States with Full Practice Authority Among the Healthiest

During the most recent legislative session, some opponents of full practice authority for nurse practitioners argued the move would put patient health and safety at risk. The fact is, full practice authority simply means that NPs would be allowed to put their full education and training to work caring for Oklahomans.

The opponents offered no data to back up their claim and, in fact, national data shows a very different picture. Compare the states with full practice authority against national state health rankings.

Here’s the regulatory map from the American Association of Nurse Practitioners:

Here are the 2016 state health rankings compiled by the United Health Foundation. Using the same colors as above, we color-coded the states to indicate each regulatory environment. There is a lot of green in the top of the rankings.

Eighteen of the top 25 states give NPs full practice authority. Only three of the top 25 states were as restrictive as Oklahoma, which ranked 46th. Of the 22 states with full practice authority, New Mexico had the lowest ranking at 38th.

While that doesn’t prove that full practice authority results in better health for citizens — there are dozens of variables that figure into a population’s health — it refutes the idea that nurse practitioners offer a lesser quality of care.

Study after study has debunked the idea that patients suffer when an NP is the primary care provider. The National Governors Association looked at those studies and wrote, “None of the studies in NGA’s literature review raise concerns about the quality of care offered by NPs. Most studies showed that NP-provided care is comparable to physician-provided care on several process and outcome measures. Moreover, the stud­ies suggest that NPs may provide improved access to care.”

Within their scope of practice, nurse practitioners offer health care outcomes that are comparable to doctors. They also offer our state a chance to improve access to quality health care for all Oklahomans. Many lawmakers got that message this year and supported lifting these antiquated restrictions. But that support wasn’t universal. Supporters of NP full practice authority need to keep working to build support in the legislature and awareness in the general public.

Our state, and the health of Oklahomans, has nowhere to go but up.


Gearing up for the 2019 Legislative Session

New faces will be a common sight at the State Capitol this year. Of the 149 legislators in the House and Senate, more than one-third—58 of them—are freshmen. Prior to the 2019 Legislative Session’s start on Feb. 4, those newly-elected lawmakers will be busy learning about the legislative process and delving into the many issues facing our state.

Past AONP president Toni Pratt-Reid spoke to new lawmakers during an orientation—Legislative Boot Camp—hosted by the State Chamber on Dec. 6. We need you to contact legislators, too!

We must take advantage of this time to get our message to the new lawmakers and reiterate that message for returning legislators. Nurse practitioners can do more to increase access to health care in every part of our state, but the outdated requirement for a collaborative agreement is holding us back. Red tape and the financial interests of a few physicians are key components limiting increased health care access for Oklahomans.

Contact your state legislators now, before we get into the full swing of the holidays! Tell them about your education, training and what you do every day to care for patients. Share with lawmakers the ways you, as a nurse practitioner, could serve more of your community’s citizens all while increasing consumer choice and providing more health care options to underserved parts of our state.

If you’re unsure of how to get started, we have some talking points and other resources on the legislative page of the AONP website. While you’re on our website, take a moment to sign up for text alerts through Voter Voice. That way, we can contact you quickly with action alerts during the legislative session.

If you’re unsure who represents you in the legislature, you can find that information here. Once you’ve talked to your state House and Senate members, let us know how it went. Email us at

In recent years, we’ve been building support in the legislature and working to elect the candidates who support us. The 2019 session is full of promise and the time is right for legislative victory.


Election results promising for nurse practitioners

The general election foreshadowed good things to come for nurse practitioners across the state. Tuesday saw the election of one nurse practitioner to the legislature, along with a number of other candidates who are supportive of full practice authority.

Cynthia Roe, a nurse practitioner from Lindsay, OK, won her race for House District 42. Because of her support for full practice authority, the Oklahoma State Medical Association spent nearly $8,000 against her in the closing days of the race. The anesthesiologists’ political action committee donated $2,000 to her opponent in the course of the campaign.

AONP volunteers knocked doors for Cynthia in Pauls Valley the Saturday prior to Election Day.  Voters saw through the misinformation that was being spread, and she won her race handedly.

