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Make a difference with the AONP PAC

Posted By Administration, Tuesday, August 21, 2018

Last month’s AONP blog stressed the importance of getting out and speaking to candidates during the campaign season. Our members can learn where candidates stand on issues like full practice authority and educate them on why it’s a sound health care solution for Oklahoma.

But there’s more that we can do. It’s not enough to just know where candidates stand—we need to support those candidates who will support us. That’s why the AONP political action committee (PAC) is so important. It’s a tool we can use to help elect legislators who share our views on these issues.

While any of us can (and should!) give small donations to candidates we support, the PAC allows us to band together to make a bigger impact in races across the state. As our members talk to candidates throughout the state and report on their findings, we’re looking for those candidates who are worthy of support this fall. 

AONP leadership is also speaking to a number of legislators and candidates and determining where our money and our manpower will be most effective in building a strong legislative coalition.

We need your help in this effort! It’s easy to give to the AONP PAC. You can set up small, reoccurring donations that will have a big impact over time. Pooling our resources offers the best chance to have an impact in close legislative races.

We’ll also be bringing our members out to knock doors and campaign for some candidates who support us. Be on the lookout. We’ll let you know about upcoming campaign opportunities via email and on our Facebook page.

Until then, keep talking to candidates in your community about full practice authority. We’ve made great strides over the last few years. This November we can ride our current momentum to legislative victory! 

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Time to Talk to Candidates

Posted By Administration, Monday, July 30, 2018

There will be dozens of new faces in the legislature next year, so it’s important that we continue educating lawmakers and candidates about full practice authority and building support for our profession.

The Oklahoma primaries were held on June 26 and a number of candidates are facing run-off elections on August 28. Now is the time to educate legislative candidates about the role of nurse practitioners in the health care industry and get their thoughts on the issue.

State House and Senate candidates are out knocking doors, attending community events and hosting rallies and fundraisers in their districts. Candidates want to connect with people in their districts. They’re accessible and open to conversations.

If you’re not sure who is running in your area, contact your county election board. They can also confirm if you’re registered to vote.

Once you know the names of your local candidates, seek out opportunities to speak to them. Most campaigns will have a website, or at least a Facebook page, with contact information. It might also list upcoming campaign events.

Candidates will also be found around the community at events like parades, fairs and festivals. Introduce yourself and start a conversation. If you need tips on talking to candidates or talking about full practice authority, check out the toolkit on our legislative page.

Once you're spoken to your candidates, let us know how it went! AONP leadership needs to know who supports us, who doesn't and who needs more information about the issue. Call us at 405-445-4874 or email and tell us about your conversations.

We’ve made incredible strides in the last few years. More than ever, the public and lawmakers understand the issue and they support our drive for full practice authority. Oklahomans want the freedom to choose their health care providers, and they want care that is accessible and affordable. Let’s work together to elect candidates that will make that a reality.

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NPs Boost State's Health and Economic Development

Posted By Administration, Tuesday, April 24, 2018
Updated: Tuesday, April 24, 2018

By: Emily Shipley, VP Government Affairs, State Chamber of Oklahoma 

A healthy business climate in Oklahoma depends on many factors — our cost of living, regulatory environment, corporate tax rates and more. In many of these areas, Oklahoma’s business environment is strong. One area where our state needs a check-up, however, is the health of our citizens and workforce.

The overall health of Oklahoma residents is poor compared to other states, and many in our state lack easy access to a primary care provider.

Oklahoma ranks 49th in physician-to-patient ratio, and significant portions of 76 of our 77 counties are designated primary care shortage areas. We desperately need more primary care providers, and this problem affects both the health of Oklahomans and economic development efforts in our state.

Businesses are unlikely to relocate, grow or expand in areas without adequate access to health care for their employees. Granting full practice authority to nurse practitioners could change that.

Every day in Oklahoma, thousands of people already rely on nurse practitioners for their primary care. For some, seeing a NP is a personal preference; for others, NPs are the only viable option, given the scarcity of primary care providers in many rural areas. 

Under Oklahoma’s current regulations, nurse practitioners must have a signed “collaborative agreement” with a physician, even though little or no collaboration may take place. Often, these agreements are merely signatures on a piece of paper, signatures that can cost a nurse practitioner thousands of dollars each month. 

