Columbus, OH – In a new policy memo, Policy Solutions for the Pandemic: Lifting Restrictions on Nurses to Fight COVID-19 (see full text below or download a PDF), The Buckeye Institute calls for Ohio to end the collaborative supervision requirements that prevent advanced practice registered nurses (APRN) from offering the medical care they have been trained and licensed to provide.

“The Buckeye Institute has consistently argued and testified that ending restrictive collaboration agreements will help patients receive more affordable health care,” said Rea S. Hederman Jr., executive director of the Economic Research Center and vice president of policy at The Buckeye Institute. “The COVID-19 pandemic makes this commonsense policy recommendation more urgent than ever and Ohio should suspend collaborative supervision requirements on the way to eliminating them so that nurses can help provide the necessary medical care to those in need.”

This new policy memo builds on the recommendations The Buckeye Institute made in Policy Solutions for the Pandemic: How Ohio Can Fight the Impact of Coronavirus, which outlined immediate actions Ohio policymakers can take to ensure Ohio is ready to fight and recover from the pandemic. The Buckeye Institute’s recommendations can be found at www.BuckeyeInstitute.org/Policy-Solutions-for-the-Pandemic.

Ohio has adopted a number of Buckeye’s recommendations that will boost the state’s health care system and support Ohio’s workers, small businesses, and economy. Ohio has increased telehealth access and monitoring, eliminated unnecessary budget commitments, instituted a hiring freeze in state government, enlisted medical and nursing students to support doctors and nurses fighting COVID-19, and has allowed establishments with an existing liquor permit to sell alcohol on carryout menus. 

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Policy Solutions for the Pandemic
Lifting Restrictions on Nurses to Fight COVID-19

By Rea S. Hederman Jr.
April 8, 2020

The Buckeye Institute’s Recommendation
Ohio should end the collaborative supervision requirement that prevents nurses from practicing to their full medical training. The COVID-19 pandemic makes this commonsense policy recommendation now more urgent than ever.

Background
Advanced practice registered nurses (APRN) receive additional training in nursing school to administer more medications and tests. Recently, Ohio has removed some—but not all—barriers that keep APRNs from offering all of the medical care that they are trained to provide. Unfortunately, Ohio still requires that nurses, even APRNs, only practice under physician supervision. This “collaborative supervision” requirement needlessly increases health care costs and reduces available care. Studies (here and here) have shown that primary care patients receive comparable care whether treated by doctors or qualified nurses, so Ohio’s restrictions on APRNs may be denying patients quality, necessary medical treatment during the COVID-19 crisis.

Most other states, including neighboring West Virginia and Kentucky, already have removed collaborative supervision restrictions. Ohio’s House Bill 177 would let Ohio join them. Until the General Assembly enacts H.B. 177, however, Ohio should suspend the collaborative supervision rule during the pandemic for any APRNs who are not within 50 miles of a collaborating physician. Such a suspension may have little effect in urban centers but could provide critical relief to patients in rural areas who do not have access to as many hospitals or doctors.

Federal studies have recognized the value that APRNs provide. President Obama’s Council of Economic Advisors found that increasing APRN availability improved the public’s access to health care services without detracting from the quality of care. A 2014 Federal Trade Commission report concluded that APRNs provide quality, safe health care, and can meet a critical public health need by treating patients in underserved areas. A more recent Trump Administration report explained how empowering APRNs could reduce health care costs while maintaining care quality. And the Department of Veteran Affairs has eliminated its own collaborative supervision requirement to address care provider shortages in the VA health care system.

Conclusion
The Buckeye Institute has consistently argued and testified that ending restrictive collaboration agreements will help patients receive more affordable health care. Now more than ever Ohio needs its advanced practice registered nurses free to practice to their full training and potential during this pandemic. Ohio should temporarily suspend collaborative supervision requirements on the way to eliminating them so that nurses can help provide the necessary medical care to those in need.

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