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



KPRC 2 Houston, More Patients Seeking APRNs for Timely Care

In a recent KPRC 2/Click2Houston news story that ran Wednesday, reporters highlight how a growing number of patients are opting to see nurse practitioners rather than wait weeks for an appointment with a physician. “They just call and see me the exact same day, and that goes back to the ease of accessibility," said Daisy Newhook, a nurse practitioner patient who was interviewed for the piece. Newhook is not alone. Across Texas, more and more patients are seeking out nurse practitioners to meet their primary care needs and help them manage chronic disease. “When a patient leaves our practice, I hope that they have the right skill set, the right knowledge and the right attitude, so they can

A Practical Guide to Nurse Practitioners

What is an advanced practice registered nurse, anyway? The health care world can often be an alphabet soup for patients. But health care novice or expert, getting to know your health care providers and the role they play in your health care is something every patient should know. Last week, AARP published A Practical Guide to Nurse Practitioners. With 38 million members nationwide, AARP is one of the largest membership organizations in the country, and most -- if not all -- of these individuals will encounter a nurse practitioner or another advanced practice nurse at some point during their health care experience. And odds are you will, too. In the guide, AARP addresses some of the most freq


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