Representative Preston spoke to the committee in support of his substitute to House Bill 43 99, saying the bill is intended to address the state's shortages in primary care and expand access in rural and underserved communities. Preston described nurse practitioners as "rigorously educated, clinically trained, and already deliver high quality cost effective care nationwide in states with full practice authority."

Preston said the substitute strengthens the bill to "phase[] out of the contract process once they complete a thousand collaborative hours" and to add continuing-education requirements "on subjects relating to pharmacology, therapeutics, and prescribing" to ensure mentorship during the transition to full practice authority. He noted a federal notice of funding opportunity for a Rural Health Transformation Program, described in testimony as a "$50,000,000,000" program, and said the federal rubric awards 100 points to states that have full practice authority. Preston argued the substitute "represents a balanced evidence based approach and good steps forward."

The committee adopted the H-1 substitute by roll call (14 yays, 0 nays). Representative Tisdale moved to report House Bill 43 99 as substituted with recommendation and to refer the bill to Rules; the roll call on that motion recorded 12 yays, 1 nay, 1 pass and the bill was referred to Rules.