Across Oklahoma, candidates who are favorable to full practice authority won. They won in metro districts and in small towns. They are Republicans and they are Democrats.

NPs spent a lot of time this fall talking to candidates and making the case for full practice authority. We’ve worked hard, and now the makeup of the new legislature gives us an excellent opportunity heading into 2019.

That’s no reason to be complacent, though. With the elections behind us, the work of AONP and nurse practitioners across the state turns to the legislative session that starts in February.

Talk to your legislators about nurse practitioners and full practice authority. Brand new legislators may not be familiar with the issue, so it’s our job to educate them. We’ve got a toolkit on our website to help you get started.

Once you talk to them, let us know how it went. Email and we’ll keep a tally of who supports us and who needs more information. 2019 can be our year, but we’ve got a lot of work to do to get our legislation passed into law.


Invest in the Future

The elections are only a few weeks away, and it’s time to invest in the future of Oklahoma’s nurse practitioners. 

Through the AONP PAC, we pool our resources and support candidates who support our drive to increase health care access in Oklahoma. This is critical. We need your contributionmore than ever. Opponents of full practice authority are spending money to elect candidates who side with them. We need to make our voices heard as well.

This year, we distributed a survey to legislative candidates to educate them and get their opinions on the issues that are important to nurse practitioners. What we’ve seen is strong support for our position. A list of candidates who replied to our survey and expressed favorable support for full practice authority can be found below.

While candidate research is important, we also need to back up research with action. To do that, we need your help!

Our work won’t stop with the election. At the annual conference, we also unveiled Voter Voice, a powerful tool to harness advocacy by nurse practitioners from across the state. If you choose to receive notifications, we can alert you via text or push notification when to call your legislators at the State Capitol. This will be a critical tool when the legislative session starts in February.

You can register for an account HERE. You also can sign up for text updates, simply text AONP to 50457. And don’t forget to download the Voter Voice app for iPhone or Android and opt into notifications from AONP!

There are great things ahead for AONP and for nurse practitioners across the state. We’ve spent years educating the public about full practice authority and building support in the legislature. With everyone working together, we’ll get this initiative through the legislature and signed into law!

See the attached list of legislators who replied to our survey with favorable support for full practice authority.


Now Is the Time

With the runoff elections decided last month, legislative candidates are focused on November’s general election and we should be too. If you haven’t familiarized yourself with your local candidates for the legislature, now is the time to do so.

 AONP has already started this process by sending a survey to all registered candidates who made it through the primary and runoff elections. As the results of that survey come in, we’ll be deciding on candidate support.

 But we need your help on the ground, too.

 Several opponents of full practice authority were defeated during the runoff and primary elections. This results in many new faces in the legislature when the 2019 session starts in February. Those new members may not be familiar with the health care challenges facing our state or how nurse practitioners can help increase access to affordable, quality care.

 It’s up to us to explain it to them. AONP has the tools to help you!

 If you’re unsure of what to say or how to explain the issue, the Legislative page on our website has a toolkit that includes full practice authority talking points. If you don’t know who’s running for the legislature in your area, visit the Oklahoma State Election Board site or call your county election board.

 Once you’ve identified your local candidates, get out and find her or him and start the conversation about full practice authority. Throughout the fall, candidates will be attending fairs, parades, festivals and other events in their prospective districts. Most candidates have a website or a Facebook page with contact information.

 Once you’ve spoken to your candidates, tell us how it went! AONP leadership needs to know who supports us, who doesn’t and who needs more information about the issue. Call us at 405-445-4874 or email and tell us about your conversations.

 And, don’t forget how important it is to support the candidates who support us. Contributions to the AONP PAC help us elect legislators who believe in increasing health care access for Oklahomans.

 We’ve been building momentum for full practice authority in recent years and we’re closer than ever to success. This fall we have the opportunity to elect legislators who will get us across the finish line.


