Texas Railroad Commission Chairman Christi Craddick recently hosted a Rural Issues Workshop in Austin to facilitate an open discussion centered around rural issues in our state, and the important role of nurse practitioners in these communities was a key focal point (watch the video here). The event featured a panel on rural health that included Texas Nurse Practitioner Holly Jeffreys, Texas Rep. Stephanie Klick and John Henderson, CEO and President of Texas Organization of Rural & Community Hospitals (TORCH). The panel’s discussion focused on the challenges of providing health care in the state’s least populous areas, and how freeing nurse practitioners from unnecessary restrictions like delegation agreements is an important step toward expanding much-needed care into these communities. “We have a crisis in primary care and mental health care providers, and Nurse Practitioners are very well trained to step into that gap.” said Rep. Stephanie Klick. Speaking to an audience of local and state leaders, Holly shared the important role nurse practitioners have in their communities and opportunities to improve access to care. Holly told the story of her Family Care Clinic, which today has four locations in the Panhandle and serves thousands of patients. While her clinic has grown and helped improve lives across the region, nurse practitioners in nearby communities seeking to do then same have been unable to do so. Texas law that requires NPs to enter into ongoing, often costly, lifetime agreements with physicians is standing in the way of quality access to care, especially for rural communities. For NPs trying to open their own clinics in neighboring communities, the biggest problem was finding physicians who were willing or able to enter into such agreements. Indeed, as Holly pointed out, if something happened with her current delegating physician, she would have to close her doors and patients would abruptly be without care. Just as troubling for Holly is having nurse practitioners train with her, only to move and put that training to work in other states with less restrictive regulations. “We were training Nurse Practitioners and they were heading across state lines to practice. That was disappointing because we need them here,” said Holly. Nearly half of the states – as well as the VA and all branches of the military – have already cut the red tape and done away with delegation agreements, with equal or even better outcomes for the conditions they treat when compared to physicians. While getting rid of delegation agreements would not expand what Nurse Practitioners can treat, it would eliminate cost and bureaucracy, and improve access to care for millions of Texans. Having a seat at the table to shine a light on the role of nurse practitioners in our health care system, including the need for changes in our laws, is critically-important. We want to thank Chairman Craddick for hosting this workshop and giving Texas Nurse Practitioners the opportunity to discuss Texas’ rural health care issues.