Medical Society CEO: Nursing bill won’t improve healthcare in rural NC

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Healthcare: SAVE Act won’t help NC

The writer is CEO of the N.C. Medical Society.

It is time for truth.

Increasing access to healthcare in rural areas of North Carolina has been and remains a top priority for numerous stakeholders in the Tar Heel state. The pandemic and the economic distress it put on rural areas is leading to countless policy discussions and debates.

Since my early days growing up in eastern North Carolina, increasing access to healthcare has been a vital issue worthy of the attention it’s now getting. It is important to make sure actions taken to achieve this objective are supported by excellent, unbiased data. It’s time for the plain truth.

Rural areas have a hard time recruiting and retaining physicians, physician assistants (PAs), nurses and administrators. That truth is based on empirical data. The SAVE Act as currently written would allow nurses to practice without physician supervision. Evidence does not support that a change in how nurses practice will increase access to care in rural communities. That is also the truth.

A look at the 38 states that passed legislation to expand the scope of practice for nurses shows no positive correlation to an increase in access. Research shows that infrastructure and higher pay makes practicing in rural areas more attractive. Independent practice does not. That is the truth.

The N.C. Medical Society understands that incentives are essential to attract new physicians to rural areas. For more than three decades we’ve been putting physicians, PAs and nurses in underserved communities through our signature Community Practitioners Program. That is the truth.

Rural areas are generally populated by older and sicker people, fewer people have health insurance, and the economies are not as robust compared to urban areas. Physicians in rural areas choose to serve there because of their commitment to the community. It is infrastructure that is needed, rather than the independence sought in the SAVE Act.

If we’re truly going to transform healthcare for everyone in N.C. we must hit the right targets. Team-based care with physicians, PAs and nurses working together, proven incentives that bring and keep physicians and healthcare workers in the area, and promoting the assets that rural areas offer will yield far greater results than the policy promoted in the SAVE Act. That is the truth.

Chip Baggett, Raleigh

NC is losing too many caregivers

The writer is regional director for BAYADA Home Health Care.

Home care helps keep more than 58,000 vulnerable seniors, disabled and medically-fragile North Carolinians safe and healthy at home and out of long-term care institutions like nursing homes and hospitals. But home care programs are at a crossroads: If the N.C. legislature does not take action by the end of the month, home care funding will be cut by 18% in the next budget.

That would devastate the industry and the thousands of individuals and families that rely on this care to stay safe and healthy at home. Even before the pandemic, home care providers were suffering recruitment and retention challenges. This year, BAYADA Home Health Care has declined hundreds of patient cases in N.C. because we can’t find aides.

Over the past year, private companies, namely big retail and fast food, have increased starting wages to $15+ per hour. They pass on increased labor costs to consumers. Alternatively, home care providers rely on state funding to cover costs of care delivery, including caregivers’ wages, training, benefits and supplies. Those costs have increased 10% in the past year. Current turnover among aides is greater than 50%, with many leaving for higher wages elsewhere..

Now is not the time to cut funding. On behalf of home care providers, clients, and families, I urge the legislature to take action by June 30 to stop home care funding from dropping by 18%.

Without adequate funding for home care, we cannot compete for the workforce. State lawmakers must help stop the mass exodus of caregivers from the home care industry. Reducing funding now will put more residents in jeopardy of losing the care they need to stay in the most cost-effective and patient-preferred setting: their own homes.

Shannon McCarson, Winston-Salem