H. R. 6261 Week 1 Essay

While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.

Bill HB 1225 was filled 01/23/2017, made it out of the House Committee on 05/08/2017, with Committee report sent to Calendars on 05/09/2017. Bill SB 654 was filed on 01/30/2017, made its way through the various bill stages, and was passed into law on 05/29/2017 to be effective on 09/01/2017. The passing of Bill SB 654 will especially escalate insurance network capabilities in regions of the State of Texas with healthcare provider shortages. There have been comparable bills in the past that have failed being passed into law. The discussed legislation embraces the APRN consensus model with regards to the need to increase access to APRNs (Walker,

The Kentucky Coalition of Nurse Practitioners and Nurse Midwives (KCNPNM) have concerns with three major medical and political issues. One of those issues is a concern about health care to the poor and uninsured. According to the KCNPNM (2014), Kentucky alone has 20% of the population at or below 100% poverty and 41% under 200% poverty in 2007. Their focus on this is driven by the fact that those uninsured suffer negatively, including premature death and illness, due to lack of medical care (KCNPNM, 2014). As a group, they make an effort to provide the underserved community with information regarding available healthcare programs (KCNPNM, 2014). They also work to encourage legislation to aid those without health insurance by reaching out and informing local and regional lawmakers of our due diligence to promote health in all populations (KCNPNM, 2014).

In recent years, APRNs have been very vocal through many nursing coalitions and associations. The voices of all ARNPs seeking full practice authority has been heard with the proposed bills. The Florida Panhandle Nurse Practitioner Coalition (FRNPC), has given information to all ARNPs to keep ahead in legislative issues. A white paper published by the American College of Physicians have been shared to all Floridian ARNPs through the

A practice change in a non-VA primary care practice led by a Nurse Practitioner (NP) that includes identifying eligible veterans and utilizing the referral process guidelines to peer support services. In the Veterans Choice Program, 2015 the authorization for all non-VA medical care for veterans who resides more than 40 miles from a VA health care clinic or is not able to obtain a medical appointment within 30 days is eligible to receive care from a non-VA entity. The consignment of all medical care appointments are over sought by Health Net, which authorizes all non-service, secured care. PCPs are highly fortified to communicate with veterans with a courtesy memorandum for their medical appointment. PCPs must adhere to the subsequent standards

Healthcare reform and politics are on the forefront of most citizens throughout the United States. Our access to healthcare has become a barrier for many citizens, and a hurdle for the advanced practiced registered nurses (APRN) throughout the years. Strict state laws have burdened APRNs and limited their practice throughout Ohio. It would be prudent to follow suit of other states, and retire the Collaborative Agreement; Richards and Polsky (2014) noted an immediate 20 to 30 percent increase in nurse practitioner providers in those particular states after it was retired. House Bill 216 (H.B. 216) helps modernize the Nurse Practice Act and the retire the mandatory collaborative agreement and extensive drug formulary. Within this paper, the contents and purpose will begin to unravel as I describe the meeting Naserin Salameh and I were able to connect with Representative Margaret Ann Ruhl of Ohio House District 68 on March 30, 2016, about H.B. 216.

Current pending policy in the 114th United States’ Congress includes the Home Health Care Planning Improvement Act (ANA). This legislation advocates changing the current Medicare conditions of participation, by granting authority to Advanced Practice Registered Nurses (APRNs) to certify plans of care for home health patients. If written into law, Advanced Practice Registered Nurses that would be able to certify home health services would include nurse practitioners, certified nurse mid-wives and clinical nurse leaders. In addition, this designation would also give physician assistants access to the same authority (ANA).

IHAC found that barriers exist around nurses practicing at the top of their scope, and lack of diversity among health care providers. Legislators and consumers were educated about the information demonstrating the existence of barriers for the nurse to work to the entire capacity of their education and competency, since in Illinois APRNs have no full practice authority (IHAC, 2016). IHAC conducted a detailed APRN survey and held follow-up gatherings, including boards of specialists from practice, training and research, with centered proposals on enhancing diversity of APNs, and additionally other health care providers (IHAC, 2016).

