I support the revision of the current Clinical Nurse Specialist regulations based on the Institute of Medicine Report of October 2011 which identifies the four types of APRNs (IOM, Table 1-1, page 26), and challenges states to reduce fragmentation within the Nursing profession and enhance quality and access of care by allowing APRNs to "work to the full extent of their training and education", (IOM, Key message #1, p. 29).  Such prescribed revisions will also reinforce the role of the CNS in accordance with the nationally developed Consensus Model for APRN Regulations. 

Please support the Revision to CNS Regulations for your state which will enable citizens of the Commonwealth of Virginia to benefit from the expertise of Psychiatric-Mental Health Clinical Nurse Specialists, improving access and quality of care.  Thank you for your attention to my comments.

IOM (2011).  The future of nursing, leading change, advancing health. Washington, DC: The National Academies Press.