-
Erin Lee, BSN, RN (Editorial Team / Admin)
Learn more about the best Acute Care Nurse Practitioner (ACNP) programs in Florida as we explore their nuances, including coursework, clinical training, prerequisites, salary expectations, and more. Whether you're a practicing nurse seeking to advance your career, or generally curious about the educational pathway, you've come to the right place.
Best Acute Care Nurse Practitioner Programs in Florida - Online & Campus
The selection of the following nursing schools relies on a comprehensive methodology that includes direct input from our readers, extensive data analysis, and continuous updates to ensure accuracy and relevance. Our team of Data Analysts dedicates over 100 hours weekly to refine our database, incorporating critical criteria like reader surveys, graduation rates, cost of attendance, mode of delivery, admission rates, and more elements valued by our community.
*Tuitions are subject to change based on a student's number of transfer credits, yearly increases, and more. Our rankings are based on the latest college data from the U.S. Department of Education complemented by additional insights from our analysts.
1. University of Miami - Miami, FL
The University of Miami School of Nursing and Health Studies offers an Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) program designed to master acute care nursing. This program provides an excellent educational foundation in advanced practice nursing, coupled with significant clinical and leadership experience. It prepares nurses for leadership roles in caring for patients who are acutely and critically ill across the continuum of acute care services.
AGACNP Program Overview:
-
Program Pathways:
-
MSN AGACNP
- Duration: 5 semesters part-time
- Credit Hours: 37
- Clinical Hours: 616
- Tuition: $45,288 estimated total program cost
-
DNP AGACNP
- Duration: 6 semesters (2 years) full-time plan of study, or 12 semesters (4 years) part-time plan of study
- Credit Hours: 70
- Clinical Hours: 1,176
- Tuition: $94,000 estimated total program cost
-
MSN AGACNP
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Admission Deadlines: Apply annually by December 15th for Spring admission.
Both the MSN and DNP information above are based on entry with a BSN. The University of Miami also provides a post-masters certificate pathway at the cost of $1,500 per credit for MSN-prepared nurses to obtain their AGACNP certification.
Program Highlights:
- Pass Rate: Overall pass rate of 96% for all MSN graduates.
- Certification: Graduates are prepared for the AGNP Acute Care specialty certification examination.
- Clinical Matching: Students are matched to a well-established network of over 200 clinical, nonprofit, and global partner sites.
- Innovative Facilities: Features the S.H.A.R.E.™ Simulation Hospital Advancing Research and Education, a 5-story facility offering on-site, virtual, and extended-reality simulation opportunities.
2. University of Central Florida - Orlando, FL
The University of Central Florida (UCF) offers a hybrid-online AGACNP DNP degree program. This program is designed to prepare nurses for advanced practice in acute care, focusing on adult or gerontology patients with medically complex, stable, and unstable acute, critical, and chronic illnesses. The AGACNP program equips nurses to provide care across a spectrum of settings, from hospitals to sub-acute, ambulatory care, clinics, and home care environments.
DNP AGACNP Program Overview:
- Duration: Full-time (9 semesters); Part-time (12 semesters).
- Credit Hours: 76
- Clinical Hours: 1,080
- Tuition: Estimated total tuition for the program is $28,093.40 (FL residents) and $90,747.80 (non-residents).
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Admission Deadlines: Apply annually by February 1 for Fall admission.
Program Highlights:
- Program Type: Hybrid with intensives twice a year, combining online learning with on-campus sessions.
- Pass Rate: Recent UCF NP graduates obtained 100% pass rate on the national certification exam.
- Curriculum: Focuses on disease prevention, acute and critical care management, based on a strong scientific foundation for practice. It emphasizes evidence-based practice, leadership, organizational analysis, and the analysis of the DNP project.
- Interprofessional Education: Features interprofessional educational events in the College of Nursing's STIM Center with acute care nurse practitioner and athletic training students.
3. University of South Florida - Tampa, FL
The AGACNP program at the University of South Florida (USF) College of Nursing is designed to prepare graduates to provide advanced nursing care for adults who are physiologically unstable, technologically dependent, and/or highly vulnerable to complications. This program is tailored for nurses focusing on acute patient care needs across a continuum of care settings that require frequent monitoring and intervention.