Nurses have an opportunity to change health care in the community in which they practice. It is of great importance for nurses to be involved in health care policy. There are many ways in which each and every nurse can become involved in legislative decisions. Whether it is writing a letter, making a proposal or actually joining a legislative group. There are bills passed daily that can have either a negative effect or a positive effect on patients. As primary care providers, we see these effects on a daily basis.

This paper explores the contemporary role of the nurse practitioner in the care of U.S. veterans within the Veterans Health Administration (VHA) system. The VHA is is one of the largest employers of advanced practice providers (APPs) in the United States. Currently some role confusion exists between nurse practitioners (NPs), physician assistants (PAs) and physicians within the system. In addition to role confusion, NPs are practicing at various levels across the country demonstrating a lack of standardization of care within the VHA. Additionally, not all practitioners are currently practicing to the full scope of their training and are often unfamiliar with the scope/role of their colleagues. The data suggests that all three

There has never been a group of individuals in history who have been exposed to more health risks and hazards than our nation’s veterans. After completing their service and seeking healthcare through the VA, many have been subjected to extremely long wait periods and care that is not up to standards. Veterans living in rural areas have little or no access to health care through the VA since the VA facilities are limited (Project on government oversight, 2013). As a result of recent focus on the plight of veterans receiving poor care through the VA, veterans now have the option of receiving care through a non-VA facility (VA, n.d.). For this community health presentation project, information will be presented about nursing care for our veterans.

The advanced practice nurse (APN) will be impacted greatly by these health care initiatives. The nurse practitioner’s quality of care will be measured directly graded by Medicaid and Medicare reimbursement based on their patient outcomes (Haycock, Edwards & Stanley, 2016). Other efforts for ensuring high quality care requires the APN to meet strict criteria with their education and training to become efficient primary providers. It is also imperative their training include the ability to work collaboratively with other health care providers and to be knowledgeable in health care policies (Hain & Fleck, 2014). Working as an APRN allows for interprofessional team care with physicians working collaboratively to identify areas of improvement for patient outcomes (Hain & Fleck, 2014). Furthermore, the APN offers the

Thank you for your thoughts. There is currently a shortage of physicians and an increasing growth for new insured patients. Specifically now, that by law every one has to have medical insurance. There are certain states in the US that are not giving full scope of practice for the Nurse Practitioners, nor giving them the right to prescribe medications and treat patient without a physician oversight.(Iglehart, J. 2013).

The policy and regulations on the nurses scope of practice in every state varies, where few states allowed their nurses to practice independently without the physicians’ supervision (Garner, 2010). But more states “…impede the full utilization of nurses” ("Issues for Nursing," 2010, p. 3). “The ACA relies heavily on the concept of the Patient Centered Medical Home (PCMH) model and free preventive care” (Anderson, 2014, p. 3), but these models need sufficient primary care providers to care for the newly insured individuals (Anderson, 2014, p. 3). With the primary care physician shortages, advanced practice registered nurses (APRNs) play an important role in attaining the goal of ACA ("Issues for Nursing," 2010, p. 3). Patient have no access to APRNs services and several health plans failed “…to include APRNs in their provider directories” ("Issues for Nursing," 2010, p. 3). This limits their choices and availability of provider ("Issues for Nursing," 2010, p. 3). Even though some state authorized the APRNs in practicing to the full extent “…without a statutory relationship with a physician” ("Issues for Nursing," 2010, p. 3), the services will not be covered unless collaboration with the physician occurred ("Issues for

Primary care Nurse practitioners are significantly more likely than primary care physicians to practice in urban and rural areas. Studies show that nurse practitioners can manage 80-90% of care provided by primary care physicians. Evidence from research literature shows that primary care outcomes, including disease-specific physiologic measures, improvement in pathological condition, reduction of symptoms, mortality, hospitalization and other measures, and patient satisfaction, are comparable between patients served by Nurse practitioners and patients served by your everyday doctor. How does this connect to