Legislative Talking Points

Health in Alabama

• Ranked 45th r/t smoking, obesity, heart disease, premature death, infant mortality, children in poverty, and poor mental health

• Ranked in the top 5 states for death r/t obesity, heart disease and stroke

Access to Health Care in Alabama

• Virtually all of Alabama designated as a health provider shortage area

• Shortages are magnified in rural areas with increased morbidity/mortality

• Ranked 51st in access to health care in 2007

Cost of Health Care in Alabama

• Ranked 20th in health care spending per person for public health in 2004 ($159 per person for public health) on top of other health care expenditures

• Cost Alabama citizens approx. $3500/person for health care in 2004 (more than 17 billion dollars)

• Despite these expenditures, Alabama ranks dismally in health and access to health care

Health Care Resources in Alabama

• Shortfall of primary care physicians (shortfall currently 237); worst in rural areas; inability to retain and attract primary care physicians is a serious on going threatto the rural health care system

• Physicians selecting primary care as specialty continues to decline despite recruitment efforts

• Primary care physicians currently in practice approaching retirement with no primary care physician replacement

Untapped Health Care Resources in Alabama

• Health care outcomes for patients receiving primary care from nurse practitioners are comparable to that of physicians in several studies

• Nurse practitioners provide cost effective primary health care

Barriers/Limitations of Nurse Practitioners in Health Care in Alabama

• The most restrictive environment for NP’s in the United States

• Lack of recognition of NP’s as health care providers in state law

• Written collaborative requirement with a physician in order to practice/prescribe

• Limited prescriptive authority (Alabama 1 of 3 states not allowing scheduled prescriptive authority)

• NP graduates from Alabama schools leaving the state to practice elsewhere because of these restrictions.

• Some NP's living near border states of Georgia, Mississippi, and Tennessee chose to work in those states because of better practice environment.