Proven success

Modernizing how care is delivered is not an untested idea in North Carolina.

During public health emergencies and natural disasters, the state temporarily removed or relaxed restrictive supervision requirements so qualified providers could respond more quickly to patient needs.

These temporary changes were not theoretical exercises. They were real-world tests conducted under the most demanding conditions, when communities needed care urgently and at scale.

Emergency waivers expanded access

During the COVID-19 public health emergency, North Carolina issued emergency waivers that allowed Advanced Practice Registered Nurses to practice with fewer regulatory constraints. These waivers helped expand access to primary, preventive, and acute care during a time of unprecedented demand.

Importantly, these changes did not result in increased complaints, safety concerns or quality issues. Care was delivered efficiently, responsibly and safely.

From temporary to permanent

The question facing policymakers is not whether expanded APRN practice can work in North Carolina, but whether the state should continue relying on emergency exceptions to solve ongoing access challenges.

Making these proven flexibilities permanent would allow North Carolina to strengthen access to care every day—not just during emergencies—while preserving the safeguards patients expect.

Precedent already exists in North Carolina law

North Carolina has already taken steps to modernize certain areas of care delivery. For example, Certified Nurse Midwives have been allowed to practice without physician supervision for years, establishing a clear precedent for responsible modernization.

These changes have been absorbed into the healthcare system without controversy, demonstrating that updating outdated rules can be done safely and effectively.

What these tests prove

Together, these experiences show that modernizing APRN practice authority:

• Expands access quickly when patients need care most
• Maintains patient safety and quality standards
• Strengthens system resilience during crises
• Works within North Carolina’s existing healthcare infrastructure

In other words, North Carolina does not need to guess whether this approach works—it has already seen the results.

Disaster response: Hurricane Helene

When Hurricane Helene disrupted communities and healthcare infrastructure, North Carolina again relied on flexibility to meet patient needs.

APRNs played a critical role in maintaining access to care during recovery efforts—providing services in settings where physician availability was limited and response time mattered.