What obstacles are in the way of easier access to health care in NC?

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RALEIGH, N.C. (WNCN) — One of the biggest lessons from the pandemic is the need for access to health care.

One group of front-line workers said their ability to be easily accessed is being made more difficult than it should be, and it all comes with a hefty price that some lawmakers want to keep in place.

With the COVID-19 pandemic bringing anxiety, anguish, and uncertainty, many who have never struggled with mental health are looking for help.

Raleigh therapist and nurse practitioner Jessica Sparrow has seen plenty of patients just like that.

Sparrow said there is proposed legislation that would help increase access to care.

“Not allowing this bill to be heard has no benefit” she said.

The bill Sparrow is referring to is Senate Bill 277, also known as the SAVE Act. It would take away the requirement for nurse practitioners, who own their own business like she does, to also have a supervising physician.

Senate Bill 277 by on Scribd

“My supervising physician is great. We have a great relationship, but he’s never been to this office before, he’s never looked at any of my charts, he’s not responsible for the patient care I provide on a day in, day out basis,” said Sparrow.  

“Is it just a basically formality?” CBS 17’s Russ Bowen asked.

“Yes,” Sparrow said.

“It’s a formality. Serves no purpose?” Bowen responded.

“No. No purpose,” Sparrow said.

The supervising physician is only required to meet with the nurse practitioner they supervise twice a year, but they are paid for the whole year. In the first 6 months of practice, they meet once a month.

“They can charge you whatever they want to, and we’re talking big bucks,” said Rep. Gale Adcock.

Adcock is a Democrat who represents western Wake County’s 41st House District. 

“Is this all about easy money for physicians?” Bowen asked.

“There is a profit motive there that does not serve patients,” Adock said.

Adcock has been a nurse practitioner for more than three decades.

She said the additional expense prevents people in her profession from adding personnel or expanding the business to areas where patients need care, particularly in rural areas with few doctors.

“Well, having to pay for overhead that does not add value to your business is not good for any business. So a nurse practitioner that has to pay for paper supervision that does not add to the quality, the safety or outcomes of his or her patients is paying for something they do not need,” she said.

The SAVE Act has gone nowhere in the House Committee on Health, of which Adcock is a member.

It only takes one co-chair out of five to stop any bill from being heard. 

“So what’s the holdup?” Bowen asked.

“So the real holdup is that there are powerful forces who have influence at the General Assembly who do not want to change the status quo. It’s physician organizations who believe that a change in the status quo upsets their business model and their revenue streams,” Adcock said.

One of those organizations against the SAVE Act is the North Carolina Medical Society.

It has donated thousands of dollars to House committee co-chair, Dr. Kristen Baker (R-Cabarrus).

When asked via email and voicemail to talk about the SAVE Act, CBS 17 did not receive a response.

When asked in person, Baker said she had to take a phone call and did not have time.

“Well Rep. Baker is a physician and the Medical Society is proud to stand with our physicians who like to run for office in the same way that the nurses and nurse practitioners do who run for office,” said North Carolina Medical Society Executive Vice President and Chief Executive Chip Baggett.

The SAVE Act has overwhelming bi-partisan support.

There are 77 cosponsors in the House and 50 in the Senate.

But, Baggett said getting rid of the need for physician supervision isn’t the right approach.

“The bill as introduced and proposed right now is really more of a siloing because it spends more time focusing on independence for various nurse practitioners to go off and kind of be on their own rather than partnering with physicians and other healthcare providers,” said Baggett.

Baggett added, “In many cases, I would speculate in most cases, that the relationship between the nurse practitioner or another advanced practice practitioner is more developed than what you’re describing. As we talk about access to care and moving into more rural communities, we need to further develop the rural communities. They have lost industry, they’ve lost funding for schools because they can’t fund them on the property taxes that are remaining in those areas, they’ve lost commercial businesses that are attractive to bring professionals to an area. We’ve got to look at a holistic approach and just letting nurses practice independently is not going to be the answer to our rural health concerns.”

Senate Bill 249 by on Scribd

Rep. Larry Potts (R-Davidson) is another member of the House Committee who has received donations from physician-related interest groups and PACs.

When asked to comment about the SAVE Act, Potts said, “I don’t think it would be proper as the chairman of the committee to discuss the bill or give my opinion or my position on it until it is scheduled to hear in committee.”

According to the non-profit Mental Health America, North Carolina dropped from 38th to 44th in the nation in 2020 when it comes to access to mental health care.

“This access to care problem predates COVID by decades, decades and it is not getting better,” said Adcock.

Sparrow said another obstacle for nurse practitioners who are looking for a supervising physician is the fact that so many have their own practice or work for a hospital group.

“Why would a psychiatrist who owns their own practice be willing to supervise me? They would say well why don’t you just work for me? This bill is bi-partisan, it saves the state money on health care expenses and it increases access to care. It’s a no-brainer.”

To view campaign finance documents for a committee registered with the North Carolina State Board of Elections, click here.

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