Open Letter to the National Governors Association

Thank you for your leadership as our nation navigates the response to the COVID-19 pandemic. The American Association of Nurse Practitioners® (AANP) affirms the commitment of the 290,000 nurse practitioners (NPs) serving on the front lines of our health care system as part of the robust response to combat the spread of COVID-19 while continuing to meet the need of ongoing primary care in communities across the nation. We ask that you encourage governors to waive existing state-level restrictions that prevent NPs from responding at the top of their education and national certification.

NPs evaluate patients; make diagnoses; order, perform and interpret diagnostic tests and initiate and manage treatments — including prescribing medications and non-pharmacologic treatments; and coordinate care and provide patient counseling and education to patients, families and communities. In 22 states, Washington D.C., two U.S. territories, the Veterans Hospital Administration and the Indian Health Service, NPs are authorized to directly provide these services. In the remaining jurisdictions, outdated regulation needlessly bottlenecks the workforce by making it illegal for NPs to provide these services unless they maintain a collaborative or supervisory contract with a physician. This requirement ties a state's capacity to use NPs to meet health care needs to the supply and availability of the physician workforce; needlessly restricts the number of NPs who could otherwise evaluate, diagnose and treat patients; and creates unnecessary geographic maldistribution of services and delays in care. In 2012, the National Governors Association recommended that states consider easing these restrictions as a way to improve access to care. Waiving these requirements would remove a significant roadblock toward ensuring states have the necessary workforce capacity our nation needs during a pandemic.

Additionally, AANP requests that the National Governors Association work with states to address the need for a surge in health care providers by encouraging states to expand emergency health care workforce declarations that authorize states to use out-of-state health care licensees to include clinicians with retired or inactive states to resume work, provided their inactive or expired license was in good standing. Addressing our nation's needs will require all hands on deck. Given the nationwide scale of COVID-19 cases, states will not be able to rely on neighboring states to send health care providers to meet the demand. Authorizing recent licensees to return to the workforce offers a way to bolster our reserves and utilize the qualified clinicians already in our communities. The state of Colorado has already taken this wise step. We ask that the National Governors Association encourage other states to adopt similar measures.

NPs are practicing in every setting and geographic area that is impacted by COVID-19. Removing barriers to care across the health care system and ensuring that clinicians can bring all their knowledge and skill to treat patients will improve the efficiency of our health care workforce and our ability to fight back during this crisis.

Thank you for your leadership at this critical time. Together, we will get through this.

Sincerely,
Sophia L. Thomas, DNP, FNP, PNP, FAANP
AANP President