Decades ago, when advance practice registered nurses were a new concept, this sort of regulation may have made sense. However, nurse practitioners have proven their effectiveness and professionalism over the years. 

Today, this regulation is unnecessary red tape that creates a financial barrier to opening new clinics. Without additional providers and greater access to health care services, Oklahoma will maintain its poor health outcomes and perpetuate the status quo. Oklahomans need health care that is both affordable and close to home.

There are nurse practitioners across the state ready to do their part caring for Oklahomans who live and work in designated primary care shortage areas/underserved communities. Plus, creating a more favorable regulatory environment could draw nurse practitioners from neighboring Texas, where they face similar restrictions.

This idea is cropping up across the country, with 22 states and the District of Columbia having already modernized their laws and regulations to provide greater health care access. Oklahomans deserve the same access.

Full practice authority for nurse practitioners will support economic development efforts across our state and provide Oklahoma businesses a healthier and more prosperous workforce. We look forward to supporting the legislature as they tackle this important health care issue.

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Full Practice Authority Wins Popular Support

Posted By Administration, Wednesday, March 28, 2018

The more people learn about how nurse practitioners can meet crucial primary care needs, the more they support measures allowing them to do so.

That’s the takeaway from a survey conducted by AARP Oklahoma last fall. The poll found that 87 percent of Oklahoma voters age 40 and older support allowing nurse practitioners to serve as the primary or acute care provider of record for a patient.

That support cuts across political divides, with 84 percent of Republicans, 92 percent of Democrats and 89 percent of independents supporting the idea.

It’s no surprise, then, that a bill allowing nurse practitioners to put their full education and training to work caring for Oklahomans sailed through the Oklahoma House of Representatives last year on a bipartisan 72-20 vote.

That measure, House Bill 1013 by Rep. Josh Cockroft and Sen. AJ Griffin, has since been bottled up in the Senate Health and Human Services Committee. The committee’s chairman, Sen. Ervin Yen, refuses to hear the bill.

Oklahoma is in desperate need of more primary care providers. The state is 49th in physician-to-patient ratio, and all or part of 76 out of 77 counties are designated as primary care shortage areas

Nurse practitioners can do more to care for Oklahomans. They know the level of care they are educated to provide, and they are already regulated by the Oklahoma Board of Nursing. Patient safety hasn’t been an issue in the 22 other states where NPs enjoy full practice authority.

It’s time to cut through the red tape and let NPs do their jobs. If you agree, contact your State Senator today and ask them to co-author HB 1013! 

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NPs lead the way with state Capitol advocacy

Posted By Administration, Wednesday, March 14, 2018

Thank you to all of those who turned out at the state Capitol on Feb. 27 to advocate for greater health care access for Oklahomans!

Approximately 80 nurse practitioners attended AONP’s legislative day in support of House Bill 1013 by Rep. Josh Cockroft and Sen. AJ Griffin. We heard from a number of speakers, including AARP Oklahoma executive director Sean Voskuhl, before visiting with lawmakers about ideas to increase access to health care in the Sooner State.

HB 1013, which was introduced last year, aims to do away with the outdated requirement that NPs sign a collaborative agreement with a physician.

This is a common-sense solution to a real problem.

The truth is, our state is woefully short of primary care providers and that impacts the health of Oklahomans in substantial and measurable ways. We’re 49th in physician-to-patient ratio, and always in the bottom 10 in national health rankings. It’s time Oklahoma joined almost half the states in the country in giving NPs full practice authority.

HB 1013 passed the Oklahoma House of Representatives on a 72-20 vote last legislative session but failed to receive a hearing in the Senate Health and Human Services Committee. The measure is still active and we are urging legislators to pass it this year.

Nurse practitioners have been leading the charge to cut through Oklahoma’s needless red tape, and implement a reform that’s already working in almost half of all states. This issue has momentum now, with a number of advocacy and business groups joining in the fight.

House Bill 1013 must pass out of the Senate Health and Human Services Committee before April 12. If you’re tired of long drives or of waiting days for a primary care appointment, contact your state senator today and ask them to support and co-author HB 1013.



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Make your voice heard!

