YES: EXPANDING SCOPE OF PRACTICE BOOSTS ACCESS TO CARE

California has a severe shortage of mental health professionals. According to the Rural Health Information Hub in 2019, 49 out of California’s 58 counties have a deficit of providers.

All around us, we see how people are suffering because of this shortfall. In San Diego, the rate of suicide among veterans and active-duty military is rising. And on our streets, we see the suffering from addiction and mental illness in our homeless population.

For more than 25 years, I have worked with those battling mental illness. I have provided services for those who have been sexually assaulted. I served in Germany where I provided mental health treatment to sailors returning from combat. I even served with a submarine squadron as the first embedded mental health nurse practitioner.

From my experience, I know the vast majority of people with serious mental illnesses can benefit significantly from treatment. But access to this care has become increasingly difficult to find. I get calls and emails from parents, spouses and concerned family members who are desperate for their loved ones to get the care they so desperately need.

Unfortunately in California, we lack available providers that can provide the services I have during the course of my career. Part of that is due to a dire physician shortage. And that deficiency is going to only get worse. For example, last year, the California Future Health Workforce Commission, a group of health care experts, noted that our state is projected to experience a 34% decline in the number of psychiatrists.

So there really should be no question that we should be doing more and using every tool to bring more health care providers into the mix. That same California Future Health Workforce Commission recommended nurse practitioners be given full practice authority, just as the Veterans Administration did in 2016 when it changed its regulations to allow nurse practitioners to practice independently. Twenty-two other states have also made this common sense change to provide health care access to patients from highly-educated and skilled nurse practitioners.

Yet California has stubbornly not yet followed suit.

Fortunately, there is a new energy to make this change.

Assembly Bill 890 recently passed out of the state Assembly with strong bipartisan support. It is backed by a broad coalition of organizations that care about closing the provider gap — a coalition that includes some of the top mental health providers and advocates in the state.

This proposal would allow California’s nurse practitioners full practice authority to continue to provide quality care. Nurse practitioners are on the frontlines across California working in every setting imaginable — clinics, hospitals, prisons, schools and even on firetrucks.

Enacting Assembly Bill 890 would allow more nurse practitioners to do what they are trained to do without the current administrative requirement that calls for an agreement with a doctor.

This arrangement does not require that the doctor be present, just that a written agreement is in place. If the supervising doctor retires or moves then the nurse practitioner is often forced to close their practice and more patients lose their care. Considering the growing number of retiring doctors, we are facing a critical need for more nurse practitioners in the primary care arena.

In my long career, I’ve had the privilege to give the patients the care they need —

Some say using nurse practitioners more could create a two-tiered system. But a two-tiered system already exists — those who can get care and those who cannot.

care that often involves giving them time. Many patients do not have this luxury, trying to get an appointment in a crowded doctor’s office. Allowing qualified nurse practitioners to practice independently would provide patients with more options and the opportunity to be seen more by a professional sooner.

Some have raised concerns about the quality of care from nurse practitioners while others have said that this could create a two-tiered system. But a twotiered system already exists — those who can get care and those who cannot. When people are suffering from mental illness, telling them that they have a two-month wait to see a trained professional could be a death sentence.

Nurse practitioners like me are ready to do more. We are educated and experienced and can do the job that is required. The state Senate should pass Assembly Bill 890 and send it to Gov. Gavin Newsom to sign into law so more nurse practitioners can provide the care that so many desperately need.

Sorenson is a licensed psychiatric mental health nurse practitioner and clinical specialist in San Diego who served nearly 25 years in the Navy. She now has a private practice and is accepting new patients. Information: sandiegopsychnp.com