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Petition to United States Department of Health and Human Services, US Surgeon General, Jeff Merkley, Ron Wyden, Earl Blumenauer, Rachel Prusak, Suzanne Bonamici, Kate Brown, Peter DeFazio, Kurt Schrader, Oregon

"X the X waiver" for APRNs and PAs too! Let us save lives!

We are Oregon Health Care Workers: Nurses (RNs), Physicians (MDs/DOs), Physician Assistants (PAs), and Advanced Practice Registered Nurses (APRNs) including Nurse Practitioners, Midwives, Nurse Anesthetists and Clinical Nurse Specialists. We are especially committed to the compassionate treatment of persons with opioid use disorder in our state, where 8 of every 100,000 Oregonians die from opioid overdose annually.    While there is great promise in the January 15th, 2021 HHS announcement stating physicians will no longer be required to complete additional “X-waiver” training in order to prescribe medication containing buprenorphine, we are disappointed that this does not extend to ALL clinicians eligible to prescribe this life-saving treatment. The elimination of this time-consuming and unnecessary obstacle in fighting our country’s opioid epidemic is monumental, but it also excludes two groups of qualified frontline practitioners.   For more than 50 years, PAs and APRNs have provided primary, acute, and specialty healthcare services by diagnosing, treating, and prescribing medications. Since PAs and APRNs were first given authorization to prescribe buprenorphine in 2016 they have made great progress in increasing access to medication. APRNs and PAs were the first X-waivered clinicians in 285 rural counties covering 5.7 million residents.   As of 2018, less than 5% of all eligible US clinicians had completed the requirements to obtain an X-waiver. Furthermore, while there are fewer waivered clinicians per capita working in the rural areas that APRNs and PAs are most likely to serve, PAs and APRNs have been primarily responsible for managing buprenorphine there. Without question, buprenorphine treatment (and in turn, HIV and Hepatitis C prevention) in rural areas cannot succeed or grow without empowering PAs and APRNs.   PAs and APRNs are clinical leaders in America’s interprofessional healthcare system. It is critical that DHHS grants APRNs and PAs the same exemption from X-waiver training as physicians.    Thank you in advance for your respectful consideration and support.   Sincerely,  Ben Colburn, MD-Family Physician Laurel Hallock Koppelman, DNP, FNP-C, APRN-Nurse Practitioner Shelby Lee Freed, MSN, FNP-BC-Nurse Practitioner          

Laurel Hallock Koppelman
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