Op-ed: Nurse Practitioners Hold Key to Expanding Access to Quality Care

By Senator Camera Bartolotta (R-46)

Pennsylvania is in the midst of a healthcare crisis, and nowhere is the problem more obvious than in rural communities. Insurance and service costs have gone through the roof. Many doctors are refusing to accept new patients, and some are even turning away existing patients who rely on government-sponsored health care coverage.

The troubling financial trends in the industry are not the only cause for concern; availability of health care is becoming an even more serious challenge. As older doctors in rural areas retire, fewer new physicians are opening up shop to replace them. This means that many patients have to drive 30 minutes or more just to find one doctor who will accept new patients.

Without action by lawmakers to ease this crisis, patients may reach a point in the near future when they are forced to travel an hour or more just to see a doctor – if they can find proper care at all.

As the number of primary care doctors in rural areas continues to decline, nurse practitioners are uniquely positioned to fill the need for quality healthcare services. Unfortunately, state law prevents nurse practitioners from providing services to the full extent of their knowledge, training and education.

Even the most experienced and capable nurse practitioners can only serve patients under business contracts with physicians. This severely limits their ability to expand care options to a broader number of people.

Studies have shown that patient outcomes are as good or better for patients who are treated by a nurse practitioner when compared to care by a physician. The only thing stopping them from playing a larger role in meeting the growing demand for services is our antiquated state law.

The Senate passed a bill I introduced last year that would address this problem by providing full practice authority to advanced practice registered nurses. Rep. Jesse Topper introduced a companion bill in the State House. These qualified providers would still be required to complete a period of collaboration with a doctor for a number of years, but they would be allowed to serve patients to the full extent of their knowledge and training without a contract with a physician thereafter.

Essentially, the bill would allow nurse practitioners to help stop the slow bleed of healthcare providers out of smaller communities. It does not solve all of the issues plaguing the health care community, but it is a necessary tourniquet as new ideas are debated at the state and federal levels of government.

Much of the debate regarding healthcare coverage in recent years has centered on dollars and cents, and for good reason. The problem is extremely complex – and expensive. It is estimated that spending on healthcare in the U.S. is approximately $3 trillion annually. We can’t solve those issues easily, and it certainly won’t happen overnight.

However, it is within our power to expand the number of qualified healthcare providers to ensure patients can continue to access quality services in their home communities for the foreseeable future. Providing full practice authority to nurse practitioners is a step that is certain to ease this crisis and expand access to care without costing taxpayers or ratepayers another dime. 

CONTACT: Katrina Anderson (717) 787-1463

Baker Bill Would Aid Disabled Voters

HARRISBURG –Permanently disabled voters could have an easier time casting their ballot if a bill introduced by Sen. Lisa Baker, R-20th, becomes law. Senate Bill 263 passed the Senate unanimously this week and was sent to the House for consideration.

Currently, with physician certification, disabled and bedridden voters are added to a permanently disabled absentee ballot list. County election bureaus then automatically mail absentee ballot applications. But individuals are required to confirm their health status every four years, which can be cumbersome for many. Because they must also notify voter registration if there is a change that would prevent them from claiming permanent disability, Baker believes the verification requirement is unnecessary and should be eliminated.  

“We ought to be doing whatever we can to make it easier to vote, especially for our elderly and disabled citizens,” Baker said. “What might seem like a small inconvenience can be a huge burden for these folks. Relieving them of the additional stress and inconvenience just makes sense.”


Andrew M. Seder
District Communications/Constituent Services for Pike and Wayne Counties
Office of Senator Lisa Baker
2512 Route 6
Hawley, PA  18428
(570) 226-5960

Senate Honors “American Red Cross Month”



The Senate today adopted a Resolution introduced by Senator Randy Vulakovich designating March 2018 as “American Red Cross Month” in Pennsylvania.

Senate Resolution 282 salutes the 137-year history and exemplary service of the American Red Cross and its Pennsylvania chapters.

“This resolution recognizes the important role this great organization plays in communities across Pennsylvania.  In fact, the Red Cross responded to 2,116 disasters and provided direct assistance to 4,369 families across the Commonwealth in 2017,” said Senator Vulakovich, who serves as Chairman of the Senate Veterans Affairs & Emergency Preparedness Committee.

