Day at the Legislature Talking Points

Coverage gap

The ask: we want the General Assembly to pass legislation that will close the healthcare “coverage gap.”

Nurses know better than anyone the importance of access to quality, affordable healthcare.
Over 1 million North Carolinians are currently uninsured. Of those, approximately 400,000 could benefit from closing the insurance gap.
Many people who lost jobs in the last year due to the pandemic, lost their insurance as well; closing the coverage gap would help them, as well as employers like restaurants who struggle to provide health benefits to employees, especially now on their small margins due to COVID impacts.
Closing the gap will also help rural hospitals keep their doors open. With so many uninsured North Carolinians living in rural areas of the state, rural hospitals often struggle to compensate for patients who cannot afford to pay for their care.
Far too many of our fellow citizens are putting off preventative care because it is too expensive or simply unavailable. Many of these people are forced to decide between paying for prescriptions and putting food on the table. The status quo is not acceptable.
Every day, we see people turn to our Emergency Departments as their only, last options for healthcare. This is quite literally the most expensive way of paying for healthcare, and the rest of us foot the bill when these patients cannot afford to pay for it.

Workforce

The ask: we want the General Assembly to budget for increasing nursing school faculty salaries to be more competitive and to attract qualified candidates.

The Bureau of Labor Statistics estimates there will be over 1 million vacancies for Registered Nurses by 2024, yet each year thousands of qualified nursing school applicants are turned away. Talking points on this include:

Increasingly, Registered Nurses are on an educational path that includes BSN and higher degrees. NCNA supports ongoing educational advancement wholeheartedly, but we also know that in our state, we continue to depend heavily on the N.C. Community College System (NCCCS) for entry in to practice.
For years, community college nursing schools in our state have been forced to turn away qualified students because they get more applications than seats allotted by the state. It is an ongoing problem that has been made even worse because of significant faculty vacancies and shortages in their area.
The result is that we are not even meeting the state’s allotment, despite a high demand and obvious need. While certainly not the only thing that needs attention, community college faculty salaries simply cannot compete with the direct care market for RNs, or even other faculty positions in the university setting.
NC community colleges are paying BSN faculty $14,923 less on average than they could make in the hospital setting and are paying MSN faculty $17,618 less on average than they could make in the university setting.
At a time when North Carolina needs an influx of healthcare professionals, this is the low-hanging fruit. The fastest way we can help boost those numbers is by letting more of the qualified people who want to be nurses actually train to be nurses.

School Nurses

The ask: we want the General Assembly to budget for a nurse in every school.

Increase the number of school nurses in North Carolina to a minimum of one school nurse per school.
School Nurses save every teacher 20 minutes per day.
School Nurses save clerical staff 45 minutes per day.
School Nurses save principals 60 minutes per day.
32% of School Nurses’ time is spent providing mental health services to children in need.
18% of students have a chronic illness.
School Nurses improve attendance through health promotion, disease prevention and management. Students assessed by the nurse (instead of teachers) are 50% less likely to be sent home, keeping them in class and ready to learn.

APRNs

The ask: we want the General Assembly to pass the SAVE Act (SB 249/HB 277).

Access to quality healthcare is paramount in the middle of a pandemic and will remain a challenging issue in North Carolina for years to come.
Almost all national studies point to a looming national shortage of physicians and other critical care providers. That shortage will have a greater impact in North Carolina given the rapid growth the state has experienced and will continue to experience.
An underlying problem for rural residents is the centralization of healthcare services in major urban cities. Healthcare provider shortages will be dramatic for many residents living in rural North Carolina.
Access to quality healthcare not only carries a human cost, it carries an economic cost to areas of the state that continue to struggle in a mixed economic recovery.
North Carolina lawmakers have the opportunity to lessen the impact of the physician shortages without compromising the quality of healthcare by modernizing regulations impacting many care providers.
Streamlining regulations to allow for Advanced Practice Registered Nurses (APRNs) to fully utilize their training is one path to alleviate the looming crisis while helping to keep healthcare costs under control.
Giving patients greater access with more choices will help to strengthen the overall quality of healthcare in North Carolina.
Lawmakers need to focus on a patient access system that ensures quality care with proper oversight. A provider-based approach leads to increased regulatory control and additional costs to the patient at the added expense of patient access.
Numerous other states have lessened the regulatory burden on APRNs as a way to meet the demand for increased care without showing any compromise in the quality of patient care. None of those states have rescinded similar laws after they were enacted.
A 2015 North Carolina study conducted by the Center for Health Policy and Inequalities Research at Duke University concluded that modernized APRN regulations in North Carolina would add to new economic and job growth across our state. Legislation like the SAVE Act would lead to annual healthcare system savings between $433 million and $4.3 billion in North Carolina.
Lack of access to qualified healthcare professionals means lack of quality care. Not being able to see a care provider when needed is the worst possible healthcare delivery system.