Professional Advocacy Through Nursing Organizations. 2.Community Health & The Global Burden Of Disease

Professional Advocacy Through Nursing Organizations. 2.Community Health & The Global Burden Of Disease

Mr. Riley approaches the steps to the congressman’s office. She reflects on her journey and knows she has the information needed and the political competence to present a thorough and compelling argument about her health care policy position. She enters the office and is greeted by one of the congressman’s legislative aides. Hello, my name is Dr. Sarah Riley and I have a meeting this morning with Congressman Akin. Oh, Yes, nice to meet you, Dr. Riley. The congressman is expecting you. Please follow me.Congressman, it is a pleasure to meet you. My name is Dr. Sarah Riley. Welcome Dr. Riley. I have read the policy brief you sent over to the office yesterday and have some thoughts. Congressman, as a family nurse practitioner and a DMP practice scholar, my journey to our meeting began with exploring how I could secure additional funding for my rural clinic. Along the way, I discovered the impact social detriments of health have on the quality of life for people in our community. The socioeconomic issues facing people who live in your district are significant and are reflected in the number of homeless people. I met with a homeless woman at the tent camp just down the road. Her story is tragic, but what is more important is the circumstances that left her homeless were mostly out of her control. She was unable to find a job with a livable wage. One of the major factors in her homelessness was transportation. The community has limited bus routes and people living in the more rural areas have no access to transportation. They cannot get to the grocery store, the health department and in many cases have a hard time getting to my clinic. While I want to solve all these problems with you, my focus today is addressing the issues with House Bill 255. Yes, I know we have some challenges in my district, and I am committed to resolving these issues. However, as you know, Dr. Riley, it takes time, money and the will of the people to make swift change to improve the quality of life within this district. After reading your brief yesterday, I made a call to the mayor, and we talked about adding two bus routes to the service to more rural parts of the district. This has been on the agenda for the district for many months, and the mayor said she was looking at funding for the additional routes. It is my understanding from the mayor that one additional route is funded, and will provide transportation to the rural parts of the district. Another route is proposed, but funding is the primary concern at this point. Congressman, this one route alone will provide service to many people who otherwise would not have transportation. Thank you for your advocacy on this issue and I look forward to seeing the second round added soon. If we could turn our attention now to House Bill 255, I wanna thank you for authoring such a comprehensive bill and providing additional funding to rural clinics through the expansion of this Medicaid program. Nurse practitioner led clinics provide service to many people in the state who otherwise would not be able to afford or access health care. The evidence on this is compelling and speaks to the important role, nurse practitioners play in the health care system. One of the provisions of your House Bill calls for the addition of a physician medical director. I was surprised when I read that. As you might imagine, I cannot support this provision for several reasons. Number one, the provision is inconsistent with the evidence. The research clearly defines the impact nurse practitioner-run clinics have on providing qualify, evidenced-based care. Number two, the addition of a medical director only serves to increase costs with no tangible benefit to patient care. Number three, the provision fails to recognize the sizable and significant contributions nurse practitioners make to serving populations and aggregates often marginalized or forgotten. My recommendation for House Bill 255 is to remove the provision for physician medical director. This would allow nurse practitioner led clinics to apply for expanded funding. Congressman, you must understand, nurse practitioners and physicians enjoy a highly collaborative relationship. In fact, our relationship is truly a partnership, to ensure the highest quality of care. Dr. Riley, you certainly have enlightened me to the concerns you have about this House bill. The addition of the medical director for additional funding was based on recommendations from my colleagues. But I will readily admit that none of them are physicians or nurse practitioners. We received no objections to the provision from other nurse practitioners. I will take your recommendation under advisement, moving forward with the House bill. As we move this House bill along, I may need the additional support of your professional network and coalition. We do indeed have a coalition of support for revisions to the House bill, Congressman. And I know members of this coalition will be happy to meet with you in support of my recommendation. It’s always nice to meet with health care providers from the community, as I often feel you have the pulse of the community. I hope we can continue to meet over future issues because it is important to have a resource to talk to regarding proposed health care policy or new health care legislation. I would welcome the opportunity to serve as a resource for you. Thank you for coming to meet with me today, Dr. Riley. Your recommendation for change within our community is important. Your recommendation for change within our community is important and deserves additional thought and consideration. It has been my pleasure, and thank you for your time today. As Dr. Riley leaves the Congressman’s office, she has a renewed sense of strength and purpose. She knows her actions today provided strong, high level advocacy for her patients, her community, and her profession. Sarah, is that you? Thank you for believing in my resiliency.


In this session of Dr. Riley’s meeting with Congressman Aiken – she states she cannot support the provision of HB255 where it calls for a physician contract. Please check the Nurse Practice Act for your State regarding independent practice for nurse practitioners.


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