New Legislation:

[briannamariec]

Hi everyone! I am currently an FNP student, and part of my course this semester was to deep-dive into a piece of nursing related legislation.  I chose to explore H.R.8812, "Improving Care and Access to Nurses Act", which would expand the scope of practice for APRNs who care for Medicare & Medicaid patients. Following is a letter I have drafted that could be sent to senators and representatives on this bill, and I would love to hear other's thoughts on the bill itself!

Quote

Dear _______,

My name is Brianna Colangelo, and I am a Registered Nurse in an Intensive Care Unit at a large Level-1 Trauma center in Connecticut. I started in this unit at the start of the Covid-19 pandemic, and have seen how rapidly healthcare can change in order to support the needs of the people we care for. I am currently studying to become an Advanced Practice Registered Nurse (APRN), which would allow me to manage the primary care of individuals from many backgrounds. During my studies, I have come across bill H.R.8812, "Improving Care and Access to Nurses Act", which proposes to allow advanced practice nurses to expand th eir care to patients under Medicare and Medicaid (Congress.gov, 2022). Some of the tasks APRNs would be able to complete include ordering and supervising cardiac and pulmonary rehabilitation, certify when patients with diabetes need therapeutic shoes, refer patients for medical nutrition therapy, certify/recertify a patient's terminal illness for hospice eligibility for these patients they care for (Nurse.org, 2022).

Currently, there is a massive shortage of physicians in the primary care speciality, and it is predicted that by 2034 the shortage could range anywhere between 17,000 and 48,000 physicians (AAMC, 2021). This creates an additional barrier to receiving care for the already disadvantaged Medicare and Medicaid patient populations, and patients must go through a lengthy, costly process to receive the above services if they are being treated by an APRN because a physician must then approve the services. Many physician-led organizations are disapproving of the widened scope of practice H.R.8812 would create, due to fear of increased costs and a decrease in quality patient care due to a lack of education, training, and clinical expertise of APRNs (AAFP, 2022). However, there is much research that shows quite the opposite. It has been found that APRNs in states where they had full practice reign showed improved health outcomes of Medicare and Medicaid patients, as well as decreased hospitalizations of Medicare and Medicaid patients compared to states where APRNs had lower levels of practice (Oliver et. al., 2014). 

I am writing to ask you to support this bill, as it has not made any progress since being introduced to the House in 2022. The process for physician referrals for the services stated that APRNs currently cannot independently manage need to be streamlined in order to promote access to care and to cut down the healthcare costs that these patients face. In order to support this bill, I would be honored to use the expertise I have gained as an Intensive Care Unit nurse to educate other senators and representatives about H.R.8812 and the potential benefits it could bring to the health of our nation's Medicare and Medicaid population. I plan to follow up for a response and to discuss further action by June 1st, 2023. I look forward to continuing to support this bill and subsequently supporting the patients I will soon care for as an APRN. 

All the best,

Brianna Marie Colangelo, RN, BSN

Policy Briefing Paper-3.docx