Statement for the Record - American Association of Nurse Practitioners - “VA’s Federal Supremacy Initiative: Putting Veterans First?”

Sep 21, 2026

Statement for the Record submitted by the American Association of Nurse Practitioners (AANP) to the House Veterans’ Affairs Subcommittee on Health for the hearing “VA’s Federal Supremacy Initiative: Putting Veterans First?” AANP supports the push for Full Practice Authority (FPA) for nurse anesthetists and urges the VA to implement a process for this policy. The text describes NPs as master’s or doctoral-prepared APRNs providing assessment, diagnosis, treatment management, prescribing, education, and coordination, and argues NPs deliver high-quality, cost-effective, equitable care while addressing disparities for veterans.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Overview

Support for Full Practice Authority

Role of Nurse Practitioners

Impact on Access and Equity

Statement for the Record American Association of Nurse Practitioners “VA’s Federal Supremacy Initiative: Putting Veterans First?” House Committee on Veterans’ Affairs Subcommittee on Health September 22, 2023 The American Association of Nurse Practitioners (AANP) appreciates the opportunity to submit a statement for the record to the House Veterans’ Affairs Subcommittee on Health hearing entitled “VA’s Federal Supremacy Initiative: Putting Veterans First?” AANP represents the more than 355,000 nurse practitioners (NPs) in the United States and is committed to empowering all NPs to advance high-quality, equitable care, while addressing health care disparities through practice, education, advocacy, research, and leadership (PEARL) . 1 For the record, we support our certified registered nurse anesthetist (CRNA) colleagues in their efforts to seek Full Practice Authority (FPA) in the Department of Veterans Affairs (VA) and encourage the VA to move forward with a process to implement this policy. As outlined below, the VA previously authorized NPs to practice to the full extent of their education and clinical training within VA facilities, and this decision has yielded positive results for our nation’s veterans. NPs are advanced practice registered nurses (APRNs) who are prepared at the masters or doctoral level to provide primary, acute, chronic and specialty care to patients of all ages and backgrounds. Daily practice includes assessment; ordering, performing, supervising and interpreting diagnostic and laboratory tests; making diagnoses; initiating and managing treatment including prescribing medication and non-pharmacologic treatments; coordinating care; counseling; and educating patients and their families and communities. NPs currently provide a substantial portion of the high-quality2, cost-effective 3 care that our communities require, including the over 5,000 NPs practicing within VHA facilities.4 NPs are also essential to addressing issues of health equity, as they provide a substantial portion of health care in rural areas and areas of lower socioeconomic and health status.5, 6, 7 NPs practice in nearly every health care setting including VHA facilities, schools and schoolbased clinics, hospitals, Indian Health Services facilities, emergency rooms, urgent care sites, 1 [https://www.aanp.org/advocacy/advocacy-resource/position-statements/commitment-to-addressing-health-care-disparities](https://www.aanp.org/advocacy/advocacy-resource/position-statements/commitment-to-addressing-health-care-disparities)during-covid-19 2 [https://www.aanp.org/images/documents/publications/qualityofpractice.pd](https://www.aanp.org/images/documents/publications/qualityofpractice.pdf)[f](https://www.aanp.org/images/documents/publications/qualityofpractice.pdf). 3 [https://www.aanp.org/images/documents/publications/costeffectiveness.pd](https://www.aanp.org/images/documents/publications/costeffectiveness.pdf)[f](https://www.aanp.org/images/documents/publications/costeffectiveness.pdf). 4 81 Fed. Reg. 90198, 90200. (Based on VHA payroll data from August 31, 2016, the VHA employees 5,444 NPs) . 5 Davis, M. A., Anthopolos, R., Tootoo, J., Titler, M., Bynum, J. P. W., & Shipman, S. A. (2018) . Supply of Healthcare Providers in Relation to County Socioeconomic and Health Status. Journal of General Internal Medicine, 4–6. [https://doi.org/10.1007/s11606-017-4287-4](https://doi.org/10.1007/s11606-017-4287-4) 6Xue, Y., Smith, J. A., & Spetz, J. (2019) . Primary Care Nurse Practitioners and Physicians in Low-Income and Rural Areas, 2010-2016. Journal of the American Medical Association, 321(1), 102–105. [https://jamanetwork.com/journals/jama/fullarticle/2720014](https://jamanetwork.com/journals/jama/fullarticle/2720014) 7Andrilla, C. H. A., Patterson, D. G., Moore, T. E., Coulthard, C., & Larson, E. H. (2018) . Projected Contributions of Nurse Practitioners and Physicians Assistants to Buprenorphine Treatment Services

FAQs

What organization submitted this statement and for what hearing?

The American Association of Nurse Practitioners (AANP) submitted it for the House Veterans’ Affairs Subcommittee on Health hearing titled “VA’s Federal Supremacy Initiative: Putting Veterans First?”

What position does AANP take regarding Full Practice Authority (FPA)?

AANP supports moving forward with a process to implement FPA for certified registered nurse anesthetists within the VA and encourages the VA to continue implementing FPA for NPs broadly across VA facilities.

How does the document define nurse practitioners (NPs) and their scope of care?

NPs are advanced practice registered nurses prepared at the master’s or doctoral level to provide primary, acute, chronic, and specialty care, including assessment, diagnostic and lab test activities, diagnosis, treatment management with prescribing and non-pharmacologic treatments, care coordination, counseling, and patient education.

Sep 21, 2026

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