Health Policy Updates

Support SSB 3040

Charlotte Kelley — Sun, 19 Feb 2012 18:25:00 GMT

SSB 3040
mportant legislation that IANP and INPS support has passed out of subcommittee and will be taken up in the Senate Human Services Committee probably on Tuesday, Feb 21. It is important that we make contact to the members of the Committee and urge them to support the bill.

Our message should be:
Support SSB 3040 and the amendment.
There is not a number for the amendment that includes NPs by code. Just ask them to support the bill and the amendment. Talking points for the bill are included below as to why the bill is important.

You can contact the senators by e-mail or by phone. If you e-mail, the address is firstname.lastname@legis.state.ia.us (Ex. amanda.ragan@legis.state.ia.us)
If you contact them by phone call the Senate switchboard at 515-281-3371 and ask for the Senator. If they are not available you can leave a message with their clerk. The members of the Committee are below.

Senate Members

Amanda Ragan(D, District 7), Chair
Mary Jo Wilhelm(D, District 8), Vice Chair
James A. Seymour(R, District 28), Ranking Member
Robert Bacon(R, District 5)
Nancy J. Boettger(R, District 29)
Joe Bolkcom(D, District 39)
William A. Dotzler, Jr.(D, District 11)
Jack Hatch(D, District 33)
Pam Jochum(D, District 14)
David Johnson(R, District 3)
Liz Mathis(D, District 18)
Herman C. Quirmbach(D, District 23)
Jack Whitver(R, District 35)

Thanks for your help with this important legislation. Contact me if you have any questions.

Charlotte Kelley ARNP
INPS Health Affairs Chair
cmkelley@netins.net

Branstad Signed Senate File 149 into Law

Charlotte Kelley — Sun, 03 Apr 2011 20:04:00 GMT

On March 30, 2011, Governor Terry E. Branstad signed the following legislation into law

Senate File 149: An act allowing the Department of Transportation to accept reports from advanced registered nurse practitioners and physician assistants disclosing a physical or mental condition that renders a person incompetent to operate a motor vehicle.

- Charlotte Kelley ARNP

Why I Need You!

Charlotte Kelley — Tue, 01 Mar 2011 08:18:00 GMT

Health Policy Fact: If a legislator does not hear from you about an issue they think the issue is not important to nurse practitioners.

Your representative is a person – like us – who was elected to listen to our concerns, especially as it affects the people in their district. They are elected to work for us. Make the Ask by saying, “this is the way you can help people in your district to have better health care and there is no money involved.”

Hello colleagues: This is an update to the policy legislative development regarding the two issues 1. NPs signing the death certificate; 2. DOT accepting NPs assessments:

1. An act allowing nurse practitioners to sign the death certificate

a. Passed out of the House subcommittee now HF 393 (was HSB 25)

b. Passed out of Senate subcommittee SSB 1039 just last week and has not been assigned a bill number yet

1. There was an amendment, acceptable to the Iowa Nurse Practitioner Health Policy Committee (INPHPC), to require training of NPs to sign the death certificate

c. When the bill has passed to a bill in both chambers (Senate and House) it will be debated on the floor of both. The House will need to align HF 393 to accept the amendment by the Senate to be debated on the floor.

d. TALKING POINTS (use all or some – customize):

1. Iowa has 1,646 nurse practitioners Iowa who are licensed to provide care independently without physician supervision.

2. An informal survey of 100 NPs at the INPS Fall 2010 conference indicated over half report needing to fill out the content of the death certificate for their patients and then find a physician to sign it.

3. Funeral home directors, especially rural based, report delays in returning paperwork to the state because of the delay in finding a physician who will sign the death certificate. This is an economic issue.

4. As the patient’s primary care provider of record, signing the death certificate will help to increase the timeliness and accuracy of vital stat reporting.

5. Allowing all primary care providers to continue the care of their for patients, including the deceased, will streamline the process for the families during their time of grief and assist funeral directors by eliminating the barriers of delayed paperwork.

6. ARNPs frequently are the only provider to some individuals and best know the cause of death

7. Sixteen states allow for ARNPs to sign death certificates with no reported adverse outcome or inaccuracies in reporting.

There is great opposition to this from the medical community.

PLEASE contact your legislator in your area and tell her/him that you are in support of this bill. See below how to find and contact your legislator.

If you would – customize your email to a personal experience or the experience of a NP colleague you know is affected by this.

2. An act to allowing the Department of Transportation (DOT) to accept reports from APNs that renders a person incompetent to operate a motor vehicle

a. HF / SF149

1. The Medical Society has been neutral on this issue and not formally opposing this bill. That makes it equally important you tell your legislator that you support this bill

b. TALKING POINTS:

1. Federal regulation allows NPs to make this determination already.

2. If the DOT questions a decision by an NP it would go to the same physician review panel that does a physician decision under question.

This link will take you to find you legislators by address: http://www.legis.iowa.gov/Legislators/find.aspx Click far top left tab: “Legislators” and choose Representative or Senator

Last but not Least: Please shoot an email to Joe Kelly who works with our legislators at the Capitol so he knows who has been contacted jkelly@amha.org

Feel free to contact me at cmkelleynp@netins.net for any questions – please act on these important bills.

