A nonprofit publication of the Kentucky Center for Public Service Journalism

Jessica Estes: Hornback bill is a common sense solution to Kentucky’s growing healthcare crisis

The healthcare crisis in Kentucky, with a reduced number of healthcare providers, has resulted in communities where proper care is scarce. Without desperately needed healthcare resources, a community crisis becomes a very personal one – forcing people to make difficult, even impossible decisions, with few choices and options available to them. But in many communities across Kentucky, APRNs (Advanced Practice Registered Nurses), also known as Nurse Practitioners, serve as a lifeline to the people and communities that need them the most

Nurse Practitioners are essential to quality care in Kentucky. They offer well-rounded, personalized treatment with education at its core. A quick look at the numbers explains why nurse practitioners are so valued.

The numbers tell the story

Health Professional Shortage Areas (HPSAs) are common across Kentucky. These are geographical areas and populations where the number of primary care providers relative to the population is below the federal standards. According to the Kaiser Family Foundation, more than 1 million Kentuckians reside in 87 HPSAs. That equates to approximately 25 percent of Kentucky’s population not having the necessary access to primary care providers. Think about it – one out of every four Kentuckians lives in a shortage area.

The hurdles

In Kentucky, Nurse Practitioners serve a vital need, often in small communities where access to healthcare professionals is limited, at best. They fill a void by providing treatment, education and care. People with acute problems such as infections or cuts requiring stitches and those with chronic conditions such as high blood pressure, emphysema, and diabetes rely on them for care. Nurse Practitioners also prescribe medications as part of the treatment they provide.

But in Kentucky, many Nurse Practitioners must have a Collaborative Agreement for Prescriptive Authority (also known as a CAPA-CS) signed by a practicing physician in order to prescribe certain medications to patients – including some that treat very common ailments such as a severe cough, epilepsy, fibromyalgia, diarrhea, ADD and more. Without access to a physician to sign the agreement, these Nurse Practitioners are restricted in their ability to help the patients in their community.

Additionally, these Collaborative Agreements often require a fee that can be costly to Nurse Practitioners. There are many states where these agreements are not required. The Federal Trade Commission has even weighed in, stating these agreements unnecessarily restrict the practice of APRNs and limit consumer choice.

This hurdle only creates an even bigger healthcare crisis for people who already may be struggling.

A sensible solution

Kentucky State Senator Paul Hornback introduced a bill last year that would eliminate the need for the CAPA-CS – allowing Nurse Practitioners to more effectively serve their patients. This is common sense legislation that helps communities and improves healthcare access.

Please contact your state representative and senator. Ask them to support the Hornback bill in the upcoming legislative session. Your access to quality healthcare could very well depend on the passage of this bill.

Jessica L. Estes is president of the Kentucky Coalition of Nurse Practitioners and Nurse-Midwives

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