An old North Carolina law linking nurse practitioners to physicians is putting a lot of their practices, and patients, at risk. New legislation could fix that problem.
The Problem in NC and Many Rural Areas in America
In order to operate her practice, psychiatric nurse practitioner Olehonna Lynch is required to have a supervisory psychiatrist through a collaborative agreement. This is a $500 per month fee — just for two signatures by the psychiatrist per year. Lynch utilizes her supervisory psychiatrist beyond the signatures in order to maximize patient treatment. Soon, Lynch’s supervisor will be retiring, leaving her to find another one before she is unable to run her practice properly.
Lynch started her practice after seeing a need for mental health services in Robeson County, North Carolina. Patients went from a three-month wait for mental health issues, to down to a week of waiting with Lynch’s practice. This reduces a patient’s chance of returning to the emergency department in a crisis.
Donna Francis is nearing retirement, but refuses to do so until she can find someone as her replacement or there is more autonomy in North Carolina for nurse practitioners. She said it has been hard finding a replacement, because psychiatrists are reluctant to supervise a nurse practitioner. Francis currently sees around 100 patients a week, most of whom are older and unwilling and unable to travel an hour or more away to see another mental health professional.
The SAVE Act
Bipartisan lawmakers in North Carolina have been trying to pass the SAVE Act for years. This would allow for nurse practitioners to have more autonomy in their practice. A big reason behind this push is the lack of access to care in rural parts of North Carolina. Physicians are less likely to practice in rural areas, leaving the job to nurse practitioners. Surprisingly enough, it has been physicians and their professional organizations who have opposed the bill. The COVID-19 pandemic has shifted perspectives and lawmakers are hopeful for passage this time around.
If the SAVE Act was passed in 2019, North Carolina would have saved $866 million dollars in health care expenses, according to state Senator Joyce Krawiec. By passing the act, it will increase the quality of care and actually reduce costs across the state. Twenty-three states along with the District of Columbia have passed similar legislation and have yet to reverse the decision.
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Sources
northcarolinahealthnews.org