Call to Action on Latest Legislation

Charlotte Kelley — Mon, 21 Feb 2011 02:00:00 GMT

HSB 25/ SSB 1039 An act to allow nurse practitioners to sign the death certificate.

Please contact your House Representatives and Senators regarding the status of this bill. Our legislators need to hear from you or they will not think this is an important issue for NPs. Keep in touch with the latest developments though postings on our website www.iowanpsociety.org under the left tab: Health Policy Updates. You may review the past eBlasts there also that has talking points and a sample email you may send. Sometimes it is hard to get through the switchboard of the House or Senate. There has been several subcommittee hearing regarding the language, one in the House and one in the Senate. Kathy Morris and Charlotte Kelley attended the House meeting and Kathy attended the Senate meeting. There is good support from the legislators on the bill. However, the medical community is still working against us very diligently. We may have to accept an amendment to include the requirement for all practitioners who sign a death certificate, to have training. Presently we think the bill will be out of the House Human Resources Committee on Monday February 21st. There is a companion bill in the Senate (SSF 1039) which also has good legislator support. Nonetheless, we have to continue working hard as the physicians. At the Senate subcommittee, they brought in a couple of medical examiners to testify as to how bad it would be to have nurse practitioners trying to determine the cause of death.

SF 149 An act to allow nurse practitioners the Department of Transportation to accept our assessment of a persons ability to operate a motor vehicle.

Our legislators need to hear from you or they will not think this is an important issue for NPs. This it a Senate bill allowing advanced registered nurse practitioners to advise the Department of Transportation (DOT) when someone should not be driving as well as advising DOT when a person is ready to resume driving. SF 149 has been unanimously approved by the Senate Transportation Committee and is eligible for consideration by the full Senate in the near future. A companion bill, HSB 94, has been introduced in the House. We are confident that this issue will be approved by the legislature since the Iowa Medical Society had dropped its opposition, citing the fact that DOT has use of a panel of doctors in case they have any concerns about a physical. This same panel is used when doubts are raised about a physical submitted by a physician.

Please feel free to contact me if you have questions.
Charlotte Kelley ARNP
Chair INPS Iowa Nurse Practitioner Committee
cmkelleynp@netins.net

HSB 25 - Updated Call to Act Now

Charlotte Kelley — Mon, 31 Jan 2011 21:57:00 GMT

Colleagues:

Thank you to those who have responded to the call the action to contact your local representative if they sit on the House Human Resources Committee. I know that some of you had personal calls from INPS members to help you understand the immediacy of your response to the members. I personally have talked with Linda Miller and Bruce Hunter and was impressed with how sincerely interested there were in knowing the issue. I also had an email from Linda Upmeyer since she is an NP and gets our email blasts. She understands the issue and supports us but does not sit on the committee - however she is recognized by many to be the go-to person about health issues.

If this is the first time you have seen this email, please read on to understand what you can do to assist in getting HSB25 to move out of committee as a bill.
Thank YOU!

Charlotte Kelley ARNP
INPS Health Affairs Chair
cmkelleynp@netins.net

Act Now - HSB 25 - More Information

Charlotte Kelley — Fri, 28 Jan 2011 11:37:00 GMT

You are being asked to contact only your representative who is on the human resources committee. The list of members and the link to the bill is at the end of this email.

Several weeks ago the state NP organizations, through Rep. Linda Miller - introduced legislation that was assigned to a subcommittee and reviewed to determine its merit.

There was a subcommittee meeting yesterday (1/26) and Joe Kelly and Linda Goeldner (INA) were there... facing many physician group representatives who say we are not educated to make a determination of cause of death. Consequently I called and Rep. Linda Miller and she scheduled another subcommittee meeting on Monday so I could be there! Kathy Morris and Kerri Rupe have also plan to be here.

Have you been affected by not being able to sign a death certificate? If so, you have needed to find a physician to sign it after you had completed all of the paperwork and advised them what they died from.  Following are two real life scenarios. You no doubt have your own.

Tess practices in rural clinic and this has happened to Tess. After any death, it is difficult and a real pain because the docs are 20 miles away and have never met the patient.

I practice in an urban area where a 89 year old primary care patient, who had only seen me and a neurologist in the last 52 years, broke her hip and died of pneumonia in the nursing home within days.  The hospital nor the neurologist would sign. The family called me in desperation because no one would sign the death certificate (holding up probate and the need for out of town family to leave) and I had to make calls before I found a physician willing to sign.

POINTS:

Nurse practitioners are educated to make the decision of the cause of death. The way the language introduced reads is just as it is now written in the rules only with Nurse Practitioner added.
A Family Nurse Practitioner has served as the Medical Examiner in one county. In another, a Paramedic was considered qualified.
As the rule reads we would be making the decision for patients "under our care". This encompasses the hospital setting also.
Nurse practitioners know their patients and medical conditions. It changes nothing for the way our patients are now cared for in death except we do not need to find a physician to sign about a patient for whom they do not know.

