Congress and Health Care

Legislator Communication
Dear Representative Pigman,
It is my great privilege to thank you for sponsoring CS/HB 7011: Health Care Access Bill (Florida Senate, 2017). I highly support this bill and encourage patients in our community of Lee County, Cape Coral, Florida, to do so as well. I am an advanced practiced registered nurse (APRN) and I and my colleagues all appreciate what you are doing to help us overcome the restrictive challenges that current legislation and policies have on preventing us from providing the kind of quality care that we have been trained to provide to patients.
This bill is important because as the Office of Disease Prevention and Health Promotion (ODPHP, 2017) has noted in its Healthy People 2020 campaign, access to health services is one of the most crucial and important problems that needs to be addressed in the U.S. One of the big hurdles to addressing this problem is that too few providers are available to give quality care. Your bill will help to answer that problem by freeing APRNs to practice as they are intended to practice, which is what the Institute of Medicine (2012) has also called for in its treatise on the “Future of Nursing.”
Current policy is restrictive and prevents APRNs from practicing to their fullest extent possible unless a physician is there to provide oversight. The fact is that APRNs are fully qualified to provide quality care, diagnose and prescribe treatment without the oversight of a physician. Indeed, that was the entire point of educating and training APRNs—to get more able-bodied care providers into the industry who could operate independently of physicians and provide patients with the type of care they require (Lewenson, McAllister & Smith, 2016; Lofgren, Berends, Reyes, et al., 2017).
What CS/HB 7011: Health Care Access Bill would do is it would allow independent APRNs to practice advanced and specialized nursing without the need of a physician there to supervicse them. It would also authorize Florida-licensed health care providers to utilize new technology like telehealth to provide quality care as well. These two options of providing care would greatly facilitate Florida’s need to provide patients with a broader range of options so that the problems that the community is facing in terms of obtaining access to care might be alleviated. These problems include too few people (both children and adults) obtaining access to health care (CDC, 2016).
The stakeholders who would benefit from the policy change intended by your bill include patients, providers and tax payers. Indeed, the latter stand to save a substantial amount of money, as much of what they spend in taxes goes to housing prisoners who suffer from mental problems that have never been treated because of this lack of access to care. Patients would benefit as it would allow them to have more options in terms of where they can go for preventive care or for treatment. Instead of always having to rely on a physician, they can go to an APRN and obtain care. Providers would also benefit because they would not be so overworked and overbooked: cases could be spread around with APRNs available to take on more work independently of physicians. In other words, there would be more access to quality care because APRNs would finally be allowed to do their job. This bill could greatly impact the nursing practice by encouraging other states to pass the same type of legislation and finally get APRNs to occupy the place in the health care industry that they were intended to occupy from the beginning. As Englebright (2017) notes, the demand for APRNs continues to grow because these nurses have a great deal of specialization services to offer a public with a wide range of needs, desires and demands. The health care system as a whole would benefit from this policy as it would allow for broader availability of care services to patients.
Since the ODPHP has advocated for greater access to care, your bill is truly indispensible. It serves the community by helping providers like APRNs to embrace their training, knowledge, skills and abilities, and open up facilities independently of physicians, who are already stretched the max. Patients are forced to wait for days sometimes before they can get in to see someone. This is very problematic because patients’ needs should be put first and foremost. Since APRNs have been trained to provide quality care, diagnose, write prescriptions, and do all the things that patients need, it only makes sense that the restrictive legislation that keeps them from practicing to the fullest extent of their abilities in Florida is overturned by new legislation such as your own.
Indeed, the IOM has shown that the future of nursing depends on nurses operating to their fullest extent. And the future of health care depends on the future of nursing (Walker, 2017). I am grateful for your attention to our cause and to the needs of all patients in our community. I would like to do more to support this bill and to help to promote it so that it receives the attention it deserves in order to get through Congress and help new policies take shape all around the country. The health care industry needs to grow and regressive restrictions like what currently exist in Florida act as constraints on quality care. Every health care agency in the world recognizes the power and impact that APRNs can have on the medical field and they recognize the value they could bring in terms of expanding the limited access to care that currently exists.
Your bill would help to free APRNs and enable them to give to patients the care they require. It would be a shining example to the rest of the world of what APRNs can do for a community if they are simply given the legal ability to do so. They already have the skills, knowledge and training to engage in evidence-based practice, preventive care, and treatments. Now all they need is the permission to do so. In many ways, we are at the forefront of a new movement that mirrors the Civil Rights Movement—when it was recognized that old laws and ways of thinking were outmoded and in fact harmful for society. Today, society needs greater access to care and APRNs are here ready and willing to meet that need. All it takes is a little help from representatives like you. We are here to help as well and want to see this bill succeed.
In conclusion, I want to express my gratitude to you for sponsoring this bill and I want to work with you and others to see it get passed. APRNs need to be able to work independently of physicians so that they can reach more patients and help the Office of Disease Prevention and Health Promotion meet its Healthy People 2020 objectives. Access to care is an important issue to many people in the community—especially to those who do not have it because there are too few practitioners available to give them care. Legally speaking, APRNs are restricted in terms of exercising their skills to their fullest potential. However, your bill could help to change that and could be the start of a new policy change not just in Florida but all over the U.S. APRNs were trained and educated for this distinct purpose. They are here waiting to be able to open the doors to quality care. All it takes is a little help from legislators like yourself. We are looking forward to assisting you in this process. Please let me know how I can be of any help in the future.
References
CDC. (2016). Health United States Report. Retrieved from
https://www.cdc.gov/nchs/data/hus/hus16.pdf#062
Englebright, J. (2017). The emerging role of aprns in hospital nursing practice:
perspectives from a survey of chief nursing officers. Nurse Leader, 15(6), 387-391.
Florida Senate. (2017). CS/HB 7011: Health Care Access. Retrieved from
https://www.flsenate.gov/Session/Bill/2017/07011
Institute of Medicine. (2012). Future of nursing. Retrieved from
http://nacns.org/wp-content/uploads/2016/11/5-IOM-Report.pdf
Lewenson, S. B., McAllister, A., & Smith, K. (Eds.). (2016).  Nursing history for
contemporary role development. New York, NY: Springer Publishing Company.
Lofgren, M. A., Berends, S. K., Reyes, J., Wycoff, C., Kinnetz, M., Frohling, A., ... &
O’Brien, M. (2017). Scope of practice barriers for advanced practice registered nurses: a state task force to minimize barriers. Journal of Nursing Administration, 47(9), 465-469.
ODPHP. (2017). Access to health services. Retrieved from
https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services
Walker, N. (2017). Embrace action: protect the future of nursing. AORN Journal, 105(6),
535-537.