Factors Influencing Georgia Legislators' Decision-Making on Nurse Practitioner Scope of Practice

Abstract

The state of Georgia faces challenges in providing access to care, largely due to rural hospital closures and physician shortages. Although nurse practitioners (NPs) could help address Georgia's urgent health care needs, the state remains restrictive with respect to NP scope of practice (SOP). This study examined factors that influence Georgia legislators' decision-making on NP SOP. In June 2016, after the January through March legislative session, a questionnaire was e-mailed to 49 state legislators on the Committees on Health and Human Services in Georgia's House of Representatives and Senate. The questionnaire was adapted from a legislative questionnaire previously used in research on state educational policy. Nine of 49 (18%) Georgia legislators responded. The majority of nine respondents were Republicans having served less than 15 years in the legislature. The number of respondents was approximately equal between Senate and House of Representatives. The respondents rated expert testimony and hearing from constituents as most likely to influence their decision-making on NP SOP. They reported that media and concerns about reelection were least likely to influence their decision-making about NP SOP. Therefore, nurses who aim to influence state policy should consider legislator preferences, such as speaking personally with constituents and receiving expert testimony. In-person communication could enhance interactions with legislators, potentially improving policy outcomes. Future research is necessary and should be conducted by NPs to determine the forms of communication and content in testimony most effective in influencing state lawmakers about NP SOP and examine if results vary by state political or other contexts.