HCA 320 Discussion: Healthcare Policy and Economics

HCA 320 Discussion: Healthcare Policy and Economics

HCA 320 Discussion: Healthcare Policy and Economics

An ongoing challenge for advanced practice registered nurses (APRNs) has been changing state legislation that allows APRNs to practice to the fullest extent to which they were academically prepared. For this discussion question, contact the Board of Nursing (BON) in your state or access your BON online. Examine laws that govern APRNs in your state. Consider the following: do APRNs in your state have prescriptive authority; is there legislation in place that allows them to practice autonomously; and finally, if a bill has been passed and adopted, which legislator introduced the bill and who were the strongest advocates for the bill? Then post an initial response that addresses the following:

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Explain how the lack of autonomy for APRNs impact patients in rural populations? As a health care professional in an advocacy role, what resources could you utilize to guide you in changing policies that impact APRNS in your state? Include in your discussion the type of stakeholders and collaborative partners you would seek to guide or assist you on this cause.

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The role of Advanced Practice Registered Nurses in the healthcare industry is crucial for improving access to care, particularly in underserved regions such as rural areas. However, variations in legislation across different states affect their ability to provide comprehensive care autonomously. This can limit patient access to timely appointments with physicians and lead to delayed diagnoses and treatments, significantly impacting rural populations due to longer travel distances. The limitations also contribute to the shortage of healthcare providers in these regions despite APRNs being qualified for primary care services that could address this gap. In Michigan, APRNs have encountered significant obstacles concerning their scope of practice, prescriptive authority, and autonomy. This discussion explores the state of APRN practice in Michigan, focusing on recent legislative changes, the consequences of limited autonomy in rural settings, and the resources and stakeholders essential for advocacy efforts.

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In Michigan, nurse practitioners are subject to strict scope-of-practice laws that mandate supervision by licensed physicians rather than allowing independent practice. These laws are some of the most stringent in the nation, as they do not recognize NPs as primary care providers within the state (Nurse Practitioner License, 2023). Consequently, many NPs advocate for Michigan to transition into a Full Practice state, aiming to improve public access to affordable healthcare services. Michigan is currently challenged by a shortage of primary care professionals, especially in rural areas where 3.4 million residents live in federally designated primary healthcare shortage areas. According to the US Health Resources and Services Administration (Bureau of Health Workforce Health Resources and Services Administration (HRSA) US Department of Health & Human Services, 2023), only half of their primary care needs are being addressed. Numerous nurse practitioners in Michigan have received advanced education at the doctoral level and have acquired significant clinical expertise that meets the criteria established in other states. With a growing elderly population, there is an urgent requirement for Michigan to introduce new laws aimed at increasing healthcare accessibility for those most in need.

Current State of APRN Practice in Michigan

As of October 6, 2021, Senate Bill No. 680 was introduced in Michigan to bring about significant changes in the regulation of APRN practice (Michigan Legislature, 2021). The bill expands the prescriptive authority of nurse practitioners with specialty certification, allowing them to independently prescribe certain controlled substances without requiring delegation from a physician. Additionally, the bill addresses the ordering and dispensing of complimentary starter dose drugs by registered professional nurses and advanced practice registered nurses. The document explains the responsibilities of supervising physicians and how these duties are delegated (Michigan Legislature, 2021). Advanced practice registered nurses, especially those holding nurse practitioner specialty certification, now have the authority to request, receive, and distribute controlled substances. This expansion strengthens their contribution to healthcare delivery.

Impact of Limited Autonomy on Rural Populations

The limited independence of APRNs, particularly nurse practitioners, has had notable consequences for patients in rural areas of Michigan. Rural communities frequently encounter difficulties obtaining healthcare because few physicians and other primary care providers are available (Zwilling & Fiandt, 2019). APRNs are strategically positioned to address this gap by providing prompt and accessible healthcare services. However, the previous mandate for nurse practitioners to operate under Collaborative Practice Agreements with physicians hindered their capacity to deliver immediate care in remote regions. The amendments introduced by Senate Bill No. 680 address this issue by allowing nurse practitioners to diagnose, treat, and manage patients, order and interpret tests, and prescribe necessary medications without direct physician oversight. This change enables nurse practitioners to provide more timely and comprehensive care, making a significant difference in rural areas where immediate access to healthcare can be a matter of life and death.

Advocacy Resources and Stakeholders

Resources and cooperative efforts are crucial to advancing policies that benefit APRNs in Michigan. Important stakeholders involved in this advocacy effort and resources include:

• Michigan Council of Nurse Practitioners (MICNP): MICNP is a helpful resource and ally in advocacy efforts since it has been a well-known advocate for nurse practitioners in Michigan (Michigan Council of Nurse Practitioners, 2023).
• Legislators: Senate Bill No. 680 was introduced by Senators Outman, Barrett, Runestad, Santana, Irwin, and Schmidt. Making ties and developing a rapport with these lawmakers is essential to pushing for additional improvements.
• Physician Associations: Finding common ground in advancing healthcare legislation and addressing the scope of practice challenges requires cooperation with groups like the Michigan State Medical Society.
• Rural Health Organizations: Collaborating with institutions such as the Michigan Center for Rural Health can aid in bringing attention to the distinct healthcare obstacles rural communities encounter.
• Patient Advocacy Groups: By involving patient advocacy groups, governments can garner public support for expanding APRN practice, making it an appealing subject.

Recent legislative amendments in Michigan, including Senate Bill No. 680, have created opportunities for advanced practice registered nurses, especially nurse practitioners, to work with greater independence and more comprehensive prescribing capabilities. These revisions play a crucial role in enhancing healthcare availability in rural areas. Engaging in cooperative initiatives with relevant stakeholders and advocacy groups is imperative to continue progressing these regulations. Through collaboration, healthcare providers can improve medical services in Michigan, ultimately positively impacting patients’ well-being, particularly those residing in underserved rural areas.

References

Bureau of Health Workforce Health Resources and Services Administration (HRSA) US Department of Health & Human Services. (2023). Designated health professional shortage areas statistics. https://data.hrsa.gov/Default/GenerateHPSAQuarterlyReport

Michigan Council of Nurse Practitioners. (2023). Micnp.org. https://micnp.org/

Michigan Legislature. (2021). Michigan legislature – Senate Bill 0680 (2021). Www.legislature.mi.gov. http://legislature.mi.gov/doc.aspx?2021-SB-0680

Nurse practitioner license. (2023). Limitations of practice as a nurse practitioner in Michigan. NursePractitionerLicense.com. https://www.nursepractitionerlicense.com/nurse-practitioner-licensing-guides/limitations-of-practice-as-a-nurse-practitioner-in-michigan/#:~:text=Michigan%20allows%20nurse%20practitioners%20(NPs

Zwilling, J. G., & Fiandt, K. (2019). Where are we now? Practice-level utilization of nurse practitioners in comparison with state-level regulations. Journal of the American Association of Nurse Practitioners, 10.1097/JXX.0000000000000270. https://doi.org/10.1097/JXX.0000000000000270