Scope of Practice Laws in Health Care: Rethinking the Role of Nurse Practitioners

Sharon Christian
Catherine Dower


This is archived content; for historical reference only.

Nurse practitioners (NPs) are registered nurses with advanced clinical training who serve as primary care providers in a wide range of acute and outpatient settings. NPs are valuable members of the health care system, but wide variation in scope of practice laws means that their ability to deliver care to patients differs dramatically from state to state.

This issue brief summarizes the results of a national survey of NP scope of practice laws, reviews recent legislative attempts to rework California’s statutes, and discusses opportunities for expanding the state’s use of NPs to address physician shortages and rising health care costs.

The survey finds that California is roughly in the middle of the nationwide range for NP practice autonomy and independence; other states, in contrast, provide NPs with scopes of practice that are far more expansive or restrictive. This lack of consistency can inhibit the uniform expansion of NP services, block NPs from providing medical care for which they are trained, and effectively bar the use of NPs in efforts to improve access and control health care costs.

The complete issue brief is available under Document Downloads. A report by the Center for the Health Professions at the University of California, San Francisco, which contains the full survey results, is available under External Links below.