Make a difference with the AONP PAC

Last month’s AONP blog stressed the importance of getting out and speaking to candidates during the campaign season. Our members can learn where candidates stand on issues like full practice authority and educate them on why it’s a sound health care solution for Oklahoma.

But there’s more that we can do. It’s not enough to just know where candidates stand—we need to support those candidates who will support us. That’s why the AONP political action committee (PAC) is so important. It’s a tool we can use to help elect legislators who share our views on these issues.

While any of us can (and should!) give small donations to candidates we support, the PAC allows us to band together to make a bigger impact in races across the state. As our members talk to candidates throughout the state and report on their findings, we’re looking for those candidates who are worthy of support this fall. 

AONP leadership is also speaking to a number of legislators and candidates and determining where our money and our manpower will be most effective in building a strong legislative coalition.

We need your help in this effort! It’s easy to give to the AONP PAC. You can set up small, reoccurring donations that will have a big impact over time. Pooling our resources offers the best chance to have an impact in close legislative races.

We’ll also be bringing our members out to knock doors and campaign for some candidates who support us. Be on the lookout. We’ll let you know about upcoming campaign opportunities via email and on our Facebook page.

Until then, keep talking to candidates in your community about full practice authority. We’ve made great strides over the last few years. This November we can ride our current momentum to legislative victory! 


Time to Talk to Candidates

There will be dozens of new faces in the legislature next year, so it’s important that we continue educating lawmakers and candidates about full practice authority and building support for our profession.

The Oklahoma primaries were held on June 26 and a number of candidates are facing run-off elections on August 28. Now is the time to educate legislative candidates about the role of nurse practitioners in the health care industry and get their thoughts on the issue.

State House and Senate candidates are out knocking doors, attending community events and hosting rallies and fundraisers in their districts. Candidates want to connect with people in their districts. They’re accessible and open to conversations.

If you’re not sure who is running in your area, contact your county election board. They can also confirm if you’re registered to vote.

Once you know the names of your local candidates, seek out opportunities to speak to them. Most campaigns will have a website, or at least a Facebook page, with contact information. It might also list upcoming campaign events.

Candidates will also be found around the community at events like parades, fairs and festivals. Introduce yourself and start a conversation. If you need tips on talking to candidates or talking about full practice authority, check out the toolkit on our legislative page.

Once you’re spoken to your candidates, let us know how it went! AONP leadership needs to know who supports us, who doesn’t and who needs more information about the issue. Call us at 405-445-4874 or email and tell us about your conversations.

We’ve made incredible strides in the last few years. More than ever, the public and lawmakers understand the issue and they support our drive for full practice authority. Oklahomans want the freedom to choose their health care providers, and they want care that is accessible and affordable. Let’s work together to elect candidates that will make that a reality.


NPs Boost State’s Health and Economic Development

By: Emily Shipley, VP Government Affairs, State Chamber of Oklahoma 

A healthy business climate in Oklahoma depends on many factors — our cost of living, regulatory environment, corporate tax rates and more. In many of these areas, Oklahoma’s business environment is strong. One area where our state needs a check-up, however, is the health of our citizens and workforce.

The overall health of Oklahoma residents is poor compared to other states, and many in our state lack easy access to a primary care provider.

Oklahoma ranks 49th in physician-to-patient ratio, and significant portions of 76 of our 77 counties are designated primary care shortage areas. We desperately need more primary care providers, and this problem affects both the health of Oklahomans and economic development efforts in our state.

Businesses are unlikely to relocate, grow or expand in areas without adequate access to health care for their employees. Granting full practice authority to nurse practitioners could change that.

Every day in Oklahoma, thousands of people already rely on nurse practitioners for their primary care. For some, seeing a NP is a personal preference; for others, NPs are the only viable option, given the scarcity of primary care providers in many rural areas. 

Under Oklahoma’s current regulations, nurse practitioners must have a signed “collaborative agreement” with a physician, even though little or no collaboration may take place. Often, these agreements are merely signatures on a piece of paper, signatures that can cost a nurse practitioner thousands of dollars each month. 

