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Nurse Practitioners to Governor Wolf: Please Let More NPs Fight COVID-19

Monday, April 6, 2020   (1 Comments)
Posted by: Katie Maher
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Harrisburg, PA (April 6, 2020) – Pennsylvania nurse practitioners on Friday asked Governor Tom Wolf to take executive action to speed more health care providers to the front lines of the fight against COVID-19.

Five governors have used nurse practitioners (NPs) to bolster their health care workforce and protect citizens during the coronavirus pandemic. They include New York Governor Andrew Cuomo, New Jersey Governor Phil Murphy, and the governors of Kentucky, Louisiana and Wisconsin. They signed executive orders to enact Full Practice Authority for NPs, suspending a requirement that NPs obtain signed agreements with physicians before they can practice. An additional 22 states have permanently abolished this mandate. The Pennsylvania Coalition of Nurse Practitioners formally called on Gov. Wolf to do the same.

“We have one mission: to care for patients during this COVID-19 pandemic. It is a time for all hands-on deck. Yet there are nurse practitioners today in Pennsylvania who are unable to work due to outdated regulations. We urge Governor Wolf to go one step further, similar to the other Governors, to waive the restrictive barriers and put our NPs to work immediately,” said Dr. Adele Caruso, DNP, CRNP, President of the Pennsylvania Coalition of Nurse Practitioners.

Caruso thanked Governor Wolf for taking steps in the right direction. First, the Governor allowed NPs licensed in one focus area to practice in other areas during the pandemic.  Second, he lowered the number of signed agreements must obtain from a physician, from two to one. Additionally, the Department of State has done everything in its power to streamline the process.

“The Governor is a strong leader and I applaud him with our state’s efforts to fight the COVID-19 pandemic. However, as long as restrictive barriers remain in place, we will have members who are unable to work. It’s time to take the next step,” Caruso said.

Dozens of nurse practitioners have contacted the Pennsylvania Coalition of Nurse Practitioners (PCNP) asking for help because they are currently unable to work.

One is Lynn Heard. She owns and manages a primary care practice in Lackawanna County, but will be required to close in a matter of hours unless Gov. Wolf intervenes.

“I became a nurse practitioner so I could help people in need. Tomorrow, state law will force me to close my practice just when my patients need me the most. I beg Governor Wolf, please, allow me and other nurse practitioners to care for patients,” Heard said. 

Another NP who reached to PCNP is Stephanie Phillips of Chester County, who has 15 years’ experience including emergency room care.

“I was furloughed last week due to decreased office visits. Now I am jobless during a pandemic, unable to use my experience to help patients. If I worked in Maryland, New Jersey or New York, I could start a new job tomorrow in a hospital or another practice. But because I work in Pennsylvania, it will be weeks before I see another patient,” Phillips said.

Lori Martin Plank is the former President of the Bucks-Montgomery Nurse Practitioner Association. She has been an NP for more than 30 years.

“I am desperate to help my community during this pandemic. I am ready, willing and able to offer telehealth services to those in need. I have the experience and the skill to care for patients. I’m asking Governor Wolf, please allow me to work,” she said.

Why is this a problem?

To combat COVID-19, Health care providers need to be able to move rapidly from one job to another. Unfortunately, outdated state law related to the collaborative agreement locks many NPs to their employer. When they change jobs or are furloughed, many NPs are frozen out of the workforce.

This is because every Pennsylvania NP is required to secure signed documents, called Collaborative Agreements, with two physicians as one of many conditions of licensure. Often NPs and these physicians work for the same employer. When the NP leaves, the Collaborative Agreements are cancelled and their ability to practice is effectively suspended.

The process to reactivate their practice authority typically takes months. They have to find new physicians to sign Collaborative Agreements, negotiate how much they will pay the physicians for these documents, and finally resubmit their application to the state.

Why Are Collaborate Agreements Mandatory?

Pennsylvania is one of a shrinking number of states that mandate Collaborative Agreements. They are a vestige of decades-old policy, established before the nurse practitioner profession adopted proven, national standards. Researchers – including physicians and NPs alike – have proven that this mandate offers no patient health benefits. To the contrary, research shows that the mandate restricts access to care and correlates to worse patient health outcomes.

Almost every major health care stakeholder group in Pennsylvania has endorsed legislation – Senate Bill 25 and House Bill 100 – to permanently eliminate the mandate and move to a modern process for NP licensure: 

The Hospital and Healthsystem Association of Pennsylvania, AARP Pennsylvania, the Pennsylvania Homecare Association and SEIU Healthcare Pennsylvania; free market advocates like the Commonwealth Foundation  and Americans for Prosperity; the Pennsylvania Rural Health Association; newspaper editorial boards; and many, many more.

About Nurse Practitioners

Nurse practitioners, also called certified registered nurse practitioners (CRNPs) or advanced practice registered nurses (APRNs), have advanced graduate education with master’s degrees or doctorates, and are nationally certified in their population focus areas. Among their many services, NPs:

  • Order, perform and interpret diagnostic tests;
  • Diagnose and treat acute and chronic conditions such as diabetes, high blood pressure, infections and injuries;
  • Prescribe medications and other treatments;
  • Manage a patient’s care.

More than 100 studies have proven that NPs provide safe, high-quality health care.

About the Pennsylvania Coalition of Nurse Practitioners

The Pennsylvania Coalition of Nurse Practitioners (PCNP) is the state organization dedicated to advancing, supporting and promoting the role of nurse practitioners. PCNP protects the practice of more than 13,700 certified registered nurse practitioners (CRNPs) in Pennsylvania. Formed in the 1980s by just three forward-thinking NPs, PCNP now has more than 2,000 active members across the commonwealth in 17 regional groups, which provide educational and networking opportunities. The organization strives to improve communications among nurse practitioners, other healthcare professionals, healthcare organizations and the community by providing continuing education programs, fostering networking and professional development, and advocating for affordable, accessible healthcare. Learn more by visiting PACNP.org.

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Comments...

Carolyn Morris says...
Posted Monday, April 13, 2020
My husband and I are board-certified, mental health-psychiatric nurse practitioners licensed by the states of NJ and PA. We are currently being held up from the opening of our private practice in PA due to the barrier of finding a "back up" collaborator. We have a practice location and are capable of providing tele/health services during the COVID-19 pandemic. With over four years of practice as a mental health psychiatric nurse practitioner, my husband and I have provided outstanding care to our mental health consumers. We currently have a primary physician collaborator for both NJ and PA but, the "backup collaborator" for PA continues to be a barrier. I urge all fellow PA NP's to speak up and get the word out about the evidence-based, holistic, highly skilled and exceptional professional care we have been trained to provide. We, nurses, are the ones who have been there for our patients at the bedside, in the home and community. We are proud, caring professionals.

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