MSN AGACNP Program Overview:
- Credit Hours: 48
- Clinical Hours: 540
- Tuition: $430 per credit hour (FL resident), $877 per credit hour (non-resident)
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Admission Deadlines: Apply annually by July 1st for Fall admission.
Program Highlights:
- Certification: Prepares graduates for the Certification Examination offered by the American Nurses Credentialing Center (ANCC) or the Association of Critical Care Nurses (AACN).
- Curriculum: Includes both didactic and clinical experiences to develop competencies in acute care, as outlined in the Adult-Gerontology Acute Care Nurse Practitioner Competencies (2012).
- Program Plan: Offers a standard plan and course sequence for both part-time and full-time enrollment, with specific sequences determined upon admission.
- Comprehensive Examination: A Master's College of Nursing Comprehensive Examination is required at the end of the program.
4. University of Florida - Gainesville, FL
The University of Florida College of Nursing offers an AGACNP track within its DNP program. This track is meticulously designed to prepare graduates for the independent and collaborative management of young, middle-aged, and older adults from diverse populations who are suffering from acute, critical, or chronic illnesses. The program places a strong emphasis on the stabilization and management of these populations in various high-acuity inpatient settings.
DNP AGACNP Program Overview:
- Duration: A full-time plan of study will take 8 semesters or just over 2 years to complete, and part-time will take 11 semesters or just over 3 years to complete.
- Credit Hours: 76
- Clinical Hours: 1,260
- Tuition: Estimated annual total tuition is $12,740 for FL residents and $30,134 for non-residents.
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Admission Deadlines: Apply annually by February 1st for Fall admission.
For 35 credits and 660 clinical hours, MSN graduates can complete the MSN to DNP program pathway at UF.
Program Highlights:
- Clinical Sites: Availability within the state of Florida, with travel periodically required for structured clinical learning experiences.
- Certification: Graduates are eligible for national certification through the American Nurses Credentialing Center (ANCC) and the American Association of Critical Care Nurses (AACN).
- Experience Requirement: At least one year of critical care experience (ICU/Emergency Department) is preferred for applicants.
- Curriculum Plans: Offers both full-time and part-time track sample curriculum plans, ensuring flexibility to accommodate the needs of diverse student populations.
- Clinical Learning: Individualized clinical learning experiences are arranged in appropriate healthcare settings across Florida, emphasizing supervised and precepted experiences in specialized clinical settings.
5. Jacksonville University - Jacksonville, FL
Jacksonville University's MSN program offers a specialization in AGACNP, designed to elevate nursing careers to advanced practice roles. This program focuses on managing adults with critically complex and acute episodic illnesses experienced in both clinical and hospital settings. Graduates are equipped with advanced diagnostic reasoning skills for analyzing, interpreting, and synthesizing complex concepts in patients with active and ongoing chronic illnesses.
MSN AGACNP Program Overview:
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
Post-graduate AGACNP certificate available for MSN prepared nurses.
Program Highlights:
- Faculty: Taught by experienced, board-certified acute care Nurse Practitioners.
- Clinical Experiences: Includes hospital medicine, ICU, trauma, and various specialties related to the management of acutely ill patients, complemented by live simulation activities.
- Curriculum: Covers MSN core subjects such as Nursing Theory and Research, Organization, Delivery and Policy in Healthcare, Nursing Leadership, and Advanced Roles, Information Systems and Technology for Improved Healthcare, and APRN Core including Advanced Health Assessment, Advanced Pathophysiology, and Advanced Pharmacology.
- AGACNP Courses: Encompass Advanced Role Practicum, Acute Care Nursing I, II, III, Advanced Acute Care Clinical Skills, Advanced Acute Care Discharge Planning and Health Promotion, and Advanced Acute Care Pharmacology.
- Certification: Prepares graduates for the Adult Gerontology Acute Care Nurse Practitioner National Certification Exams through the American Nurses Credentialing Center and the American Association of Critical Care Nurses. Successful completion allows graduates to apply for licensure as an Advanced Practice Registered Nurse in Florida.