Posted By Administration, Friday, February 23, 2018

Time is running out to register for AONP’s legislative day at the state Capitol on February 27! We need you to join us to tell your elected representatives how nurse practitioners can help ease Oklahoma’s critical shortage of primary care providers.

For more than a year now, AONP has been working for the passage of House Bill 1013, by Rep. Josh Cockroft and Sen. AJ Griffin. The bill would free the profession from costly and needless collaborative agreements. That legislation remains stalled in the Senate Health and Human Services committee.

 Now is the time to act to secure full practice authority!

 The day will begin at 9 a.m. across the street from the Capitol at the Oklahoma History Center, 800 Nazih Zuhdi Drive. Attendees will hear from several speakers, then take a bus to the Capitol to visit with legislators. The event concludes back at the History Center with lunch.

We need to turn out in large numbers to make a final push to get HB 1013 across the finish line. Today, 76 of Oklahoma’s 77 counties are designated as primary care shortage areas. Nurse practitioners can do more to care for their neighbors. We just need the legislature to remove the unnecessary red tape and let us put our education and training to use.

Join us on February 27 to make that goal a reality!

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Legislative Session Primer

Posted By Administration, Thursday, February 1, 2018


As the legislative session gets underway, we’ll hear a number of arguments against full practice authority for nurse practitioners. Many of these arguments relate to patient safety, though those concerns are unfounded. Study after study has shown that utilizing a nurse practitioner as a primary care provider does not put patients at risk, and may increase health care access for many.

Here are some of the arguments you’ll hear in the coming months, as well as responses you can use to educate the public and allay any concerns they may have.

NPs simply want to play doctor, but without putting in the time that physicians do for education and training.

Nurse practitioners have at least a masters’ degree, and many have doctorates. In addition to their formal education, many NPs spend years working in clinical settings as registered nurses before achieving their NP certification. What’s more, they are not trying to “play doctor” or do anything more than NPs are trained to do.


Due to their lack of education and training, NPs are not qualified to make the best decisions for patients.

NPs know and understand their scope of practice. They know the limitations of their training and when to refer or consult with other professionals. Just like an ear, nose and throat specialist wouldn’t attempt heart surgery, NPs know what they are qualified to treat and what is outside their area of expertise. Many NPs currently run independent practices and they provide quality care for patients.


NPs practicing without physician oversight will create a patient-safety issue in Oklahoma.

Twenty-two states and the District of Columbia grant full practice authority to NPs. That’s almost half the country, yet we don’t hear about patient safety crises in those states. Several years ago, the National Governors Association undertook a review of the available research and concluded that:

“None of the studies in NGA’s literature review raise concerns about the quality of care offered by NPs. Most studies showed that NP-provided care is comparable to physician-provided care on several process and outcome measures. Moreover, the stud­ies suggest that NPs may provide improved access to care.”

Further, a majority of states that employ full practice authority rank in the top half of the nation’s health rankings.


The best role for NPs is part of a team-based approach with a physician at the head of the team.

Nothing about full practice authority precludes nurse practitioners from working in a team-based setting. NPs are a vital part of many health care teams. Full practice authority simply means that nurse practitioners can practice as such without the necessary expense of paying for a collaborative agreement.


There’s no proof that NPs will open clinics in rural Oklahoma, and statistics show that NPs currently tend to practice where physicians are practicing.

NPs are currently clustered near physicians because they are required to have a collaborative agreement, and they face financial obstacles to opening their own clinics. In other words, they are practicing where they can currently find jobs.

Studies that have looked more in depth, though, have found that NPs are more likely than physicians to locate in rural areas. One study from Nursing Outlook found that:

“States granting NPs greater SOP [scope of practice] authority tend to exhibit an increase in the number and growth of NPs, greater care provision by NPs, and expanded health care utilization, especially among rural and vulnerable populations. Our review indicates that expanded NP practice regulation can impact health care delivery by increasing the number of NPs in combination with easing restrictions on their SOP.”

 Another study performed at Montana State University found that:

“For the 17 states that did not restrict scope-of-practice laws governing nurse practitioners at the time of the study, 62 percent of the state’s population had high geographic accessibility to a primary care nurse practitioner,” said Peter Buerhaus, the study’s author. “In contrast, in the 21 states that fully restricted the practice of nurse practitioners, the percent of the population with high accessibility to a primary care clinician decreased considerably.”


