Health Reform Will Support School and Nurse-Managed Clinics
The new health care reform law, called the Patient Protection and Affordable Care Act (PPACA) will bring about a change in the way we view healthcare in the United States. For years, we have operated under a “sickness” model, meaning that health care was primarily for treatment of a condition or disease. The new law will improve preventative and community care, and one of the changes will be an increase in both school-based and nurse-managed clinics.
Health problems in children, such as poor vision, malnutrition and hyperactivity greatly affect their ability to learn, particularly in low-income neighborhoods. Financial instability in a poor economy adds to the issue, as parents may lose employer-based health insurance and may have limitations in Medicaid expenses.
To combat this growing problem, the PPACA has set aside $200 million to fund comprehensive school-based health clinics for medically underserved children and adolescents.
Although most schools and school districts employ nurses for children who become sick at school, their scope of practice is limited. The nurse can recommend to parents that children seek more advanced care; however, according to Carolyn Kramer who runs a program in Seattle that brought medical clinics inside middle and high schools, “as soon as they leave that building, the chances of them getting to the doctor plunge.”
Currently, there are now 2,000 school-based health center across the country. Kramer’s program has decreased both absenteeism and discipline problems in the schools where it is based.
The PPACA also provides grants for clinics managed by Advanced Practice Registered Nurses, or APRN’s. These can provide primary and wellness care, particularly in areas where primary care physicians are in limited supply. The law also expands education funding options for RN’s who wish to pursue Advanced Practice licenses.
One of the most notable APRN benefits is that for the Certified Nurse Midwife (CNM). The law provides that CNM’s will be paid the same as physicians for Medicare B patients which is a great step forward for improving access to care for many pregnant women.
Under the PPACA, the expansion of Medicaid along with the opportunity to purchase a more affordable private insurance plan, will significant increase the number of insured Americans. School-based and nurse-managed clinics are just two measures that will help reduce the burden of providing care for those currently underserved.