Since 2013, every year, the Pennsylvania Coalition of Nurse Practitioners swarm Harrisburg, advocating for full practice authority.

Today was this year’s annual rally.

“Pennsylvania is in the throes of a healthcare provider shortage, and it’s only set to get worse,” Amanda Laskoskie said, president of the Pennsylvania Coalition of Nurse Practitioners.

Laskoskie said that in rural areas specifically, doctor offices have decreased from 2010 to 2020. However, nurse practitioners opening their own practice in these areas have increased.

“Nurse practitioners see patients, they diagnose, they treat, they prescribe medications for them,” Laskoskie said.

Here’s the legal catch—in order for a nurse practitioner to have a solo practice in Pennsylvania, they need a collaborative agreement.

This is a contract with two physicians, who legally vouch that the nurse can operate. The physicians take on some legal liability and the nurses pay a hefty fee to keep the contract.

“Many of my nurse practitioner colleagues never see their collaborator, really never talk to their collaborator,” Kelly Weary said, a nurse practitioner who owns the Presque Isle Mind, Body, Wellness clinic in Erie. Weary promotes a holistic approach to mental health, and shares that while right now she talks with her collaborator more, she’s had much less contact with past collaborative agreements.

Weary made the drive to Harrisburg to advocate for the day.

“It's really all about access of care, giving more opportunities for healthcare providers to open offices for patients,” Weary said. “And less restrictions, less paperwork for nurse practitioners.”

Senate bill 25 and House bill 739 would eliminate the need for collaborative agreements, thus creating the full practice authority. Similar legislation has been passed in 27 other states, Washington D.C., and the federal Veterans Affairs (VA) network also gives full authority practice to nurse practitioners.

The legislation has some broad bipartisan support—but is opposed by some physician associations. They maintain nurse practitioners have less training. Specifically in promoting nurse practitioners in rural areas, the Pennsylvania Medical Society notes patients can wait longer before seeking medical help.

“Do we want the lesser experienced people to have those all-comers, that are often people who have more severe disease?” Lorraine Rosamilia said, vice chair of the Pennsylvania Medical Society.