Geriatric Nurse Practitioner Supply and State Scope-of-Practice Laws

Background: The population of adults aged 65 years or older in the United States has continued to expand, reaching 17% of the total population in 2020. This increase has consequently led to a growing demand for geriatric care and a corresponding need for more geriatric clinicians. Given these demographic trends, it is essential to understand the relationship between state nurse practitioner (NP) scope-of-practice (SOP) laws and geriatric nurse practitioner (GNP) supply. Purpose: To investigate the relationship between SOP laws and GNP supply in the United States. Methods: We constructed a county-level national dataset that included data from 2009 to 2019. We explored trends in SOP laws as well as trends in GNP supply by type of SOP laws. To assess the relationship between state SOP laws and GNP supply, we performed a random effect repeated measures zero-inflated Poisson regression. Results: Twelve states and the District of Columbia had full SOP for NPs in 2009, and 10 additional states adopted full SOP laws for NPs between 2009 and 2019. Although the GNP supply increased nationwide, a considerable proportion of counties did not have any GNPs during the study period. Among counties with any GNPs, we found that states with full SOP laws experienced higher growth in GNP supply during the study period. However, we did not find that adoption of a full SOP law was significantly associated with a decrease in the number of counties without GNPs over time, particularly among small, nonmetropolitan counties. Conclusion: The growing GNP supply is an encouraging trend. Our findings highlight the potential benefits of supportive SOP laws in expanding GNP supply, which can enhance the geriatric workforce and improve access to care for the aging population.