As an advanced practice nurse (APRN), it is almost impossible to thrive in Michigan—one of the most restrictive states for NPs. These limits don’t just hold back providers; they hurt the people who needs the most care. I’ve dealt with crime and trauma first hand but usually faced limited resources, in which many people would just give up. Every day, I see how the system fails everyone -and most people can’t relate to the older psych doctors despite their best intentions.
I respect physicians deeply, but we’re in a mental health crisis with far too few psychiatrists or doctors in general, not including the red tape—insurance panels, DEA barriers—that keeps most of the care out of reach. I’ll keep speaking up, not out of anger, but because people are suffering in silence. We need change—real, compassionate, structural change—so that healing is possible for everyone.
Therefore, providers have to continue to speak out and advocate, but MORE strategically. Chat GPT has formatted a great formal way to contact our representatives (below). I’m going through different channels all the time and hopefully others can find creative ways to reach out besides voting. Formulating our laws and policies can take YEARS to manifest, therefore think of being creative from the very beginning via social media, emails, grass roots, etc. For example, in the past I have discussed with local reps about the lack of access and NP restrictions mainly because they usually really don’t know… But how can I be more creative? Well now I am considering sending reps a list of crimes related to insanity in Michigan and how a lack of treatment can cause poor impulse control, mental distress/trauma, substance abuse, and how it’s affecting our quality of life and much more:
Crimes in Michigan Linked to Mental Health or Insanity (2015–2025)
- 2016 – Kalamazoo Uber shootings (Jason Dalton): Six people killed; suspect claimed a mental breakdown and bizarre delusions. Insanity defense considered but later pled guilty.
- 2016 – Berrien County Courthouse shooting (Larry Darnell Gordon): Inmate killed two bailiffs during escape attempt; history of severe mental and substance issues surfaced afterward.
- 2017 – Flint airport stabbing (Amor Ftouhi): Canadian suspect stabbed a police officer; underwent psychiatric evaluation for radicalization and competency.
- 2018 – Lenawee County family homicide (Bradley Miller): Man with documented schizophrenia killed relatives; found not guilty by reason of insanity (NGRI) and committed to a forensic hospital.
- 2019 – Grand Rapids mother–child murder case (Amber Smith): Diagnosed with bipolar disorder and psychosis; pleaded guilty but mentally ill (GBMI).
- 2020 – Battle Creek shooting (William Jones): Former Army veteran with PTSD killed a coworker; experts testified about mental-health deterioration due to untreated trauma.
- 2021 – Oxford High School shooting (Ethan Crumbley): 15-year-old opened fire at school; journal entries and behavior showed deteriorating mental state. Parents also charged for ignoring warning signs.
- 2021 – Detroit serial stabbings (Arthur Williamson): Claimed voices told him to attack; mental evaluations ordered repeatedly to assess competency.
- 2022 – Detroit random killings (Dontae Smith): Killed three people at random; pled guilty but mentally ill, diagnosed with paranoid schizophrenia.
- 2022 – Kent County domestic double homicide (Cristian Lopez): Young man killed parents during psychotic episode; found not guilty by reason of insanity.
- 2023 – Lansing apartment standoff: Suspect fired at police while in mental-health crisis; later committed to a psychiatric facility after competency findings.
- 2024 – Midland County assault (Brien Burton): Assaulted stranger during delusional episode; accepted NGRI plea and transferred to Michigan Center for Forensic Psychiatry.
- 2024 – Detroit police shooting of man in crisis (Porter Burke case): Fatal encounter sparked protests and reform calls around crisis-intervention response for mentally ill individuals.
- 2025 – The most recent includes Grand Blanc Township church attack and a Nanny charged in murder of child’s grandfather at Royal Oak home
In addition to Michigan, I’m keeping an eye on other states facing similar barriers. The South and East Coast continue to struggle, and while the West is more progressive, it’s still restrictive in its own ways. This post was also inspired by a friend (who received an alert from MANA) and urged me to write to legislators about Michigan’s House Bill 4399. I initially thought nothing could move forward during this government shutdown—but then I thought well advocacy doesn’t have to stop just because Congress does. We can still flood their email, vote, or make noise! The fight for better healthcare access should never stop—so keep fighting (for your own state and others).
