Texas Nurse Practitioners

06/05/2017 | Press release | Distributed by Public on 06/06/2017 18:11

85th Legislature Removes Barriers to Texas Nurse Practitioners, Expands Access to Health Care »

Monday, June 5, 2017
Posted by: Emily Eastin

Texas Nurse Practitioners worked with lawmakers during the 85th Legislative Session to advance two key bills on its legislative agenda that will expand access to care to Texas patients, especially those in rural and underserved areas. Senate Bill (SB) 654 by Sen. Kel Seliger and Rep. John Smithee allows advanced practice registered nurses (APRNs) to see Medicaid and CHIP patients, regardless of whether their delegating physician also participates in those plans. Another bill, SB 919 by Sen. José Rodríguez and Rep. Garnet Coleman, extends signature authority to APRNs and Physician Assistants (PAs) for death certificates.

'We applaud Sens. Seliger and Rodriguez and Reps. Smithee and Coleman for championing legislation that will greatly improve access to healthcare for patients across Texas -- from the Panhandle to El Paso to the Rio Grande Valley,' said Jan Zdanuk, President of Texas Nurse Practitioners. 'Their bills make important strides to remove barriers preventing Texas patients from accessing the vital care they need.'

SB 654 will benefit some of the most vulnerable Texas patients, like those Panhandle Nurse Practitioner Holly Jeffreys cares for. Jeffreys provides health care to 300 foster care children in the Cal Farley's Boys Ranch clinic - many of whom are Medicaid patients. Right now in Texas, APRNs can only accept Medicaid or CHIP if their delegating physician also accepts those plans. Since Jeffreys' delegating physician has a practice in the neighboring town and is not in-network for Medicaid, Jeffreys has been unable to accept and seek reimbursement for the Boys Ranch Medicaid patients for almost two years.

Jeffreys is not alone. Providers across the state - in rural, urban, and suburban areas - are forced to turn Medicaid patients away or otherwise go without payment due to this insurance requirement. SB 654 gets rid of this needless barrier and allows APRNs to freely choose whether they want to accept Medicaid/CHIP patients or not.

'I am thankful that I will be able to continue to serve the children at Boys Ranch and provide healthcare not just to Boys Ranch residents, but to patients throughout the Panhandle,' said Jeffreys.

SB 919 by Sen. Rodríguez and Rep. Coleman grants signature authority for death certificates to APRNs and PAs providing care to hospice and palliative care patients. For far too many Texans, especially those in rural areas, obtaining a signature for death certificates can take days and even weeks, incurring an unnecessary financial and emotional burden for families during a delicate time of grieving. SB 919 adds APRNs and PAs to the list of providers who can sign these documents, improving continuity of care for patients' families.

'SB 919 will make a huge difference in the lives of those who have lost a loved one,' said Erin Perez, a Palliative Care Nurse Practitioner and member of Texas' statewide Palliative Care Interdisciplinary Advisory Council. 'My own patients have had to wait up to three weeks for what should be a simple administrative task, and thanks to Sen. Rodríguez and Rep. Coleman, these families will no longer have to jump through unnecessary hoops.'

These initiatives were supported by the Texas Nurse Practitioners, APRN Alliance, AARP Texas, Center for Public Policy Priorities, Methodist Healthcare Ministries of South Texas Inc., Texas Association of Business, Texas Hospice and Home Care Association, Texas Medical Association, and the Texas Association of Health Plans.

Highly-skilled, trained health care providers

There are more than 21,000 APRNs in Texas, and growing. These highly skilled and specialized providers play a crucial role in caring for Texans and addressing our state's growing and changing health care needs, providing services ranging from treating the common cold to geriatric care, women's health, and mental health services. And it's not just Texas who is making changes to the health care arena to accommodate these providers. States everywhere are modernizing their laws and removing barriers to APRNs. Just this year, the Veteran's Health Administration granted full practice authority to APRNs, freeing them up to practice without a physician delegation agreement. 22 states and the District of Columbia have done the same.

Progress toward full-practice authority

This legislative session also saw tremendous momentum toward granting full practice authority to APRNs. A group of diverse organizations representing consumers, business, and a broad range of health care stakeholders came together during the 85th Legislature to form the Coalition for Health Care Access. This group of over 20 business and consumer-advocacy groups, including AARP, Center for Public Policy Priorities, Texas Association of Business, and the Texas Public Policy Foundation, supported HB 1415 and SB 681 by Rep. Stephanie Klick and Sen. Kelly Hancock, which would expand access to health care by removing outdated and costly regulatory barriers for APRNs. Legislation to grant full practice authority was heard in committee on April 25. It was ultimately left pending.


Chartered in 1989, Texas Nurse Practitioners is a statewide professional association representing over 15,000 nurse practitioners. Nurse Practitioners across Texas provide invaluable services, including performing physical examinations and evaluations, providing health education, treating common illnesses, and helping patients manage chronic illness.