SB 15-197

After Hearing Testimony From HCAC Leader, CO Senate Bill 15-197 Passes Out of Committee

HCAC has taken the position to support SB 15-197, a bill that reduces the number of hours required for Advance Practice Registered Nurse (APRN) oversight from 3600 to 1000 hours, an amount that is still higher than the requirement in most states.  Although years of research and the most recent Institute of Medicine Study conclude that APRNs provide safe, high quality access to care at a lower cost, this bill faces strong opposition from physician groups.  

On March 12,  Judith Burke, HCAC secretary, provided the following testimony to  Senate Health & Human Services Committee on behalf of HCAC. 

Chairman Lundberg & Committee Members, 

My name is Judith Burke.  I am the secretary for Health Care for All Colorado, which is the Colorado Chapter for Physicians for a National Health Program.  On behalf of my organization, I am speaking in support of SB 15-197.  Health Care for All Colorado has a diverse membership from across the state including physicians, nurses, other healthcare providers, individuals from other professions and occupations, retirees, and students.  Many of our members have been advocating for increasing access to health care services for decades.

Our mission is to promote social welfare by achieving single-payer, comprehensive health care for all Coloradans.  To achieve this, we believe that the health care delivery system must be based on primary and preventive care, with coordination of specialty care. 

Colorado must have an adequate number of providers to create a delivery system based on primary and preventive care.  (Note:  80% of APRNs are trained in primary care and the majority of those serve the uninsured and patients on Medicaid and the uninsured).  At the present time, the demand for care exceeds the capacity to provide that care.  Based on workforce estimates, to meet the current and increasing demand, Colorado will need more than 1000 new physicians, advance practice registered nurses, and physician assistants every year for the next ten years.  

Currently, Colorado’s professional schools graduate half the number of providers needed, and based on the current restrictions on practice, many of the newly graduated advance practice registered nurses are leaving our state.  We cannot afford to lose these providers if we want to provide access to health care to Coloradans across the state. 

We believe that training and credentialing adequately prepares APRN care givers for independent practice.  Unfortunately, some members of Colorado’s  physician community continue to build barriers, and their arguments are not based on the principles of high quality care at a reasonable cost to create healthy communities.   APRNs have abundantly demonstrated their abilities in these three areas. 

Our members in rural areas can attest to the value of APRNs and other licensed independent practitioners' value and essential functions on behalf of Colorado’s citizens.  To quote one of our physician members, “We are long past the days when physicians should impose practice barriers to well-educated and licensed advance practice nurses.  Over the years, much to the detriment of the community we serve, we have seen this same resistance to licensing of psychologists, chiropractors, alternative medicine providers, naturopaths, podiatrists, etc.  Gradually this resistance has eroded, resulting in a diversity of opportunities for access to care with only beneficial results.” 

Although there is no evidence to support the requirement for even 1000 hours of supervised practice before receiving full prescriptive authority, Health Care for All Colorado honors the work of the nurse physician task force that analyzed the current requirements, reached conclusions, and made recommendations that have been included in this bill. 

In summary, Health Care for All Colorado supports SB 15-197 as written. 

Thank you for this opportunity to testify. 

 The bill passed out of committee unamended on a 3/2 vote and will now go to the full Senate for consideration.  This bill has not yet been calendared for debate by the Senate.