 “The American Red Cross has been at the forefront of helping Americans prevent, prepare for and respond to large and small disasters, and just as families and communities depend on the Red Cross in times of need, the Red Cross depends on the support of the American people to help sustain the foundation,” Senator Vulakovich said.  “As we commemorate American Red Cross Month, it is also important that we recognize the 6,265 dedicated Red Cross volunteers in Pennsylvania who gave their time and resources to aid their friends and neighbors last year.”

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Nate Silcox (717) 787-6538   nsilcox@pasen.gov

Public Hearing to Consider Nominations and Confirmations of Teresa Miller, Jennifer Smith and Rachel Levine

Senate Health and Human Services

Monday, March 19, 2018
10:30 a.m. in Room 8E-B, East Wing

Public hearing to consider the nominations and confirmations of
Department of Human Services Acting Secretary Teresa Miller
Department of Drug & Alcohol Programs Acting Secretary Jennifer Smith
and Department of Health Acting Secretary Rachel Levine


Establish a Quorum

Opening Statements
Sen. Lisa Baker & Sen. Judy Schwank

Administer Oath to Acting Secretaries
Sen. Lisa Baker

Introduce Acting Secretary Jennifer Smith
Sen. Folmer

Opening statement followed by Q &A by committee members
Acting Secretary Jennifer Smith | Attachments

Vote on Confirmation

Introduce Acting Secretary Dr. Rachel Levine
Sen. Folmer

Opening statement followed by Q & A by committee members
Acting Secretary Dr. Rachel Levine | Attachments

Vote on Confirmation

Introduce Acting Secretary Teresa Miller
Sen. Baker

Opening statement followed by Q & A by committee members
Acting Secretary Teresa Miller | Attachments

Vote on Confirmation


Emergency Prescription Refill Bill Signed Into Law

Legislation addressing prescription refills in emergency situations was signed into law by Governor Wolf today as Act 8 of 2018, according to Senator Pat Browne (R-16) and Representative Ryan Mackenzie (R-134) who sponsored companion legislation for this law.

Senate Bill 542 eliminates a life threatening loophole in the state’s emergency prescription refill law. Under current law, in the event of an emergency situation where a patient cannot obtain a doctor’s script for the refill of a prescription, a pharmacist could issue a 72 hour supply of that drug. Issues with the law arose, with drugs that are not available in 72-hour supplies, such as insulin, and therefore could not be dispensed to the patient. This situation has resulted in fatalities in other states.

With the signing of this legislation, pharmacists are now permitted to dispense up to a 30 day emergency supply as long as certain conditions are met, such as the drug is not available in a 72-hour supply, is not a controlled substance and is essential to maintain life.

“Fixing this oversight in the current law has the real potential to save lives in Pennsylvania,” Senator Browne said. “There are a wide range of reasons as to why an individual would need to be able to obtain an emergency refill of their life-sustaining medication. I thank my colleagues in the legislature for passing this legislation that helps ensure patients do not reach a life-threatening situation because they are denied access to an emergency supply of their medication.”

“I am pleased to have this bill approved by the General Assembly and signed into law,” said Mackenzie, author of companion legislation House Bill 1186. “Individuals on life-sustaining medication need to know there is a backup plan in place in case they run out of medication and are not in a position to get a hold of their doctor for a prescription refill. They should not be placed in a panic situation or be forced to go to an emergency room to get the medically necessary medication they need.”

Local advocates brought this issue to Sen. Browne’s and Rep. Mackenzie’s attention, hoping to prevent in Pennsylvania cases like that of Kevin Houdeshell. Houdeshell passed away in 2014 because state law in Ohio would not allow for him to obtain an emergency supply of insulin.

The Act takes effect immediately.


Matt Moyer       (Senator Browne) 717-787-1349, mmoyer@pasen.gov
Tricia Lehman  (Rep. Mackenzie) 717-772-9840, tlehman@pahousegop.com

Committee Approves Vogel Bill Promoting Telemedicine in Pennsylvania


The Senate Banking & Insurance Committee today (January 30) approved legislation introduced by Senator Elder Vogel (R-Beaver) aimed at promoting telemedicine in Pennsylvania as a way to overcome barriers to quality patient care created by distance and reduce the costs of those services.

Senate Bill 780 specifically defines telemedicine as “the delivery of health care services provided through telecommunications technology to a patient by a healthcare practitioner who is at a different location.” It also establishes guidelines regarding who can provide telemedicine services, and provides clarity regarding insurance company reimbursement for those services.

The bill now goes to the full Senate for consideration.