About the House Bill 4399 (2025)
What the bill does? House Bill 4399 would amend Michigan’s Public Health Code to broaden the scope of practice for advanced practice registered nurses (APRNs) who hold nurse practitioner specialty certifications. If enacted, NPs would be authorized to perform comprehensive assessments, diagnose and treat acute and chronic conditions, order and interpret labs and imaging, prescribe medications (including controlled substances under specified conditions), and otherwise practice in their certified specialty area without a required supervisory/collaboration agreement with a physician.
Why it matters? Proponents say full practice authority (FPA) will increase access to primary and specialty care — especially in rural and underserved communities — and let highly trained NPs deliver the full spectrum of services they were educated for. Opponents (including some physician groups) argue the change removes safeguards and that post-graduate experience and collaborative oversight improve patient safety.
Where the bill stands (status snapshot)? HB 4399 was introduced in the Michigan House on April 29, 2025 and was referred to the House Health Policy Committee. The bill has had committee hearings and actions in 2025 and was reported with recommendations as it moved through the legislative process.
How to contact lawmakers about HB 4399 — what to do right now?
If you want to support (or respectfully oppose) HB 4399, the fastest routes are:
- Contact your state Representative — tell them you are a constituent and whether you support or oppose HB 4399. Find your representative and contact form at the Michigan House site (enter your address).
- Contact the bill sponsor — Rep. Dave Prestin is the primary sponsor; contacting the sponsor’s office is a direct way to register support or feedback.
- Contact the House Health Policy Committee chair — committee members hear testimony and vote on referral recommendations; chair contact is important for timing and hearings.
- Send a short, personal message (draft below) by email or call the offices listed on the Michigan House directory and on your representative’s official page.
Sample email (but PERSONALIZE IT)
Subject: Please support full practice authority for NPs — HB 4399
Dear Representative [Last name],
My name is [Your name]; I live in [Town], MI (House District [#]). I’m writing to ask you to support House Bill 4399, which would grant full practice authority to nurse practitioners who hold an NP specialty certification.
As an [NP/patient/primary care consumer/health-care worker], I believe this bill will expand access to care in [your area/describe need], reduce wait times, and improve care for underserved communities. I respectfully ask you to vote yes on HB 4399 and to support policies that maximize the role of NPs in Michigan’s health care system.
Thank you for your time. Please let me know if you would like additional information or data about NP outcomes and patient access.
Sincerely,
[Your name]
[Address — street, city, zip]
[Phone] | [Email]
Simple phone script (60 seconds): “Hello — my name is [Name], I’m a constituent from [Town]. I’m calling to ask Representative [Last] to support HB 4399 (full practice authority for nurse practitioners). I’m concerned about access to care in our area and believe this bill will help. Thank you for passing my message to the Representative.”
Want a shorter social/post message? Use: “I support HB 4399 (FPA for NPs). It will expand access to care in MI—please vote yes. #HB4399 #FullPracticeMI”
Here are key email contacts you can use to reach out about House Bill 4399:
- Primary sponsor: Dave Prestin, Rep. (R-108) — DavePrestin@house.mi.gov (MichiganVotes)
- General contact for the Michigan House of Representatives: BusinessOffice@house.mi.gov (Michigan House of Representatives)
- Contact for the House Health Policy Committee (which handles HB 4399): Committee@house.mi.gov (Michigan House of Representatives)
TO THOSE WHO DISAGREE
Be aware of the opposition even among those you work with, including physicians who may act as gatekeepers. Stay polite toward those who disagree, but don’t waste energy arguing—focus your efforts on formal, effective actions that create real impact. Here are some of the key organizations and agencies opposing House Bill 4399 (HB 4399) in Michigan — along with how to contact them:
⚠️Major Opponents & Their Contact Info
Michigan State Medical Society (MSMS)
- Position: Strongly opposed. MSMS states the bill “jeopardizes patient safety” by removing physicians from the care team. (Michigan State Medical Society)
- Contact: They use a general form, but one public email is for the House Health Policy Committee Clerk which MSMS suggests using to submit opposition: hcrawley@house.mi.gov (Michigan State Medical Society)
- Also general contact email / form for MSMS: Through their “Contact Us” page. (Michigan State Medical Society)
Michigan Academy of Family Physicians (MAFP)
- Position: Opposed. MAFP wrote a piece titled “Protect Physician-Led Care: Take Action and Oppose HB 4399…” noting the risks to care quality, access and patient outcomes. (Mafp)
- Contact: They list a specific email for questions: (Chief Executive Officer) Karlene Ketola, MSA, CAE at [email protected] according to their article. (Mafp)
- Note: The actual email address appears truncated in the article; you may need to go to their website for the full address.
