Policy in Action: 2010 National Nurse Practitioner Summit and Leadership Conference
February 26 – March 1, 2010, Washington DC
The past year has been a rollercoaster from both a financial as well as job market perspective. This years conference was focused on: 1) workforce issues in healthcare reform for Advanced Practice Registered Nurses (APRNs), 2) policy and practice changes needed to be prepared for national health care reform, and 3) development of strategies to effect positive policy changes.
On behalf of ASMNP Kathy Casey, Deb McCauley and Kerry Stoick attended this meeting in Washington. The speakers were well informed and passionate about the importance of legislation that is inclusive of Nurse Practitioners as Primary Care Providers. To that end, the final day was spent on Capitol Hill. We met with our respective House and Senate Representatives. Kathy, Deb and Kerry met with the Legislative Assistants for Tim Walz, Al Franken and Amy Klobuchar to gain their support in: 1) inclusion of NPs in any legislation or any newly created or expanded emerging models of care, 2) recognizing Nurse Practitioners as Primary Care Providers in any health care reform initiative, 3) cosponsoring the Health Care Planning Improvement Act which would allow Nurse Practitioners to order home health, and 3) cosponsoring Senate Bill 63 – The Medicaid Advanced Practice Nurse and Physician Assistants Access Act of 2009, supporting the patients’ full access to NPs by ensuring that third party payment for care provided by nurse practitioners is integrated into Medicaid.
We also asked for enhanced funding towards the Nurse Reinvestment Act.
We all have a roll in advocating for our profession. You can advocate by talking to your patients about health care reform, patient access to care and cost containment. You can also talk to your state and national representatives. Accessing them is not as hard as you think. Follow the Policy/Advocacy “Get Involved” link on the ACNP website @ www.acnpweb.org and put in your zip code. You will see the name of all your representatives and you can email them from there. If you have any questions or need help, please contact Kathy Casey or Kerry Stoick for more information.
Legislative Update January 2010
Minnesota APRN Legislative Steering Committee:
Next Meeting February 15
Open to all to attend: Only board members voting
Contact: Kerry Stoick, FNP stoick.kerry@mayo.edu
ASMNP Representatives: Kerry Stoick and Kathy Casey
Steering Committee Action Plan 2010: Educate your Representative
We need to do this before we can move forward with removing the collaborative practice agreement and the prescriptive written agreement. This year we will create a strategic plan to educate our representatives, and keep what we currently have in place for our practice. Watching all efforts of the organized groups such as AMA, who are actively trying to dominate and take privileges away (like reimbursement and oversight of the BoN, Board of Nursing).
APRN Day on the Hill: February 23, 2010
Debriefing session February 22, 2010 5:30-6:30 Panera South
(Contact Kerry Stoick to register ASAP) 507-251-8301 or stoick.kerry@mayo.edu
Schwartz Bill Announcement
American Academy of Nurse Practitioners Endorses Major New Bill to Improve Health Care. The Preserving Patient Access to Primary Care Act of 2009 (HR 2350) addresses the critical shortage of primary care providers in the U.S. today. The bill is a nurse practitioner inclusive bill that provides for scholarships, loans, incentive payments, medical home support and primary care services evaluation for nurse practitioners as well as primary care physicians. The bill also calls for the elimination of barriers to access preventive health care. For further information, contact the AANP Office of Health Policy dcoffice@aanp.org
American College of Nurse Practitioners National Legislative and Leadership Summit, Washington, DC
February 20 -23, 2009
By: Kerry Stoick
ASMNP Legislative Chair
My trip to the ACNP National Legislative and Leadership Summit in Washington DC was an amazing experience. I represented our regional ASMNP group and had the opportunity to meet with leaders from the other state affiliates. The ACNP group works especially hard to advance legislative issues and to collaborate with the other large NP groups (NAPNAP, AANP, ACNP, FAANP). Recently, these groups have come together to prepare a position statement which presents a united voice regarding advance practice issues. THIS IS A HUGE STEP!
The ACNP board of directors is an outstanding group of leaders and accomplished Advanced Practice Nurses. They were not only impressive with their achievements for our practice; they were amazing hosts for this event.
Kerry Stoick, FNP, is pictured with Thad Wilson, FNP, PHD. Mr. Wilson is the current president of the American College of Nurse Practitioners (ACNP)
Washington D.C., February 2009,
Kerry Stoick, FNP, (center) is pictured with NPs Representing Wyoming (left) Martha S. and Alaska (right) Susan R. Both of these individuals are current ACNP board members. Washington D.C., February 2009.
Current MN Legislative Issues:
Please familiarize yourself with these bills.
House of Representatives
H. R. 6826: To amend title XVIII of the Social Security Act to ensure more timely access to home health services for Medicare beneficiaries under the Medicare Program.
Nurse Practitioners must be identified in the language in order to be able to order Home Health Care. The bill originally contained Physician-only language and left NPs out.
H.R. 1668
Senate
S. 1678 To Amend title XVIII of the Social Security Act to ensure more timely access to home health services for Medicare beneficiaries under the Medicare Program.
The language of the bill needs to specifically identify Nurse Practitioners.
S. 63 “Medicaid Advanced Practice Nurses and Physician Assistants Access Act 2009”.
This bill would amend title XIX of the Social Security Act to improve access to NPs.
