JEFFERSON CITY, Mo. — All but one of the state’s counties are in a health professional shortage, and that’s why nurse practitioners are asking lawmakers to change state law to help combat this deficit. 

Under current state law, advanced practice registered nurses (APRN) are required to in be in a collaborative practice agreement, which means nurse practitioners have a physician nearby to do their job. 

Nurses came to Jefferson City on Wednesday to tell lawmakers that if this restriction is lifted, patients will have better access to care. 

“When a physician dies, moves or goes on vacation, those practitioners, they don’t have a backup collaborative physician, those clinics are dead,” JoAnn Franklin a nurse practitioner from Reynolds County said. “They have to close down.”

During a House workforce committee on Wednesday, Kirk Mathews with MO HealthNet, the state’s Medicaid program, said the state is short 600 primary care doctors. Some nurses said the solution is changing state law. 

“Freeing up nurse practitioners, clinical nurse specialists, midwives and CRNAs [certified registered nurse anesthetist] would really make a difference,” Franklin said. “Particularly in Missouri, considering the deficit that we have of providers.”

Currently, Missouri doesn’t allow nurse practitioners to diagnose, prescribe medications or evaluate patients without a doctor signing off. House Bill 271 and Senate Bill 79 would allow registered nurses to administer that type of care without needed a signature from a physician. 

“This law restricts nurse practitioners to have to be within 75 miles of a physician,” Franklin said “For physicians to try and control what we do and link that with monetary gain is not beneficial to Missourians whatsoever.”

Dozens of nurses from across the state met with the governor Wednesday morning. He told the room full of front-line workers, the state should be proactive. 

“We’re always trying to fix things on the tail end,” Gov. Mike Parson said. “Instead of doing preventive things of the forefront.”

According to the Missouri Hospital Association (MHA), the current turnover rate for hospital staff is 24%, nearly double the amount before the pandemic. Parson said retention and recruitment starts at the bottom. 

“If you don’t take care of your front-line employees, you’re kidding yourself,” Parson said. “There is no reason, and I’m sure I’ll step on toes when I say this, but there is no reason why they [healthcare administrators] don’t take care of front-line employees.”

Mathews also told the committee Missouri’s Department of Mental Health told him in a report, it has 900 vacancies in its behavioral health division alone. Parson is asking lawmakers for $88 million for treatment and support for Missourians with behavioral health and developmental disabilities. 

“You have to start with funding, you have to fund it better than you have to get the infrastructure in place to deliver the service and then you have to have the manpower to deliver mental health,” Parson said. 

According to MHA, since 2015, there have been more than 15 Missouri hospitals, most in rural areas. 

“The only county in the whole state that actually has good primary care is Platte County, the rest are all considered health professionals shortage areas,” Franklin said. “In mental health, there is not a single county that has adequate care.”

Nearly 40 other states have already lifted the restriction on nurse practitioners. 

The two bills to change the state’s law are waiting to be debated in the House and the Senate. The session ends on May 12.