Update on what’s going on legislatively in Florida! Legislative update from AANP. Also, an NP's rebuttal to the FMA position on NPs prescribing controlled substances can be found at this website: http://www.tallahassee.com/article/20090325/OPINION05/903250302/1006/OPINION Date: Wed, 25 Mar 2009 08:07:56 -0700 Good morning colleagues! AANP is pleased to inform you that the AANP video is currently streaming online. It has been successfully uploaded to both YouTube and Google. To view, please click on one of the links below (you may need to press your control key and click on the link at the same time or copy and paste into your browser). YouTube: http://www.youtube.com/watch?v=ezym96Inma8&feature=channel_page Google: http://video.google.com/videoplay?docid=6049783560648698225 The segment can also be found on these sites by either searching under American Academy of Nurse Practitioners or National Medical Report. In the near future the segment will be aired on national TV. More information to follow! Lobby Days in Tallahassee March 17th and 18th had the largest attendance than prior years. Over 130 ARNPs and RNs took the Capitol by storm! The AP picked up on our controlled substance prescribing legislation and several articles in various papers across the state. Below are links to a series in the Tallahassee Democrat that you will want to read (you may need to press your control key and click on the link at the same time or copy and paste into your browser): http://www.tallahassee.com/apps/pbcs.dll/article?AID=2009903190311 http://www.tallahassee.com/article/20090320/OPINION05/903200319/1006/OPINION http://www.tallahassee.com/article/20090325/OPINION05/903250302/1006/OPINION It is clear that we need a strong, coordinated grassroots base to make our legislative efforts successful amongst other strategies. In this light the Florida Nurse Practitioner Network (FNPN) is strategizing and organizing the following: 1. Build a PAC. 2. Organize a Committee of 1000. This idea is based on the FMA model and is how they are able to infuse so much cash into the election cycle and coffers of legislators (and is how they are able to keep blocking our legislation). Basically it is a committee of 1000 ARNPs (or other supporters) who agree to donate 500 a year (1000 every 2 year cycle) The first 500 goes into the PAC, the second 500 is collected via overnight mail and made out to an individual legislator or candidate, when that legislator needs influencing and/or assistance with election/re-election. It is over nighted to one central person who then hand delivers all of the checks to the legislator and of course the person who delivers the checks talks about our issues. 3. Hire a professional PR person to begin May 1st to get the message out over the entire year with heavy emphasis on the Jan -April season (proposals are under review). 4. Designate one contact person in each local group in our state and organize to be the grassroots committee. This group of grassroots leaders will be responsible to communicate with the legislative team and to their individual groups. They will be well versed in the talking points. They will implement and organize a campaign to contact every legislator in their region and hand deliver the educational packet that was distributed by several of the ARNPs at Lobby Days which includes a copy of the DVD “Florida’s Healthcare Crisis: The Advanced Practice Nurse Solution (you can view at www.fnpn.org and click on the link at the very top of the page), Coalition White Paper, Senate Interim Report, AANP info including the national map of prescriptive authority, and talking points. This grass roots group will also be instrumental in delivering the Committee of 1000 checks. The grassroots committee will also write to the local news papers editorial sections in connection with the PR strategy. 5. Organize public rallies as a part of the PR efforts. 6. Identify our consumers who are willing to do video testimonials of how this law has negatively impacted them especially patients in the districts of those members on the committees that are blocking our legislation. These videos could be viewed on YouTube and distributed to the media via our PR person. 7. Set up a link to the FNPN web page to down load a "business card" that has the names of the legislators on the committees who are blocking our legislation. When we cannot write a prescription, we can give the patient a card and ask them to call. 8. Start a “Pick a Day” campaign. In this campaign we ask each regional group to pick a day of the week when their members will call, email and fax the committee members who have blocked our legislation so that every day of this coming year, they receive phone calls, faxes and email educating them on the issues. 9. Explore various legal strategies including the restraint of trade option. This is being investigated. 