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Texans for Healthcare Access Applauds Chair Klick on the Filing of HB 2029

HB 2029 Will Remove Burdensome, Outdated Mandates on APRNs

AUSTIN – Texans for Healthcare Access today applauded House Public Health Chair Stephanie Klick on the filing of HB 2029, which will remove unnecessary and outdated mandates that are preventing Advanced Practice Registered Nurses (APRNs) from providing more access and more options to Texas patients.

“Removing outdated and unnecessary mandates on APRNs will enable them to provide more access to high-quality care to Texans when and where they need it the most,” said Christy Blanco, President of Texas Nurse Practitioners. “Texas is competing with other states for quality health care workers and it’s time to level the playing field. We applaud Chair Klick’s commitment to improving health care for millions of Texans.”

California and Florida, two of Texas’ biggest competitors for talent and business, are among 31 states who have done away with the requirement for APRNs to contract with physicians before they can practice. Advanced practice nursing is the only profession in Texas where independently licensed professionals are mandated to contract with a member of another profession in order to go into business. 

“Too many Texans face barriers to care due to outdated regulations, red tape, and excessive costs,” says Cindy Zolnierek, PhD, RN, CAE, CEO of Texas Nurses Association. “When almost one in five Texas counties lacks a physician, APRNs can fill the gap in primary care. APRNs are more willing to work in rural counties and more willing to take Medicaid and Medicare.”

A 2020 Texas Nurse Practitioners member survey found that more than 50% of nurse practitioners say delegation requirements prevented them from expanding or creating their own practice to care for more patients. Nearly 80% said they would consider practicing telehealth to patients outside of Texas in states that do not have such onerous regulations.

“Removing unnecessary barriers and allowing full practice for APRNs will permit Certified Registered Nurse Anesthetists to continue to provide most of the rural anesthesia care to Texans in need of these crucial services,” said Gregory Collins, DNP, CRNA, and President of TxANA Board of Directors.

In 2013, Texas lawmakers removed the requirement that APRNs have an on-site supervising physician, yet years later the state continues to require them to have contracts with physicians before caring for patients. The law does not require APRNs and physicians to work together or to consult on any cases, mandating nothing more than a single phone call once a month. Further, in response to the COVID-19 crisis, Gov. Greg Abbott waived the delegation requirements temporarily, underscoring the fact these regulations are preventing APRNs from doing the most they can to provide care to the Texans who need it.

“It was true before, but the COVID-19 crisis has made the need for increased health care access and affordability even more evident,” said Jamie Dudensing, CEO of the Texas Association of Health Plans. “Freeing APRNs from burdensome and unnecessary delegation agreements will help expand affordable health care to the areas that need it most, including rural and underserved urban parts of Texas. This is a bill whose time has come.”

More than 7 million Texans live in primary care shortage areas. Studies have shown that APRNs tend to have a greater proportion of their practices in rural areas and other regions that are designated health professional shortage areas. In states that eliminate delegation agreements, APRNs have been 1.5 times more likely to practice in rural areas. Currently, more than 80% of nurse practitioners in Texas specialize in primary care.


Texans for Healthcare Access is a coalition of organizations representing consumers, business, and a broad range of health care stakeholders. These groups have joined forces to remove unnecessary barriers to care and allow Advanced Practice Registered Nurses to provide more access and more options for Texas patients. Learn more here.


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