NPs simply want to use legislation – not the education or training needed – to earn the privilege of practicing medicine.

Nurse practitioners don’t want to practice medicine — they want to practice nursing. That’s why many of them have spent tens of thousands of dollars and years of their lives to earn Doctor of Nursing degrees. Nurses treat specific ailments, like a general practice physician, but their treatment philosophy also encompasses the health and well-being of the individual as a whole.


If a physician has an agreement with an NP, but isn’t providing any real supervision, that physician needs to be reported to the board.

That argument isn’t really related to the issue of full practice authority. Rather, it’s a talking point the physician community uses to distract from the issue of utilizing full practice authority to increase access to care for all Oklahomans. The fact is, several nurse practitioners already own their own clinics in Oklahoma, and many more are providing services to Oklahomans every day with little or no oversight from their collaborating physicians. In fact, the law doesn’t even require oversight — it only requires a signed collaborative agreement. The problem is that NPs might pay thousands of dollars every month for that agreement. Those are funds that could be used to open new clinics, hire additional staff — or just considered income for work performed. Nurse practitioners are nationally certified and regulated by the Oklahoma Board of Nursing. The requirement for collaborative agreements is simply outdated red tape that is holding back health care in Oklahoma.

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Building a healthy business climate

Posted By Administration, Tuesday, December 26, 2017
Updated: Thursday, December 14, 2017

Quality health care access is vital to creating and maintaining a healthy economy, according to researchers in neighboring Kansas.

That should be common sense. Who would build or relocate a business where their employees have little or no access to health care? Common sense was borne out in a study that is part of a statewide initiative called the Kansas Rural Health Works program sponsored by the Kansas Hospital Association.

We know that full practice authority for nurse practitioners will increase access to health care, and that means an improvement in the health and wellbeing of residents. But it turns out that health care access is also a vital economic statistic.

Dr. John Leatherman, agricultural economist at Kansas State University’s Office of Local Government and lead author of the report, noted that health care access and education are two of the most important factors in attracting and retaining business and industry.

“Research has shown time and again that local health care and education are two enormously important factors for economic development,” Leatherman said, “and both can be positively or negatively influenced by local action or inaction.” He said the local health care system has sometimes been the “tie-breaker” in industry location decisions and that retirees view quality local health care as a “must have” local service.

Kansas isn’t the first of Oklahoma’s neighbors to argue that quality health care is a good prescription for economic development. Last year, Ben Hammond, president and CEO of the Texas Association of Business, penned an opinion piece in support of full practice authority for the San Antonio Express-News.

The reality is our state does not have enough health care providers to meet our population’s needs. Texas ranks 47th among the 50 states in primary care access. And while Texas is busy worrying about whether APRNs should have to pay doctors to practice, other states like New Mexico are happily recruiting our Texas-trained APRNs to come to them. Why wouldn’t an APRN go to a different state where their competitors aren’t allowed to deny them the right to practice?

That sounds strikingly similar to Oklahoma, except we rank 49th in physician-to-patient ratio. We all know the need, and studies have shown that nurse practitioners are more likely to set up shop in rural areas.

HB 1013, by Rep. Josh Cockroft and Sen. AJ Griffin, would allow nurse practitioners to put their full education and training to use caring for Oklahomans. That bill passed the Oklahoma House with an overwhelming, bipartisan vote before stalling in a Senate committee. The measure isn’t dead, though, and can move forward once the legislature reconvenes in February.

In addition to researchers in neighboring states, a number of free-market think tanks have pointed to the advantages of full practice authority. Current regulations, in many states, include burdensome red tape that does nothing to improve patient safety or outcomes. Jettisoning outdated regulations would improve health of both the citizens and the business environment. It’s a move that Oklahoma should make sooner rather than later.

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Early diabetes detection is key

Posted By Administration, Monday, December 18, 2017
Updated: Monday, December 18, 2017

 Guest Blog by Leah Melton, APRN-CNP, BC-ADM

Leah Melton

In Oklahoma, more than 1 out of every 3 people you pass in the store or sit with in a movie theatre or restaurant are on a path to developing diabetes. Most of them don’t even know it.

