Advanced Practice Legislation SAVE Act Essay
Advanced Practice Legislation SAVE Act Essay
Advanced Practice Legislation Paper

Select a bill that is related to Advanced Practice nursing and is currently in congress and address the following:

1. Provide a thorough description of the bill including the sponsor of the bill, committees, latest action, amendments, the number co-sponsors (include the name of the congressman from your state if applicable) and the reason the bill was presented. 10points

2. Address how the bill relates to advanced practice nursing. For example, practice authority, reimbursement, collaborative practice, NP’s as primary care providers. What are the challenges to getting the bill passed? 15points

3. Address how this bill affects health care in general including cost savings, patient safety, quality, access to care. 20points
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4. Find an advanced practice professional organization and explain the purpose of the organization and the APN roles who participate in this organization. What are the benefits of joining this organization? Review their political advocacy portal to find out how they are involved political advocacy Advanced Practice Legislation SAVE Act Essay. Include the advocacy efforts they are currently engaged in. Are they involved in contacting legislators regarding current advanced practice legislation and specifically the bill you are discussing. What support or resources does the organization have for new members who want to be involved in legislation? How does the organization keep members abreast of upcoming legislation? For example: Sunset of the nurse practice act in your state. 30points

5. Contact your legislator through the “home” office (in your state, not Washington, D.C.) and convey to speak to someone about health-related legislation and tell them the name of the bill you want to discuss. Find out the legislator’s view point on the bill, whether or not they are in support of the bill and why or why not. 30 points

6. What is your viewpoint on the bill? Do you support passage of the bill? Advanced Practice Legislation SAVE Act Essay Why or why not? How can you as an advanced practice student participate in the passage of the bill? How will passage of the bill influence your practice? 10points

