In yesterday’s episode of TSHL 101, listeners met Viola Hebert, a four‑term member of the Texas Silver‑Haired Legislature whose path into advocacy began nine years ago at a Senior Day event at the State Capitol. A chance encounter with TSHL members sparked her interest, but it was the organization’s mission—amplifying the voices of older Texans—that convinced her to step forward and serve.

Drawing on decades of nursing experience, Viola has become a steady advocate for the state’s rapidly growing older population. She spoke candidly about her motivation: ensuring that older adults, especially those who feel overlooked or unheard, have a place in the policy conversations that shape their daily lives. Her civic‑mindedness, curiosity, and compassion continue to fuel her work both inside and outside TSHL.

Viola’s advocacy extends beyond the Legislature. She has worked closely with the Alzheimer’s Association and understands the challenges of caregiving on a personal level—her own family has walked that journey. She also emphasized the importance of digital literacy for future TSHL candidates, noting that much of today’s legislative work, communication, and research happens online.

A major focus of her recent efforts is the resolution she authored to grant full practice authority (FPA) to Advanced Practice Registered Nurses (APRNs) in Texas. Viola explained that while more than 30,000 nurse practitioners are licensed in the state, their ability to practice is restricted by delegation requirements that tie them to physician oversight. These rules affect everything from billing to clinical independence, placing Texas behind much of the country in healthcare access.

Her concerns are backed by sobering data. Texas is projected to face a shortage of 16,000 primary care physicians by 2036, a gap that will hit rural communities hardest. The state has 172 non‑metropolitan or rural counties, home to 13% of Texas’s older adults. Many of these counties have populations larger than entire states, yet they struggle with limited access to affordable care, too few trained healthcare professionals, and a growing need for geriatric services. The more rural the community, the harder it becomes to find caregivers—whether family members or paid providers. It’s no surprise that Texas ranks 47th in healthcare access, according to U.S. News & World Report.

Viola noted that in states where APRNs have full practice authority, nurse practitioners are more likely to serve in rural and underserved areas. These states have seen stronger workforce recruitment, improved access to primary care, and no decline in quality or safety. Nationally, 76% of APRN graduates specialize in primary care, compared to just 15% of MD/DO graduates—a critical difference for communities struggling to attract physicians.

More than half of U.S. states, along with the Department of Veterans Affairs and all branches of the U.S. military, have already eliminated delegation requirements. Even Texas temporarily lifted these restrictions during the COVID‑19 pandemic. Decades of peer‑reviewed research show that APRNs deliver outcomes comparable to physician‑provided care.

During the conversation, Gary Emmert shared his own positive experience receiving consistent, high‑quality care from a nurse practitioner at the VA. Viola agreed that stories like his reflect a broader truth: nurse practitioners are an essential part of the healthcare workforce, especially in rural Texas.

Looking ahead, Viola plans to introduce a new resolution in the upcoming TSHL session to address practice authority, billing procedures, and the transition‑to‑practice model. Her goal is simple but urgent—ensure that older Texans, no matter where they live, can access the care they need.

As Texas continues to grow and age, advocates like Viola Hebert are working to make sure the state’s policies keep pace with its people.