4 - The Michigan Daily - Wednesday, June 5, 1996
Edited and managed by LAURIE MAYK ERIN MARSH
students at the Editor in Chief PAUL SERILLA
University of Michigan Editorial Page Editors
unless otherwise note<, unsigned editorials reettee the opinion <$
420 Maynard Street majority of the Dailty editorial board All other articles, letters an
Ann Arbor, Ml 48109 cartoons do not necessarily reflect the opinion ofThe Michigan Doa

T his month, the University Board of
Regents will vote on two student pro-
posals. The first proposal would increase
the fee students pay to Student Legal
Services, a University organization that
provides free or reduced-price legal assis-
tance. Students approved the fee hike in
campus-wide elections last fall. This
spring, students also approved a $1 fee for
the implementation of a child care pro-
gram for students with children.
These proposals were student-
approved; students requested to pay for
programs they want to see on campus. The
regents, who have the final say in all bud-
getary matters, should give these pro-
grams their tacit approval. Their support
would allow the programs to move further
along in their planning stages. Besides the
fact that students have requested the pro-
grams, the programs should be approved
on their own merits.
SLS has been an underfunded and
understaffed program for several years.
Past failures to raise the student fee that
supports SLS have forced the program to
make internal cuts and hire fewer staffers.
The SLS office is often the only place a
student can afford to turn for legal advice

Services studenswant
Regents should approve SLS, childcare fees

and options. Frequently, it is the only
force standing between a student and the
administration, expulsion or forces out-
side the University. SLS allows students
to navigate the often hostile waters of the
criminal and civil justice systems, avoid-
ing costly and time consuming alterna-
tives.
Students who need legal assistance
should not be forced to sacrifice an edu-
cation for the heavy costs of professional
legal services. SLS helps relieve the bur-
den of that choice. The funding increase
would maintain the program at levels that
would better serve the student community.
Similarly, no student should be forced
to choose between pursuing higher educa-
tion and giving their child the best possible
care. Childcare costs in Washtenaw county
average $10,000 per child per year, and
many parents cannot afford that expense

combined with the costs of University
education. A program providing childcare
at little or no cost to students would assist
many who presently cannot afford it. In
helping these students solve the childcare
problem, the University would be helping
students obtain an education. Clearly,
childcare could be a valuable addition on
campus.
Though no final plan has been defined
for the proposed childcare program, initial
goals include an infant care center in addi-
tion to day care for older children. For
those parents unable to place their chil-
dren in University programs, "scholar-
ships" could possibly be used to help off-
set the cost of childcare not directly affil-
iated with the University.
In a time when many people fall into
the "non-traditional student" category, the
University should be searching for ways to

meet these students' needs. It shot
ensure that qualified students will not
denied a chance at higher educatic
Approving the childcare fee is the fi
step in what hopefully will be an effe
program for students with chil
Students have recognized the need #
such a program. The long road to maki
University childcare a successful and ef
cient program must begin now.
Potential for a serious road block to t
program's implementation lies in ti
month's regents meeting. The regents ha
not been warm to the proposal
University-paid childcare. Michig
Student Assembly President Fiona Rc
- the driving force behind getting
proposal on the student ballot - chart
terized her impression of the regen
stance as, "If you can't come here becau
you have a child, find another school."
Students and student service grou
are among the most qualified to deci
how their funding dollars should be all
cated. The student population h
expressed its priorities to the regents. T
regents should now respect students'
es by passing the proposals quickly a
with unanimous support.

