Texans for Healthcare Access

Allow Advanced Practice Registered Nurses to care for Texans.

Desk with Stethoscope
 The Issue

Advanced Practice Registered Nurses (APRNs) are masters or doctorate level health care providers who are subject to specific occupational licensing barriers which limit access to care for patients and drive up the cost of health care in Texas.


Texas has a critical shortage of primary care providers, with 432 Primary Care Health Professional Shortage Areas (HPSAs) in urban, suburban, and rural areas across the state.  APRNs are quality, cost-effective providers who can help address this shortage if Texas passes legislation to remove barriers standing in the way of APRNs and their patients.

The Problem

To practice in Texas, APRNs are required to enter into a contract, or what’s called a “delegation agreement,” with a physician. In many cases, the delegation is simply a physician's signature that says the APRN can practice. Some APRNs actually have to pay thousands of dollars a year for this agreement.


More states are opting to cut the red tape, eliminate delegation agreements, and give patients full and direct access to the quality care APRNs provide. Currently 22 states, the District of Columbia, the Department of Defense, and the U.S. Department of Veteran Affairs do not require these agreements. Meanwhile, lawmakers in New Mexico and Arizona are recruiting Texas-trained APRNs to their states, where APRNs face fewer regulatory burdens and lower practice costs.

The Solution

The Coalition for Health Care Access urges all Texas legislators to join us in supporting legislation, which will keep more APRNs in Texas and remove the requirement for unnecessary, expensive, and many times unfair pay-to-play delegation agreements between APRNs and physicians. This is zero-risk, zero-cost solution that will put patients first, and ensure that more Texans can access the vital care they need.

Recent Posts



Statesman Op-ed Says APRNs Could Help Fill Provider Shortages

In an Op-ed in the Austin-American statesman just this week, Austin native and neonatal nurse Toni Inglis highlighted what seems to be one easy solution to our health care provider shortages as the nation still struggles to find a path forward for health care reform. "In the shadow of Congress failing to improve health care, Texas lawmakers have a golden opportunity to sharply increase access to care: They could substantially increase the number of primary-care providers — and it wouldn’t cost a dime," said Inglis. She added, "If every single nurse practitioner and family doctor were deployed, Texas still could not meet the need for primary care; the growing demand far outstrips the supply."

Dallas WFAA Piece Shows How Texas Laws Make it Difficult for APRNS to Serve Patients

Four Nurse Practitioners from the Greater Dallas area -- Martha Strong, Juanita Flint, Elishia Featherston, and Maggie Lieser -- shared their stories on WFAA-TV about how Texas laws make it hard for them to keep their businesses open and serve patients to the fullest of their ability. "When Martha Strong first opened her pediatrics practice at Children’s Clinic of Richardson 12 years ago, she shared a business relationship with a doctor," the WFAA piece by Chris Sadeghi began." "He was a physician and she was a nurse practitioner. Their two clinics were located just two blocks from each other. Then the physician died unexpectedly and Texas law kicked in." “The day he died, I had to stop prac

Campaign Video Highlights Need for APRNs in Texas

Over the past year, Texas Nurse Practitioners has been going out into the community to interview Advanced Practice Nurses, their patients, and key stakeholders in the business and health care community about why it's important to them to remove barriers to Advanced Practice Nurses and expand access to health care in Texas. Three Stories, Three Reasons to Expand Access "We were never used to having a stable nurse or doctor or someone to help us through our medical needs, and so they (nurse practitioners) helped me out a lot. "They made sure I got my shots in the right amount of time, got my medicine, and they just really took care of me." -Wendy Bodecker, patient at Cal Farley's Boys Ranch “C

Dallas Morning News Op-ed: "These two bills could help solve Texas's health care access cri

In a Dallas Morning News Op-ed published on the heels of the public launch of full practice bills HB 1415/Sb 681, Jim Mitchell calls Texas out for what he calls the "talent drain" effect and archaic "pay-to-play" policies holding Texas Advanced Practice Nurses and their patients back. "Tanya Marin, a pediatric nurse practitioner, wanted to open her own clinic in El Paso," Jim Mitchell described in his article. "But when she looked into the requirements, Marin discovered that state law required her to shell out anywhere from $20,000 to over $100,000 to get a doctor to oversee her operation." So what did Tanya decide to do? "Frustrated, Marin took matters into her own hands — over the state l


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