For far too long, Indiana has faced a self-inflicted healthcare crisis, caused in part by outdated regulations and a lack of commitment from our legislature to change them. The issues we face as a state now leave Indiana at a disappointing 32nd between countries on health quality, access and public health measures. However, the Indiana General Assembly has an opportunity to address these challenges. Together, our organizations are calling on lawmakers to take action in January to expand Hoosiers’ access to the health care they need and deserve by making Full Practice Authority (FPA) Indiana law. Failure to make sensible, cost-free changes to these restrictive, outdated, and inefficient policies has far-reaching implications for our state. They limit the supply of health workers, jeopardize our ability to attract new businesses, jeopardize the health of aging Hoosiers, limit access to mental health services, and harm health outcomes for expectant mothers and their families.
More:Op/Ed: Indiana will need 5,000 nurses by 2031. Here are ways to fix the lack of care.
Today, more than 2 million Indiana residents live in federally designated areas with primary care shortages. Along with these Hoosiers, another 6.6 million residents have no access to mental health care. Additionally, 33 of Indiana’s 92 counties are classified as maternal health care deserts, where women do not have access to even the most basic obstetric and gynecological services they need. Older Hoosiers do not have access to basic services in their own communities and our existing businesses struggle to hire and retain a healthy workforce without adequate access to health care. When it comes to new businesses, they may refuse to invest and settle in areas without adequate access to healthcare.
It’s time lawmakers acted urgently to join the 26 other states already authorizing registered nurses and other advanced practice nurses (APRNs) to practice to the full extent of their license. In doing so, Indiana will eliminate financially burdensome and duplicate regulations that limit patient access to quality healthcare through Indiana’s 8,000 APRNs. This antiquated rule requires these nurses to contract as a condition of practicing as a physician, which in turn prevents them from practicing in our state. FPA was temporarily implemented in Indiana by Executive Branch order for 22 months of the COVID-19 pandemic with great success. It is already the law of the country in most states and Washington DC, and the national VA health care system also offers FPA.
More:6 things you need to know about maternal mortality in Indiana
Under current law, a doctor retrospectively reviews 5% of an APRN’s prescribing charts, often at great cost. This review is typically months after care and provides no benefit to patients. This contractual arrangement often costs APRNs or their employers thousands of dollars a month. If a panel doctor cannot be found, APRNs could leave the profession or be forced to travel abroad for work, leaving communities and patients without healthcare providers close by. This increases healthcare costs and reduces access to care for Hoosiers.
Throughout the COVID-19 pandemic, until Gov. Eric Holcomb’s emergency orders expired earlier this year, Indiana temporarily waived those requirements and APRNs answered the call to serve patients in the most difficult of circumstances. This action alone demonstrates the commitment of the APRNs to Hoosier health and the vital role they play in our state’s health care system. If Indiana identified this regulation as a roadblock at the height of a pandemic, why don’t we see it every day for Hoosier patients?
After the passage of the FPA in states like North Dakota, APRN’s workforce grew 83% in six years. In Arizona, APRN’s workforce doubled statewide and grew 70% in rural areas in five years. We have also seen a significant increase in APRNs setting up practices in rural areas. While Indiana ranks at the bottom of most U.S. health rankings, states that rank at the top for health outcomes have adopted FPAs.
Unfortunately, without changes to these guidelines, Indiana may lose talented clinicians to other states, where they are free to exercise the full capacity of their training and patients have full access to the care they provide. If we are to grow our economies and improve the health of our communities, this cannot go on.
The Indiana Legislature has an opportunity in 2023 to prioritize the health of patients and the health of our state’s economy. We call on lawmakers to build a healthy future for Indiana where every citizen has access to the healthcare they deserve, from the provider of their choice. By giving Hoosiers unrestricted and direct access to APRNs, Indiana will take a critical step forward in ensuring it is among the healthiest and most business-friendly states in the nation. Visit www.hoosiersforhealthcareaccess.com for more information.
Sarah Waddle is the State Director of AARP Indiana.
Josh Webb is the state director of Americans for Prosperity Indiana.
