the Beacon Journal editorial board

A bill that would improve the stateís health-care system by increasing efficiency and access to care is getting much-needed attention before the Ohio House Health and Aging Committee. The measure, House Bill 216, would update state laws governing advanced practice registered nurses. It would give these skilled professionals, who have masterís degrees or doctoral degrees, freedom from outdated, burdensome restrictions.

Advanced practice nurses last week offered persuasive testimony for the bill, which would mark a major step toward addressing a shortage of primary care physicians, especially in rural areas. A 2015 study by the RAND Corporation showed the potential for reducing emergency room visits in Ohio by about 70,000 a year. The think tank projected that some 1.5 million Ohioans would receive better access to care, including access to preventive care.

Nationally certified and required to meet continuing education requirements, advanced practice nurses can provide preventive care, diagnose and treat illnesses, order and interpret tests, prescribe medication, deliver babies and administer anesthesia. The problem is, Ohio laws prevent using the nurses to maximum advantage.

Standing in the way is a requirement for advanced practice nurses to have a written collaborative agreement with a physician, even though the physician might be miles away. Twenty-two states and the District of Columbia allow advanced practice nurses to provide care without such agreements, and Ohio should join them.

Studies in those states have found that care provided by advanced practice nurses remains safe. Nothing in the legislation would affect national certification, scope of practice or how advanced practice nurses work with physicians on the job every day.

Another key part of the bill would remove a complex drug formulary that limits what advance practice nurses can prescribe. At more than 35 pages, the formulary is often out of date. Ohio is now the only state with such complex limits, spelling out what advanced practice nurses can prescribe and what they cannot. Just four other states have a formulary of any kind.

Both the need for a written collaborative agreement and a drug formulary easily can become barriers to care. If a collaborating physician dies or moves out of state or loses his or her license, then an advanced practice nurse must find another physician to resume working. Navigating the complex drug formulary can delay life-saving medications for days.

As the bill sponsor state Rep. Dorothy Pelanda, a Marysville Republican, has noted, Ohio must deal with a shortage of primary care physicians, an aging population and an increasing number of patients, the latter due to the welcome availability of health insurance under the Affordable Care Act. In this situation, the state cannot afford to continue to impose paperwork and other obstacles that impede the ability of advanced practice nurses to contribute to the highest levels of their abilities, providing essential care in a cost-effective way.