6. Nova Southeastern University - Fort Lauderdale, FL
The AGACNP program at Nova Southeastern University (NSU) is designed to advance the careers of nursing professionals by preparing them to provide restorative care for rapidly changing clinical conditions. This program is structured to equip students with the necessary skills and knowledge to manage adults with complex, acute, or chronic illnesses across various care settings.
MSN AGACNP Program Overview:
- Duration: As little as 7 semesters
- Credit Hours: 51
- Clinical Hours: 765
- Tuition: $799 per credit hour
- Accreditation: Commission on Collegiate Nursing Education (CCNE)
- Admission Deadlines: Apply annually by August 1st for fall admission and December 15th for Winter admission.
MSN-prepared nurses can complete the post-graduate certificate AGACNP program, requiring 24-33 credits and 765 clinical hours to complete.
Program Highlights:
- Delivery Options: The program offers a blend of online and on-site coursework at NSU's Palm Beach Regional Campus, providing flexibility for students.
- Clinical Hours: Students are required to complete significant practicum hours, offering hands-on experience in various acute care settings.
- Certification: Graduates are prepared for the Adult Gerontology Acute Care Nurse Practitioner National Certification Exams through the American Nurses Credentialing Center (ANCC) and the American Association of Critical Care Nurses (AACN).
- Faculty Support: Students are guided by experienced, board-certified acute care Nurse Practitioners and have an assigned faculty adviser from start to finish.
- Curriculum: Includes courses such as Health Promotion & Disease Prevention, Advanced Pathophysiology, Advanced Pharmacology, and Advanced Health Assessment, along with specialized AGACNP courses focusing on acute care nursing and advanced acute care clinical skills.
5 Best Online Dual FNP/ACNP Programs
What Is an Acute Care Nurse Practitioner Program?
An ACNP program in Florida is a specialized area of nursing that prepares registered nurses (RNs) to provide advanced nursing care to patients with complex acute, critical, and chronic health conditions. These programs are designed for nurses who wish to focus their practice on patients with acute conditions, often in settings such as hospitals, intensive care units, emergency departments, and specialty clinics. ACNP programs are typically offered at the graduate level, leading to a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP).
The curriculum of an ACNP program combines advanced nursing theory, evidence-based practice, and clinical skills development. It is designed to equip nurse practitioners (NPs) with the knowledge and skills necessary to make complex decisions, perform diagnostic procedures, and manage acute patient care interventions effectively. Graduates of ACNP programs are prepared to work autonomously and in collaboration with other healthcare professionals to provide high-quality care in fast-paced and often high-stakes environments.
Acute Care Nurse Practitioner Coursework
The coursework in an ACNP program covers a broad range of topics essential for the effective management of patients with acute and complex conditions. While specific courses may vary by program, common coursework includes:
- Advanced Pathophysiology: Understanding the physiological processes and changes associated with disease.
- Advanced Pharmacology: Comprehensive study of pharmacological interventions for acute and chronic conditions.
- Advanced Health Assessment: Skills for conducting thorough physical and diagnostic assessments.
- Acute Care Procedures: Techniques for performing emergency and critical care procedures.
- Disease Management: Strategies for managing acute and chronic illnesses across the lifespan.
- Diagnostic Reasoning: Skills for interpreting diagnostic tests and formulating treatment plans.
- Healthcare Policy and Ethics: Examination of ethical and policy issues affecting acute care practice.
- Evidence-Based Practice: Applying research and evidence to clinical decision-making in acute care settings.
Acute Care Nurse Practitioner Clinical Training
Clinical training is a critical component of ACNP programs, providing students with hands-on experience in managing patients with acute conditions. Clinical training includes:
- Clinical Rotations: Supervised rotations in various acute care settings, such as emergency departments, intensive care units, and specialty clinics.
- Patient Management: Experience in assessing, diagnosing, and managing the care of patients with complex acute and chronic conditions.
- Procedural Skills: Training in essential procedures, such as central line insertion, lumbar puncture, and intubation.
- Interprofessional Collaboration: Opportunities to work alongside physicians, pharmacists, and other healthcare professionals in a team-based approach to patient care.
- Case Studies and Simulations: Use of case studies and simulation labs to practice and refine clinical decision-making and procedural skills.
