Pa. nurse practitioners lobby to remove ‘archaic’ collaboration requirement

‘It does include those safeguards — three years of practice, 3,600 hours — before they can provide care independently,’ Sen. Lisa Boscola, D-Northampton, said

By: - May 3, 2023 3:30 pm

Sen. Camera Bartolotta, R-Washington, joined a host of nurses from across the state to push legislation expanding their ability to provide care without a doctor in the Capitol April 9, 2019. (Capital-Star photo by Stephen Caruso)

Dozens of nurse practitioners filled the Pennsylvania Capitol on Wednesday, lobbying for a bipartisan bill that would let them treat patients without a collaboration agreement with a doctor, an existing law the Pennsylvania Coalition of Nurse Practitioners calls “archaic.”

Sens. Camera Bartolotta, R-Washington, and Lisa Boscola, D-Northampton, have reintroduced legislation removing the current requirement and calling for nurse practitioners to complete a three-year, 3,600-hour collaboration period with a physician, after which they would be able to practice freely.

During a Capitol news conference, the lawmakers noted that their proposal doesn’t take away the training needed to ensure proper treatment and skills. Instead, it removes the regulation that mandates a collaborative agreement with a doctor for a nurse practitioner to treat patients.

More than 20 states have implemented full practice authority, including New York, Maryland, and Delaware.

In addition to enhancing health care options statewide, they hope the legislation will address staffing shortages statewide, especially in rural communities, where Bartolotta said constituents have to travel at least an hour for appointments — “if they can find someone to treat them at all.”

“It does include those safeguards — three years of practice, 3,600 hours — before they can provide care independently,” Boscola said. “That’s a strong, solid safeguard.”

A November 2022 study estimated that the number of patients seen by nurse practitioners each week would increase by nearly 1,800 if Pennsylvania made the change.

PCNP President-elect Amanda Laskoskie, who practices in Reading, said full practice authority changes nothing nurse practitioners already do — such as diagnosing illness, ordering tests and medications, and making referrals.

“It only removes the antiquated collaborative agreement,” Laskoskie said during a news conference.

She noted that the proposed change could also solve existing staffing shortages — especially in rural communities — lead to shorter wait times, increase primary care options, and proactively address anticipated gaps, estimating that 32% of health care workers in Pennsylvania are nearing retirement age.

“We have nurse practitioners ready and able to care for the people of Pennsylvania,” Laskoskie said. “It is time to stop the hemorrhage and allow nurse practitioners to bring health to the commonwealth.”

PCNP President Cheryl Schlamb said the COVID-19 pandemic, which caused the state to waive some restrictions, showed it was possible and necessary to expand their ability to treat patients, describing the health crisis as a “pilot program” for Boscola and Bartolotta’s proposal.

Janice Miller, who works at Thomas Jefferson University in Philadelphia, compared the proposal to a learner’s permit before earning a driver’s license, citing restrictions, such as not being able to drive after midnight, needing a licensed driver in the front seat, “because you weren’t deemed safe.” She described how learning from her father and other people’s wisdom helped her become “a very safe driver.”

“I don’t need somebody sitting in my front seat telling me what I need to do anymore,” Miller said. “I don’t need somebody’s piece of paper — collaborative agreement piece of paper — on my front seat, saying I’m safe while they’re in another practice or while I’ve never even met them for several years.”

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