Please call your Representative on the Human Resources Committee - the committee where the bill is being reviewed. It would do us very well if you would call or email your Representative and let them know how important an issue this is.

The need to hear it from us individually how important it is!
Your Representative needs to be called before Monday Noon.
It's ok to talk and leave a message with their staffer. The House switchboard is 515/281-3221.

You may send an email. The following is an email template:
--
Please review HSB 25 which is a bill that would allow nurse practitioners to sign their patients death certificates.
Presently in [your county and town] as a patient's primary care provider, I will do the paper work and then find a physician to sign a death certificate for a patient that he has never met. If I, as the patient's primary care provider who has the responsibility for the paperwork, could also sign the death certificate, it would streamline the process for grieving families and hard-working funeral home directors.  Finding a physician to sign the death certificate is a needless and burdensome step when I have had the responsibility of being the primary care provider during the patient’s life.

At our Annual Fall Conference, over 100 nurse practitioners were questioned and nearly all of these NPs report having to fill out the death certificate paperwork for their patients and then find a physician to sign the death certificate. Allowing NPs the responsibility of signing the death certificate paperwork is consistent with their role and is within our scope of practice.
--

House Human Resources Committee:

Linda J. Miller (R, District 82), Chair
Joel Fry (R, District 95), Vice Chair
Beth Wessel-Kroeschell (D, District 45), Ranking Member
Ako Abdul-Samad (D, District 66)
Richard Anderson (R, District 97)
Mark Brandenburg (R, District 100)
Julian Garrett (R, District 73)
David E. Heaton (R, District 91)
Bruce L. Hunter (D, District 62)
Ron Jorgensen (R, District 54)
Kevin Koester (R, District 70)
Mark Lofgren (R, District 80)
Mary Mascher (D, District 77)
Glen Massie (R, District 74)
Kim Pearson (R, District 42)
Janet Petersen (D, District 64)
Renee Schulte (R, District 37)
Mark D. Smith (D, District 43)
Sharon S. Steckman (D, District 13)
Cindy Winckler (D, District 86)
Mary Wolfe (D, District 26)

Nurse Practitioner Legislative Day

Charlotte Kelley — Sun, 23 Jan 2011 22:02:00 GMT

Please sign up for Iowa Nurse Practitioner Legislative Day. The event takes place Thursday, February 24th, 2011 at the Iowa State Historical Building.

The schedule follows:

10:00- 11:00	Cheryll Jones: “So you want to be an advocate”
11:00-11:30	Joe Kelly: 2011 Session State Legislative Bills and Issues
11:30-12:00	Lorinda Inman: Iowa Board of Nursing updates
12:00-1:00	Panel of legislators (if available) and lunch
1:00	Adjourn to the Capitol to meet with your legislators

To participate open the following Sign Up Form, print the form, and follow the instructions to complete and mail the form.

Click here to open Sign Up Form
www.iowanpsociety.org/portals/0/downloads/IowaNursePractitionerLegislativeDay2011.pdf

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Harkin Regional Forums
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The Affordable Care Act became our nation’s new health reform law in March 2010, and we’ve already begun to see some of its changes to our health care system, from protections against abusive insurance company practices, to new investments in prevention and wellness and the health care workforce.

To keep you up to speed on these changes, Senator Tom Harkin’s Nurse Advisory Committee will host informational meetings in the coming weeks at hospitals throughout Iowa. The presentation and discussion will be hosted by a nurse for an audience of nurses, and will provide clear information on the new law and answer questions about its impact.

Below is a list of locations and dates for the meetings. For further information, please contact Laura Sands at laura_sands@harkin.senate.gov or 515-284-4574.

Location	Date and Time
Des Moines Mercy Medical Center East Tower Auditorium	Monday, January 31, 2011 12:00 – 1:00pm
Ft. Dodge Trinity Regional Medical Center Conference Rooms 2A-2B in the Atrium	Wednesday, February 9, 2011 12:00 – 1:30pm
Harlan Myrtue Memorial Hospital	Thursday, February 10, 2011 12:00 – 1:00pm
Des Moines Iowa Health Kelley Conference Center	Tuesday, February 22, 2011 12:00 – 1:00pm
Cedar Rapids Mercy Medical Center Hallagan Education Center	Thursday, March 10, 2011 12:30 – 1:30pm
Davenport Genesis Health System Adler Health Education Center	Thursday, March 17, 2011 12:00 – 1:00pm

Laura Sands
Health, Education, Workforce Outreach Liaison
Office of Senator Tom Harkin
210 Walnut Street
Room 733
Des Moines, IA 50309
515-284-4574
515-284-4937 (fax)
Laura_Sands@Harkin.senate.gov

First Post

Charlotte Kelley — Tue, 02 Feb 2010 22:31:00 GMT

Watch here for Health Policy updates. Federal and State legislative decisions can have a great deal of effect on the work of a Nurse Practitioner. Get involved!