Acute Care Nurse Practitioner Prerequisites & Requirements
ACNP programs in Florida come with several prerequisites and requirements to ensure students are adequately prepared for the rigors and demands of education and practice.
Acute Care Nurse Practitioner Prerequisites
Before applying to an ACNP program, prospective students must typically complete the following prerequisites:
- Bachelor of Science in Nursing (BSN): A BSN degree from an accredited nursing program is usually required. Some programs may offer bridge options for Registered Nurses (RNs) with an associate degree in nursing (ADN).
- RN Licensure: Active and unrestricted RN licensure in Florida or the state where clinical training will be completed.
- Clinical Experience: A specified amount of clinical experience as an RN, often requiring experience in acute care settings such as emergency rooms, intensive care units, or similar environments. The required duration of experience can vary, with many programs requiring one to two years of full-time work.
- Undergraduate Coursework: Completion of specific undergraduate courses with a minimum grade, which may include anatomy and physiology, Microbiology, statistics, and health assessment.
- Letters of Recommendation: Letters from academic faculty or professional supervisors who can attest to the applicant's clinical abilities, professional demeanor, and potential for success in an ACNP program.
- Personal Statement: A written statement of purpose explaining the applicant's interest in acute care nursing, career goals, and reasons for pursuing an ACNP degree.
Acute Care Nurse Practitioner Requirements
Once admitted into an ACNP program, students must meet the following requirements to graduate and become eligible for certification:
- Completion of Coursework: Successful completion of all required coursework, which covers advanced pathophysiology, pharmacology, health assessment, and acute care management, among other topics.
- Clinical Hours: Completion of a minimum number of supervised clinical hours in acute care settings. The exact number of hours required can vary by program but typically ranges from 500 to 800 hours.
- Capstone Project or Thesis: Some programs may require a capstone project or thesis that demonstrates the integration of academic knowledge with clinical practice.
- Certification Exam: Upon program completion, graduates must pass a certification exam specific to acute care nurse practitioners, such as the ACNP-Adult-Gerontology exam offered by the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN).
- State Licensure: Apply for and obtain state licensure as an Acute Care Nurse Practitioner in Florida. Requirements for licensure can vary by state but generally include passing the national certification exam and submitting proof of education and clinical hours.
Acute Care Nurse Practitioner Job Description
Acute Care Nurse Practitioners (ACNPs) specialize in the management of patients facing life-threatening and complex health situations. They play a pivotal role in healthcare settings, delivering urgent care to those in need.
Essential Functions of ACNPs:
- Patient Assessment: ACNPs perform detailed evaluations of patient health status, synthesizing medical history, physical findings, and test results to inform clinical decisions.
- Diagnose & Prescribe: Tasked with the critical role of developing and directing care strategies, ACNPs have the responsibility to prescribe treatment and coordinate various aspects of patient healthcare.
- Interventional Techniques: ACNPs are trained to execute life-saving techniques in critical moments, including the placement of central and arterial lines and the insertion of chest tubes.
- Interdisciplinary Coordination: ACNPs collaborate with a spectrum of healthcare specialists to deliver multi-faceted care that addresses all aspects of a patient's condition.
- Health Literacy Promotion: They take an active role in teaching patients and their support networks about condition management, therapeutic options, and health maintenance.
- Urgent Care Provision: As experts in the rapid evaluation and initiation of care, ACNPs respond with expertise in urgent care and critical care environments.
- Advancement and Research: ACNPs are dedicated to lifelong learning, keeping pace with healthcare innovations, and participating in research and practice improvement activities.
While ACNPs have a broad set of responsibilities, the exact nature of their role can shift according to institutional policies, local laws, and the needs of the populations they serve.
Acute Care Nurse Practitioner Program Costs
Investing in an Acute Care Nurse Practitioner (ACNP) program involves various costs that can vary with each educational institution and the circumstances of the student. Below is an exploration of the potential expenses associated with pursuing an ACNP program:
- Tuition Expenses: The cost of tuition is contingent upon the nature of the institution—public universities often offer lower rates to in-state students, whereas private colleges may have higher, uniform fees irrespective of residency. Out-of-state learners typically incur higher tuition costs at public institutions compared to their in-state counterparts.
