Advocacy – Non-Member

VCNP’s Government Relations Committee meets year round to prepare for the Virginia General Assembly each January. Committee members organize regional legislative events each fall, connect with local legislators, and work to provide resources to the regional members to help them better understand how their involvement in the legislative process can advance NP practice for all of Virginia’s NPs.

We are excited to share the progress NPs have made through the years.

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Advocacy Toolkit

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Autonomous Practice Licensure

Nurse Practitioner Scope of Practice

Legislative Information

Links to Organizations

2024 Virginia General Assembly

As we prepare for the 2024 Session, we will post information sharing how supporters of NP practice can get involved.

Ask legislators to vote ‘YES’ to support
HB 971 (Tran) & HB 983 (Walker)

Nurse practitioners; patient care team provider, autonomous practice

Current landscape and challenges

  • Nurse practitioners (NPs) are advanced practice registered nurses (APRNs) who have master’s, and often doctorate, degrees as well as extensive clinical training in the diagnosis, treatment and management of common and complex medical conditions.
  • NPs have been providing safe, high-quality care for more than 50 years. NP-provided care has been shown to have outcomes equal to care provided by physician colleagues. 
  • There are 16,000+ NPs currently providing care in Virginia including 3,100+ with autonomous practice licensure. Many employers prefer – and some require – hiring NPs with autonomous practice licensure because it reduces administrative and practice agreement costs.
  • Virginia’s NPs are governed by the Joint Boards of Nursing and Medicine. Virginia is one of only three states with Joint Boards. NPs in other states are governed solely by the Board of Nursing.
  • Unique to Virginia, NPs are restricted by a mandated practice agreement with a physician for 5 years before they are eligible to apply for autonomous practice licensure and practice without a practice agreement.
  • Mandated practice agreements with physicians do not involve training from physicians, are not residencies or fellowships, and do not require the physician to practice in the same location as the NP.

Why these issues need to be addressed now

  • Virginia’s transition to practice requirement is the most restrictive in the nation. The majority of states, the District of Columbia and two U.S. territories do not require any transition to practice or practice agreement. Of the states with such requirements, the requirement is 2 or 3 years, or 2,000-3,000 clinical hours.
  • Virginia’s mandated practice agreement requirement ties NP practice to a specific physician and healthcare setting. This impedes an NP’s ability to provide care where it is most needed, especially in rural and underserved areas where physician shortages are even greater than in urban areas.
  • Changing Virginia’s transition to practice requirement aligns the Commonwealth with the majority of states, the Virginia Board of Nursing’s recommendation and the National Consensus Model for Advanced Practice Nursing Licensure, which recommends that all APRNs are granted full practice authority upon graduation of an accredited program. The national model also recommends regulating APRNs solely under the Board of Nursing.
  • Virginia’s 5-year transition to practice requirement was passed in 2018. There have been significant changes in health care since that time including increasing provider shortages, a growing aging population and a greater number of patients with chronic diseases.
  • Nearly 100 million Americans currently lack adequate access to primary care. By 2030, it is estimated the U.S. will face shortages of more than 120,000 providers needed to address patient demand. NPs can help fill the gap to provide this care.

2023 Virginia General Assembly

VCNP worked with Delegate Roxann Robinson to introduce HB 2183. During the January 19 House Health, Welfare & Institutions subcommittee meeting, House Bill 2183 failed to move forward after a tie vote.

2022 Virginia General Assembly

VCNP worked with Delegate Dawn Adams to introduce HB 1245. The bill failed after going into “conference” (a small group of House and Senate members who meet to reconcile differences between each chamber), but they were unable to come to an agreement. As of July 1, 2022 the sunset clause from HB 1737 ended, and NPs returned to the five-year experience requirement to apply for autonomous practice licensure.

2021 Virginia General Assembly

On February 25, Governor Northam signed HB 1737, which became effective July 1, 2021. HB 1737 reduced from five to two the number of years of full-time clinical experience a nurse practitioner must have to be eligible to practice without a written or electronic practice agreement. This legislation had a “sunset” clause and expired in June 2022.

2020 Executive Order 57

In April 2020, Executive Order 57 allowed NPs with 2 years of experience to practice without a practice agreement during the COVID-19 state of emergency.

2019 Virginia General Assembly

Virginia HB 1640 and SB 1178 ensure that NPs are able to bill insurance directly through their National Provider Identifier (NPI) numbers. Without this simple code change, patients could lose their access to needed care due to an inability to utilize their insurance.

2018 Virginia General Assembly

HB 793 eliminated the requirement for a practice agreement with a physician for a nurse practitioner (NP) who has completed the equivalent of at least five years of full-time clinical experience and submitted an application attestation for autonomous practice licensure from the physician. NPs meeting this requirement may practice autonomously in the category in which the NP is certified and licensed.

FAQs: Autonomous Practice Licensure & the Attestation Process