📝 How to Use This Info
- If you or your readers oppose HB 4399, you can direct them to submit comments to the House Health Policy Committee via the contact email hcrawley@house.mi.gov (as MSMS recommends) to formally register opposition.
- You could also encourage readers to contact MSMS or MAFP directly if they want to coordinate or align with organized advocacy efforts.
- When messaging these groups, you might write something like:
“I’m a [NP/physician/health-care professional/resident] in Michigan concerned that HB 4399 will reduce care coordination and patient safety. I’d like to support your work in opposing this bill. Please let me know how I can help.”
A full list of all stakeholder organizations for and against HB 4399 (including smaller specialty groups, rural health associations, NP associations) with direct contact emails and links:
| Organization | Position & Key Messaging | Contact Email / Info |
|---|---|---|
| Michigan State Medical Society (MSMS) | Opposes HB 4399, citing concerns about patient safety and changes to physician-led care teams. (Michigan State Medical Society) | Recommended contact: hcrawley@house.mi.gov (House Health Policy Committee Clerk) per MSMS action alert. (Michigan State Medical Society) |
| Michigan Academy of Family Physicians (MAFP) | Opposes HB 4399 and the companion SB 268; argues the physician-led model ensures quality care. (Mafp) | Email not explicitly listed in the article; check their website (mafp.com) for contact form. (Mafp) |
| Michigan Academy of Physician Associates (MAPA) | Has expressed concerns about HB 4399’s implications for PAs and the healthcare team structure. (Michigan Academy of Physician Associates) | Their website may list “info@” or contact form (not in the publicly cited article) |
| Other healthcare-provider groups / specialty societies | Some specialty physician groups or care-team associations have voiced caution or opposition (often via coalition statements) | Contact info would need individual lookup (via each organization’s website) |
Here are several useful websites related to the issue of full practice authority (FPA) for advanced practice registered nurses (APRNs) in Michigan:
- Michigan Council of Nurse Practitioners (MICNP) — Full Practice Authority page
- https://micnp.org/page/fullpracticeauthority (MICNP)
- Provides background on Full Practice Authority legislation in Michigan, fact sheets, and advocacy information.
- American Association of Nurse Practitioners (AANP) — Michigan State Practice Environment
- https://www.aanp.org/advocacy/michigan (AANP)
- Overview of NP/ARNP scope of practice in Michigan, regulatory structure, and requirements.
- Website titled Full Practice Authority (by “Mi Patients First”)
- https://www.mipatientsfirst.com/ (Full Practice Authority)
- Advocates for FPA for nurse practitioners in Michigan; gives legislative status, arguments, and how to support.
- Citizens Research Council of Michigan — article on scope of practice expansion for NPs
- https://crcmich.org/expanding-nurse-practitioner-scope-of-practice-deserves-serious-consideration-to-address-primary-care-needs (Citizens Research Council of Michigan)
- Research/policy discussion of how expanded NP/APRN scopes might address primary care shortage in Michigan.
- Michigan Legislature — legal statute pages for APRNs
- Example: Michigan Compiled Laws (MCL) Section 333.17201 (Definitions for APRNs) — https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-333-17201 (Michigan Legislature)
- Statutory foundation for APRNs in Michigan’s Public Health Code.
