As a Board Certified (by ANCC) CNS in Virginia, I support the Virginia Clinical Nurse Specialist organization (VaCNS)  petition to the Virginia State Board of Health requesting a review of the regulations regarding CNS practice in Virginia. The ever increasing population of older adults and the uninsured demands that all nurses with advance degress be allowed to practice to the full extent of their education. The recent release of the Institutes of Medicine's Future of Nursing addresses these issues. CNS's should be granted Advance Practice Licensure consistent with ANCC recommendations.