Andrew Overbey, FNP-BC, ENP-C

Scope of practice

Autonomous APRN practice in Virginia

The clinician practices as an APRN with full practice authority (autonomous practice) in Virginia. This authority comes from Va. Code § 54.1-2957(I) and is implemented by 18 VAC 90-30-86. Eligibility requires at least three years (5,400 hours) of full-time post-graduate clinical experience in the practice category in which the APRN is certified and licensed (2024 Va. Acts ch. 305 (HB 971), eff. July 1, 2024), attestation by the patient-care-team physician(s), and approval by the Joint Boards of Nursing and Medicine.

Under 18 VAC 90-30-86(G), an APRN with autonomous practice is individually responsible for:

1. Practicing only within the scope of the APRN's clinical and professional training, knowledge, experience, and applicable standards of care.
2. Consulting and collaborating with other health care providers based on the patient's clinical condition.
3. Maintaining a plan for referral of complex medical cases and emergencies to physicians or other appropriate health care providers.

Practiclear's services are deliberately bounded to a narrow, online screening use case that fits squarely inside that scope: pre-employment, pre-clinical, and pre-matriculation screening documentation (TB IGRA, MMR / Varicella titers, and Hep B surface antibody / anti-HBs immunity documentation) and clinician review of existing immunization documentation. Practiclear does not provide:

• Primary care, urgent care, or chronic-disease management.
• Controlled-substance prescribing.
• Acute symptomatic evaluation. Patients with active symptoms are referred to in-person care.
• Treatment of latent or active tuberculosis. Positive IGRA results are referred to primary care, the local health department, or an infectious-disease clinician for workup and management, consistent with reportable-disease rules at 12 VAC 5-90-80.

Telehealth is governed by the same standard of care as in-person care under board guidance. The bona fide practitioner-patient relationship is established consistent with Va. Code § 54.1-3303 and the statewide telehealth framework at Va. Code § 32.1-122.03:1. See the Telehealth Informed Consent for the patient-facing description of how this works in practice.