Nurses bill may give boost to state’s rural health care

The Oklahoma House overwhelmingly passed a measure Wednesday that lets nurse practitioners cut ties with doctors and practice alone.

House Bill 1013 would eliminate the need for advanced practice nurses and nurse practitioners to contract with a physician. The agreements are designed to give the doctor the ability to supervise the nurse’s prescribing authority.

Damarcus Nelson, a family nurse practitioner in the Oklahoma City metro area, said the bill would help people like him start up their own clinic in underserved areas.

“It’s going to lift that restrictive barrier so I could treat more patients in the rural area,” Nelson said.

According to the Association of Oklahoma Nurse Practitioners, the cost of a supervisory physician contract is between $10,000 and $50,000 per year. Doctors can only contract with two nurses at a time, which Nelson said limits the industry.

“If you have a physician that has two already and you want to set up in Stroud, but there’s no one around to help you, you’re stuck,” he said.

Nurses also face a difficult time if their supervisory physician retires, loses their ability to practice medicine or dies.

The medical community isn’t aligned on the bill, however. Doctors have lobbied against it and vowed to continue their efforts as the bill leaves the Oklahoma House.

“We are incredibly disappointed by today’s vote,” said Dr. Sherri Baker, president of the Oklahoma State Medical Association. “House Bill 1013 will put patients at risk while not making a significant dent in our rural health care shortage.”

Physicians have criticized the bill and its

promise of bringing more nursing jobs to rural Oklahoma.

The Oklahoma State Medical Association released a survey last month in its fight against the legislation.

According to the CHS and Associates poll, 57 percent of respondents opposed expanding services that nondoctors, like nurses, can provide. About a third of respondents supported the notion.

“This data simply reinforces what our patients have been telling us all along,” Baker said. “In important medical situations, they want a welltrained doctor to be the one overseeing the process and making a final diagnosis.”

However, Nelson said the bill would not expand his industry’s scope of practice.

“Right now, we’re diagnosing and treating,” he said. “It’s going to lift the signature (requirement) so we won’t have that unnecessary supervision.”

The bill passed by a vote of 72-20. It now moves to the Senate for approval, but it still has to make it through the committee process.

Of Oklahoma’s 77 counties, 64 have been designated by the Oklahoma Health Department as primary care Health Professional Shortage Areas.

More than half of Oklahoma’s population lives in those areas, and the state ranks near the bottom in physician-to-patient ratio, according to the Health Department’s report.