7. APA-10points
 
Advanced Practice Legislation
A description of the Bill (SAVE Act
The SAVE Act is a bipartisan bill (Senate Bill 143 and House Bill 185) that aims to remove requirements for APRNs in North Carolina to work in collaboration with a physician.   The key sponsors of the bill include Senator Ralph Hise and Representatives Donny Lambeth, Josh Dobson, Gale Adcock, and Sarah Stevens.  The bill is co-sponsored by over forty legislators including  Representatives  Ager John,  Jonh Autry, Rep  Lisa Barnes, Deb Butler,   Allison  Dahle, and  George Cleveland and Senators Jim Burgin,   Deanna Ballard, Senator  Danny Britt,  senator, Jim Burgin, and  Ben Clark.  The Bill is aimed at delivering Safe, Accessible, value Directed and Excellent (SAVE) health care by updating APRN regulations. Advanced Practice Legislation SAVE Act Essay. Senate bill 143 is currently before the senate rules committee and while the house bill 185 is before the House health committee.
The bill was presented to update laws regulating APRN practice. For the last four decades,  the laws regulating APRNs as one of health care providers with high training have not been changed. With the SAVE Act, lawmakers aim at modernizing healthcare in  North Carolina by eliminated unnecessary and outdated restrictions on APRNs (NCNA, 2019).  Everybody in the United States is looking at schemes that can be used to save the cost of healthcare while ensuring patients receive excellent care.   The bill proposes the removal of the requirements for clinical CNMs and NPs to be supervised and physicians.  By removing the requirements for APRNs to work under the supervision o physicians, APRNs in North Carolina will be able to deliver care independently and fully exploit their training, and education, which will provide North Carolina residents to have faster access to quality and less costly healthcare.
How the bill relates to advanced practice nursing
The bill relates to advanced practice nursing in that it seeks to eliminate state impediments that hinder APRNs from having independent practice.  The bill addresses outdated state laws and regulations on APRNs, including certified nurse midwives (CNMs), nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), and clinical nurse specialists (CNSs).   These advance practice roles have attained a certain level of education and become certified. Nevertheless,  restrictions imposed by state laws reduces the ability of APRN to deliver care independently which in turn less access to care and also raises costs of healthcare (Roberts, 2019) Advanced Practice Legislation SAVE Act Essay.
The SAVE aims at accomplishing two goals.  According to Roberts (2019), the first goal addresses the power of the North Carolina Board of Nursing to control the roles of advance practice nursing. Under the present law, certified midwives and nurse practitioners are regulated by the state Board of Nursing as well as the Medical Board.  The bill seeks to provide the Board of Nursing with the exclusive authority of regulating the practice of CNMs and NPs. The North Carolina Board of nursing exclusively supervises CRNAs and CNSs. Advanced Practice Legislation SAVE Act Essay  In addition, the legislation aims at codifying the services being performed by both CRNAs and CNSs and endows each profession with the APRN title.  The scope of practice of CNSDs and CRNAs will not change as a result of the passage of the bill into law, meaning that they will not be providing any novel services.
The other objective of the legislation is to eliminate the mandatory requisite for CNMs and NPs to collaborate with a physician to provide patient care. North Carolina is among the states that restrict CNMs and NPs to practice authority mandating them to have a written collaborative practice agreement supervising physician. The agreement delineates prescribing authorities, patient management, as well as the way the physician and the ARN will be communicating with one another. Roberts (2019) asserts that the problem with requiring APRNs to have practice agreements with Physicians is that the physician does not do much of the supervising. CNMs and NPs are not required to be in the same geographic area as the physician and they meet only biannually. The agreements between NPs and CNMs can be costly because nurses are required to pay collaborating fees to the physician, which increases health care costs. Advanced Practice Legislation SAVE Act Essay.
The challenges to getting the bill passes are opposition from physicians and physician organizations such as the North Carolina Medical Board.  Physicians have the perception that APRNs are not sufficiently trained to provide safe care  As Roberts,  (2019) indicates, antagonists of the bill maintain that the elimination of collaborative practice agreements will put patients at safety risks as nurses are not in a position to provide high-quality care compared to physicians.
How the bill affects health care
The bill will improve access to care by North Carolina residents.   When CNMs and NPs are authorized to practice independently, they will be able to deliver less costly care. When collaborating with a physician and the physician relocates to another state or retires, the nurse is forced to halt his or her practice until they get another physician to collaborate with. Roberts (2019)  claims that the removal of collaborative agreements will increase acre access in the state since nurses with the required education and certification will be able to deliver primary care services since their practice will not be constrained by accessibility or relocation of the collaborating physician. Advanced Practice Legislation SAVE Act Essay.
Apart from improving access to care, the independent practice of APRNs will lead to health cost savings because APRNs provide less costly care compared to physicians. It is approximated that with the passage of the bill, the state will be able to save up to four billion dollars healthcare costs.  According to Roberts (2019, the bill will also address the regional shortages of physicians in the state.  There is a shortage of physicians in remote regions and there is also an uneven distribution of physicians in the region Advanced Practice Legislation SAVE Act Essay.  Giving APRNs more flexibility to practice could alleviate the shortages of health care providers in rural regions of the State.
APN professional organization
The American Association of Nurse Practitioners (AANP) is a professional nursing organization for NPs of different specialties. The organization represents over twenty thousand NPs across the country.  The purpose of AANP is to offer lawmaking leadership at the national and state levels as well as the local level, promote research, education, and practice, and promote health policy. The organization also establishes standards that NPs must adhere to ensure that they serve patients that receive care from nurse practitioners as well as other consumers of health care. ANNP acts as the voice of nurse practitioners and represents NPs’ interests as providers of care that are less costly, of superior quality, comprehensive and centered on the patient.
