The Association of Oklahoma Nurse Practitioners (AONP) is a statewide professional association. The organization not only focuses on the everyday needs of its members, but also advocates for legislation to improve access to health care and promotes the impact of nurse practitioners (NPs) in Oklahoma.

An NP is a registered nurse who is prepared through advanced education and clinical training to provide a wide range of preventive and health care services to individuals of all ages. NPs have a graduate-level education, either a master’s degree or a doctoral degree, and are highly qualified, comprehensive health care providers.

The opinion piece authored by Landon Hise, but written by Koch Communications, for AONP aimed to increase support for House Bill 2841. This piece of legislation would have allowed NPs to practice without a collaborative agreement with a supervising physician, increasing access to health care for all Oklahomans.

As the administrator of Cordell Memorial Hospital, Hise was in a unique position to speak about the impact this measure would have for hospitals and on health care access in rural areas of Oklahoma.


In Oklahoma, NPs must sign a collaborative agreement with a supervising physician in order to prescribe medications. Without the ability to prescribe medications, it would be impossible for NPs to practice. In many instances, these physicians provide little or no oversight of the NP. Additionally, the regulation is costly — many NPs pay physicians several thousand dollars each year for their signature. This creates a barrier that limits Oklahomans’ access to quality health care.

Twenty-one states and the District of Columbia offer NPs full practice authority. Oklahoma is one of 12 states that require a physician to have paid agreements with NPs. Seventeen states have laws that fall between restricted practice and full practice authority for NPs.

During the 2016 legislative session, a bill was introduced which would have repealed this regulatory limitation. By allowing NPs to practice at the full scope of their capabilities, Oklahoma would have an opportunity to increase access to affordable health care throughout the state, particularly in rural areas, improve public health, and offer consumers the freedom to make the health choices that are right for them and their families.


AONP wanted to raise awareness of the limited practice of NPs across the state. The Oklahoma State Department of Health publishes information annually about the health care workforce in Oklahoma, as well as information about medically underserved areas in the state. These reports were used to illustrate the scope of the problem with hard data and relevant figures.

The American Association of Nurse Practitioners (AANP) provides information about the regulatory environment of each state. This information was used to demonstrate that full practice authority is not a radical idea and has already been enacted into law in 21 states and the District of Columbia.

Finally, an interview with Landon Hise revealed his thoughts on the issue and provided personal anecdotes to support the objective. For example, Hise mentioned he had been trying for 18 months to hire a second physician at his hospital without success. In Hise’s rural hospital, NPs are a vital part of providing health care services to his community.

Upon completion of research, Koch Communications drafted the opinion piece. It was reviewed by both the client (AONP) and Mr. Hise. Once edits and changes were made, the piece was distributed to newspapers statewide.


The op-ed was published on major online publications and in several smaller, rural papers. For many readers, this op-ed was likely their first exposure to the issue of NPs and full practice authority.

HB 2841 was assigned to a House committee chaired by a physician who declined to give the measure a hearing. Despite this legislative roadblock, the bill garnered more than 30 co-authors and many legislators were introduced to the issue for the first time.

Though NP groups in other states have succeeded in passing full practice authority legislation, few, if any, succeeded in the first year of their efforts. Because of the Landon Hise op-ed, legislators are more familiar with the issue and the surrounding messaging. Ongoing communications strategy will build on that foundation.

A new bill to allow NPs to practice without a collaborative agreement with a supervising physician, HB 1013, was introduced during the 2017 legislative session, and is currently being reviewed. An editorial about the bill was recently published in The Oklahoman. You can read the editorial here.