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The latest on the Key Bridge collapse, New York puts forth legislation to get clean energy projects on the grid and Wisconsin and other states join a federal summer food program to help feed kids across the country.

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Republicans float conspiracy theories on the collapse of Baltimore's Key Bridge, South Carolina's congressional elections will use a map ruled unconstitutional, and the Senate schedules an impeachment trial for Homeland Secretary Mayorkas.

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Historic wildfires could create housing and health issues for rural Texans, a Kentucky program helps prison parolees start a new life, and descendants of Nicodemus, Kansas celebrate the Black settlers who journeyed across the 1870s plains seeking self-governance.

NC Health Depts. "Burdened" by Doctor Supervision Contracts

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Monday, August 2, 2021   

GREENSBORO, N.C. - Local health departments that rely heavily on Advanced Practice Registered Nurses say the costly contract requirement that they be supervised by a physician are draining already scarce resources and affecting North Carolina's most vulnerable populations.

By law, APRNs must must work under doctor supervision, have a collaborative practice agreement, and meet once every six months with their supervising physician.

Health Director at Guilford County Public Health Department Dr. Iulia Vann said her large APRN staff spans the fields of maternal health, primary care, family planning, and HIV and Sexually Transmitted Disease prevention and care.

"And all of these team members, they have to have a supervising physician," said Vann, "based on the requirements from the Board of Nursing in order for them to stay licensed and certified."

The SAVE Act, introduced in North Carolina this year, would remove supervision requirements statewide. But physician groups like the American Medical Association maintain patients are better served by an integrated care team led by a physician.

Vann noted her department shells out tens of thousands of dollars for supervision contracts.

"Our role in the community, and our services for the community are really nurse-driven," said Vann. "And we do not have the resources to include some of these collaborations all the time."

At the Craven County Public Health Department, Health Director Scott Harrelson said physician oversight costs his department around $91,000 a year. He explained that they rely mostly on primary-care physicians to help keep contract costs low.

"They can go from pediatrics and adult primary care, so you could see some maybe potential savings of just doing one contract for the whole shebang," said Harrelson, "especially if you're a smaller health department that doesn't have a whole lot of volume coming through on your primary care."

One 2018 study of rural health clinics in the Southeast found loosening supervision requirements for nurse practitioners improves the numbers of providers, healthcare access and quality of care in rural regions.




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