The Texas Team believes all Texans deserve better care, better health and lower healthcare costs. Nurses – as the largest group of health care providers in the state – are essential to achieving these three goals in Texas. Texas Team members are enthusiastically working to transform nursing and health care in Texas. Please visit our website to learn more about us.



To ensure high-quality patient care nurses need to be better prepared as care becomes more complex and moves into the community. Yet, about 50 percent of Texas nurses hold an associate degree (or diploma) in nursing as their highest degree.  

Learn about the Texas work in Advancing Progression in Nursing - Texas is one of 10 states to be awarded an APIN grant.  Access the APIN website at   www.texasapin.org  to learn how your organization can engage.

Texas is also working to assure the nursing workforce is sufficient to meet the growing population needs of a diverse state.  During 2013 Co-Lead Texas Nurses Association worked collaborative with a variety of stakeholders to achieve continued funding for the Texas Nursing Shortage Reduction Program.  Legislation was passed in May 2013 resulting in $33.75 million dollars being allocated by the legislature to continue growth of Texas Schools of Nursing during the next biennium – this is approximately $3 million more than received last session.  Texas Team served as a partner and two Texas Team leaders provided legislative testimony.  In addition, TCWNS received additional legislative funds and continues to work with the Texas Team in tracking all IOM goals and overall numbers of nurses in the state and provides reports to the legislature.

With over 130 nursing programs statewide, we are fully engaging them in our plan to increase the number of nurses with baccalaureate degrees in nursing.
We are developing a multi-focused statewide model (CABNET) to assist all RN to BSN programs in the state to increase the number of associate degree prepared nurses graduating each year from 1,826 in academic year 2010-2011 to 4,200 in academic year 2013-2014, a 130 percent increase.  A recent Robert Wood Johnson Foundation grant award, will help us achieve this goal, as well as increase the percentage of minority graduates of RN to BSN programs from 45 to 50 percent of the graduates by 2014.  Twenty nursing programs are being recruited to adopt the standardized general education courses and prerequisites established by CABNET and 40 programs to implement the concept based curriculum at the associate and baccalaureate degree levels as well as recommended standardized education courses.  


Texas is expanding leadership ranks to ensure that nurses have voices on management teams, in boardrooms and during policy debates.


Texas Team: Advancing Nursing Leadership Team


The Advancing Nursing Leadership team (Leadership Team) is charged with the development of demonstration strategies designed to meet recommendation number seven cited above.  To meet this recommendation, the Texas Team strategic plan includes the following goals and sub-goals:

  1. Facilitate increased nurse involvement on boards.
    1. Expand leadership opportunities for nurses to lead in board rooms, policy discussions and on management teams.
    2. Identify nurse leaders & advocate for appointment to various boards, commissions, task forces at state and community levels.
  2. Facilitate nurse involvement in innovation designed to improve the care environment.
    1. Develop partnerships with innovative organizations & leaders, both in and outside of health care, that support advancements aimed at improving the nurses work environment.
  3. Facilitate nurse leader mentorship and internships.
    1. Identify resources that enable nurses to identify, mentor and coach current and aspiring nurse leaders.
    2. Encourage leadership organizations (non-nursing) to develop internship & leadership opportunities for nurses & to communicate, educate and publicize the contributions of nurses in advancing the health of Texans.


The members of the Leadership Team represent various aspects of nursing and non-nursing sectors.  The Leadership Team has been assembled to ensure diverse perspectives needed to develop demonstration strategies to meet the identified goals in the previous paragraph.  Each member is asked to commit to approximately 4-6 hours per month with his/her time being divided between the Leadership Team and one of three sub-teams: Board involvement, Innovation, and Mentorship.  The commitment is for a two year term culminating with demonstration of identified strategies.




American Organization of Nurse Executives (AONE). (2012)  Chapter leaders/affiliate members meeting.  AONE Strategic Plan 2013-2015


Future of Nursing: Campaign for Action. (2012). Texas action coalition status report.  Retrieved 12-2-12 from http://campaignforaction.org/sites/default/files/TX-Status-Report-Q22012.pdf.


Institute of Medicine of the National Academies. (2010) The future of nursing: Leading change, advancing health. Retrieved 11/27/2012 from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx.


