by Anthony Hennen
Though a majority of states allow nurse practitioners full authority to deliver care, Pennsylvania still requires oversight from a physician. A bill in the legislature could change it though, but it’s unclear if it will advance through the General Assembly soon.
The legislation, SB25, sponsored by Sen. Camera Bartolotta, R-Washington, would update state requirements for nurses and would remove a requirement for nurse practitioners to have a collaborative agreement with a physician for them to practice and write prescriptions.
“A significant number of Pennsylvanians, including numerous residents in my district, live in areas underserved by our current health care delivery system,” Bartolotta said in a legislative memo. “The reasons for this are many, but allowing certified nurse practitioners to provide primary care should be an easy – and obvious – approach to addressing part of this problem.”
The pandemic has forced states and health care organizations to rethink their practices, and nursing groups have pushed for such a change for years. Nor is the end of a collaborative agreement unheard of.
Already, 26 states have granted nurse practitioners full practice authority, mostly in the northeast, Great Plains, and West, according to the American Association of Nurse Practitioners. New York and Maryland are both full-practice states.
“We have to modernize our Pennsylvania laws,” said Cheryl Schlamb, president of the Pennsylvania Coalition of Nurse Practitioners and chairwoman of the nursing program at West Chester University. “They’re outdated.”
Changing the law to allow full practice for nurse practitioners would mean that they “are being permitted to do what we were trained and educated to do,” Schlamb said. The collaborative agreement requirement can present problems when a doctor retires or leaves the state. Then, nurse practitioners may struggle to find a replacement or patient care may be interrupted.
“It’s such a barrier for us in Pennsylvania,” said Mary Jo Cerepani, a nurse practitioner who ran a small practice providing medical exams for truck drivers for their PennDOT CDL requirements. When the physician on her collaborative agreement retired, she had to close the business, though she’s been a nurse practitioner for 25 years.
“It’s frustrating,” she said.
Nurse practitioners can already set up independent clinics in Pennsylvania. Collaborative agreements do not require doctors and nurses to work together or share facilities, but it does act as another hurdle for expanding health care options.
“We could be doing so many better things than still trying to get rid of the collaborative agreement and work toward the extent of our training and education,” Schlamb said.
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Anthony Hennen is a reporter for The Center Square. Previously, he worked for Philadelphia Weekly and the James G. Martin Center for Academic Renewal. He is managing editor of Expatalachians, a journalism project focused on the Appalachian region.