Other third payer programs typically follow Medicaid’s lead for payment.
Key Points: FYI
- The PCPCC (Patient Centered Primary Care Collaborative) advances arguments for identifying the physician as “the center” of primary care, without any input or involvement from APRNs or PAs. This assumes Physician provided care is best, assumes the MDs are the best providers, and excludes other provider care models.
MDs are AT the TABLES where the decisions are being made!!
But…………. Only 7% of MDs are going into Primary Care while 50% of NPs are Primary Care Providers. Why are we not at this group’s round table and involved in the discussions??
- What is a PAC? Ok, I did not know this either. It is a Political Action Committee. This is how we get heard. Organized medicine’s members donate to their PACs to get their opinions heard; we have to do it too. Consider a Cash Donation.
- 46.5 Million are uninsured (Keep in mind that many of these individuals are working adults.)
What has Congress Done? (2008-2009)
#1 February 4th, signed into law the Children’s Health Insurance Program (CHIP).
#2 Health Provisions in the recently adopted Recovery Package
Federal matching assistance to states
Improved COBRA benefits
Health maintenance technology (Computerized charts)
Prevention and Wellness
Health care professional training support
A good start, but still a long way to go!
- How the “Stimulus Package” affects the NP profession
Title VIII (2009-2010) provides funding for many nurse loans and for education Health Information Technology Act
Resources are allocated as follows:
- 500 million for heath care workforce initiative
- 300 million for national health services corps
- 200 million for Title VII, and VIII
I Challenge you to………….
- #1 Understand what is going on at our state and at the national level. Our voices need to be heard. Talk to your senators and representatives. Write letters to editors of publications and/or your senators and representatives. Communication via E-mail is also an effective tool. Get on a distribution list in your district. Even engaging in dialogue with the legislative assistants is extremely helpful! I will help you, call me at any time!
- #2 Encourage Physician Colleagues who are supportive of NP practice to run for office on the boards of medicine.
- #3 Join your local, state and national APRN groups. I am working to start a state group, in addition to being part of the local group (ASMNP).
We need to be at the table…………….
- #4 Consider giving financial support (any amount from 5 to 100 dollars) to a PAC. When lobbyists see that we have a money flow, we will get noticed. We can consider organizing a PAC fundraiser event.
- #5 Promote consistent and enhanced messaging, Keep issues like our “Degrees” an “insider” issue (eg. DNP). Keep decisions regarding this issue out of the hands of other Professions.
- #6 Translate nurse-driven research into practice.
In Closing,
“If you are not at the table, you are likely to be on the menu”
(Zerhouni, 2008)
This is why we need to be passionate about the issues regarding Advanced Practice Nursing and healthcare policy. We need APRN representation at the levels where the decisions are made that affect our practice. We need to take active roles in the discussions that take place. Understand, that through the efforts of organized medicine (AMA, MMA, SOPP etc.), the potential exists for prescriptive rights, payment and reimbursement rights, and autonomous practice rights to be compromised. Constant vigilance at the legislative level is needed. “Because it is here today, does not mean it will be there tomorrow” This is the hard reality of our profession. Especially- if we do nothing.
2010 National ACNP NEWS:
AMA SOPP document – The following is AMA’s description:
The AMA has completed its Scope of Practice Data Series, now available to the
Federation on the Advocacy Resource Center’s Web site at www.amaassn.
org/go/arc under “State advocacy campaigns,” then “Scope of practice”
and “Scope of Practice Partnership.” You can also find the link on MSMA’s
web site at www.msma.org.
This ten-module data series is intended to assist in educating physicians,
physician organizations and policy-makers on the training and qualifications of
particular non-physician health care professions as well as the qualifications
physicians possess that prepare them to accept the responsibility for full,
unrestricted licensure to practice medicine.
To help counter the common claims non-physician practitioners make in attempts
to expand their scopes of practice, each module contains an in-depth examination
of the profession, including: education and training, licensure, certification and
regulation, accreditation, professional organizations, advocacy initiatives,
relevant medical association policies, and medical and other literature. The non physician
professions in the current set include: audiologists, dentists,
naturopaths, nurse anesthetists, nurse practitioners, optometrists, pharmacists,
physical therapists, podiatrists and psychologists.
The Nursing community is working on correcting the inaccuracies portrayed and augment the positives.
Current Legislative Bills Important to NP Practice
*S = Senate Bills
**HR = House of Representatives
H.R. 3288, the Fiscal Year 2010 Consolidated Appropriations Conference
Report passed by a vote of 57 to 35 and is going to the President for
signature. Includes Title VIII- More funds sent to nursing education, same
amount to advanced practice. Flat line can be good or bad. Nursing groups
meeting to plan 2011 Appropriations bill
HR 2350, Preserving Patient Access to Primary Care Act of 2009- Allyson
Schwartz D PA- Support for this bill is growing
http://www.govtrack.us/congress/bill.xpd?bill=h111-2350&tab=summary
“Further, we support the explicit language included in HR 3962 that
clarifies that all primary care providers who meet the requirements to
serve as an individual’s PCMH should be reimbursed for that care including
nurse practitioners and physician assistants acting in
accordance with state laws. Ensuring that all Americans have access to
necessary primary care services will require every primary care
practitioner to be able to function at the full scope of his or her practice.
Especially with respect to the PCMH.
