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The Association of Oklahoma Nurse Practitioners today voiced its support for legislation introduced by Rep. Josh Cockroft aimed at expanding access to primary health care services for all Oklahomans, particularly in rural areas.
House Bill 1013, filed today by Cockroft, R-Wanette, would grant nurse practitioners and advanced practice registered nurses full practice authority, allowing them to provide health care services consistent with their education and training without a so-called collaborative agreement with a physician, even though little or no collaboration occurs.
Last year, a similar measure, HB 2841, by Rep. Jon Echols, gained more than 30 coauthors during the legislative session, but was not granted a committee hearing.
“Rural Oklahoma is hurting for primary health care services, and that’s an issue that affects the health and quality of life for many Oklahomans, not to mention limiting economic development opportunities in smaller communities,” said Cockroft, the chairman of the House Rules Committee. “This is a common-sense measure that would increase access to quality health care for all Oklahomans.”
A nurse practitioner is a registered nurse who is prepared, through advanced education and clinical training, to provide a wide range of preventative and health care services. Nurse practitioners complete graduate-level education that leads to a master’s or doctoral degree. Nurse practitioners can provide physical examinations, diagnose and treat acute and chronic problems, interpret laboratory results and X-rays, prescribe and manage medications and other therapies, provide training and supportive counseling on the prevention of illness, and refer patients to other health professionals as needed.
“This bill doesn't change the scope of practice for nurse practitioners,” said Toni Pratt-Reid, president-elect of the Association of Oklahoma Nurse Practitioners (AONP) “Physicians don’t see my patients or review their charts — they sign a collaborative agreement form with the Board of Nursing once every two years and can charge thousands of dollars for it.
“We’ve spent many years in school and don’t need to carry permission slips any more,” Pratt-Reid said. “Nurse practitioners carry national board certifications in their area of training and are licensed and regulated by the Oklahoma Board of Nursing. We want the freedom to practice and to provide quality health care to the Oklahomans who need it without the added oversight which has proved in 21 other states to be unnecessary ”
Oklahoma is one of just 12 states that still require all nurse practitioners to have agreements with a physician, while 21 states, including New Mexico and Colorado, offer nurse practitioners full practice authority. The remaining states have regulatory schemes that fall between full practice authority and restricted practice.
Most recently, the U.S. Department of Veterans Affairs announced that it would allow nurse practitioners, certified nurse specialists and certified nurse midwives to work with full practice authority in Veterans Affairs facilities in all 50 states.
“Our veterans deserve the best care possible and the Department of Veterans Affairs trusts nurse practitioners to carry their share of that awesome responsibility,” Pratt-Reid said. “Oklahoma’s legislators should do the same and allow nurse practitioners to do their part in providing health care to all Oklahomans.”
Under current state law, a physician can only sign agreements with two nurse practitioners, placing a hard cap on the number of nurse practitioners who are able to work in the state.
“Rural Oklahoma faces a health care provider crisis,” Pratt-Reid said. “There’s no reason for the legislature to build artificial barriers that keep nurse practitioners from working in areas where physicians are hard to find. Other states have successfully passed similar bills and they have dramatically improved access to care and improved their health record.”
According to the most recent Oklahoma Health Workforce Databook compiled by the Oklahoma State Department of Health, 64 of Oklahoma’s 77 counties are designated as primary care Health Professional Shortage Areas (HPSAs). More than 58 percent of Oklahomans live in a primary care HPSA. With 80.2 physicians for every 100,000 Oklahomans, the state ranks 49th in physician-patient ratio.
“Because businesses are unlikely to relocate to areas without an adequate health care infrastructure, full practice authority would help to spur economic development in rural parts of the state,” Pratt-Reid said. “Plus, each new clinic that opens creates new jobs and gives average Oklahomans the opportunity to make the health care choices that are right for them and their families.
“This is a common-sense step, already taken by more than 20 other states, which can improve Oklahomans’ access to health care without costing taxpayers a single penny.”
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