That’s why awareness and early diagnosis are critical. Once diagnosed with diabetes, there is no cure. Many of our friends and neighbors are not aware of their risk, though Oklahoma has one of the highest diabetes rates in the nation.

According to the American Diabetes Association, approximately 451,888 Oklahomans, or 14.3 percent of the adult population, have diabetes. More than 1 million Oklahomans – 36.9 percent of the adult population – have prediabetes. 

In my work as a diabetes care specialist, I see every day how dangerous and painful diabetes can be if it’s undetected, untreated or uncontrolled. It’s not a problem that goes away. If left untreated, it only gets worse and could lead to blindness, amputations and more.

The disease sometimes shows few symptoms at first, but early diagnosis is key to successful treatment and avoiding serious complications in the future. Though there is no cure, healthy lifestyle habits can help to successfully manage the disease.

Everyone can reduce their risk and even those with prediabetes can slow its progress with a few simple steps.

Actions like eating a healthy diet, exercising regularly and maintaining a healthy weight are key. Controlling cholesterol, watching for high blood pressure and not smoking also reduce your risk.

Early detection is vital. If you have risk factors for diabetes, it’s important to have your blood glucose level tested. Make an appointment and chat with a medical professional today.

Diabetes is a problem that you can’t start treating soon enough.

Leah Melton is a nurse practitioner specializing in diabetes care. She is board certified in Advanced Diabetes Management through the American Association of Diabetes Educators. She practices in Norman.

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Oklahoma City VA Moves Closer to Full Practice Authority

Posted By Administration, Monday, December 4, 2017

Last December, the U.S. Department of Veterans Affairs approved rules to grant full practice authority to nurse practitioners working in its facilities, regardless of state regulations.

Now the Oklahoma City VA is moving closer to putting those rules into practice.

Officials said the Oklahoma City VA is on the cusp of granting full practice authority to more than three dozen advance practice registered nurses.

Kerri Craft, associate director for patient care services at the Oklahoma City VA, and Siobhan Gower, credentialing and privileging supervisor at the local VA, explained that officials at the Oklahoma City Veterans Center has been amending their clinical bylaws and setting up the privileging process for nurse practitioners to be granted full practice authority.

“We’ve got 38 APRNs in our center, and our hope is to get all of them through the privileging process in the next few months,” Craft said.

Gower said that the privileging process for nurse practitioners will work much in the same way that it currently does for physicians.

“There are standardized privileging forms for different areas of concentration, like primary care, medicine and so on,” Gower said. “That form will be approved by a professional standards board and then it’ll go to the director of the center for final approval.”

Craft and Gower also said that pay scales have been adjusted. Nurse practitioners have the opportunity to make more once they move through the privileging process.

“We really hope that moving from a scope-of-practice approach to a privileging process with be a good recruiting tool,” Kraft said. “We’re looking to hire a number of additional APRNs from across the country in the coming years.”

That’s following a recent trend of using nurse practitioners and other APRNs to increase access to health care. In addition to the move at the VA to grant full practice authority to nurse practitioners, 22 states and the District of Columbia grant full practice authority to NPs, and the list continues to grow every year.

There are nearly 6,000 advance practice registered nurses who work for the U.S. Department of Veterans Affairs, not to mention thousands more who care for veterans in other facilities.

But access to medical care, even to basic primary care services, can be limited as the U.S. faces a shortage of providers. This is especially true in rural areas and VA facilities are no exception.

Though the nation as a whole faces this shortage of primary care providers, the need is particularly acute in Oklahoma, which ranks 49th among the states in physician-to-patient ratio.

Too many residents lack access to basic care, and simply put, the state faces a crisis in health care access. Nurse practitioners can be a part of the solution.

The VA is expanding the role of nurse practitioners and actively recruiting new hires to serve veterans. The Oklahoma legislature can give the same rights and privileges to the nurse practitioners who are serving Oklahomans in communities across the state each day.

Lawmakers will have that chance in the upcoming legislative session. House Bill 1013 would grant Oklahoma nurse practitioners full practice authority. The bill was passed overwhelmingly in the House last year, but now awaits a hearing in a Senate committee.




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