- Educational Resources: Expenses here cover textbooks, clinical supplies, and other essential educational materials, which can differ greatly in cost.
- Technology Fees: Online or blended learning formats may require additional financial outlay for tech services, software, and online learning resources.
- Clinical Training Charges: Certain ACNP courses may include additional fees for utilizing clinical labs and specialized equipment.
- Miscellaneous Costs: Students should budget for various other expenses, such as application fees, graduation attire, and other administrative costs.
- Living Expenses: These costs, including accommodation, food, and utilities, are significant, particularly for those who need to work less or move to pursue their studies.
- Certification Fees: Post-graduation, students must budget for the costs associated with certification exams to practice as an ACNP.
It's essential for students to be aware of and plan for these financial aspects as they prepare for their ACNP education and the professional journey that follows.
Acute Care Nurse Practitioner Salary Expectations
The salary of an ACNP can vary widely depending on factors such as geographical location, years of experience, type of practice setting, and level of education and certification.
According to the U.S. Bureau of Labor Statistics (BLS), the average salary for NPs was $124,680 or $59.94 hourly.
The top-paying states were:
- California: $158.130
- New Jersey: $143,250
- Massachusetts: $138,700
- Oregon: $136,250
- Nevada: $136,230
The three top-paying industries for this profession include:
- Home Health Care Services $148,960
- Vocational Rehabilitation Services: $139,640
- Business, Professional, Labor, Political and Similar Organizations: $137,310
Unfortunately, the BLS doesn't specify between NP specialties. However, ZipRecruiter reports that the national average annual salary for ACNPs is $121,877 or $59 per hour.
Are Acute Care Nurse Practitioner Programs Worth It in Florida?
Deciding whether an ACNP program is worth it requires considering its various advantages and disadvantages.
Pros of Acute Care Nurse Practitioner Programs
- Increased Earning Potential: ACNPs generally earn higher salaries than registered nurses due to their advanced skills and responsibilities. In Florida, the demand for specialized nurse practitioners can lead to competitive salaries.
- Expanded Scope of Practice: ACNPs have a broader scope of practice, including diagnosing and managing acute and complex conditions, which allows for a more autonomous role in patient care.
- High Demand: With the aging population and the increasing complexity of healthcare needs, ACNPs are in high demand, especially in critical care, emergency rooms, and specialty clinics across Florida.
- Opportunities for Specialization: ACNP programs offer opportunities to specialize in areas such as cardiology, pulmonology, or critical care, making it possible to focus on areas of personal interest and expertise.
- Professional Satisfaction: Working as an ACNP provides a high level of professional satisfaction due to the significant impact on patient outcomes, especially in life-threatening situations and complex cases.
Cons of Acute Care Nurse Practitioner Programs
- Cost of Education: The cost of ACNP programs can be high, with tuition, books, and fees adding up. Prospective students in Florida must consider the financial investment and potential student loan debt.
- Intensive Study and Clinical Hours: ACNP programs are rigorous and time-consuming, requiring extensive clinical hours on top of coursework, which can be challenging to manage, especially for those working or with other commitments.
- Stressful Work Environments: ACNPs often work in high-stress environments such as ICUs and emergency departments, where the stakes are high, and the hours can be long and unpredictable.
- Licensing and Certification Requirements: After completing an ACNP program, graduates must pass a certification exam and obtain licensure in Florida, which can be a lengthy and sometimes stressful process.
- Continuing Education: To maintain certification and licensure, ACNPs must complete continuing education requirements, which can be time-consuming and sometimes costly.
Acute Care Nurse Practitioner Scope of Practice in Florida
The scope of practice for Nurse Practitioners (NPs) is determined by the regulatory statutes of each state, leading to a spectrum of professional autonomy. In certain areas, NPs enjoy full practice authority, while in others, their practice is subject to physician supervision to varying degrees.
It's imperative for NP aspirants to familiarize themselves with the scope of practice that is unique to each state. It's possible that the educational background provided by some Advanced Practice Registered Nurse (APRN) NP programs may not fulfill the requirements for licensure in certain jurisdictions. Therefore, selecting an educational program that aligns with one's professional objectives requires an in-depth understanding of the regulations of the state where one intends to practice, especially the duties specific to the NP specialization. This strategic approach is vital for ensuring that the chosen educational program matches the professional environment one seeks post-graduation.