Decades ago, when advance practice registered nurses were a new concept, this sort of regulation may have made sense. However, nurse practitioners have proven their effectiveness and professionalism over the years. 

Today, this regulation is unnecessary red tape that creates a financial barrier to opening new clinics. Without additional providers and greater access to health care services, Oklahoma will maintain its poor health outcomes and perpetuate the status quo. Oklahomans need health care that is both affordable and close to home.

There are nurse practitioners across the state ready to do their part caring for Oklahomans who live and work in designated primary care shortage areas/underserved communities. Plus, creating a more favorable regulatory environment could draw nurse practitioners from neighboring Texas, where they face similar restrictions.

This idea is cropping up across the country, with 22 states and the District of Columbia having already modernized their laws and regulations to provide greater health care access. Oklahomans deserve the same access.

Full practice authority for nurse practitioners will support economic development efforts across our state and provide Oklahoma businesses a healthier and more prosperous workforce. We look forward to supporting the legislature as they tackle this important health care issue.


Full Practice Authority Wins Popular Support

The more people learn about how nurse practitioners can meet crucial primary care needs, the more they support measures allowing them to do so.

That’s the takeaway from a survey conducted by AARP Oklahoma last fall. The poll found that 87 percent of Oklahoma voters age 40 and older support allowing nurse practitioners to serve as the primary or acute care provider of record for a patient.

That support cuts across political divides, with 84 percent of Republicans, 92 percent of Democrats and 89 percent of independents supporting the idea.

It’s no surprise, then, that a bill allowing nurse practitioners to put their full education and training to work caring for Oklahomans sailed through the Oklahoma House of Representatives last year on a bipartisan 72-20 vote.

That measure, House Bill 1013 by Rep. Josh Cockroft and Sen. AJ Griffin, has since been bottled up in the Senate Health and Human Services Committee. The committee’s chairman, Sen. Ervin Yen, refuses to hear the bill.

Oklahoma is in desperate need of more primary care providers. The state is 49th in physician-to-patient ratio, and all or part of 76 out of 77 counties are designated as primary care shortage areas

Nurse practitioners can do more to care for Oklahomans. They know the level of care they are educated to provide, and they are already regulated by the Oklahoma Board of Nursing. Patient safety hasn’t been an issue in the 22 other states where NPs enjoy full practice authority.

It’s time to cut through the red tape and let NPs do their jobs. If you agree, contact your State Senator today and ask them to co-author HB 1013! 


NPs lead the way with state Capitol advocacy

Thank you to all of those who turned out at the state Capitol on Feb. 27 to advocate for greater health care access for Oklahomans!

Approximately 80 nurse practitioners attended AONP’s legislative day in support of House Bill 1013 by Rep. Josh Cockroft and Sen. AJ Griffin. We heard from a number of speakers, including AARP Oklahoma executive director Sean Voskuhl, before visiting with lawmakers about ideas to increase access to health care in the Sooner State.

HB 1013, which was introduced last year, aims to do away with the outdated requirement that NPs sign a collaborative agreement with a physician.

This is a common-sense solution to a real problem.

The truth is, our state is woefully short of primary care providers and that impacts the health of Oklahomans in substantial and measurable ways. We’re 49th in physician-to-patient ratio, and always in the bottom 10 in national health rankings. It’s time Oklahoma joined almost half the states in the country in giving NPs full practice authority.

HB 1013 passed the Oklahoma House of Representatives on a 72-20 vote last legislative session but failed to receive a hearing in the Senate Health and Human Services Committee. The measure is still active and we are urging legislators to pass it this year.

Nurse practitioners have been leading the charge to cut through Oklahoma’s needless red tape, and implement a reform that’s already working in almost half of all states. This issue has momentum now, with a number of advocacy and business groups joining in the fight.

House Bill 1013 must pass out of the Senate Health and Human Services Committee before April 12. If you’re tired of long drives or of waiting days for a primary care appointment, contact your state senator today and ask them to support and co-author HB 1013.