Home - Hoosiers for Health Care Access

Today, more than 2.4 million Hoosiers lack access to primary care.

Tell Lawmakers to Pass H.B. 1059

About

Hoosiers for Health Care Access is a statewide coalition dedicated to expanding access to Advanced Practice Registered Nurses (APRNs) to meet our state’s growing health care needs. Today, More than 2.4 million Hoosiers live in federally designated primary care provider shortage areas without adequate access to primary care, while more than 6.6 million lack access to mental health care. In fact, the federal government has designated 138 health care provider shortage areas across the state. Additionally, 33 of Indiana’s 92 counties are classified as maternal health care provider shortage areas where women don’t have access to even the most basic obstetric and gynecological services they need.

Under Indiana law, APRNs are unable to practice without mandatory physician contracts — known as a “collaborative practice agreement.” Far from professional collaboration, this contract requires APRNs to submit a subset of their patient charts to a physician for review for “quality assurance.” Often, the physician will charge a fee as a condition for signing the collaborative practice agreement. These fees can run thousands of dollars per month and do not result in actual collaboration on patient care between the contracted physicians and APRNs

Often, the physician review of patient charts occurs months later and offsite and has no immediate impact on patient care. The Indiana Board of Nursing already calls on APRNs to practice independently and interdependently. Collaboration already occurs without the need for a written contract nor the payment of fees.

Advanced Practice Registered Nurses (APRNs) offer a high-quality, accessible and affordable solution to the state’s primary care access problem. However, current Indiana state law limits the capacity of these professionals to deliver the patient care they are educated and clinically trained to provide. Join us in advocating for a proven solution to Indiana’s health care access issue: greater access to APRN-provided care.

Our Coalition Partners

The Problem

APRNs are trained to provide high-quality, accessible and affordable care, but state law requires they sign “collaborative practice agreements” in order to practice, which is costly, time-consuming and provides little patient benefit. According to the recently released America’s Health Rankings by the United Health Foundation, Indiana ranks a dismal 36th among states for primary care access and 43rd for mental health access. Its health outcomes rank 37th among states.

Patients

Hooslers deserve better access to primary care.

Advanced Practice Registered Nurses

Indiana’s more than 9,400 APRNs stand ready to meet patient need.

Policymakers

Should remove mandatory collaborative agreements and unleash Indiana’s APRN workforce.

The Solution

APRNs are licensed in all states and the District of Columbia and practice under the laws of the state in which they are licensed. Nearly half of all states allow patients full and direct access to nurse practitioners (NPs), the largest APRN provider workforce. APRNs provide patients choice in health care and lead the way to better health care access. This model of legislation is known as Full Practice Authority.
Removing the requirement that Indiana APRNs sign a contract with a physician in order to practice would drastically expand Hoosiers’ access to care by allowing APRNs to practice to the full extent of their training statewide – especially in primary care shortage areas.
APRNs will strengthen our primary care provider workforce. 85 percent of APRNs provide primary care, and last year, more than 1 billion patient visits were conducted by NPs in the United States.
APRNs increase patient choice and access and are a healthy solution to Indiana’s physician shortage. APRNs tend to be more available, provide more personal attention, spend more time with patients and provide more comprehensive, whole-patient care.