Nurse practitioner participation in the AANP provides a variety of benefits.  Professional nursing organizations offer the opportunities to engage in advocacy efforts connected in areas like health, policy and regulators issues.  Being a member of the professional organization offers members the networking and training opportunities to advance their careers as well as knowledge in the profession.   Like any other professional organization, AANP   organizes conferences and meetings as networking events for members. Advocacy is another benefit that I can get from joining the AANP.  Goolsby and DuBois (2017) indicate that professional nursing organizations play an important role in advocating for their members’ interests and communities or patients served by nurse practitioners.
Participation in a professional organization enables members to have a say in identifying and developing health policy initiatives. These organizations publish policy agendas and policies related to regulation, reimbursement, safety, and practice. Additionally, professional organizations offer informative educational resources and position statements to inform their members on crucial pertinent policy and support both old and new members to voice their opinions at the institutional, state and federal levels. Resources are aimed at preparing members to have effective communications with policymakers (Goolsby & DuBois, 2017) Advanced Practice Legislation SAVE Act Essay.
AANP has involved in advocacy efforts at the state as well as the federal level.  Federal legislation directly influences the NP role and the patients served by NPs. AANP has a  legislative team that represents NPs along with their patients on significant matters connected with practice, reimbursement, healthcare reform, licensure and access to care. Apart from advocating on policies related to NP practice, AANP represents NPs’ health organizations and national committees, enabling NPs to take their perspectives to health care leaders. With the support of NPs, AANP works in partnership with federal legislators to ensure sufficient coverage of and access to NP services. At the state level, AANP supports NP policy initiatives (AANP, 2020).
The organization AANP is involved in contacting legislators regarding current advanced practice legislation. AANP contacts legislators via phone calls, emails or meetings in Capitol Hill. AANP is currently in numerous advocacy efforts.  The AANP pushes the 116th congress to eradicate feeder barriers that restrict the ability of patients to access less-costly, superior care and ensure that legislators do not enact laws that create additional barriers for NPs. Advanced Practice Legislation SAVE Act Essay. AANP is advocating for the passage of S. 296/H.R. 2150 to grant authority to NPs to sign eligibility of patients to receive home health care and S. 237/H.R. 808 to authorize NPs to certify patients’ requirement for therapeutic shoes. AANP is also Advocating for the passage of S. 2842/H.R. 3911 to allow NPs to order and oversee pulmonary and cardiac rehabilitation. The professional nursing organization keeps members up to date of upcoming legislation and healthcare issues through its advocacy center on its website.
Health-related legislation
The Home Health Care Planning Improvement Act of 2019 H.R. 2150/S. 296) is legislation to authorize physician assistants and APRNs to sign eligibility of patients for home healthcare services.  Under the present Medicare regulations, physicians are the only providers authorized to declare that patients are eligible to receive health care (Jaffe, 2019), after calling my legislator and discussing this bill, the legislator supports the legislation because when enacted into laws, the bill will enable patients to easily access home health services by expanding the scope of providers who can endorse the requirement for home health care under the rules set forth by Medicare. The legislator stated that the legislation is a pragmatic and practical approach of increasing access to him health care by elderly individuals who require it the most, entailing those who are provided care by clinicians who are not physicians.
My viewpoint of the bill
I view the Home Health Care Planning Improvement Act of 2019as a legislation that will be beneficial to patients, APRNs and physician assistants. If enacted,   physician assistants and advanced practice nurses would be able to provide certification for home healthcare, possibly cutting the requirement for a physician. I support the passage of the legislation because physician assistants and APRNs provide professional, personal and invaluable care to numerous individuals around United States. When enacted, the bill will enable Medicare patients to more easily and directly access home care and significantly cut the cost of health care services. It will be a win for providers, patients as well as Medicare Advanced Practice Legislation SAVE Act Essay.
As an advanced practice student, I can participate in the passage by asking my congressperson to speak with other lawmakers on how the bill will benefit their constituents and convince them to pass the bill.  As indicate by Edelman et al (2017), knowing local legislators, enlightening them about health care matters affecting their constituents and advising them on the needs of their constituents is a way in which nurses can be involved in policy-making.
The passage of the bill will influence my practice by enabling be provide home care services to my patients in a timely and consistent manner. When Medicare beneficiaries under the Care of APRNs need home care, (a physician, is often not the primary care provider for the patient) must be contacted to certify the requirement for home health care. This leads to incoherent care and the inclusion of a provider who might not know the care needs of the patient. The bill will ensure that as a clinician with a better knowledge of the patient, I will be able to order care that is clinically appropriate for the patient. Advanced Practice Legislation SAVE Act Essay
 
References
AANP. (2020). AANP Advocacy: Championing the NP Role and Amplifying the NP Voice. Retrieved from https://www.aanp.org/advocacy
Edelman, C., Mandle C., & Kudzma, E.  (2017). Health Promotion Through the Life Span.  St. Louis, MO: Elsevier.
Goolsby, M., & DuBois, J.  (2017). Professional organizations membership: Advancing the nurse practitioner role. Journal of the American Association of Nurse Practitioners, 29(8), 434-440. Advanced Practice Legislation SAVE Act Essay.
Jaffe, S.  (2019). Home Health Care Providers Struggle With State Laws and Medicare Rules As Demand Rises. Health Affairs, 38(6), 981-986. 
North Carolina Nurses Association, (NCNA).   (Feb 26, 2019). NC Legislators Introduces Bipartisan SAVE Act to Increase Access to Quality Health Care.  Retrieved from https://ncnurses.org/about-ncna/latest-news/nc-legislators-introduce-bipartisan-save-act/
Roberts, J.  (2019). SAVE Act: Increasing Freedom for N.C. Nurses. Retrieved from https://www.johnlocke.org/update/save-act-increasing-freedom-for-n-c-nurses/  Advanced Practice Legislation SAVE Act Essay