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Investing in the Next Generation of Health-Focused Leaders

Sep 12, 2016, 9:00 AM, Posted by Pam S. Dickson

Collaboration—among people who don’t traditionally work together on a daily basis and who bring unique perspectives—carries the best potential to solve today's complex health and social issues effectively and equitably.

A meeting facilitator refers to a bar chart.

Looking out upon the worshippers at New Era Church in downtown Indianapolis, Rev. Dr. Clarence C. Moore sees row after row of families facing difficult challenges stemming from a pressing statewide problem: the over-incarceration of black people. Indiana ranks second in the country for the number of children who have an incarcerated parent. As a result, many children live in single-parent households or foster care, and live in poverty. Many lack a formal education until they reach kindergarten—and so they aren’t ready when they get there. They struggle, many ultimately drop out of school, and the vicious cycle continues.

“I tell my congregation that there is nothing wrong with these seeds—these children,” Rev. Moore says. “It’s the soil these seeds are planted in that is the problem.”

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Nurse Practitioners and the Primary Care Shortage

Mar 20, 2013, 9:00 AM

In light of concerns about the nation’s shortage of primary care providers—which is likely to be exacerbated as health reform takes effect—many have argued that nurse practitioners (NPs) can help increase capacity. But because state laws about NPs’ scope of practice vary widely, in some places NPs may not be able to help fill the gap and satisfy demand for primary care services.

A new report from the National Institute for Health Care Reform examines the scope-of-practice laws and payment policies that affect how and to what extent NPs can provide primary care. The report examines laws across six states (Arkansas, Arizona, Indiana, Maryland, Massachusetts and Michigan) that represent a range of restrictiveness. The National Institute for Health Care Reform is a nonprofit, nonpartisan organization that conducts health policy research and analysis.

Rather than spelling out specific tasks NPs can perform, scope-of-practice laws generally determine whether NPs must have physician supervision. Requirements for documented supervision—collaborative agreements—are seen “as a formality that does not stimulate meaningful interaction between NPs and physicians,” according to the report. Collaborative agreements can limit how NPs are used in care settings or prohibit them from acting as the sole care provider, and can limit NPs’ range or number of practice settings, which can have serious consequences for underserved rural communities, the report says.

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