Psychiatric nurse practitioners, mental health advocates join Bartolotta to discuss SB 25
Kirstyn Kameg, a psychiatric-mental health nurse practitioner for nearly 25 years and a professor of nursing at Robert Morris University, is frustrated.
Three years ago, Kameg and her daughter, Brayden Kameg, also a psychiatric-mental health nurse practitioner, or PMHNP, co-founded Peace of Mind Psychiatry, an outpatient private practice in Bridgeville that has grown to serve about 3,000 patients.
As nurse practitioners, they can do many of the same things doctors can do – diagnose conditions, prescribe drugs, manage their own practices.
But under Pennsylvania law, nurse practitioners must work under a collaborative agreement with a doctor who provides oversight. The physician doesn’t have to be on site. And those agreements can cost upwards of $1,000 a month for nurse practitioners.
“Collaborative agreements are a huge expense to nurse practitioner practices and a barrier to patients to secure physical and mental health treatment,” said Kameg, who serves as coordinator of the PMHNP program at Robert Morris. “Collaborative agreements truly have nothing to do with collaboration. My collaborating physician lives in Florida.”
State Sen. Camera Bartolotta aims to change that.
Bartolotta is the prime sponsor of Senate Bill 25, which would grant full practice authority to nurse practitioners and allow them to operate independent of doctors.
Bartolotta, who appeared alongside Kameg and other mental health nurse practitioners at a press conference at Southpointe Psychiatry and Wellness in Canonsburg on Tuesday during National Suicide Prevention Month, said the legislation would allow nurse practitioners to serve and treat more Pennsylvania patients.
“Pennsylvania continues to stay behind while state after state after state passes similar legislation,” said Bartolotta, noting 27 states and Washington, D.C., have adopted full practice authority for nurse practitioners. “It is far past time for us to join that list.”
Bartolotta said the commonwealth – including the rural communities throughout Washington, Greene and Beaver counties that she represents – lacks enough psychiatrists and physicians to meet the health care needs of Pennsylvanians, forcing patients to face lengthy wait times or travel long distances for appointments, including for mental health services.
Jen Bowman, co-founder of Southpointe Psychiatry & Wellness, said the change would allow nurse practitioners to work to their full abilities.
Bowman, a PMHNP, shared the struggles that she and her partners – who have about 1,300 clients – have encountered trying to find collaborative physicians since they opened their practice about two years ago. It can take months to find a doctor, she said.
“Now, to run Southpointe Psychiatry & Wellness, it’s going to cost us about $25,000 a year in collaboration fees, which (could be used) for another staff person to help with all the things we need to do day to day,” said Bowman.
Bowman, who is currently undergoing treatment for breast cancer, said she is concerned about the financial commitment it takes to run the growing business, “but I’m also concerned mostly that my patients are going to be taken care of.”
She said Pennsylvania “has the opportunity to address this crisis by loosening the restrictions that prevent nurse practitioners from practicing to the full extent of our training and skills. Getting through this red tape has honestly been exhausting for me and everyone here, and has only delayed mental health care to all of those in need. We are not discounting in any way the training of physicians; we are asking for the ability to practice fully for what we are trained to do.”
Kameg said studies show that patient outcomes are equivalent in care provided by nurse practitioners compared to care provided by physicians and physician assistants.
“Pennsylvania is becoming an island as it relates to prescriptive authority or full practice authority, as most neighboring states such as Maryland, New York and Delaware have provided nurse practitioners with this opportunity,” said Kameg.
There is no denying that lack of access to mental health care negatively impacts the nation, she said, citing Centers for Disease Control statistics: Suicide is the second-leading cause of death in individuals between the ages of 10 and 34; one-third of adolescents said they have seriously considered suicide; 1 in 4 families has at least one member with a mental disorder.
“Given the staggering statistics on suicide in our nation, voting to pass Senate Bill 25 and grant nurse practitioners full practice authority is truly a matter of life and death,” said Kameg.
Bartolotta said under the bill, nurse practitioners would receive full practice authority once they complete a three-year, 3,600-hour program.
Lisa Raerhys, president of the Washington affiliate of National Alliance on Mental Illness, called Senate Bill 25 “a game changer.”
Raerhys, who was diagnosed with bipolar disorder with psychotic features in her early 20s, went on to graduate from Washington Hospital School of Nursing and has worked to improve the lives of those with mental health disorders.
“People like myself, like my friends, like the people who live in my communities and surrounding areas, would be able to access (nurse practitioners) so that when those problems start to happen, they can catch them before they fall to the ground, before they have to pick themselves up and struggle for years to get somewhere,” she said. “What I have learned is that with the right supports around you, the supports that (SB 25) could offer, you can achieve great things.”