Nurse practitioners; eliminates requirement that they practice as part of patient care team. (SB620)

I have earned my national Psychiatric Mental Health Nurse Practitioner certification in addition to a Family Nurse Practitioner certification because I recognize the urgent need for more comprehensive mental health services in the New River Valley. I wish to provide care to individuals experiencing hardship and I plan to pursue clinical practice in Montgomery County as well as Pulaski County. Both Counties have been identified by the Virginia Department of Health as mental health underserved areas. I have been trying to start practicing and have many collaborative connections with advanced nurses, therapists, social workers and counselors as well as clinic sites. However, according to Virginia Nurse Practitioner laws, I am required to obtain a practice agreement and collaborate with a physician as part of a patient care team.

Many physicians are employed by a contract with clinics and organizations that limits the ability to collaborate with others, especially if the individuals aren't part of that organization. Also physicians in the rural areas of Montgomery and Pulaski County are hesitant to agree to collaborate with others if they don't know them or haven't worked with them before. Physicians in rural areas may also be hesitant due to malpractice risks and/or risk of increased unknown future costs.

I am writing to you to request for your assistance in the passage of the following bill in the upcoming General Assembly:
SB 620.
I urge you to consider assisting with the passage of the bill above. The professional practice of an NP should not be dependent on a collaborative agreement with another licensed healthcare professional.
- Collaborative agreements are an unnecessary barrier and weaken a key source of high-quality primary care for Virginia. The results are poor access to care and higher costs of healthcare.
- There are many NPs currently employed by solo MDs. If that MD retires or becomes ill, that community will lose ALL providers from that MD's practice. There is no relief under the current law for when a practice agreement is disrupted. This is a major health risk for the under-served areas of Montgomery and Pulaski Counties.
-There are 23 other states already allowing full practice authority with another 15 planning legislation in 2016. NPs are safe and effective providers with high patient satisfaction scores and excellent clinical outcomes.
Multiple studies have demonstrated that allowing NPs to practice to the full extent of their education and training produces results in significant savings for consumers, businesses and public programs.
- Consumers should have the opportunity for a free market choice of medical provider in an innovative and competitive environment. The Federal Trade Commission, the AARP, and the Institute of Medicine all support the expanded use of NPs.
- Virginia is not competitive with less restrictive states. Virginia is currently losing entrepreneurial NPs to other states. Also, as a state with a large military presence and turnover, we have many NPs coming in to Virginia from less restrictive states, who are unable to practice within the scope of practice to which they are accustomed.
Nurse Practitioners have been providing safe high quality care to your constituents for years. Patient satisfaction scores and outcome measures testify to the effectiveness of NP care. Please support efforts to increase access to safe, effective NP care across the Commonwealth.

Thank you.
Sincerely,

Melanie Parks DNP, RN-BC, FNP-BC, PMHNP-BC