SAVE US FROM DROWNING

To: The Honorable Mikie Sherrill

Governor of the State of New Jersey
Office of the Governor
State House
Trenton, NJ 08625

RE: Immediate Executive Review Requested – Executive Order 415, APN Practice Restrictions, and the February 16, 2026, Deadline

Governor Sherrill,

Congratulations on assuming office as Governor of New Jersey. I am writing to request your immediate review and emergency action concerning the sudden implementation of Advanced Practice Nurse (APN) practice restrictions triggered by Executive Order No. 415, signed by Governor Murphy on January 16, 2026, which sunsets the COVID-era emergency flexibilities effective February 16, 2026, at 5:00 PM.

I am writing this letter on behalf of IVs by the Seas and on behalf of every other APN-run practice and business operating across the great State of New Jersey—many of which have served their communities faithfully for years and now face an abrupt and destabilizing compliance deadline.

As a result, APNs who have operated under full-practice-type autonomy for the past five years are now facing a forced restructuring with only 30 days’ notice—with no permanent reform enacted, no transition plan, and no protection for small independent practices.

The reality this creates is unacceptable

Many APN-owned practices have been successfully operating for five years or more, built from scratch through personal risk, loans, leases, staffing, equipment, compliance programs, and long-term patient relationships.

Yet today, these practices are being told—effectively—that within 30 days they must either:
• close,
• downsize,
• sell, or
• give up majority ownership and financial control of what they built in order to meet supervisory/structural requirements.

Governor Sherrill, this is not a regulatory adjustment. For many women-owned and minority-owned small practices, it is an economic displacement event.

Women-owned business impact

It is widely reported that approximately 89% of the affected independent APN practices are owned and operated by women. Even if the underlying policy language is framed as “neutral,” the real-world impact is anything but.

That raises serious questions that deserve immediate answers:
• What equity review was performed before imposing a 30-day compliance deadline with this level of disproportionate impact on women-owned healthcare businesses?
• What safeguards exist to prevent consolidation of independent healthcare access into fewer hands?
• How does the State justify a timeline so short that it functionally forces the sale or shutdown of lawful, successful healthcare practices?

Patient access is being harmed right now

This is not theoretical. The consequences are already unfolding:
• APNs preparing to leave New Jersey
• APNs leaving clinical practice entirely
• Practice closures and staffing reductions
• Patients losing access to care—especially in underserved areas
• Strain on already overloaded physician offices, urgent care sites, and emergency departments

New Jersey is facing continuing primary care shortages and workforce pressure. This abrupt reversal undermines access, continuity of care, and stability for patients with ongoing needs.

Legislative solution already exists: S2996

Senate Bill S2996 was reintroduced on January 13, 2026, and would restore practice autonomy by eliminating certain restrictions—aligning New Jersey with dozens of other states that have adopted full practice authority models and stabilizing the workforce.

This matter is urgent and requires action before the February 16, 2026 deadline, when the emergency flexibilities formally end and APNs are expected to be fully compliant.

Request for Emergency Executive Action

Governor Sherrill, I respectfully request that your administration take immediate steps to prevent irreversible harm to both communities and small business owners, including:

1) Immediate review of EO 415 impact on APNs

A formal review of the APN-related consequences of EO 415 and any associated guidance or enforcement interpretations.

2) Emergency extension or injunction

A temporary injunction or enforcement pause, OR an executive-backed timeline extension (e.g., 180–365 days) to allow review of EO 415 and its impacts or lawful transition without destroying practices.

3) Immediate public stakeholder meeting

Convene APN for small-practice owners, healthcare access advocates, workforce leaders, and equity stakeholders to document the real-world impact and create a solution that protects patients.

4) Support swift legislative action

Publicly support expedited consideration of S2996 to provide permanent reform and stop preventable harm.

Governor Sherrill, New Jersey should not be in the business of forcing hardworking healthcare entrepreneurs—most of them women—to surrender autonomy, ownership, and financial control of practices they built, with only 30 days to comply.

This situation is correctable, but only with swift action. The February 16 deadline creates an imminent point of harm. I urge your office to intervene immediately.

Respectfully,