By Mamilda Robinson

New Jersey is a state of health care contradictions. We house some of the world’s leading institutions of higher education for health care professionals, yet thousands of residents live in medical care deserts, waiting weeks for basic appointments or traveling miles for mental health support.

The solution to this crisis simply requires the state Legislature to allow advanced practice nurses to work in the full capacity of their education, national certification and license.

Advanced practice nurses provide primary care for up to 35% of New Jersey’s Medicaid beneficiaries and about 30% of Medicare patients. As of early 2026, nearly 1.85 million New Jersey residents live in federally designated primary care health professional shortage areas.

New Jersey law requires advanced practice nurses to have a formal, state‑regulated contract called a collaborative practice agreement with a New Jersey-licensed physician to prescribe or order medications and devices. These mandatory contracts force many such nurses to pay a physician to be their collaborator (which can be an annual expense of up to $50,000 that is passed on to patients). When the physician collaborator relocates to another state or retires, advanced practice nurses must initiate another contract with another physician to maintain their practice.

As with other disciplines, advanced practice nurses bring unique knowledge and skillsets to health care services, and we have a long history of filling the gaps within our health care system, particularly in rural and underserved regions of the nation.

Twenty-seven states, the District of Columbia and two U.S. territories already have adopted full practice authority for advanced practice nurses. These states allow them to practice without a joint protocol. Data from the states that have moved to full practice authority is undeniable. As documented in peer-reviewed studies, these regions have seen improvements in health screening rates, primary care supply and overall quality of care. Advance practice nurses are statistically more likely than physicians to practice in health professional shortage areas. In states that enacted full practice authority, the number of advance practice nurses in rural and underserved communities increased by an average of 30% within the first five years.

How New Jersey loses out

This export of talent harms our state in five distinct ways:

• Stranded patients: In a state facing a mental health and primary care crisis, we are effectively telling highly trained providers they aren’t welcome to serve the communities that need them most.
• Economic brain drain: New Jersey taxpayers fund the education of these professionals, only to see neighboring states reap the tax revenue and clinical benefits when they move to more supportive regulatory environments.
• Provider burnout: Forcing doctoral-educated clinicians into professional subordination has no basis in clinical outcomes and prevents advanced practice nurses from fully contributing to their interprofessional teams.
• The faculty shortage: New Jersey is struggling to recruit top-tier nurse educators.
• Loss of educational funding: Funders and foundations are increasingly shifting their scholarship dollars and grants to states with full practice authority, viewing New Jersey’s outdated legislation as a poor investment for the future of the nursing workforce.

There’s a solution for New Jersey

A solution is on the table: Senate Bill 2996 would permanently eliminate restrictive joint protocol requirements for experienced advanced practice nurses who have completed two years or 2,400 hours of practice. This isn’t a radical experiment. It’s a model to expand health care access without increasing taxpayer costs.

We are living on borrowed time. While Gov. Mikie Sherrill’s Executive Order 13 temporarily extended the waiver on these restrictions, that protection expires on April 2.

If the Legislature fails to act, we will see an immediate, disruptive return to the old system. Community clinics will be forced to pause services or close their doors and our newest graduates will have yet another reason to look for work in cities and states such as New York or Delaware instead of Newark or Trenton.

We cannot continue to patch a broken system with temporary orders. New Jersey needs Senate Bill 2996 before the April deadline.

It’s time to stop treating our most highly trained nurses like temporary guests and start treating them as essential pillars of New Jersey’s health care future.

Mamilda Robinson is clinical assistant professor and director of the psychiatric-mental health nurse practitioner program at Rutgers School of Nursing.

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This Opinion article was published on 3-25-26 on app.com