Advocates praise bill to make primary health care available to more Texans
Tuesday, April 25, 2017
First time a full-practice bill is heard in a Texas legislative committee
(AUSTIN) – Advocates representing consumers, business, and a broad range of health care stakeholders are testifying in Austin today in support of expanding access to primary health care for Texans. House Bill 1415 by Representative Stephanie Klick would remove remaining barriers to full practice by registered nurses with advanced degrees.
“Updating the state’s antiquated practice laws will be a powerful tool to reduce delays in receiving basic health care and lack of access to reliable and affordable care Texans experience today,” said Anne Dunkelberg, associate director of the Center for Public Policy Priorities. “Nationwide, 22 states and the District of Columbia allow Advance Practice Registered Nurses – or APRNs – full practice and it is time for Texas to learn from their experience.”
APRNs are registered nurses who have a master or doctorate degree in nursing, passed a national certification exam, and achieved advanced licensure in the state. APRNs include nurse practitioners, certified nurse midwives, certified registered nurse anesthetists, and clinical nurse specialists. Their education and training enable most to offer primary care and diagnose and prescribe medications in states that allow them to practice nursing to the full extent of their degree and experience.
“There is a vast and growing body of research showing favorable outcomes and higher satisfaction for patients cared for by APRNs in states that allow full practice,” said Andrew Cates, general counsel and director of government affairs for the Texas Nurses Association and director of the Coalition for Health Care Access. “Yet Texas still maintains artificial practice barriers that impede access to care for elderly and other vulnerable populations, discourage the pursuit of an APRN career and drive Texas-educated nurses to states without the burdensome regulations.”
The need for more primary health care providers in Texas is stark: Twenty percent of Texans lack access to a primary care provider, and Texas was recently listed as 51st in the nation – on access to and affordability of – health care by the Commonwealth Fund. As Texas’s population increases, the growth in new physicians are not keeping up with demand.
HB 1415 and its companion, Senate Bill 681 by Senator Kelly Hancock, remove the burden of an unnecessary physician supervision requirement known as a Prescriptive Authority Agreement, end expensive pay-to-play contracts, and eliminate dual regulation of APRNs by the Texas Board of Nursing and the Texas Medical Board.
"Maintaining a requirement for physicians to contract with highly educated advance-degreed registered nurses not only fails to improve patient care it reduces access," said Dr. Deane Waldman, MD MBA and director, Center for Health Care Policy at the Texas Public Policy Foundation. "Research shows that APRNs provide excellent care in independent practice but cannot afford to go where there is no care because of the prohibitive cost they have to pay doctors for a supervisory agreement that does nothing for patients. Removing the Prescriptive Authority Agreement is good for patients. Not only does the evidence prove that point, but so does the number and wide range of organizations supporting this bill. Patients' access to care comes before physician income.”
The Coalition for Health Care Access is comprised of 21 organizations representing consumers, business, and a broad range of health care stakeholders. Coalition members include AARP, APRN Alliance (Consortium of Texas Certified Nurse-Midwives, Texas Association of Nurse Anesthetists, Texas Clinical Nurse Specialists, Texas Nurse Practitioners, and Texas Nurses Association), Center for Public Policy Priorities, Leading Age Texas, Methodist Healthcare Ministries of South Texas, National Alliance on Mental Illness Texas, Nursing Legislative Agenda Coalition, Physician Assistant Business Alliance of Texas, R Street Institute, Texas Association of Business, Texas Business Leadership Council, Texas Impact, Texas Organization of Rural Community Hospitals, Texas Public Policy Foundation, Texas Silver Haired Legislature and Veterans Deserve Care. Learn more at www.putpatientsfirsttx.org Twitter: @Patients1stTX #PutPatientsFirstTx