Senators Rodriguez, Burton file bill to change nurse practitioner regulations

AUSTIN – State Senators José Rodríguez (D-El Paso) and Konni Burton (R-Colleyville) have filed SB 751, which is aimed at improving access to health care by making it easier for health care professionals to work together to deliver much needed primary care services. Identical legislation was filed as HB 1885 in the House by state Rep. Cecil Bell (R–Magnolia).

The bills would grant full practice authority in Texas to all advanced practice registered nurses (APRNs), including nurse practitioners (NPs). This move would authorize APRNs to evaluate and diagnose patients; order and interpret diagnostic tests; and initiate and manage treatments – including the prescribing of medications – activities they are already doing, but would move these items under the exclusive licensure authority of the Texas Board of Nursing.

“With more people getting insured, there is increased demand for services. This legislation will increase access statewide to high quality, cost-effective health care,” said Rodríguez.  “Medically unnecessary regulations in Texas harm our patients and push our providers out of state.  We cannot afford this continued drain on our resources.
Our APRNs need to be able to practice to the full extent of their license.”

Currently, state statute and regulations needlessly require Texas APRNs to secure a physician to delegate their authority for many elements of care. These supervisory requirements are not found in most other states, specifically next-door in New Mexico. 

Among the specifics, the bills would:
•    Eliminate the outdated requirement for individual physician delegation of diagnosing and prescribing
•    Provide for greater access to essential health care services in all areas of the state, especially those most rural and underserved regions
•    Improve the primary care provider workforce shortage by eliminating unnecessary bureaucratic restrictions requiring physician involvement before an APRN can provide patient care
•    Avoid duplication of services and billing costs associated with physician oversight
•    Reduce repetition of orders, office visits and costs for patients who are already struggling to navigate the health care system
•    Remove the risk for patients of facing the potential closure of their health care providers’ offices because of sudden physician death or contract termination.
“The passage of this legislation is critical.  Not only do we have a large aging and growing rural population, but chronic disease and health disparities are prevalent and must be addressed,” said State Rep. Bell.  “We must do what we can to ensure that there are plenty of primary care providers accessible to patients throughout the Lone Star State, particularly in medically underserved areas.”
The numbers in Texas, and District 29, are revealing:
•    The number of doctors providing direct patient care per 100,000 people in Texas was 174, which is well-below the national average.  In El Paso, the number is even lower – just 122.  
•    The number of doctors providing primary care per 100,000 people in Texas was 71 but in El Paso, it’s 49.
•    The number of primary care providers per 100,000 rural population is significantly less than in metropolitan areas. In the counties of Culberson, Hudspeth, Jeff Davis and Presidio, the number of primary care physicians per 100,000 ranged from 0 to 78.9.

Meanwhile, the number of APRNs in Texas is rapidly increasing, having gone from 2,804 in 2001, to 18,306 in 2015.  

“Texas’ current requirement for mandated agreements cost APRNs and consumers money without any benefit to patient safety or health care access. These requirements are prohibitive to many potential practice owners who want to open businesses and serve patients,” said Rachelle Campbell, APRN and private practice owner. “It’s time for Texas to promote small business and health care access by granting patients full and direct access to APRNs.”

José Rodríguez represents Texas Senate District 29, which includes the counties of El Paso, Hudspeth, Culberson, Jeff Davis, and Presidio. He represents both urban and rural constituencies, and more than 350 miles of the Texas-Mexico border. Senator Rodríguez currently serves as the Chairman of the Senate Hispanic Caucus, and is a member of the Senate Committees on Education; Health and Human Services; Veteran Affairs and Military Installations; Nominations; and Agriculture, Water, and Rural Affairs.