NC-SARA and Online Nurse Practitioner Programs: What to Know

“NC-SARA is really about ensuring student access because state authorization outside of SARA is so complicated; almost every state does it differently.”

Jeannie Pauline Yockey-Fine, JD

Standardizing education to ensure a minimum level of quality has been a challenge as the number of institutions offering higher education increases. Over the past decade, institutions have been in the news for scamming students with programs that provide little value and saddle them with costly loans. Thankfully, several public and nonprofit organizations are established to help regulate higher education. 

The Department of Education regulates higher education institutions for numerous reasons. First, it provides some level of assurance to students that their program is legitimate. It also ensures that the program adheres to a standard of education to be eligible for federal student loan dollars.  

Below the Department of Education is each state’s board of higher education. These boards regulate private and public universities and colleges that do business within their state. Requirements for institutions vary from state to state based on the legislation and laws of that state. 

There are numerous accrediting organizations at the regional and national level that also endeavor to standardize education. Accrediting bodies are overseen by the Department of Education and the Commission for Higher Education Accreditation (CHEA). 

However, none of these addressed standardizing distance-based education provided across state lines, which is why the National Council for State Authorization Reciprocity Agreement (NC-SARA) was created. “Schools that are accredited, and have state approval from a SARA state create the opportunity for their nursing programs to be available where a student resides, as long as it is also a SARA state,”  says Jeannie Pauline Yockey-Fine, general counsel and vice president for policy, regulatory affairs, and administration at NC-SARA.

Keep reading to learn about the history of NC-SARA, why it is essential, and the special considerations nurse practitioners should take in choosing a graduate program.

Meet the Expert: Jeannie Pauline Yockey-Fine, JD

Jeannie Pauline Yockey-Fine is the general counsel and vice president for policy, regulatory affairs, and administration at NC-SARA, where she provides advice, risk analysis, and counsel to the organization. 

With a background in analyzing regulations and licensure issues, Yockey-Fine has worked with prestigious law firms and served as licensure manager at the Florida Department of Education’s Commission for Independent Education. She shares her expertise through presentations, workshops, and co-authored papers. She holds a bachelor’s degree in journalism and a JD from the University of Kansas.

NC-SARA History

With the rise of online education, students began attending school in states where they do not live. Institutions in other states were providing education in states in which they were not permitted to operate. To provide distance education, an institution would have to reach out to a students state’s education board and obtain permission to provide education in that state. They would have to ensure they met the state requirements and submit annual reports. It was a costly and time consuming process.  

To tackle this problem, regional organizations worked to standardize online education standards within their member states. The Western Interstate Commission for Higher Education, Midwestern Higher Education Compact, New England Board of Higher Education, and Southern Regional Education Board all endeavored to find a solution. In 2013, thanks to a grant from the Lumina Foundation, NC-SARA was founded. Currently, 49 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands are SARA members. “NC-SARA is really about ensuring student access because state authorization outside of SARA is so complicated; almost every state does it differently,” says Yockey-Fine. 

These standardized reciprocity agreements benefit students and institutions alike. Students have access to a wider variety of educational programs and institutions can offer their programs all over the country. Currently, California is the only state not participating in SARA. Critics in the state cite concerns that SARA does not have enough consumer protections in place for it to be a program the state should adopt. 

Once states have joined SARA, institutions apply to their relevant regional education compact. To be eligible, institutions must hold accreditation by an accrediting body recognized by the Department of Education and whose accreditation includes distance education.

While the hard work of onboarding states has been completed for the most part, the dedicated staff at NC-SARA are constantly working on improvements. “There are over 2,400 institutions in SARA, so there is lots of work. We have a new policy modification process that started in January of this year, where people can put in ideas for policy change. It is then vetted through all four regional compacts and ultimately, once all four have voted on them, the NC-SARA board votes on them,” shares Yockey-Fine. “After this last board meeting, we will now have five new policies, some of which are very consumer protection oriented, such as language that makes it very clear if you are a SARA institution, you can’t use binding arbitration agreements.”

Why SARA Is Important

Here are some of the top reasons why SARA is important:

More Access to Education

Distance education allows students access to more degree options. Prior to the establishment of NC-SARA and states joining the compact, each institution had to manage its own cross-state authorization. “You had one person at each school trying to manage their institution’s compliance in 50 states. Many schools opted just to get authorized in their neighboring states because it was easier to keep track of bordering states and teaching across the nation was too difficult,” explains Yockey-Fine. 

“Who that really hurt was students in states that don’t have as large a population and may not have access to certain programs. They might live in Montana, and want to take a program from Florida. Well, if their university wasn’t authorized, that wasn’t possible. Now, with SARA, that isn’t the case.” 


