Texas bill removes physician supervision for rural Advanced Practice Registered Nurses

The Senate Committee on State Affairs convened on May 1, 2025, to discuss a significant bill aimed at improving healthcare access in rural Texas. The proposed legislation seeks to remove the requirement for Advanced Practice Registered Nurses (APRNs) to maintain a contractual delegation agreement with a supervising physician, a move that supporters argue will enhance healthcare delivery in underserved areas.

Proponents of the bill highlighted that 27 other states have adopted similar frameworks, with 19 states, including Texas, waiving the delegation requirement during the COVID-19 pandemic for over two years without negative consequences. They emphasized that the primary goal of the bill is to expand access to healthcare in rural regions, where nearly 90% of counties are designated as primary care shortage areas and half are classified as maternity care deserts.

The discussion underscored Texas's troubling healthcare statistics, noting that the state ranks last in healthcare access and affordability. The committee heard that Texas has experienced significant losses in rural healthcare facilities, with closures driven by shortages of healthcare professionals and the financial burdens of maintaining rural hospitals.

Supporters of the bill pointed to successful outcomes in states like Arizona, which saw a 70% increase in the nurse practitioner workforce within five years of adopting similar legislation. They argued that removing the delegation requirement would not compromise the quality of care, as evidenced by the experiences of other states.

The bill aims to address the urgent need for accessible healthcare, particularly in rural areas where residents often face long wait times for appointments with primary care physicians. Advocates stressed that APRNs provide timely and effective care, often stepping in when traditional healthcare options are unavailable.

As the committee continues to evaluate the bill, its potential impact on healthcare access in rural Texas remains a focal point of discussion, with many emphasizing the need for immediate action to address the ongoing healthcare crisis in these communities.