Kansas is the latest in a growing number of states giving direct access to nurse practitioners thanks to legislation eliminating hurdles for patients who need primary care as the Covid-19 pandemic puts a spotlight on U.S. primary care needs.
Gov. Laura Kelly, a Democrat, on Friday signed into law legislation passed by the Republican-controlled legislature that allows advanced practice registered nurses to practice independently, no longer requiring supervision by a physician. There are now 26 states plus the District of Columbia and two U.S. territories that have awarded full practice authority to so-called APRNs, which include nurse practitioners. New York earlier this month became the 25th state to grant direct access to nurse practitioners.
"Kansas, like so many other states, is experiencing a health care shortage – especially in rural parts of the state," Kelly said Friday. "This will improve the availability of high-quality health care by empowering APRNs to reduce local and regional care gaps."
Nurse practitioners are educated to perform myriad primary care functions, diagnose, prescribe medications and conduct physical exams, but state scope-of-practice laws often prevent them from such care unless they have an agreement with an overseeing physician. AANP said full practice authority is “the authorization of NPs to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments, and prescribe medications under the exclusive licensure authority of the state board of nursing.”
As retail clinics like those run by CVS Health’s MinuteClinic business have proliferated while hospitals and health systems embrace a team-based approach to medical care delivery, patients have become more familiar with nurse practitioners as an option to a busy doctor’s office and quick access to treat routine maladies.
“This is a major milestone in healthcare for Kansas and for our nation,” said April N. Kapu, president of the American Association of Nurse Practitioners (AANP). “The majority of states have now adopted this legislative model.”
During the pandemic in particular, nurse practitioners have been key to administering vaccines and booster shots to combat Covid-19 while states have increasingly expanded the ability of NPs, pharmacists and pharmacy techs to administer vaccines in recent years. State lawmakers and health policy makers during the pandemic found nurse practitioners were needed to increase access to primary care and vaccinations amid a shortage of doctors and other healthcare workers.
But under the new regulatory framework adopted by Kansas and the earlier states, there is no longer “requirements for NPs to hold a state-mandated contract with a physician as a condition of state licensure and to provide patient care.” That, supporters of full practice authority say, hurts patient access to primary care.
“This law is a necessary step toward eliminating health care disparities, managing costs and building the health care workforce for Kansas,” said Jon Fanning, chief executive officer of AANP. “States that have adopted Full Practice Authority are better positioned to address these critical issues.”