10. Build AANP and FNPN membership so we can hire the needed people to make some of this happen, ie: PR person, PAC manager, administrative assistant. Be a part of the solution! Consider helping towards a solution for our 15 year plight! For more information email myself or Susan Lynch ARNP MSN NP-C, VP Legislative Affairs, FNPN at fnpnslynch@gmail.com Doreen FNA Lobby Days are being held March 17th and 18th in Tallahassee. More information is available at the FNA website www.floridanurse.org and click on conferences. The FL video (title is not known as of this mailing) is in edit process and will be available for Lobby Days to be presented to the Senators and Representatives. If you are attending please let me know. The committee members are: House: Health Care Regulation Policy Committee 850-487-2242 1301 The Capitol 402 South Monroe St Tallahassee Fl 32399-1300 Chair Patronis, Jimmy (R) District 6 Senate: Committee on Health Regulation 850-487-5824530 Knott Building 404 South Monroe St Tallahassee Fl 32399-1100 Chair: Senator Don Gaetz (R) (Not supportive but founded a hospice) District 4 Clinical Laboratories Bill - HB 53/ SB 408 Doreen Doreen Cassarino, FNP-BC, BC-ADM Nurse Practitioner Council Collier County, Vice President Legislation Your membership in AANP keeps you connected and informed. Please share with a colleague and invite them to join AANP! AANP Florida State Representative Report February 7, 2009 The Florida Coalition of Advanced Practice Nurses formed two years ago to provide a cohesive structure for Advanced Practice Nurses in Florida. Membership consists of the Florida Nurse Practitioner Network (FNPN), The Florida Nurses Association (FNA), the Florida Association of Nurse Anesthetists (FANA), and Certified Nurse Midwives as well as individual members including myself. The coalition crafted a white paper “ADVANCED PRACTICE NURSES: IMPROVING ACCESS TO HEALTH CARE AND CONTAINING COSTS: An Action Plan for the State of Florida.” The paper details the Florida healthcare crisis and is a culmination of a unified effort by advanced practice nurses from diverse settings and organization across the state. It outlines creative solutions using advanced practice nurses to address health care needs of the citizens in Florida and will be shared with legislators, other advanced practice nurses and the public for education and information purposes. The document can be viewed at www.floridanurse.org/Resources/documents/ARNPWhitePaper.pdf The white paper was presented by members of the coalition to the Lt. Governor on November 17th 2008. The Lt. Governor and his staff were very attentive in our presentation of the white paper and the major goals of the coalition’s efforts. Emphasis was placed on the APRN’s ability to impact the health care crisis that continues to worsen in the great state of Florida. In addition to presenting the white paper we reviewed the Senate Interim study which clearly indicates the safety and efficacy of allowing NPs to prescribe controlled substances. We asked for them to review the white paper and consider strongly their endorsement of our efforts but there were no firm commitments. A follow up meeting is pending and a meeting with the Governor will be requested. The initial goal of providing information to the governor’s office has been achieved. Endorsement from other stake holders (hospice, retail clinics, the Florida Hospital Associations, Deans and Directors for the Universities, etc.) is being sought. The next major project is a video, similar to the Colorado video, that highlights the role that APNs can play in easing the healthcare crisis in FL by increasing access to care, utilizing APNs to our full educational qualifications, etc. The filming has been completed and is now in editing. The final product is to be ready for start of the legislative session. Members of the coalition will be using a short version during FNA Lobby Days being held in March. On December 11, 2008, Senate professional staff presented the findings of President Atwater’s interim study on ARNP controlled substance prescribing to the Senate Health Regulation Committee. The report can be viewed at http://www.flsenate.gov/data/Publications/2009/Senate/reports/interim_reports/pdf/2009-117hr.pdf The study findings were very positive and recommend that the legislature consider extending authority to FL licensed ARNPs. Specifically, the report states that "ARNPs are skilled nursing professionals with advanced clinical training that prepares them to provide primary care services. Giving ARNPs the authority to prescribe controlled substances will enhance the ability of ARNPs to manage their patients' care and reduce delays and costs for patients in obtaining needed medications." Members of the FNA, the FNPN, the FANA, and the Florida Hospital Association all put in speaker cards in support of the issue. There were 15 APNs from across the state in attendance. Initially, it appeared as though there would be a committee bill on ARNP controlled substance prescribing. This is where, based on the staff's recommendation, the committee as an entity files a bill. Despite obvious support on the issue from Senators Bennett and Jones and Minority Leader Lawson, there were clearly some members of the committee, Senator Sobel and Senator Altman, who were not supportive of the issue. Senator Gaetz and Senator Gardiner were silent and Senator Aronberg expressed his concern regarding ARNPs prescribing schedule II drugs. When it became obvious to Senator Bennett that there were insufficient votes to get a committee bill, he announced that he planned to file the legislation individually. Legislation for 2009 Clinical Laboratories Bill: HB 53 by Rep. Luis Garcia/ SB 408 by Senator Mike Fasano: This bill is the same as a bill which came very close to passing last year and would require clinical laboratories accept human specimens on the order of an ARNP. A statewide survey was conducted by FNPN and over 1300 responses were received. Data analysis is underway. Thanks to AANP and FNA for getting the word out! Respectfully Submitted, Doreen Doreen Cassarino, FNP-BC, BC-ADM Announcement from your AANP Region 11 Director?
