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



Texas Public Policy Foundation Highlights APRN Issues at Policy Orientation

On February 9, the Texas Public Policy Foundation (TPPF) hosted a panel on Advanced Practice Providers and Access to Care at their 16th Annual Policy Orientation, one of the premier policy conferences in Texas for media, legislators, and legislative staff. During the panel, Blake Hutson of AARP-Texas, Dr. Deane Waldman of TPPF, and Anne Dunkelberg of the Center for Public Policy Priorities (CPPP) talked about the growing needs of Texas' medically undeserved populations and made an eloquent case for why the state should untie the hands of advanced practice nurses (APRNs), like nurse practitioners, so they can better serve Texas patients. According to statistics Hutson presented: Only 2% of me

Nurse Practitioners Seek Change to State Law

On Friday, February 2, 300 advanced practice registered nurses (APRNs) from across Texas came together at the Austin state capitol to educate lawmakers about policy issues impacting nursing and the need to remove regulatory barriers preventing APRNs from serving Texas patients. "It's hard to believe that in order to practice in Texas, some APRNs are paying an additional mortgage payment a month to their collaborating physicians," said one nurse practitioner attendee. "Why would any nurse practitioner want to stay in Texas?" During a health care policy panel moderated by the Texas Tribune, panelists Blake Hutson of AARP-Texas, Dr. Deane Waldman of the Texas Public Policy Foundation, and the


Thanks for your interest in the Coalition for Healthcare Access. For more information, feel free to get in touch. Send us a message by filling out our contact form.

  • facebook


  • facebook

©2017 - By the Coalition for Health Care Access. Proudly created with Wix.com.