Rural & Underserved APRN Initiative

Survey data gathered by the Center in 2014 indicated that as many as 60% of new APRNs in Colorado planned to leave the state upon graduation because of statutory APRN practice barriers. Medicaid expansion had passed in Colorado in addition to a push for all uninsured citizens to obtain health insurance either through Medicaid or the state Exchange as mandated by the Affordable Care Act (ACA). This turn of events led to a growing shortage of primary care providers around the state, with rural and underserved areas identified by the Colorado Health Institute as the most at risk. This impending predicament moved a broad coalition of professional healthcare organizations to support statutory changes to lower practice barriers for APRNs in Colorado.

Even with the positive changes which occurred in 2015, it remained clear that vast areas of the state continued to have provider shortages, with primary care and behavioral health identified as the most problematic specialties to fill.

Responding to these challenges, the Center decided that there may be an opportunity to create a new model for building a rural and underserved provider pipeline. With the immediate support of the Daniel and Janet Mordecai Foundation, soon to be followed up by support from two separate grants from The Colorado Health Foundation, the Center designed a “Grow Your Own” APRN initiative, designed to recruit local nurses in provider shortage areas to return to school and become APRNs in their own communities. The Health Resources and Services Administration (HRSA), in 2018, provided added funding for 38 new APRNs. Since that time, over 400 nurses around Colorado have applied to become “Grow Your Own” APRNs in their communities.  (This project is supported by funds from the Bureau of Health Workforce (BHW) Health Resources and Services Administration (HRSA), Department of Health and Human Services (DHHS) under grant number UK1HP31720, titled “Achieving Systemic Impact: A Statewide Primary Care Nursing Collaborative”. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by the BHW, HRSA, DHHS or the U.S. Government.)

Recently, The United Health Foundation identified this work in Colorado and in 2019 invited the Center to create a grow your own Psychiatric Mental Health Nurse Practitioner program focusing only on rural communities. That program is now funded and has been launched. When all the current program funding is completed, The Center will have built around 150 new NPs in either a primary care or behavioral health specialty who will serve some of our communities most at risk for having no access to a provider.

The number of nurses around the state who have stepped up to return to school is helping to fill a terrible void. Thank you to our funders and nurses for your dedication to providing high quality and much needed care to the underserved.  It is making a difference!