Mar 28, 2023

State Progress in Removing Barriers to Practice and Care

Since the Campaign began, 14 states (Utah–2023, Kansas–2022, New York–2022, Delaware–2021, Massachusetts–2020, South Dakota–2017, Maryland–2015, Nebraska–2015, Minnesota–2014, Connecticut–2014, Nevada–2013, Rhode Island–2013, North Dakota–2011, and Vermont–2011) have removed statutory barriers that prevented nurse practitioners from providing care to the full extent of their education and training, helping to increase consumers’ access to care. This map shows all 27 states and the District of Columbia where consumers have full access to nurse practitioners, including where progress has been made since the Campaign began.

Map Definitions

Substantial improvement: States have made major legislative changes that bring nurse practitioners (NPs) close to full practice authority with small exceptions, such as still needing to contract to prescribe for controlled substances or being required to have an attestation agreement.

Incremental improvement: States have made minor legislative changes that have increased consumer access to care. Examples include increased signature authority (ability to sign forms such as handicap placards or POLST [Provider Orders for Life Sustaining Treatment]), and increased NP to MD ratios (increased numbers of NPs that a physician can contract with).