University of California San Francisco
Public Comments for Events Organized by the FTC's Economic Liberty Task Force
Thank you for addressing this important issue. Removing barriers to professional practice may have more far-reaching benefits to the public than any other aspect of healthcare reform. Nurse Practitioners (NPs) are registered nurses with postgraduate education and board certification, licensed to treat specific patient populations(NCSBN,2017). NPs in California are prepared to provide increased access to affordable care in communities with limited access to the range of services we provide. The majority of the psychiatric mental health nurse practitioner (PMHNP) students we teach at UCSF plan to serve in public settings where the need is greatest. However, current restrictions on NP practice make it difficult for PMHNPs to meet the needs in communities that don't already have a psychiatrist. For rural communities, the barrier poses unnecessary challenges that other states don't face. Often, NPs must pay physicians to collaborate in order to serve a community with few resources. When NPs in California have the same freedom to practice as those in our neighboring states, patients will have access to the option of seeing an NP without these market restrictions. An area where this could make a significant difference is child/adolescent psychiatry. Despite the serious shortage of providers, our graduates have limited opportunity to serve the population under current policies. Considering the nationwide move towards regulatory authority for APRNs exclusively under Boards of Nursing, the number of states with updated legislation continues to increase. While streamlining licensure across state lines will not ensure full practice authority, it is a move towards economic liberty for the citizens who deserve access to qualified providers in every state. The Economic Liberty Task Force is on the right track. Full practice authority across state lines can prevent the current "brain drain" occurring in states with economically-driven licensure restrictions on NPs who are heavily recruited to serve in neighboring states that do not impose exorbitant fees for a signed delegation agreement. Thank you for addressing such an important policy issue for the benefit of all Americans. For more information and references, please see the attached memo.