you can do it! representative melvin neufeld kansas
TRANSCRIPT
You Can Do It!Representative Melvin Neufeld
Kansas
Look to the Future
• What will the Healthcare System look like?– Shortage of primary care providers– Shortage of dental primary care– Increased demand in geriatrics
• Where do APRN’s fit?
Where are you now?• From the “Overview” of AMA Scope of
Practice Data Series: Nurse Practitioners, fighting words…“It is the AMA’s intention that these Scope of Practice Data Series modules provide the background information necessary to challenge the state and national advocacy campaigns of limited licensure health providers who seek unwarranted scope-of-practice expansions that may endanger the health and safety of patients.”-Standards of State’s vary greatly
How do you get there?• In December of 2009, the American
Nurses Association and other nursing organizations responded to the AMA report with a strongly worded letter characterizing the report as misleading.
• In January of 2010, the Engleberg Center for Health Care Reform, part of the Brookings Institution, issued a report encouraging states to increase the use of nurse practitioners and other health professionals to improve access and to reduce costs.
• On November 17, 2010, the Institute of Medicine (IOM) released its report, “The Future of Nursing: Leading Change, Advancing Health.
• The report calls for:– Increasing the use of nurse
practitioners;– Improving and increasing educational
opportunities for nurse practitioners; and
– Increasing the number of nurse practitioners.
• Nurses should:– practice to the full extent of their education
and training.– achieve higher levels of education and
training through an improved education system that promotes seamless academic progression.
– be full partners, with physicians and other health professionals, in redesigning health care in the U.S.
• Effective workforce planning and policy making require better data collection and an improved information infrastructure.
• Remove scope of practice barriers.• Expand opportunities for nurses to
lead and diffuse collaborative improvement efforts.
• Implement nurse residency programs.
• Increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020.
• Double the number of nurses with a doctorate by 2020.
• Ensure that nurses engage in lifelong learning.
• Prepare and enable nurses to lead change to advance health.
• Build an infrastructure for the collection and analysis of interprofessional health care workforce data.
Current State of Affairs
• Physician Supervision -Diagnosing/Treatment– According to the Pearson Report, with
respect to diagnosing and treating, states are almost evenly split between those which require no physician involvement (23 states and the District of Columbia) and those which require written documentation of physician involvement (24 states). Four states require physician involvement, but do not require written documentation of a relationship.
Physician Involvement – Diagnosis and Treatment
None RequiredAlaska, Arizona, Colorado, District of Columbia, Hawaii, Idaho, Iowa, Kentucky, Maine, Michigan, Montana, New Hampshire, New Jersey, New Mexico, North Dakota, Oklahoma, Oregon, Rhode Island, Tennessee, Utah, Washington, West Virginia and Wyoming.
Physician Involvement Required
Alabama, Arkansas, California, Delaware, Florida, Georgia, Illinois, Kansas, Louisiana, Maryland, Massachusetts, Mississippi, Missouri, Nebraska, Nevada, New York, North Carolina, Ohio, South Carolina, South Dakota, Texas, Vermont, Virginia, and Wisconsin.
* Connecticut, Indiana, Minnesota, and Pennsylvania do not require written documentation.
Physician Involvement-Prescribing
• Only 14 states and the District of Columbia allow nurse practitioners to prescribe without written documentation of physician involvement.
• The states are: Alaska, Arizona, Colorado, Idaho, Iowa, Maine, Montana, New Hampshire, New Mexico, Oregon, Rhode Island, Utah, Washington, and Wyoming.
Work Force Development • Nursing Shortage
– Practice– Education (Severe shortage of PhDs for
teaching)
• Health Reform– Concerns about health workforce
shortage
• Rising Health Care Costs• Focus on Primary Care
– Health Promotion/Disease Prevention
• Rise in the Use of Ambulatory Care Settings– Retail Clinics
What’s Next
• Develop and Implement a National/State Plan of Action
• Address the Concerns of Physicians and Elected Officials– Identify weaknesses in training and
preparation– Review credentialing– Build relationships with your State
Legislators
• Reciprocity
Final Thoughts
• Circumstances require us to move forward, pragmatism requires us to move forward with all deliberate speed and common sense requires us to do it well.
