I am writing to endorse the inclusion of clinical nurses specialists as advanced practice registered nurses in Virginia rules governing nursing practice. This important group of nurse specialists makes a large and very important contribution to the health and well-being of patients and their families throughout our nation. Each state must take action to recognize their status as APRNs to assure their ongoing ability to provide critically important health services. My own state, Iowa, has recognized the CNS as an APRN (called ARNP in our license) for over 10 years and it has proven to be very effective. I urge you to approve this important policy.