Texans for Healthcare Access

Allow Advanced Practice Registered Nurses to care for Texans.

 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.

March 28, 2017

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.


March 23, 2017

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 o...

March 6, 2017

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 Pra...

March 6, 2017

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 thei...

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