The dglit to wdte
State should allow APNs to prescribe drugs
, bill is currently under review in the Michigan state legislature that would enable
killed and highly qualified advanced practice nurses to independently prescribe
drus. Specially trained nurses have written prescriptions under the direction of a co-
signing doctor for years. The Prescriptive Authority Bill - sponsored by state senators
Dr. John Schwarz (R-Battle Creek) and Jackie Vaughn (D-Detroit) - would serve to
streamline medical red tape by alleviating the tremendous cost, time and paper work
required of nurse practitioners, midwives and anesthetists to justify their orders.
Advanced practice nurses care for about 250,000 patients each year in Michigan.
APNs now prescribe medication under the direction of an overseeing physician. Nurses
with masters degrees independently assess, diagnose, plan, implement and evaluate
patient health concerns. However, currently APNs cannot prescribe drugs without a co-
signing doctor. Because the co-signing doctors rarely examine the patient, they con-
tribute little to the order. The added control mechanism of monitoring APNs' prescrip-
tive decisions pushes up costs - thus unnecessarily increasing medical bills.
At the University, medical doctors receive 92 hours of pharmacology training. Within
the School of Nursing, nurse midwives receive between 86 to 101 hours of training, nurse
anesthetists receive 165 to 180 hours and nurse practitioners receive 142}to 157 hours of
formal pharmacological instruction. If the state grants APNs the autonomy to prescribe
medication, all liability and accountability for orders would fall squarely on able shoul-
ders.
APNs employ a holistic approach to assess and treat the patient as a whole. Nurses
focus on the physical, social and psychological aspects of the individual client and
explore the illness' all-encompassing ramifications. Combining research, the art of car-
ing and the science of medicine, APNs are trained to be responsive and proactive heal-
ers.They are concerned and aggressive patient advocates and tireless, meticulous inves-
tigators - the APN creed outlines these standards.
APNs are trained and licensed to treat specific diseases and populations, and will
continue to work within the confines of their training. Fears that they will usurp med-
ical power are unwarranted - APNs will continue to refer to medical doctors for diag-
noses when patients first present symptoms of illness. When diagnosed, patients will
retain access to hospitals, specialists and doctors. APNs do not seek to replace doctors
- they simply work to extend and augment access to medical services.
By passing legislation granting APNs the right to order prescription drugs, Michigan
would join Oregon, Wisconsin, Alaska and Washington in recognizing APNs' proven
ability to provide high quality, comprehensive medical care. Not only are they capable
of providing patients with quality health care, but they provide it at a fraction of the cost
of medical doctors.

Ashotin the foot
State immunization rates are substandard
mmunizing young children is one of the most inexpensive ways to practice pr9
I tative health care. Yet when the rankings for nationwide childhood immunizati(
rates were released last month, Michigan found itself at the very bottom. Michigar
immunization rate was so low that it was the only state that did not receive federal fun
by matching a 65 percent immunization level. The low rates are an inexcusable traged
The report - from the Center for Disease Control - shows that the United Stat
as a whole has a 75 percent immunization rate for young children. Michigan reports
mere 63 percent immunization rate, with the city of Detroit at 52 percent. Whi
Detroit's rate is abysmally low, the state would still place last if Detroit improved - t
is a statewide problem.
The federal government has funds available for helping states improve their iri
nization rates. The Vaccines for Children Program will give $7 billion next year
states, to be used for patients that are uninsured or underinsured. The only provision
that states must already have a 65 percent immunization rate. Michigan is the only sta
to be passed over for funding from the VCP.
Gov. John Engler must take much of the responsibility for the state's troubling situation.
CDC official said that maintaining and improving immunization rates has been primarily
state's responsibility. Yet Engler has dedicated his time to Washington recently, calling for -
among other things - a return to state control of health programs. Engler should worry abe
the responsibilities already under his control before he takes on more.
Some Englers are taking steps to help the situation. Gov. Engler's wife, Michelle, and thi
triplets are campaigning in a media blitz in the hopes it will help significantly raise
nization rates. Such campaigns do initially help raise rates, however, they do little to imp
the long term statistics. Michigan would do better to mute the media campaign and foc
more on fund reallocation. The state should register children and track their immunization s
tus. Recently, the state legislature discussed a plan for a statewide registry system, but di
cussion was discontinued due to conflict with the parental rights issue. Despite the fact tl
most doctors promote registry as a positive first step, politicians have not pursued legislatio
Officials have contributed to the low immunization rate in other ways. Currently, und
Michigan law, children do not have to be immunized until they enroll in school or day ca
centers. This is often too late, because the most deadly diseases usually strike before ai
two. An earlier, mandatory age could help spur more immunizations.
Last year, 399 Michigan children contracted hepatitis B. Over 100 suffered whQi
cough and another 60 contracted the mumps. All of these diseases are preventable 1
immunization. The fact that any child goes without this basic health service is bt
enough - when it occurs in such high numbers, the problem becomes epidemi
Michigan must bring up these low rates immediately to protect the future of its childre