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New York & Kansas Nurse Practitioners Granted Full-Practice Authority

Joelle Y. Jean, FNP-C, BSN, RN
Updated October 10, 2023
    New York and Kansas pass legislation that grants full-practice authority to nurse practitioners. Discover how this change impacts healthcare.

    This week, New York and Kansas made major moves to increase authority for nurse practitioners (NPs). Just days apart, New York Gov. Kathy Hochul and Kansas Gov. Laura Kelley signed into law legislation granting NPs full-practice authority (FPA).

    This monumental achievement will break down barriers by allowing NPs to provide cost-effective treatment and prevention, increase access to high-quality care, and decrease healthcare disparities for thousands of Americans. FPA allows patients access to NP-directed care.

    What does FPA mean for NPs? The American Association of Nurse Practitioners defines FPA as “the authorization of NPs to evaluate patients, diagnose, order and interpret diagnostic tests, and initiate and manage treatments under the exclusive licensure authority of the state board of nursing.”

    Before this week, in order to practice, the law required New York and Kansas NPs to have written collaborative agreements with doctors for a certain amount of years. The written collaborative agreement was a way for doctors to “double-check” NP’s patient charts.

    With the passing of this legislation, NPs can now work as full-functioning providers without the supervision of a doctor.

    More States Need to Follow Suit

    New York and Kansas join 24 states plus the District of Columbia and two U.S. territories that have awarded full-practice authority to NPs.

    The Association of American Medical Colleges reports by 2034, the projected primary care physician (PCP) shortage is estimated to be between 17,800 and 48,000. NPs are vital to filling this gap. Lifting restrictions and passing legislation to allow NPs FPA breaks down barriers when accessing care. In turn, this can improve healthcare for communities, especially those in rural areas and historically marginalized communities.

    An NP’s scope of practice is very similar, if not identical, to a PCP’s scope of practice. The major difference is the type of education. Doctors complete medical school and residency. NPs complete a bachelor of science in nursing, then work at the bedside before pursuing a master’s degree in nursing to become licensed NPs.

    Just like primary care providers, NPs:

    • Treat and manage patients with chronic conditions
    • Provide education on prevention
    • Collaborate with other providers and specialties
    • Offer counseling

    Outdated thoughts on the role of nurses and regulations prevent NPs from working independently. Some NPs in non-FPA states often have many years of experience but continue to provide partial or limited services to their communities due to these laws.

    Cases like RaDonda Vaught and Christann Gainey are also a reminder that nurses and NPs must protect their licenses. NPs often are forced to deny care to patients for fear of losing their license or worse, going to jail.

    But in the end, with these restrictions, the patients are the ones who suffer.

    New York Bill Supports Mental Health Services

    The New York bill supports the need for improving and maintaining access and funding for mental health. Since the COVID-19 pandemic, a U.S. Centers for Disease Control and Prevention (CDC) survey reported almost 41% of the participants are struggling with mental health issues. In addition, the CDC reports:

    • More than 50% of Americans will be diagnosed with a mental illness or disorder at some point in their lifetime.
    • One in 25 Americans live with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression.
    • One in 5 children, either currently or at some point during their life, have had a seriously debilitating mental illness.

    The New York state budget will extend:

    • Government rates for behavioral services
    • Extend government rates for behavioral services referencing the office of addiction services and support
    • Reinvest savings recouped from behavioral health transition into managed care back into behavioral health services
    • Support 9-8-8 suicide prevention and behavioral health crisis hotline systems

    What This Means for Nurses

    Due to this authority increase, registered nurses may consider pursuing higher education to become an NP. This is the best time for nurses in New York and Kansas to consider it. Americans are living longer but have more chronic conditions that need to be treated and managed.

    FPA doesn’t mean NPs are replacing surgeons and doctors in specialty areas. They are working to improve the health of communities by providing care and education rooted in evidence-based practice.

    Recent research suggests NPs provide high-quality care with fewer costs than PCPs. But NPs are paid less than primary care physicians. They also receive less reimbursement from insurance companies despite doing the same work.

    Though the FPA laws in Kansas and New York do not mention new provisions for reimbursements to NPs, the law will most likely improve revenue streams for advanced practice registered nurses (APRNs). It is important for APRNs to continue to be involved with legislation to close the pay gap and challenge state and federal laws regarding reimbursement.

    NPs are in the best position to provide this care. NPs should and can be innovative by developing tools and assessments to improve their patients’ health and quality of life.

    Find out more about how to become an NP.