All member states and participating institutions must meet the same standard with SARA: “If your state’s a member and your institution is accredited and has home state approval to participate in SARA, that is enough. All the states are in agreement,” says Yockey-Fine. “We will not make you jump through other hoops because we have faith in your state. Ultimately, it is relying on the state and relying on the accreditor. Which, when you think about it, is a big deal.”

Consumer and Student Protection

One of the primary benefits of SARA is that it provides additional consumer and student protection. “Institutions have to be licensed in their home state, and then on top of that, they have to be SARA approved, which requires accreditation,” says Yockey-Fine. “Our minimum standard is higher than many states, and we have 11  consumer protection areas that institutions must adhere to.” 

These protections play out in many different ways but are most apparent when an institution has to close. “When a school has to close, they have to follow accreditation, state, and SARA rules. We had a fairly large institution that closed about a year and a half ago, and because of SARA, they had a very orderly closure. All those students were taught out at other institutions and able to get their degrees, fully accredited,” she shares.

Considerations for Online NP Students

Students pursuing degrees with state governing boards, such as education, nursing, and psychology, must ensure that the program they are pursuing meets their state’s board licensing requirements. These requirements can vary from other educational standards, including SARA status. 

“Programs for careers that require a license step outside of SARA jurisdiction. If you are looking at a SARA institution, you don’t have to worry about studying in Tennessee and if the program happens to be in Georgia. But that’s where SARA ends,” explains Yockey-Fine. “Whether or not a program meets requirements for state licensure is up to the Board of Nursing in that state.”

Simply put, a state’s SARA status does not mean the program will meet a student’s state of residence board of nursing requirements. 

Aspiring nurse practitioners who wish to enroll in an online degree program will need to check with the program to ensure it meets their state’s requirements. This is often referred to as “state authorization.” Many institutions have gone through the lengthy and expensive process of registering with other state’s nursing boards so that distance education students may complete their program as a step towards licensure. 

When applying for an online nurse practitioner program in another state, students should ensure that the program they are considering meets local state nursing board requirements. Most schools detail their state authorization on their website. See below for examples.

State Authorization Examples in Online NP Programs

Here are five schools, some that participate in SARA and some that do not, that offer online nurse practitioner programs. 

Duke University – School of Nursing

The board of nursing authorizes the master’s of science in nursing (MSN) at Duke in most states and is a SARA institution. Only students in Alabama, Louisiana, North Dakota, Wyoming, and New York are not eligible. Tied for fourth in the nation by US News & World Report, this program offers eight different advanced nursing programs and seven specialty certificates.  

Washburn University – School of Nursing

Students from all but six states can pursue their online doctor of nursing practice (DNP) degree at Washburn University as it is SARA school and has agreements or exemptions from nursing boards across the country. This program places a strong emphasis on entrepreneurship and students can take MBA courses as part of their nursing studies. Students who graduate from this course are not only well trained medical professionals but also strong leaders with the skills necessary to thrive in the rapidly changing medical field. 

Samuel Merritt University – School of Nursing

With low tuition rates, this fully online master’s of science in nursing (MSN) can be completed in just 20 months. Samuel Merritt offers students an outstanding program that teaches students the clinical knowledge they need to become a family nurse practitioner. Since this school is located in California, they currently cannot participate in SARA. 

However, they have reciprocity agreements for students who reside in Arizona, California, Colorado, Illinois, Nevada, Ohio, Texas, and Virginia. Samuel Merritt also meets those state’s board of nursing requirements. 

Columbus State University – School of Nursing

The family nurse practitioner online degree program at Columbus State University is designed for registered nurses who hold a bachelor’s of science in nursing (BSN). Students attending full-time can complete this program in as little as two years. Practicums are completed in the student’s own area so there is no need to travel. 

This SARA program is currently not available to students in Arizona, Colorado, Idaho, Louisiana, Minnesota, Missouri, Nebraska, New York, North Dakota, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, or Washington. 

University of Southern Indiana – College of Nursing and Health Profession

Students nationwide can pursue an online family nurse practitioner degree at the University of Southern Indiana. This flexible program trains students to care for patients and families through a rigorous 42 credit-hours and 665 clinical hours. USI is a SARA school. They have also developed an agreement with California so students who reside there may also pursue their online degrees at USI.

Kimmy Gustafson

Kimmy Gustafson


Among her many diverse writing endeavors, Kimmy Gustafson has also lent her expertise to since 2020, providing insightful and engaging content about the significant role of education in shaping our future generations of nurse practitioners. Many of her pieces include interviewing experts on timely topics such as healthcare workplace violence and moral distress.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.