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Proposed ‘SAVE Act’ could ease NC healthcare provider shortage

Published: Oct. 27, 2021 at 6:51 PM EDT
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WILMINGTON, N.C. (WECT) - The need to be seen by the doctor is something people share across our region, but actually getting an appointment is harder if you live in a more rural community.

The pandemic shone a bright light on the issue of access to healthcare, and state legislators are still considering a law that would alleviate some barriers to care.

The goal of House Bill 277 and Senate Bill 249, known as the SAVE Act, is to modernize nursing regulations and ease the requirements that make it costly or difficult for nurse practitioners to treat their patients.

Having grown up in a rural area, nurse practitioner Dr. Kelly Laham has a passion for helping people who live off the beaten path. She trains future nurses now at UNCW, but spent much of her career working in a clinic in Columbus County

“It’s a very under-served area and I just fell in love with the area, the patients, and how I really felt like I could make a difference in their lives,” said Dr. Kelly Laham.

There are about 10,000 nurse practitioners in the state like Dr. Laham, and about 80 percent of them work in primary care.

Primary care is an area of critical need for rural communities like Pender, Columbus and Bladen counties.

While many nurse practitioners want to meet that challenge, state law is one obstacle they face.

“Currently nurse practitioners are required to collaborate with a supervising physician and that’s by statute, and that means that we have to have a physician supervising us, meaning a piece of paper that says that they are supervising us in order for us to get approval to practice as a nurse practitioner,” said Schquthia Peacock, chair of the NC Nurses Association Council of Nurse Practitioners.

That piece of paper can cost as much as $24,000 and the NC SAVE act aims to remove that requirement.

A 2015 study with the Duke University Center for Health Policy and Inequalities Research showed removing barriers like the physician supervision requirement could save the state between $433 million and $4.3 billion without sacrificing quality of care.

There’s 24 other states in the US where nurse practitioners with the same skills and training don’t have to get that approval to practice. In North Carolina, that requirement was temporarily relaxed by the governor in the spring of 2020 when the pandemic struck.

“Nurse practitioners during the pandemic were staffing outdoor COVID clinics, nurse practitioners were cross-trained in other areas like working in the emergency room, and acute care settings because there were increased patient needs and not enough healthcare providers,” said nurse practitioner Maria Colandrea.

It’s a staffing crunch the industry hopes won’t last forever. UNCW is expanding its programs and Dr. Laham wishes for a brighter future for her students.

“I hope that the SAVE Act will be passed and that we can practice to our full scope,” said Laham. There’s a shortage in physicians, there’s a shortage of nurses and there’s a shortage in advance practice nursing as well. I see the demand increasing as we go, and we have really seen how this has come forth with the pandemic, and how the use of nurse practitioners has really filled in some of the gaps. Where patients don’t have access to care [with] physicians, they may have access to care with nurse practitioners.”

Nursing groups have been trying to pass similar legislation like this since 2014. The bill has 76 sponsors in the House and another 25 in the Senate. Despite having support from both sides of the aisle. the proposed legislation has been tied up in committee since March.

While the bill has bipartisan support in Raleigh, many physician groups are opposed to the SAVE Act citing questions over the quality of care. However, the bill would move oversight to the Board of Nursing with steeper regulations as nurse practitioners gain full practice authority.

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