirect Supervision (if less than physician then %x10)
10
10
10
7.5
10
10
10
10
10
10
9
10
9.5
10
8.5
10
 
Subtotals Reimbursement
40
40
37.5
40
40
40
40
40
40
39
30
40
39.5
40
38.5
40
 
Prescriptive Authority
Any Authority to Write Prescriptions
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Limited Authority to Order Medications in
0-10
10
10
10
0
10
10
10
10
10
10
10
10
10
10
Inpatient settings
Absence of Specific Restrictions
0-10
10
9
9
4
2
7
9
8
8
10
9
8
9
 
Subtotals Prescriptive Authority
40
39
39
20
0
34
30
32
37
29
38
38
40
39
38
39
 
TOTAL   100 99 96.5 75 60 94 90 92 97 88 88 97 99.5 94 95.5 97
Table C-2, continued Professional Practice Index Scoring Criteria Original Scoring System for PAs for 2000
Scoring Category
Score
Optimal
Score
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
Legal Status
License or Title Recognition
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Scope of Practice Regulations
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Practice Under Physicians Indirect Supervision
0-10
10
7
10
10
10
10
10
10
10
10
10
10
9
10
10
10
 
Subtotals Legal
20
17
20
20
20
20
20
20
20
20
20
15
19
20
20
20
 
Reimbursement
Mandate Payment
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
30
Payment for Services Under Indirect Supervision (if less than physician then %x10)
10
10
10
10
10
8
8
10
10
10
10
8
10
10
10
 
Subtotals Reimbursement
40
0
40
40
40
38
30
38
40
40
40
40
38
40
40
40
 
Prescriptive Authority
Any Authority to Write Prescriptions
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Limited Authority to Order Medications in Inpatient settings
0-10
10
5
10
10
10
0
5
10
10
0
10
0
10
10
10
10
Absence of Specific Restrictions
0-10
10
8
9
4
10
8
9
6
7
5
10
9
3
8
 
Subtotals Prescriptive Authority
40
25
38
39
34
30
5
38
39
26
37
25
40
39
33
38
 
TOTAL
100
42
98
99
94
88
55
96
99
86
97
80
97
99
93
98
Table C-2, continued Professional Practice Index Scoring Criteria Original Scoring System for PAs for 2000
Scoring Category
Score
Optimal
Score
VT
VA
WA
WV
WI
WY
  
Legal Status
License or Title Recognition
5
5
5
5
5
5
5
5
Scope of Practice Regulations
5
5
5
5
5
5
5
5
Practice Under Physicians Indirect Supervision
0-10
10
10
2
10
10
10
10
 
Subtotals Legal
20
20
12
20
20
20
20
 
Reimbursement
Mandate Payment
30
30
30
30
30
30
30
30
Payment for Services Under Indirect Supervision (if less than physician then %x10)
10
10
9
10
10
10
10
 
Subtotals Reimbursement
40
39
30
40
40
40
40
 
Prescriptive Authority
Any Authority to Write Prescriptions
20
20
20
20
20
20
20
20
Limited Authority to Order Medications in Inpatient settings
0-10
10
10
5
10
10
10
10
Absence of Specific Restrictions
0-10
10
6
10
9
5
7
 
Subtotals Prescriptive Authority
40
36
25
40
39
35
37
 
TOTAL
100
95
67
100
99
95
97

CNMs

The scores on the Sekscenski CNM professional practice index indicate a trend toward greater autonomy in State practice environments for CNMs across the fifty States and the District of Columbia between 1992 and 2000. The scores indicate the trend towards greater professionalization, socialization, and standardization of the CNM profession over the last decade. These trends are discussed more fully at the end of this chapter.

Legal Status (Maximum = 20)

License or Tile Recognition = 10.

Regulation by Board of Nursing Alone = 10. [These points were allocated only if the Board of Nursing had sole regulatory authority. If another agency or board had any influence on some aspect of professional practice, such as prescriptive privilege, no points were awarded.]

Reimbursement (Maximum = 40)

Mandated Payment = 20. [This was interpreted to mean that reimbursement is required by Medicare, Medicaid, Workers Compensation, or third party payers.]

Services Covered = 0 – 20. [This was a subjective award with 20 points given to very favorable payment environments, 10 points awarded for somewhat favorable environments, and fewer points given as determined by the reimbursement environment in a particular State. Incorporated in this category was Medicaid percentage payment times ten (as found in the CNM scale).]

Prescriptive Authority (Maximum = 40)

Full Authority = 40. [This was defined as prescriptive authority for Schedule II-V controlled substances and legend drugs. Schedule III-V and legend drugs was valued at 30 points. Schedule IV-V and legend drugs was valued at 20 points, while legend drugs only was awarded 10 points.]

The detailed point allocations for CNMs for the 50 States are presented below.

