Let’s unshackle Stanislaus and Merced nurse practitioners

The coronavirus pandemic has made one thing very clear: Rural communities across America continue to face incredible obstacles in obtaining healthcare services and providers.

In California, where the governor is building a health corps workforce to ensure all communities have access to medical care, nurse practitioners are ready and able to serve.

According to a 2019 California Future Health Workforce Commission report, the state is projected to fall 4,100 primary doctors short. While current California law requires nurse practitioners to work under the jurisdiction of a licensed physician, there is no greater time and opportunity to have the governor issue an executive order unshackling them from this restriction and giving them full practice authority.

A nurse practitioner completes a rigorous and exhaustive training program that begins with obtaining a bachelor of science degree in nursing. This four-year program is followed by a master’s degree in family medicine. Some go further and obtain a doctorate.

With the California Legislature out of session, there is no better time for Governor Newsom to declare Merced and Stanislaus counties as Nurse Practitioner Practice Zones for the next two years. Doing so would free them from bondage to doctors and demonstrate to elected officials and regulators that they are wonderfully qualified, competent healthcare professionals. Moreover, this two-year pilot project could undergo an evaluation upon completion to show its efficacy.

Why the need now in these two counties?

With 55% and 45% of the population on Medi-Cal, respectively, and numbers growing, access to medical care continues to be a huge challenge. Having just graduated 19 nurse practitioners from the California State University, Stanislaus program, and with 16 more graduating in December, we are creating a workforce prepared to tackle many challenges, slowly reducing the burden on hospital emergency departments.

But needs go even further.

We have a growing elderly population, with an even larger 85-and-older cohort. Most seniors want great care; they do not care who provides it. With people sheltering in place, imagine the impact a mobile nurse practitioner team could have.

Physicians continue to retire and replacing them has become almost impossible. Patients struggle to find doctors, often waiting six to nine months for an appointment. As a result, urgent care centers have become the new primary care for many. Who staffs many of these urgent care centers? Nurse practitioners.

Our two counties have become ethnic melting pots. Creating a medically and culturally competent environment is critical if we are to address their short- and long-term medical needs.

Finally, we face a long-term care crisis. Families and individuals who do not qualify for Medi-Cal are struggling. The situation is particularly difficult for people with a spouse, parent, or partner living with Alzheimer’s or dementia who cannot afford respite or adult day care services due to high costs, assuming these services are even available.

Nurse practitioners are highly trained medical professionals. They understand the challenges faced by patients and do not rush to the next appointment. They listen to the patient and the family member, and then build strategies for care.

At times of crisis like this, the nursing profession continues to be America’s backbone for medical care. There is no greater time or opportunity to move nurse practitioners to the front lines of care, allowing Merced and Stanislaus counties to serve as a model for the state and nation.

Healthcare workforce shortages, long-term care crisis, and overall health needs of the Northern San Joaquin Valley present complex challenges. The coronavirus does not discriminate based on medical or nursing degree – and we shouldn’t either. Designate Merced and Stanislaus counties as Nurse Practitioner Zones and allow these healthcare heroes to work freely.


Jeffrey Lewis is president and CEO of Legacy Health Endowment in Turlock.
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