Indiana is the latest state to introduce legislation to grant full practice authority to 9500 advanced practice registered nurses (APRNs) as an answer to its health care crisis. The Hoosiers for Health Care Access, a statewide coalition dedicated to expanding patient access to APRNs in Indiana, and other organizations joined state legislators at the Indiana Statehouse to call for immediate action to address the high rates of people in Indiana living in health care deserts.
SB 213 and HB 1330 are “no-cost, no-delay” solutions to increase access to health care for Indiana’s patients, according to the coalition. Both bills would remove a provision requiring an APRN to operate under a collaborative practice agreement with a physician or the privileges granted by a hospital governing board. The bills also would repeal laws concerning the audit of practice agreements and allow APRNs with prescriptive authority to prescribe a schedule II controlled substance for weight reduction or to control obesity.
Health Care Deserts Are Widespread in Indiana
More than 2.4 million people in Indiana lack access to basic primary health care services, with an increase of 300,000 patients in the past 2 years, according to the coalition. Also, 6.6 million people in the state lack access to mental health services. The federal government has designated 138 primary care shortage areas and 33 counties lack maternal health care providers. Indiana ranked low in multiple measures on America’s Health Rankings annual report released in December 2022 by the United Health Foundation.
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Health Care Rankings in Indiana
| Measure | State Rank |
| Overall rank | 35 |
| Clinical care (access to care, preventive clinical services, quality of care) | 37 |
| Access to primary care providers | 33 |
| Access to mental health providers | 43 |
Under current Indiana state law, APRNs are unable to practice without collaborative practice agreements and must submit a subset of their patient charts to a physician for review for quality assurance. Often, the physician will charge a fee as a condition for signing the collaborative practice agreement. “These fees can run thousands of dollars per month and do not result in actual collaboration on patient care between the contracted physicians and APRNs,” according to the Hoosiers for Health Care Access.
One in 3 Indiana residents — or 2.4 million residents — are age 50 years or older, explained AARP Indiana State President Linda Dunno. “We urge the house and senate to cut the red tape that is limiting access to care and to allow older Hoosiers to choose APRNs as their health care provider.”
“By breaking down these outdated barriers, APRNs can help provide quality care to patients throughout the state—from small towns to urban hubs,” said AARP Indiana Legislative Director Ambre Marr at a press conference held at the Indiana capital on January 31, 2023. “Hoosiers deserve the opportunity to have more choices that will allow them to stay in their homes and communities for as long as possible, where they want to be.”
Sources
Rep Cindy Ledbetter, civic leaders host press conference calling for urgent legislative action on Indiana’s Health Care Access Crisis. News release. Hoosiers for Health Care Access; January 31, 2023. Accessed January 31, 2023. https://www.hoosiersforhealthcareaccess.com/press-releases/media-advisory-rep-cindy-ledbetter-civic-leaders-host-press-conference-calling-for-urgent-legislative-action-on-indianas-health-care-access-crisis/
Hoosiers for health care access applauds legislation expanding health access, choice. News release. Hoosiers for Health Care Access; January 26, 2023. Accessed January 31, 2023. https://www.hoosiersforhealthcareaccess.com/press-releases/hoosiers-for-health-care-access-applauds-legislation-expanding-health-access-choice/
