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Historic Hearing on Full Practice in Texas Senate

Our ongoing efforts to free nurse practitioners from the delegation agreement mandate has passed a new milestone. For the first time since we have been fighting this antiquated requirement, our cause was heard before the Senate.

S.B. 2438, by Senator José Rodríguez of El Paso, had a public hearing Thursday, May 16, before the Texas State Senate Committee on Business and Commerce. With its companion bill, H.B. 1792, before a House committee in April, that means we have had hearings before both chambers of the Texas Legislature for the first time.

Sen. Rodriguez introduced the bill, discussing the need to free NPs to practice in areas where they are most needed.

“Texas suffers from one of the worst medical professional shortages in the country, with nearly 5.5 million Texans living in areas designated as Primary Care Health Professional Shortage Areas.” he told the committee. “S.B. 2438 offers a solution that promises real progress against this shortage.”

Lutricia Harrison, a family nurse practitioner who cares for patients at her clinic in an underserved area of Houston, testified about the importance of freeing NPs to meet market demand.

“Texas has always understood the power of competition and free markets, so here more than any other state, it’s vital we take a hard look at regulations that impede the ability of trained professionals to participate in their chosen field,” Harrison said.

She said the lack of primary care in many areas makes health care more expensive.

“If my clinic were to close, many of my patients would go without care or utilize the emergency room for their primary care visits,” she said, “all of which drives up the cost of healthcare and contributes to poor health outcomes.”

Harrison said the obstacle of physician agreements is making it more difficult for many NPs to fill the significant need for primary care in communities across Texas.

“That is especially problematic for millions of patients in Texas’ underserved communities, many of which have no local physicians at all,” she said. “More than 24 states have done away with these government mandates, and in those states, nurse practitioners are more likely to work in primary care and in rural and underserved areas. That is the free market in action.”

Stephanie Morgan, an advanced practice nurse practitioner (APRN) and clinical professor at the University of Texas Austin School of Nursing discussed the high quality of care they provide.

“APRNs are safe, high-quality care providers,” Morgan said. “Over 40 years of peer-reviewed studies show that nurse practitioners are safe and that their patient outcomes are just as good or better than physicians for the kinds of conditions they treat.”

Griffin Mulcahey, an entrepreneur who has worked with NPs in ventures across several states, testified that restrictive NP laws make it more expensive to run a business involving nurse practitioners.

“Businesses bear the cost of contracting with supervising physicians and helping coordinate monthly oversight, despite the fact that these oversight responsibilities did not require the physician to actually see or provide direct care to patients,” said Mulcahey, who has analyzed NP scope of practice laws in every state. “The best state laws allow for a transition to practice for an NP, where an NP works and learns under physician delegation for a period of time, and then is able to work to their full scope of practice, under their own license. This bill does exactly that.”

This hearing represented a big step forward for nurse practitioners in our state, and for patients in need of care everywhere in the state.

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