Texas falls short to other states in national competition for health care workers

Texas health care workers are having to look into other states for primary care work due to state mandate

AUSTIN, Texas – On Monday, May 10, Texans for Healthcare Access released a short video raising awareness about the state’s overregulation of health care professionals. The video brought to light that Texas ranks 46th in health profession overregulation. Thirty-one states have adjusted their laws to attract and retain top health care talent, and others are considering it. Texas faces a high level of competition for health care professionals, such as advanced practice registered nurses (APRNs). In Texas, APRNs are still required to obtain contracts before they can provide care to patients.

“Texas’ formula for economic success over the last two decades has been simple: low taxes and fair regulations equals opportunity,” the video says. “This has helped Texas become the number one place to do business, year after year. Except when it comes to our health care workforce.”

The competition of 31 other states, the District of Columbia, all branches of the military and the U.S. Department of Veterans Affairs not requiring these contracts is causing many Texas natives and Texas-educated nurse practitioners to consider caring for patients in other states, rather than those in their own communities. They are either moving there or practicing via telemedicine.

Due to Texas’ regulations, health care clinics are not expanding in areas where they are most needed.

“Convenient care clinics provide much-needed health care to a large number of people, many of whom have no primary care provider. In many cases, our providers are able to detect more serious issues early, including mental health needs, and refer patients to more specialized medical care,” said Nathan Bronstein, Chief Operating Officer, Convenient Care Association. “As we have seen in other parts of the country, states that remove burdensome regulations on APRNs have seen an increase in clinics, including in areas that were previously underserved. Doing so in Texas would increase the ability for more clinics to open in parts of the state where they are needed the most.”

According to a 2020 Texas Nurse Practitioners member survey, 80% of nurse practitioners stated they would consider practicing telehealth in states that don’t have the same regulations as Texas.

In 2013, Texas lawmakers withdrew the requirement that ARPNs have an on-site supervising physician. Years later, the state still requires ARPNs to have contracts with physicians before caring for patients, and they must maintain these contracts throughout their career. For the most part, ARPNs and physicians don’t work together other than a single phone call once a month through this contract. By law, ARPNs and physicians are not required to consult on any cases.

Governor Greg Abbott has temporarily waived the regulation in response to the Covid-19 crisis, which has prevented ARPNs from providing the maximum care they can to Texans who need it.

The need for primary care continues to grow drastically, as the state’s population grows and more Texans are reaching their senior years. More than 7 million of those Texans live in primary care shortage area, and studies have shown that nurse practitioners tend to have a higher proportion of their practices in rural areas and other regions that are designated health professional shortage areas. Over 80% of nurse practitioners in Texas specialize in primary care.

Over 25% of Nebraska counties saw an increase in APRNs when the state removed the contract mandate.

SB 915 by Chair Kelly Hancock and HB 2029 by Chair Stephanie Klick would cancel these mandates and offer an efficient way to allow APRNs to provide care within their current scope of practice to more Texans across the state.

The newly-released video can be found here.