The NCSL Blog


By Sydne Enlund

Scope of Practice logoLawmakers in Kentucky debated the pros and cons of expanding the role of nurse practitioners to address the lack of health care providers in rural areas in their state.  After years of discussion within the medical community and in the legislature, Kentucky landed on a compromise for expanding the scope of practice for nurse practitioners while considering the concerns of local doctors.

After a four-year collaboration with a physician, nurse practitioners in Kentucky can practice independently. This collaboration provides a type of “medical residency” for the nurse practitioner after his or her graduate training.

Just like in Kentucky, state leaders across the country are grappling with different policies related to scope of practice for health care providers.

A new website,, provides policymakers with information on laws that govern the scope of practice for nurse practitioners, physician assistants, dental hygienists and dental therapists across the country.

Different states have different laws regarding scope of practice for health care providers. States define local solutions to local issues surrounding scope of practice policy. Tracking what’s happening around the country is a challenge. This website provides policymakers with an easy reference source.

What Is Scope of Practice?

A health care provider’s scope of practice describes what he or she can do for patients, and how the provider can legally practice his or her profession.

Nurse practitioners, physician assistants, dental hygienists and dental therapists have formal training requirements, and are licensed to practice in a specific state. These practitioners provide care independently or with physician oversight, particularly in rural and underserved areas, to address provider shortages.

What Is Scope of Practice Policy?

State legislators and other state health policymakers consider a broad range of issues related to scope of practice, including health care professionals’ supervision requirements, prescriptive authority and other requirements for practice. Scope of Practice Policy highlights these issues, with information from the states and territories about current legislation affecting scope of practice.

Why Do We Need a Website?

This site provides nonpartisan, unbiased and objective policy information about the scope of practice laws in the 50 states and territories.

State laws change frequently. will be updated regularly to reflect changes in the laws as they are introduced, pending, vetoed or enacted.

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Sydne Enlund is a research analyst in the NCSL Health Program.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.