[NPInfo] Alabama NP Article

[David Mittman]



LPNs pitch idea to boost rural care


Tuesday, January 15, 2008
By STEVE DOYLE
Times Staff Writer steve.doyle at htimes.com
Nurses urge lawmakers to ease regulations

Some local nurse practitioners say they have a prescription to help  
Alabama's medically underserved areas.

On Monday night, about 100 nurse practitioners packed Huntsville's  
swanky Heritage Club to press for changes in how the state regulates  
their profession. Alabama's nurse practitioner rules are among the  
nation's strictest, limiting their ability to write prescriptions and  
requiring them to be paired with a collaborating physician.

A proposed bill drafted by the Nurse Practitioners Alliance of  
Alabama would relax those rules and make it easier for trained nurse  
practitioners to work in poor, rural counties where medical care is  
scarce, said Cindy Cooke, the group's state president.

"Our biggest goal is to increase access to health care," said Cooke,  
a nurse practitioner at Fox Army Health Center on Redstone Arsenal.  
"We want to attract quality people from those underserved areas,  
train them and send them back home."

Cooke said Alabama's 1,400 nurse practitioners, who at minimum have a  
master's degree in nursing, could improve the state's dreadful  
ranking in health care access studies. One recent report placed  
Alabama behind the 49 other states and the District of Columbia at  
ensuring timely medical care for residents, she said.

Lawmakers are listening.

State Sen. Parker Griffith, D-Huntsville, is considering co- 
sponsoring the nurse practitioner bill. A bipartisan collection of  
state House members - Republicans Mike Ball, Mac McCutcheon and  
Howard Sanderford, and Democrat Butch Taylor - also showed up at the  
Heritage Club to listen.

The legislative session begins Feb. 5.

A retired cancer specialist, Griffith said nurse practitioners are  
qualified to treat most illnesses and could make a huge difference in  
rural counties that lack primary care doctors and obstetricians. He  
said he would like to see rural clinics run by nurse practitioners  
spring up across Alabama, linked by Internet to medical schools and  
teaching hospitals so the nurse can quickly get advice from  
specialists if needed.

"The health care system needs improvement, and this does that,"  
Griffith said Monday. "It's not magic; it's just getting people who  
are trained into areas that other health care providers will not go."

Nurse practitioners will always work closely with doctors, Cooke  
said, but they shouldn't be required by the state to have a formal,  
collaborative agreement. The 10-year-old rule means the nurses have  
to get their collaborating doctor to sign off on everything from  
mammograms to sports physicals, she said.

Drugs are another sore subject: Nurse practitioners in Alabama cannot  
write prescriptions for any potentially addictive medication,  
including cough medicine with codeine.

"It's very restrictive," Cooke said. "We need to be able to write  
that in order to adequately take care of our patients."

Alabama, Florida and Missouri are the only states that do not allow  
nurse practitioners to write prescriptions for narcotic medicines,  
she said.

The current rules have caused problems for at least two local  
nonprofit agencies: the Community Free Clinic and HEALS clinics for  
low-income students.

Free Clinic Director Shotsie Platt said she'd love nothing more than  
to have nurse practitioners working alongside volunteer doctors at  
the clinic on Franklin Street. But with no physician willing to give  
the OK, the idea has been stuck in neutral for eight years. When the  
doctors get swamped, some patients will continue to have to be turned  
away, Platt said.

HEALS Executive Director Tracey Wright said her group had to close  
its clinic at New Hope Elementary last fall after the clinic's nurse  
practitioner lost her collaborating physician.

"We still see those children," Wright said Monday, "but they have to  
come into town" for treatment at another HEALS clinic.


© 2008 The Huntsville Times