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Texans for Healthcare Access — a diverse coalition of organizations representing consumers, businesses and healthcare stakeholders — are calling on lawmakers to remove outdated, unnecessary and anti-competitive regulations on Advanced Practice Registered Nurses, which will provide Texas patients more health care access and options.

“In 2013, the Texas Legislature eliminated the requirement that APRNs have on-site supervision by a physician, yet, years later, the state continues to require APRNs to have unnecessary, often costly contracts with physicians in order to care for Texas patients,” said Jamie Dudensing, CEO of the Texas Association of Health Plans.

“It is time to remove this unnecessary red tape that is currently inhibiting half of Texas’ primary health care workforce from expanding into new areas and establishing new practices where they can increase access and options for Texas patients.”

California and Florida, two of Texas’ biggest competitors for talent and business, are among 31 states who have done away with these limitations on APRNs, along with the District of Columbia, all branches of the military, and the U.S. Department of Veterans Affairs.

This is the only profession in Texas where independently licensed professionals are mandated to contract with a member of another profession in order to go into business.

“Texas has attracted top talent and experienced extraordinary growth and prosperity thanks to our low cost of doing business and our focus on reasonable regulations,” said Mia McCord, president of the Texas Conservative Coalition Research Institute.

“Unfortunately, all that has been thrown out the window as it relates to our health care workforce. While other states are removing barriers, Texas has become one of the least competitive states in the country for attracting and retaining critically-needed APRNs, unnecessarily leaving too many Texas patients without access and options for care.”

A 2020 Texas Nurse Practitioner member survey found that more than 50% of nurse practitioners say delegation requirements prevented them from expanding or creating their own practice to care for more patients.

Nearly 80% said they would consider practicing telehealth to patients outside of Texas in states that do not have such onerous regulations.

Existing state law does not require APRNs and physicians to work together or to consult on any cases, mandating nothing more than a single phone call once a month.

Further, in response to the COVID-19 crisis, Governor Greg Abbott waived the delegation requirements temporarily, underscoring the fact these regulations are preventing APRNs from doing the most they can to provide care to the Texans who need it.

“Protecting the health and well-being of Texans through access to high-quality health care must be a top priority this session and improving access to APRNs is more crucial than ever,” said Anne Dunkelberg, associate director of Every Texan (formerly Center for Public Policy Priorities). “Our state’s provider shortage is compounded by the closure of many rural hospitals, making the need for local preventive care even more important. APRNs need to have the ability to serve Texas patients where they are needed most.”

More than 7 million Texans live in health care shortage areas. Studies have shown that APRNs tend to have a greater proportion of their practices in rural areas, and other regions that are designated health professional shortage areas.

In states that eliminate delegation agreements, APRNs have been 1.5 times more likely than physicians to practice in rural areas. Currently, more than 80% of nurse practitioners in Texas specialize in primary care.

 

Texans for Healthcare Access is a coalition of organizations representing consumers, business and a broad range of healthcare stakeholders. These groups have joined forces to remove unnecessary barriers to care and allow Advanced Practice Registered Nurses to provide more access and more options for Texas patients.