Interview with Policy Maker Amanda Foster, FNP-C
On March 25, 2025, I had the privilege of interviewing Amanda Foster, FNP-C, a dedicated nurse practitioner working at Neighborhood Outreach Access to Health (NOAH) Community Clinic. Beyond her clinical role, Amanda has been the Secretary of the AANP Arizona Chapter since 2022 and currently serves as Arizona’s interim health policy director. She is also completing her PhD, further solidifying her expertise in healthcare policy and advocacy.
Understanding the Policy Landscape and Challenges
Many states now grant Full Practice Authority (FPA) to nurse practitioners (NPs), allowing them to diagnose patients, manage treatments, and prescribe medications without physician oversight, according to the American Association of Nurse Practitioners (AANP). Arizona is one of 27 states where NPs can practice independently after licensure, while others permit only reduced or restricted practice.
Amanda emphasizes that with so many states now embracing FPA, there is ample evidence demonstrating its benefits for both healthcare professionals and patients. Some key advantages include:
- Improved patient health outcomes
- Reduced healthcare costs
She notes that the Veterans Affairs (VA) system paved the way for this shift. On January 13, 2017, the Department of Veterans Affairs granted Full Practice Authority to Advanced Practice Registered Nurses (APRNs) within the VA—a landmark decision that set a precedent for state-level reforms (VetsHQ, 2017).
Policy Challenges Impacting Full Practice Authority
Ms. Foster highlights a major hurdle to nationwide FPA adoption: each state sets its own Standard of Practice (SOP), creating inconsistency. Additionally, the American Medical Association (AMA) actively lobbies against FPA, fearing NPs might displace physicians—despite no decrease in medical school enrollment caps.
However, lawmakers often support FPA when cost savings are evident, as it lowers healthcare expenses.
Another contentious issue is Compact State Licensure for NPs. While the RN Compact License has been successful, Amanda warns that an NP Compact License could undermine independent practice. The AMA supports this model, which risks revoking NPs’ autonomy and narrowing their scope of practice. For this reason, Amanda, the AANP, and Arizona Nurse Practitioners are actively opposing NP Compact Licensure, advocating in legislative sessions to protect NP independence.
She also raises concerns about potential cuts to Title IX funding under President Trump’s broad program eliminations. Title IX provides critical teaching grants for PhD students, including NPs and nursing educators, cuts that could hinder the future nursing workforce.
Advocacy Approaches: A Humanistic Perspective
Amanda’s advocacy is deeply human-centered. Recognizing that many legislators are privileged healthcare consumers, she brings real patient stories, particularly from low-income communities—to the forefront of policy discussions.
Recently, she participated in a Town Hall with Democrats Mark Kelly and Ruben Gallego, opposing an $800 billion cut to Arizona Health Care Cost Containment System (AHCCCS) funding, which would devastate foster children, elderly care recipients, and other vulnerable populations. She is also lobbying against Republican David Schweikert, urging lawmakers to protect essential services for the needy, calling such cuts "cruelty toward low-income communities."
Amanda doesn’t just speak for the people; she listens to them. She gathers community feedback to inform her advocacy in both Arizona and Washington, D.C., ensuring policies reflect real-world needs.
Her efforts have already made history. In 2017, she played a pivotal role in passing Arizona’s SB1336, the landmark legislation granting Full Practice Authority to NPs, proving that persistent, patient-driven advocacy creates lasting change.
References
American Association of Nurse Practitioners, AANP | The American Association of Nurse Practitioners
VetsHQ, 2017. Advanced Practice Registered Nurses Granted Full Practice Authority
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Comments
Hie Mara,
Thank you for this inspiring and informative piece spotlighting Amanda Foster, FNP-C. Her leadership and advocacy for Full Practice Authority (FPA) exemplify the critical role nurse practitioners (NPs) play in shaping a more equitable and accessible healthcare system.
Amanda’s concerns about the proposed NP Compact License resonate deeply. While the RN Compact has improved workforce mobility, the NP Compact as currently proposed could inadvertently limit practice rights in states where NPs now have independence. As noted by Poghosyan et al. (2022), restrictions on scope of practice directly impact patient access to care, especially in rural and underserved areas.
I also applaud Amanda’s efforts to protect Title IX funding. Beyond sports equity, Title IX has quietly become a cornerstone for supporting nursing faculty and PhD candidates through teaching grants—something often overlooked in broader education debates. Continued investment in nursing education is essential to closing provider gaps in primary care (National Academy of Medicine, 2021).
Amanda’s emphasis on patient storytelling in legislative spaces is especially powerful. Research shows that policy decisions are significantly influenced when legislators hear directly from constituents about lived healthcare experiences (Salvador-Carulla et al., 2014). By humanizing policy impacts, Amanda brings a much-needed voice to a system often dominated by abstract data and professional lobbying.
Finally, her instrumental role in passing Arizona’s SB1336 cannot be overstated. Evidence from states that have adopted FPA, like Arizona and Oregon, shows increased access to care without any decline in safety or quality (Kuo et al., 2013). Amanda’s success proves that grassroots advocacy, combined with data and persistence, leads to real change.
Thank you again for highlighting this important conversation. Amanda Foster is an incredible example of what it means to lead with both intellect and heart.
References
Kuo, Y.-F., Loresto Jr., F. L., Rounds, L. R., & Goodwin, J. S. (2013). States with the least restrictive regulations experienced the largest increase in patients seen by nurse practitioners. Health Affairs, 32(7), 1236–1243. https://doi.org/10.1377/hlthaff.2013.0072
National Academy of Medicine. (2021). The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. The National Academies Press. https://doi.org/10.17226/25982
Poghosyan, L., Norful, A. A., & Liu, J. (2022). Nurse practitioner practice environments in primary care and their associations with quality of care. Medical Care, 60(1), 55–62. https://doi.org/10.1097/MLR.0000000000001632
Salvador-Carulla, L., Lukersmith, S., Martin, M., Fernandez, A., & Sullivan, W. (2014). Bridging knowledge, policies and practices across the implementation gap. International Journal of Integrated Care, 14, e015. https://doi.org/10.5334/ijic.1166