Table C-3 Professional Practice Index Scoring Criteria Original Scoring System for CNMs for 2000
Scoring Category
Score
Optimal Score
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
Legal Status
License or Title Recognition
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
Regulation by Board of Nursing Alone
10
10
10
10
10
10
10
10
10
10
10
10
10
10
 
Subtotals Legal
20
10
10
20
20
20
20
10
20
20
10
20
20
20
20
20
 
Reimbursement
Mandate Payment
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Services Covered
0-20
20
20
20
16
8
20
20
20
20
20
18
9
17
20
1
18
 
Subtotals Reimbursement
40
20
40
36
28
40
40
40
40
20
38
29
37
40
21
38
 
Prescriptive Authority
Full Authority
40
40
40
40
40
40
40
40
40
40
 
30
30
Limited or Restricted Authority
20
 
10
10
10
10
No Authority
0
10
 
Subtotals Prescriptive Authority
40
10
40
40
30
10
40
40
40
40
10
10
10
40
30
40
 
TOTAL  
100
40
90
96
78
70
100
90
100
80
58
59
67
100
71
98
 
Table C-3, continued Professional Practice Index Scoring Criteria Original Scoring System for CNMs for 2000
Scoring Category
Score Optimal Score IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH
Legal Status
License or Title Recognition
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
Regulation by Board of Nursing Alone
10
10
10
10
10
10
10
10
10
10
 
Subtotals Legal
20
20
10
20
20
10
10
10
20
20
10
10
20
10
10
20
 
Reimbursement
Mandate Payment
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Services Covered
0-20
20
17
18
18
20
20
20
20
20
20
19
20
18
10
18.5
20
 
Subtotals Reimbursement
40
37
38
38
40
40
40
40
40
40
39
40
38
30
38.5
40
 
Prescriptive Authority
Full Authority
40
40
40
40
40
40
40
40
 
35
35
Limited or Restricted Authority
20
 
10
10
10
10
10
10
10
No Authority
0
 
Subtotals Prescriptive Authority
40
40
35
10
10
40
40
40
10
40
10
10
40
10
10
35
 
TOTAL
100
97
83
68
70
90
90
90
70
100
59
60
98
50
58.5
95
 
Table C-3, continued Professional Practice Index Scoring Criteria Original Scoring System for CNMs for 2000
Scoring Category
Score
Optimal Score
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
Legal Status
License or Title Recognition
10
10
10
10
10
10
10
10
10
10
10
10
10
10
10
Regulation by Board of Nursing Alone
10
10
0
0
10
10
10
10
 
Subtotals Legal
20
10
10
10
20
20
10
20
10
10
10
10
20
10
 
Reimbursement
Mandate Payment
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
20
Services Covered
0-20
20
17
20
20
20
17
20
20
20
20
9
19
19
17
18
 
Subtotals Reimbursement
20
37
40
40
40
37
40
20
40
40
40
29
39
39
37
38
 
Prescriptive Authority
Full Authority
40
40
40
40
40
40
40
40
40
 
30
30
30
Limited or Restricted Authority
20
20
20
 
10
10
No Authority
0
0
 
Subtotals Prescriptive Authority  
40
10
40
40
40
40
30
30
30
0
40
20
40
20
10
40
 
TOTAL  
100
47
90
90
90
97
90
60
90
50
90
59
89
59
67
88
 
Table C-3, continued Professional Practice Index Scoring Criteria Original Scoring System for CNMs for 2000
Scoring Category
Score
Optimal Score
VT
VA
WA
WV
WI
WY
  
Legal Status
License or Title Recognition
10
10
10
10
10
10
10
10
Regulation by Board of Nursing Alone
10
10
10
10
10
10
10
 
Subtotals Legal
20
20
10
20
20
20
20
 
Reimbursement
Mandate Payment
20
20
20
20
20
20
20
Services Covered
0-20
20
17
20
20
18
20
 
Subtotals Reimbursement
40
20
37
40
40
18
40
 
Prescriptive Authority
Full Authority
40
40
40
40
40
 
30
30
Limited or Restricted Authority
20
20
 
No Authority
0
 
Subtotals Prescriptive Authority
40
40
20
40
30
40
30
 
TOTAL
100
80
67
100
90
78
90

Preface | Executive Summary | Introduction | Key Findings | Discussion | Chapter 1.  Study Overview | Chapter 2.  Background and Context | Chapter 3.  Professional Practice Indices | Chapter 4.  Nurse Practitioners | Chapter 5.  Physician Assistants | Chapter 6.  Certified Nurse Midwives | Chapter 7.  Factors Related to Professional Practice Indices | Chapter 8.  Field Work in Seven States | Chapter 9.  Access to Care | Appendix A.  Project Advisory Committee | Appendix B.  Professional Organizations | Appendix C.  Original Index Calculations | Appendix D.  Professional Practice Index Calculations for PAs | Appendix E.  Professional Practice Index Calculations for NPs | Appendix F.  New CNM Scope Index Calculations | Appendix G.  Field Work Details | Appendix H.  References

 


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