Robert Wood Johnson (RWJ). (2012). Nine states received grants to build a more highly educated nursing workforce.  Retrieved 12-2-12 from http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2012/08/nine-states-receive-grants-to-build-a-more-highly-educated-nursi.html.





We envision every Texan having access to high-quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success. In many settings, nurses are not able to work to the full extent of their education and training.


We worked with the Perryman Group to produce an economic impact study of the expanded use of advanced practice registered nurses (APRNs). The study found that “greater use of advanced practice registered nurses (APRNs) would generate a total current impact which includes $16.1 billion in total expenditures and $8.0 billion in output (gross product) each year as well as 97,205 permanent jobs in Texas. This economic activity also leads to additional tax receipts and cost savings for governmental entities. The Perryman Group estimates these effects include $483.9 million to the state and $233.2 million to local government entities each year.”  This report layed the ground work for our success in the Texas 2013 Legislature:

Achieved Expansion of Prescriptive Authority for APRNs (SB 406 by Sen. Nelson/Rep.Kolkhorst). Prior to the 2013 session, no legislation making significant changes in APRN prescriptive authority had passed in Texas since 2003. SB 406 eliminates the current site based model and replaces it with a prescriptive agreement model. Under the prescriptive authority agreement model, the APRN and physician have more flexibility to determine what is the appropriate level of physician involvement based on their particular practice, relationship, and experience. While the agreement must meet certain requirements, they are not nearly as prescriptive as current law. The bill increases the number of APRNs to whom a physician may delegate prescriptive authority from four to seven. It replaces the frequent onsite visits by a physician with monthly (and then quarterly) meetings at a location determined by the APRN and physician. The bill eliminates a minimum number of chart reviews and permits practitioners to determine the appropriate number. The bill also eliminates the requirement for the APRN to be located within a certain number of miles of the physician and permits APRNs to prescribe Schedule II controlled substances to hospital inpatients as well as qualified hospice patients. SB 406 requires Medicaid and CHIP to treat APRNs the same asphysicians when assigning clients to a primary care provider.

Interprofessional Collaboration

To ensure high quality, patient-centered care, nurses, physicians and other health professionals must collaborate in education and practice, and across all health care settings.   


We are building partnerships with diverse stakeholders, including physicians and other health providers, to support, spread and implement models of interprofessional collaboration in education and practice.


Texas’ population is becoming increasingly diverse and many residents have unique health care needs. The nursing workforce must evolve to reflect these changing dynamics. 


  The Diversity Plan involves coordinating the active participation of the APIN Diversity Advisory Committee, the Diversity Consultant and eight Diversity Champions to accomplish the following: 1) identify best practices, 2) implement a diversity mentorship program, 3) provide informational sessions to the target population, 4) provide scholarship and RN to BSN program enrollment via website and 5) develop and disseminate a briefing paper on the Diversity initiative. 


Effective deployment of the health care workforce requires information – data to tell us what kind of health providers we will need and with what skills. Yet major gaps exist in the workforce data we now have. 


We are exploring partnerships and examining models from other states to develop a plan for data collection in our state. Once developed, we will work to promote data-driven policy decisions that improve health care for patients and families in Texas.



Dr. Cole Edmonson, Chief Nursing Officer and Vice President, Texas Health Presbyterian Dallas

Cindy Johnson, Vice President, BlueCross BlueShield of Texas

Dr. Cindy Zolnierek, Executive Director Texas Nurses Association

APIN Grant Leaders: 

Dr. Helen Reid, Professor and Provost, Trinty Valley Community College

Dr. Kathryn Tart, Professor and Dean, University of Houston, Victoria

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Texas Team Advancing Health through Nursing - An Action Coalition of the Initiative on the Future of Nursing Coalition Members as of February 28, 2014 is 344 strong. 

Lead Organizations


Blue Cross Blue Shield of Texas – Richardson, TX

Texas Nurses Association – Austin, TX


Founding Sponsors


Associates in Process Improvement – Austin, TX

Decision Critical – Austin, TX

The Perryman Group – Waco, TX

Seton Family of Hospitals – Austin, TX

State Representative Donna Howard – Austin, TX

Texas Center for Nursing Workforce Studies – Austin, TX

Texas Tech University Health Sciences Center – School of Nursing – Lubbock, TX

Texas Tech University Health Sciences Center – Center for Innovation in Nursing Education – Lubbock, TX


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