“Telemedicine is transforming healthcare and it is something our state should embrace and encourage,” Senator Vogel said. “Through the use of telemedicine, specialists and other health care providers are able to expand their reach, helping patients stay in their communities and avoid traveling long distances for specialized care. That will not only save costs, but it could save lives as well.”

 “Telemedicine can vastly improve the availability of healthcare options for people in rural or urban areas, lower the cost of healthcare, and strengthen the bond between patients and their doctors,” Senator Vogel said. “Telemedicine is especially vital for patients who suffer from chronic illness, seniors who are homebound and families who live in rural areas where they would have to travel very far to receive medical care. We need to make this option available for all Pennsylvanians.”

While Senate Bill 780 would make substantial changes in the health care industry, physicians and other health practitioners delivering telemedicine services would still be required to follow standard state licensure and medical practice laws and requirements in Pennsylvania.

The bill establishes that services that are covered by insurance for in-person visit would also be reimbursable for telemedicine, but the measure gives insurers latitude in determining the amount that is reimbursed.

Senator Vogel’s bill is supported by the Hospital and Healthsystem Association of Pennsylvania, the Pennsylvania Medical Society and AARP. 

CONTACT:               Cheryl Schriner                       Cschriner@pasen.gov


Governor Signs Yaw Epilepsy Exclusion Bill

Updates PDMP Requirements

HARRISBURG – Legislation exempting Schedule V epilepsy drugs from having to be queried as part of the state’s Prescription Drug Monitoring Program (PDMP) was signed into law today, according to state Sen. Gene Yaw (R-23).

Senate Bill 728, now Act 79 of 2017, amends the Achieving Better Care by Monitoring All Prescriptions Program (ABC-MAP) Act to exempt prescribers from the requirement to query the database when nonnarcotic Schedule V drugs are prescribed to treat epilepsy or a seizure disorder.

The ABC-MAP Act requires prescribers to query the database prior to dispensing Schedule II through Schedule V controlled substances for each patient the first time the patient is prescribed a controlled substance by the prescriber, if the prescriber believes or has reason to believe that a patient may be abusing or diverting drugs, or each time a patient is prescribed an opioid drug product or benzodiazepine by the prescriber.

The legislature also amended the bill to clarify that a prescriber does not need to query the PDMP after an initial query if a patient remains in a licensed health care facility or is in observation status in a licensed health care facility.

“While we need to do everything we can to stop prescription drug abuse, we must also be cautious not to create unnecessary hurdles for patients to receive appropriate, prescribed, and often lifesaving medications,” Sen. Yaw said.  “Senate Bill 728 aims to improve treatment and care for Pennsylvanians living with epilepsy.  I thank the Governor for approving this measure.”

“For several years, the Epilepsy Foundation has advocated for exempting Schedule V epilepsy medications from the state’s monitoring program to ensure timely access to epilepsy care,” said Elizabeth Beil, President and CEO, Epilepsy Foundation Eastern Pennsylvania. “People living with epilepsy are at risk for breakthrough seizures and related complications, including death, when they experience delays and interruptions in care. Removing unnecessary barriers with passage of SB 728 is a big win for epilepsy families across the state and we are incredibly grateful for Senator Yaw and Representative DiGirolamo’s leadership.”

Surrounding states, including Massachusetts, New York, and New Jersey, have chosen to exclude non-narcotic, non-opioid Schedule V substances from their prescription monitoring programs.

“Our focus should be on the narcotic and opioid drugs, not on the medications that significantly improve and even save the lives of the estimated 209,000 Pennsylvanians living with epilepsy,” Yaw added.


Rita Zielonis, Chief of Staff

(717) 787-3280

Senate Panel Approves Bartolotta Bill To Improve Access to Mental Health Treatment

HARRISBURG – The Senate Health and Human Services Committee approved legislation today that would help reduce hospital emergency room overcrowding and connect patients who require mental health services to the care they need, according to the bill’s sponsor, Senator Camera Bartolotta (R-46).

Bartolotta’s legislation – Senate Bill 179 – would help improve communication between hospital emergency rooms and psychiatric units by creating a registry to identify psychiatric treatment facilities that have available beds for patients. The measure would help streamline the process for securing psychiatric beds for those patients entering hospitals, with the goal of reducing the amount of staff time spent searching for available beds.

Twenty-two other states and the District of Columbia already have similar registries in place in an effort to improve patient care.