From: aanp@aanp.org
To: sueplee@msn.com
Subject: Announcement from your AANP FL State Representative
There are several things to update you on a national and state level.
doreencassarino@gmail.com
Doreen Cassarino, FNP-BC, BC-ADM
Nurse Practitioner Council Collier County, Vice President Legislation
Florida Nurse Practitioner Network, Secretary
Florida Coalition of Advanced Practice Nurses, Executive Board Member
American Academy of Nurse Practitioners, Florida State Representative
The first committee week in February was focused on budget issues in both the House and Senate. Committees heard very few bills, if any, and instead received presentations from various agencies on proposed budget cuts. The legislative session starts the first week in March.
ARNP Controlled Substance Prescribing - SB 426
Senator Mike Bennett and Representative Juan Carlos Zapata
This bill will permit ARNPs to prescribe controlled substance schedules II-V in compliance with a protocol arrangement. There has been no movement on this issue this week, but we expect the House version of the bill to be filed shortly.
Contact information and a letter template are available on the FNPN website www.fnpn.org and click on Legislative Action. If you don't live in these districts, write to them and to your representative and senator and encourage their support.
Vice Chair Ambler, Kevin C. (R) District 47
Porth, Ari Abraham (D) Democratic Ranking Member District 96
Bovo, Jr., Esteban L. (R) District 110
Eisnaugle, Eric (R) District 40
Skidmore, Kelly (D) District 90
Van Zant, Charles E. (R) District 21
Vice Chair: Senator Eleanor Sobel (D) (Not Supportive, husband is MD) District 31
Senator Thad Altman (R) (Unsure of support, new senator who needs info and education) District 24
Senator Dave Aronberg (D) (Tentative, may not support II-V may want III-V) District 27
Senator Michael S. "Mike" Bennett (R) SPONSOR Controlled Substance Bill District 21
Senator Andy Gardiner (R) (Possible supporter, new senator) District 9
Senator Dennis L. Jones, D.C. (R) (Supports) District 13
Senator Alfred "Al" Lawson, Jr. (D) (Supports) District 6
Senator Mike Fasano and Representative Luis Garcia
This bill will mandate that clinical laboratories accept specimens from ARNPs. Labs are already required to accept specimens from most other licensed health care providers, and ARNPs have been permitted to order lab tests since 1996. This same language passed in the Senate in 2008 and through all its House committees. SB 408 is on the agenda in Senate Health Regulation for February 18, 2009.
Florida Nurse Practitioner Network, Secretary
American Academy of Nurse Practitioners, Florida State Representative
ARNP Controlled Substance Prescribing: SB 426 by Senator Mike Bennett/ HB by Representative Juan Carlos Zapata. This bill will permit ARNPs to prescribe controlled substance schedules II-V in compliance with a protocol arrangement. The bill has been filed in the Senate and is expected it to be filed soon in the House.
AANP Region 11 Leadership Meeting Report:
I just wanted to let everyone know that there was a great discussion of our state’s activities at the Region 11 meeting in Orlando on Feb 7, 2009. There were 48 in attendance with representatives from all four states. These are exciting times in Region 11 and we have great representatives from the Schools of Nursing, Boards of Nursing, Regional and State groups. I am truly excited to see the progress and innovative ideas within our states.
As you can tell from the following brief report, the day was filled with lots of discussion of state and national issues. I hope that each of you will be an active part in the advancement of NP practice. Advanced Practice Nurses are an integral part of the Health Care team to provide the citizens of our Region the highest level of health care in a cost effective, timely manner.
AANP continues to promote NP practice with continuing education, Health Policy updates, research studies and data that is up to date and well respected in the professional and legislative communities. I urge you to encourage your colleagues to become AANP members to continue the advancement and educational opportunities in NP practice.
