New York NPs Join Half of States With Full Practice Authority

Roni Robbins

April 14, 2022

UPDATED April 15, 2022 // Editor's note: Kansas followed New York's lead and became the 26th state to adopt full practice authority. They are the first states in 2022 to do so.

With New York nurse practitioners recently gaining full practice authority (FPA), half of the country's NPs now have the ability to provide patients with easier access to care, according to leading national nurse organizations.

New York joins 24 other states, the District of Columbia, and two US territories that have adopted FPA legislation, as reported by the American Association of Nurse Practitioners (AANP). Like other states, New York has been under an emergency order during the pandemic that allowed NPs to practice to their full authority because of staffing shortages. That order was extended multiple times and was expected to expire this month, AANP reports.

"This has been in the making for nurse practitioners in New York since 2014, trying to get full practice authority," Michelle Jones, RN, MSN, ANP-C, director at large for the New York State Nurses Association, told Medscape Medical News.

Michelle Jones

NPs who were allowed to practice independently during the pandemic campaigned for that provision to become permanent once the emergency order expired, she said. Jones explained that the FPA law expands the scope of practice and "removes unnecessary barriers," namely an agreement with doctors to oversee NPs' actions.

FPA gives NPs the authority to evaluate patients, diagnose, order and interpret diagnostic tests, and initiate and manage treatments — including prescribing medications — without oversight by a doctor or state medical board, according to AANP.

Before the pandemic, New York NPs had "reduced" practice authority with those who had more than 3600 hours of experience required to maintain a collaborative practice agreement with doctors and those with less experience maintaining a written agreement. The change gives full practice authority to those with more than 3600 hours of experience, Stephen A. Ferrara, DNP, FNP-BC, AANP regional director, told Medscape Medical News.

Stephen A. Ferrara

Ferrara, who practices in New York, said the state is the largest to change to FPA. He said the state and others that have moved to FPA have determined that there "has been no lapse in quality care" during the emergency order period and that the regulatory barriers kept NPs from providing access to care.

Jones said that the law also will allow NPs to open private practices and serve underserved patients in areas that lack access to healthcare. "This is a step to improve access to healthcare and health equity of the New York population."

It's been a while since another state passed FPA legislation, Massachusetts in January 2021 and Delaware in August 2021, according to AANP.

Earlier this month, AANP released new data showing a 9% increase in NPs licensed to practice in the US, rising from 325,000 in May 2021 to 355,000.

The New York legislation "will help New York attract and retain nurse practitioners and provide New Yorkers better access to quality care," AANP President April Kapu, DNP, APRN, said in a statement.

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