Developing Alliances

Abstract

The authors describe how advanced practice nurses in Pennsylvania were able to successfully advocate for nursing-related legislative reforms through Governor Edward G. Rendell's signature health care reform plan (the "Prescription for Pennsylvania"). In addition to discussing advocacy efforts related to a series of nursing-related bills considered by the Pennsylvania Assembly in 2007, the article also describes years of hard work and foundational advocacy conducted by a broad coalition of nurses, which paved the way for the Prescription for Pennsylvania's reforms. By examining the successful tactics of Pennsylvania's nurse advocates, the authors conclude that policy makers' current interest in solving the health care crisis presents a tremendous opportunity for nurses to reform legislation. To seize this opportunity, nurses must learn to speak with a unified voice and build strong relationships with a broad range of bipartisan policy makers, funders, civic leaders, business leaders, and legislative advocates.

Effective Strategies for Achieving Scope of Practice Reform in Pennsylvania

“…In 2006, shortly into his second term, Rendell introduced Rx4PA, a sweeping health reform bill that represented a set of strategies focused on controlling cost, increasing access, and addressing health-care system inefficiencies (GOHCR, 2007; Hansen-Turton et al, 2009). It also aimed to expand insurance coverage to the 800,000 Pennsylvanians without health-care insurance (Burger, 2007).…”

“…Rendell put his plan to reform SOP into motion after forming the GOHCR, led by Rosemarie Grecco and Ann Torregrossa. Although neither were health-care professionals, both Grecco and Torregrossa had extensive backgrounds in law, policy, and banking (Hansen-Turton et al, 2009). …”

“…According to representatives of the Alliance interviewed in our study and officials from the GOHCR, the white paper provided an overview of the educational background, practice settings of APRNs, and barriers to care that existed because of outdated laws and regulations (Alliance of Advanced Practice Nurses, 2005; Hansen-Turton et al, 2009) and was used to frame the SOP provisions laid out in Rx4PA.…”

“…To date, there have been few systematic examinations of the legislative process involved in reforming state-level APRN SOP regulations (Gutchell, ldzik, & Lazear, 2014; Hansen-Turton, Ritter, & Valdez, 2009; Madler, Kalanek, & Rising, 2014; Schober et al, 2016). Understanding this process, however, is of importance as the nation faces a primary care shortage and access to the underserved persists (Institute of Medicine, 2011).…”

“…Rendell tied these objectives (at least in part) to expansions in SOP for APRNs. In July 2007, key provisions of the Rx4PA legislation passed through Act 48 and with it APRNs were allowed to perform an expanded range of services including ordering durable medical equipment, signing disability forms as well as other prescriptive authorities and patient care services (Hansen-Turton et al, 2009). …”