The Pittsburgh Post-Gazette first reported on this issue, indicating that beds in hospital psychiatric units in Pennsylvania regularly sit empty due to a lack of direct communication between providers who are searching for care for patients and the facilities with available services.

“Many hospitals are not equipped or do not have the beds available to treat a patient with an acute psychiatric problem, and the process of finding a hospital that can offer the proper treatment can be difficult, tedious and time-consuming,” Bartolotta said. “We need to streamline the process so patients are not left waiting for hours on end while emergency room staff devote more of their precious time to calling numerous other facilities in search of care.”

Under the bill, the registry which would be administered by the state Department of Health and include contact information and descriptive details for participating psychiatric facilities throughout the state as well as provide information regarding the number of beds available at each facility, the type of patient to be admitted and level of security.

Representative Dan Miller is the sponsor of a similar measure in the House of Representatives.



CONTACT: Colleen Greer (717) 787-1463

Lawmakers, Family Groups Stand Up Against Abortion of Babies with Down Syndrome


HARRISBURG – Lawmakers and advocates gathered in Harrisburg today to rally in support of a resolution sponsored by Senator Scott Martin (R-13) that condemns the practice of selective abortion of babies with Down syndrome.

Senate Resolution 174 denounces the use of abortion or sterilization techniques to rid society of a class of individuals. Some studies suggest that the abortion rate of babies with Down syndrome is as high as 90 percent.

Martin’s resolution is designed to draw more attention to the fact that individuals with Down syndrome can lead amazing and fulfilling lives.

“There are a wide range of viewpoints on the topic of abortion, but we should all be able to agree that no individual’s life should be terminated based on a diagnosis of Down syndrome,” Martin said. “The idea that a child with Down syndrome is better off unborn is debunked every day by the hundreds of thousands of individuals currently living with this condition.”

The lawmakers and advocates were joined by Chloe Kondrich, a young girl from Pittsburgh who has Down syndrome and was the inspiration behind passage of Chloe’s Law in 2014. That legislation made more information available to parents and families after a pre-natal diagnosis of Down syndrome.

In his remarks at the press conference, Martin also spoke about the rewarding and full life enjoyed by a friend in his 30s with Down syndrome.

“We should be celebrating the lives of men and women with Down syndrome, not looking for ways to end them,” Martin said. “Seeking to eliminate an entire class of people is an unethical and immoral act that has no place in a civilized society, especially when it does nothing to remedy the genetic disorder.”


CONTACT: Terry Trego (717) 787-6535

Donate Life PA Act Passes Senate

On Tuesday, June 20th, in a 43-6 vote, the Pennsylvania Senate passed State Senator Stewart J. Greenleaf’s Donate Life PA Act, SB 180, to help increase organ and tissue donation in the Commonwealth.

One person in Pennsylvania dies every 18 hours while waiting for an organ transplant.  Today, over 8,000 people in our state are waiting for a life-saving organ transplant.  More await life-improving cornea, tissue and bone marrow transplants.

This is a health crisis in need of immediate action.  As organ transplant medicine advances, the Commonwealth must update its laws to accommodate the most modern and best practices. 

SB 180 would ensure that more viable organs reach the patients in need and it would increase public education about the need for donors.  Sometimes people never get the chance to give the gift of organ or tissue donation – even if they are registered – because too much time has passed before donation is considered or authorized.

The Donate Life PA Act would improve the communication process between county coroners or medical examiners and organ procurement organizations.  At the same time, the bill includes specific rules to ensure that organ donation will never interfere with a criminal investigation.

The bill would also protect every donor’s wishes by allowing someone with power of attorney to authorize donation.   If the intent of the dying person is not clear, the bill sets forth the procedure to contact family and caregivers to learn the person’s intent with regard to organ donation. 

In May of 2016, SB 180 passed by the Senate by large majority, but was not considered in the House.

Senator Greenleaf said, “Every day, doctors tell patients that they are simply not going to live without an organ transplant.  Parents receive horrible news that their child isn’t going to survive without a transplant.  SB 180 is desperately needed by these patients to give more people a greater chance of surviving.  This legislation is a fight for their lives.”

SB 180 has now been referred to the House of Representatives.

More information about the Donate Life PA Act and organ donation can be found at www.senatorgreenleaf.com/organ-donation.  The site features stories of several Pennsylvanians who have received anatomical gifts and how organ donation has saved their lives or those of their children.


Aaron Zappia (215) 657-7700