COLUMN: Help increase access to healthcare for Kentuckians by supporting nurse practitioners – The Advocate-Messenger

We, as advanced practice nurses and health care providers, would like to increase access to health care for all residents of the Commonwealth. There are over 9,000 Advanced Practice Registered Nurses (APRNs), who are nurse practitioners and registered nurse midwives in the state of Kentucky. APRNs provide primary, specialized and hospital care to thousands of Kentuckians on a daily basis. And we do it very well.

The practice of APRN under our own licenses is regulated by the Kentucky Board of Nursing. We also currently prescribe drugs under two separate collaborative agreements with physicians. One agreement concerns uncontrolled drugs like antibiotics and drugs for asthma, high blood pressure or diabetes.

The other agreement involves the prescription of controlled drugs such as those for pain and anxiety. This agreement also allows APRNs to accept more types of insurance coverage and to order drugs and medical supplies. These supplies could include oxygen, vaccines, insulin, and other medications needed in any well-equipped office.

In 2020, a COVID-19 state of emergency was declared, temporarily suspending the mandate of the Collaborative Agreement for Prescriptive Authority for Controlled Substances (CAPA-CS) to avoid disrupting healthcare for those who needed it. This suspension has improved access to healthcare for thousands of Kentuckians.

The results of a study from the University of Kentucky College of Nursing in the fall of 2020 showed that, even though the collaboration agreements were put on hold, 130 Kentucky APRNs (or 30% of those who responded to the survey) were able to agree. new patients in their practice. In addition, 59 APRNs were able to accept assurances that they were unable to provide with the collaboration agreements in place. That’s a lot of Kentuckians accessing health care!

A 2021 report from the National Academy of Medicine indicates that territories and states where NPs have full authority to practice have improved the quality of care and reduced access to care. States with barriers to the practice of APRN have higher costs, a greater burden of chronic disease, more problems accessing care, and inequalities in the geographic location of primary care providers (Cunningham & Williams , 2021; Wakefield, Williams, Menestrel & Flaubert, 2021)

According to the Bureau of Health Workforce, as of December last year, Kentucky had 178 areas with a shortage of primary health care providers and would require 184 providers from each area to remove that designation. More than 1.3 million Kentuckians live in these areas and are at risk of accessing the preventive and life-saving care they need. Giving APRNs increased prescribing power will help fill this gap in access to care, as APRNs are currently practicing in these scarce regions. Removing the Controlled Substances Agreement for APRNs will make Kentucky more attractive to primary care providers wishing to practice in areas of health care shortage and allow for a continued increase in access to care across the board. domains.

Let’s not back down. We must permanently end the collaborative arrangements that prevent APRNs from providing much-needed care. In particular, the Controlled Substance Prescribing Agreement should be dissolved, as it may restrict acceptance of patients with certain assurances and limit the ability to order necessary drugs and medical supplies.

The solution is clear. Removing the requirements of the Controlled Substance Prescribing Agreement can improve access to care statewide and facilitate health care for all.

For the fourth year in a row, Kentucky nursing organizations attempted to change the law and improve access to care by removing the prescribing agreement. Join us in advocating for this change that can increase access to care for thousands of Kentuckians at a time when they need it most.

Show your support by contacting your representative or senator and let them know that you support the APRNs.

Find your state legislator here,

This article is written by Julie Ossege, PhD, FNP-BC, FNAP, FAANP, Associate Professor at the University of Kentucky College of Nursing and Sheila Melander, PhD, APRN, ACNP-BC, FCCM, FAANP, FAAN, Associate Dean of MSN & DNP Professorial & Practice Affairs and Professor William S. & Elizabeth M. Morgan for Professional Practice of Nursing at UK College of Nursing. This article represents the views of the authors and not those of the University of Kentucky.

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