Cindy Cooke NP-C
Region 11 Director
______________________________________________
Florida: The Florida Coalition of Advanced Practice Nurses formed two years ago to provide a “cohesive structure” for Advanced Practice Nurses in Florida. Numerous groups have banded together to work together to craft a White Paper “Advanced Practice Nurses: Improving Access to Health Care and Containing Costs”. This paper has been given to legislators in Florida and can be viewed at www.floridanurse.org/Resources/documents/ARNPWhitePaper.pdf
The Florida Coalition is also near completion of a video that highlights the role that APNs can play in easing the healthcare crisis in Florida. It is presently being edited and will be presented to the legislators during Lobby Days held in March.
A Florida Senate study as presented to the Senate Health Regulation Committee concerning ARNP controlled substance prescribing. The report can be viewed at http://www.flsenate.gov/data/Publications/2009/Senate/reports/interim_reports/pdf/2009-117hr.pdf
Georgia: Georgia NPs continue to work together in the UAPRN and other Regional Groups to continue to work on the Regulations governing Advanced Practice Nurses in Georgia. Their legislation passed several years ago and NPs have a choice which statutes they wish to practice under – old or new concerning prescriptive privilege. This will eventually work itself out as the APNs continue to educate legislators and the public to the Health Care crisis in Georgia and the need for increased access to Health Care.
Mississippi: There is a bill that just came out of committee and goes before the House next week to remove Joint Promulgation for NPs and place them solely under the Board of Nursing. This has been the main topic of legislative activity and will be watched closely over the next few weeks.
Mississippi physicians who are in collaborative practice with NPs are now being inspected by a “nurse investigator” hired by the Board of Medical Examiners.
Alabama: The Nurse Practitioner Alliance of Alabama was formed to unite all the Regional Groups in Alabama 2 ½ years ago. NPAA’s bill was not submitted in last year’s legislative session but there are plans to submit a bill for consideration in this year’s session. Meetings were held with the Medical Association of the State of Alabama (MASA) in 2008 and MASA formed an ad hoc committee to study the “NP Issue”. NPAA was not invited to participate in these discussions. It is understood that MASA has a bill to submit concerning NPs and CNMs. It is also a sunset review year for the Alabama Board of Nursing.
Jan Towers provided a national policy update that focused on: the inclusion of Title VII and Title VIII funds ( includes funding for NP educational programs) and Medicaid IT funding for nurse practitioners in the current Federal Stimulus Package; Health Care Reform; Medical Home and other federal and state legislative and regulatory issues.
AANP
PO BOX 12846
AUSTIN TX 78711
IMPORTANT!!!! LOBBY DAYS COMING UP……..if you can’t go up to Tallahassee, let’s write, e-mail, phone the committee members. The following is from Florida Nurse Practitioner Network. Go to the following website:
http://www.capwiz.com/fnpn/state/main/?state=FL
Dear All
The legislative session starts the first week in March. Lobby days are march 17 and 18 in Tallahassee.
The two bills we are introducing are the Controlled Substance bill and the Clinical Lab bill.
If you live in one of these districts please call email snail mail etc. If you need a template go to the FNPN web site and look at legislative issues. I have posted everything on the cap wiz site.
If you don't live in these districts, write to them anyway and write your house rep and senator as well
FNA lobby days are March 17-18 we are planning on attending. if anyone wants to go, let me know.
The video is in edit process and will be available for lobby days. We need people who will be willing to show it to their reps/senators
The committee members that we need to be flooded with emails, phone calls snail mails etc are
House:
Health Care Regulation Policy Committee 850-487-2242 1301 The Capitol 402 South monroe St Tallahassee Fl 32399-1300
Chair Patronis, Jimmy (R)
Vice Chair Ambler, Kevin C. (R)
Porth, Ari Abraham (D) Democratic Ranking Member
District 40
District 21
Senate:
Committee on Health Regulation 850-487-5824530 Knott Building 404 South Monroe St Tallahassee Fl 32399-1100
Chair: Senator Don Gaetz (R) Not supportive but founded a hospice
District 4
Vice Chair: Senator Eleanor Sobel (D) Not Supportive, husband is MD
District 31
Senator Thad Altman (R) Unsure of support. New Senator needs info and education
District 24
Senator Dave Aronberg (D) Tentative, may not support II-V may want III-V
District 27
Senator Michael S. "Mike" Bennett (R) SPONSOR Controlled Substance Bill
District 21
Senator Andy Gardiner (R) Possible supporter. New Senator
District 9
Senator Dennis L. Jones, D.C. (R) Supports
District 13
Senator Alfred "Al" Lawson, Jr. (D) Supports
District 6