For instance, Florida mandates restricted practice for NPs, requiring them to work under physician supervision or in collaboration with a healthcare team throughout their careers. Conversely, states such as Oregon and Washington grant full practice authority. Therefore, if you're studying in a restricted practice state like Florida and intend to work in a state with full practice authority, it's essential to confirm that your program meets the educational prerequisites for autonomous practice.
Key considerations include:
- State Licensure: Each state requires its own specific licensure for NPs, and relocating will necessitate acquiring a new license.
-
Practice Authority Levels: The American Association of Nurse Practitioners (AANP) classifies states into three categories based on the level of NP practice authority:
- Full Practice: States such as Nevada, Montanna, and Maine permit NPs the capacity to evaluate patients, diagnose conditions, initiate treatment plans, and prescribe medications without the need for physician oversight.
- Reduced Practice: States like New Jersey and Ohio offer NPs a degree of autonomy; however, they must adhere to a regulated collaborative agreement with a healthcare provider or work under supervision for certain aspects of practice.
- Restricted Practice: Some states, including Florida, require NPs to engage in a practice that involves continuous supervision or team management by other healthcare providers.
To practice as an NP in a different state from where one was educated, it's essential to thoroughly investigate the specific scope of practice as outlined by that state's Board of Nursing or an equivalent regulatory authority. This understanding is critical for NPs to practice with a clear delineation of their professional capabilities and limitations.
Importance of Picking an Accredited Nurse Practitioner Program in Florida
Choosing an accredited ACNP program in Florida is crucial for several reasons:
- Quality of Education: Accreditation ensures the program meets high standards of quality and rigor set by the accrediting body, providing a comprehensive and relevant curriculum.
- Eligibility for Certification: Graduates from accredited programs are eligible to sit for national certification exams, which are often required for state licensure and employment.
- Licensure Endorsement: Completion of a state board-approved nursing program is a prerequisite for obtaining a license in that specific state. If you intend to practice nursing in a different state, it is typically mandatory for your nursing education to have been obtained through an accredited program to facilitate the endorsement and relocation of your professional license.
- Professional Recognition: Employers prefer or require graduates from accredited programs, recognizing the level of preparation and competence they bring to the role.
- Transferability of Credits: Credits from an accredited program are more likely to be recognized by other institutions, important for those considering further education.
- Financial Aid Eligibility: Only students enrolled in accredited programs are eligible for federal financial aid, scholarships, and grants.
Accrediting bodies include the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN).
Frequently Asked Questions (FAQ)
Q: Can out-of-state students enroll in ACNP programs in Florida?
Out-of-state students can enroll in ACNP programs in Florida, especially those offered online. However, it's important to verify that the program meets the licensure requirements of your home state. Some programs may also offer on-campus components, so consider the logistics of attending these sessions if you're not based in Florida.
Q: What concentrations are available within ACNP programs?
ACNP programs often offer concentrations in areas such as cardiology, pulmonology, critical care, and emergency care. These concentrations allow students to specialize in a specific area of acute care nursing, tailoring their education to their career goals and interests within advanced practice nursing.
Q: What is the minimum GPA requirement for admission into an ACNP program?
Most ACNP programs require a minimum GPA of 3.0 for admission. This requirement applies to both your overall undergraduate GPA and your GPA in upper-division nursing courses. Meeting or exceeding this GPA requirement is crucial for demonstrating your academic readiness for graduate-level study.
Q: How do ACNP programs accommodate working nurses?
Many ACNP programs, especially those offered online, are designed to accommodate working professionals. They may offer flexible scheduling options, including part-time enrollment and courses delivered in seven-week formats or on weekends. This flexibility allows nurses to balance their studies with professional and personal commitments.
Q: What are the licensure and certification steps after completing an ACNP program?
After completing an ACNP program, graduates must pass a national certification exam offered by organizations such as the American Nurses Credentialing Center (ANCC) or the American Association of Critical-Care Nurses (AACN). Once certified, graduates must apply for state licensure as an Acute Care Nurse Practitioner (APRN) in their state of practice, meeting any additional state-specific requirements.