Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences



Major Advisor

Dr. Kathy Hager

Second Advisor

Dr. Kimberly Hawkin

Third Advisor

Dr. Beth Partin

Fourth Advisor

Dr. Ellen Hahn


The purpose of this paper is to describe the policy process of changing current regulations regarding rural health clinics (RHCs). Using Kingdon’s Policy Stream Theory for guidance, the change project was designed to amend current regulations regarding the directorship of the RHCs, consequently allowing Nurse Practitioners (NP) to act as medical directors for rural health clinics (RHCs). This change fulfills the Institute of Medicine’s charge to have nurses work to the highest level of their education, as well as a defined need to fill a gap in the health care system by decreasing rural health disparities. The Rural Health Care Services Act of 1977, or Public Law (PL) 95-210, was created to assist with these health disparities by providing all-inclusive rate funding to health centers in rural areas. With the current physician shortage and a large number of health care provider shortage areas in rural areas, it is necessary to amend PL 95-210 and provide reimbursement for nurse practitioners who reside in states that recognize nurse practitioner autonomy and who wish to operate clinics in these rural, underserved communities.