The Affordable Care Act, which has so far allowed one million new consumers to receive health insurance in New York State, has been a key player in extending the current legislation. In addition, only 44% of New York-trained physicians report practicing in our state, more than 40% intend to visit a specialty and not provide primary care. This convergence of trends and developments would obviously have made it more difficult for many New Yorkers to obtain a primary supply. Can I observe as an independent Np psychiatrist in New York State in a care home without a psychiatrist or other Md? Can be an NP with a WHNP Transhealth diploma after full training and supervised by an MD in NYState Recognizing their advanced education level many professional associations have asked for more flexibility in admitting nursing practitioners for patient care. For example, The Future of Nursing: Leading Change, Advancing Health report in 2010 highlighted the importance of nurses”s ability to “exploit their potential as primary care providers to the full extent of their initial and continuing education” and stated that “restrictions on the scope of the practice… the ability of the carer profession to provide and improve both general and advanced care. Newly certified nurses must submit the New York State Education Department`s (SED) Form 4NP-Verification of Collaborative Agreement and Practice Protocol within 90 days of starting professional practice. The NP is not required to submit additional 4PPs with the SED. A completed 4NP form does not correspond to a common practice agreement. Form 4 NP can be downloaded from the SED website by clicking here. I look forward to the day when the achievements of New York nurses will serve as a model for progressive and ongoing reforms across our country, even as we take additional steps to ensure that our own legal field reflects the important skills, training and training that nurses put on the table.