Nursing law change could increase health care access in Kansas

A large population of Kansans delay seeking healthcare for several reasons; one of those is the limited number of providers, especially in rural areas. One proven intervention is to increase the number of primary care APRNs. APRNs are nurse practitioners, nurse midwives, nurse anesthetists and clinical nurse specialists who have masters or doctorate degrees and can be primary care providers.

Hurdles to primary care include difficulty finding a primary care provider, delays in treatment, appointments scheduled days and weeks into the future and trouble finding providers who accept uninsured patients or Medicaid reimbursement. According to the Health Resources and Service Administration, more than 994,000 Kansans live in designated health provider shortage areas. Access to mental health care professionals is even more elusive, with only 31 percent of the population having adequate access to psychiatric care.

Rural communities face different health challenges that we cannot ignore. Rural residents tend to be poorer, rely on supplemental assistance and have greater transportation difficulties. The incidence rates of diabetes and heart disease are higher. Youth tobacco use and suicide rates are unfortunately real issues that need attention.

The solution has been stated many times by several experts, including the Federal Trade Commission, the National Governors Association, American Enterprise Institute, American Hospital Association, United Health Group, the AARP and the Robert Wood Johnson Foundation: Utilize APRNs to their fullest extent of training and education by removing restricting state regulations that limit APRN full practice.

Kansas House Bill 2066 updates APRN statutes so that APRNs can practice to their full potential as primary care providers. If passed, APRNs will no longer need a physician-signed work agreement to practice, providing more choices for Kansans. The bill includes requirements of APRN national certification and malpractice insurance.

Physician groups oppose this legislation, citing that APRN education is not comparable to physician education and that APRNs cannot substitute for physicians.

They also suggest that APRNs be regulated by the Board of Healing Arts. However, advanced-practice nursing is effectively regulated by the Board of Nursing; regulation by the Board of Healing Arts would create unfair regulation of a profession by a competing profession, thereby denying healthcare consumers the benefits of greater competition.

Kansans are speaking up in support of HB 2066. The Kansas Chamber of Commerce believes that HB 2066 will help businesses reduce health care costs. The AARP supports this legislation and urges lawmakers to cut the red tape and give nurses full authority to heal. In an AARP survey of voters, 87 percent supported APRNs as primary providers.

Twenty-two other states have passed this legislation and are reaping the benefits of APRNs opening clinics and providing needed care. In the two years since Nebraska passed similar legislation, the number of APRNs increased 40 percent.

Also note that the Veterans Health Administration system allows APRNs full practice authority, so veterans enjoy timely access to APRN providers who manage chronic diseases such as diabetes, hypertension, depression and anxiety.

HB 2066 is a winning strategy for increasing access to healthcare in Kansas. Rural communities with their unique health problems will benefit from passing this bill.

This story was originally published March 19, 2019 at 4:09 PM.