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Dr. Lori Lioce, CRNP September 30, 2010 Alabama State Nurses Association Legislative Workshop Update: Alabama’s Health and Legislation

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  • Alabama State Nurses Association Legislative Workshop Update: Alabamas Health and Legislation Dr. Lori Lioce, CRNP September 30, 2010
  • Alabama Statistics Alabama Legislature Overview State Health Authority OverviewStrategies/Issues/Recommendations Letter Writing NP Update
  • The question is:Are you concerned about the following issues? Safe nurse staffing standards Scope of practice Prohibition of mandatory overtime Safe patient handling no manual lifting Malpractice reform Reimbursement Nursing education funding Public health funding Continuing education Funding for uninsured Monetary/scholarship support for nursing education, certification, and training Licensure issues Nurse retention/shortage Health care access Safe work environment
  • ALABAMA OBESITY (49 th/32.2%)
  • ALABAMA SMOKING (41st/22.2%)
  • AlabamaMedicarePatients w/ ICU stay in last 6months:AL 38%
  • AL HealthRankings(-0.546) States with +Changes2008-09
  • Alabamas Infant Mortality 2009 48th
  • Alabama AllDeterminants vs. US 43rd
  • Alabama vs. U.S. AllOutcomes2001-09 49th
  • Alabama Legislature Facts Quadrennium (4-year period) 1st Year: 1st Tuesday in March 2nd Year: First Tuesday in February 3rd Year: First Tuesday in February 4th Year: 2nd Tuesday in January Regular Annual Session No more than 30 Legislative (meeting) days, within a 105 Calendar day period Tuesdays/Thursday Sessions Committee Meetings on Wednesdays.
  • Alabama House & Senate Standing Committee Meetings open to public Call ahead to meet with Legislators ALISON Galleries: Senate 8th & House 6th Floor Alabama State Legislature 11 South Union Street Montgomery, AL 36130 Senate: (334) 242-7800 House: (334) 242-7600
  • Alabama State Senate (7th Floor) Secretary of the Senate & Senate Staff (7th Floor) Senate Gallery (8th Floor)Senate Committee Meeting Rooms (6th & 7th Floors) Lt. Governor (7th Floor) House of Representatives (5th & 6th Floors) Clerk of the House & House Staff (5th Floor) House Gallery (6th Floor) House Committee Meeting Rooms (6th Floor) Speaker of the House (5th Floor) Legislative Reference Service (6th Floor) Legislative Fiscal Office (6th Floor) Legislative Reapportionment Office (8th Floor) Joint Briefing Room (8th Floor) Governors Legislative Office (2nd Floor) State Budget Office (2nd Floor) Attorney General (3rd & 4th Floors)
  • State Representatives (House) 105 Members each represent ~40K 4 year term (no limit) Must be 21 and citizen for 3 years Lived in their District for 1 year Revenue raising matters must originate in the House (like US Congress). Quorum of 53 members to conduct business Majority of quorum can pass any bill except a constitutional amendment, which requires 63 votes Appropriation to a non-government organization such as a private college requires a two-thirds vote of those elected Exclusive power to originate revenue bills, such legislation can be amended and/or substituted by the Senate
  • HouseDistricts
  • Alabama Senate 35 Senators representing 125,000 Alabamians Must be 25, Citizen for 3 years and lived in their District for 1 4 year term (midnight day elected) Governor fills vacancy The Senate is considered to be the "deliberative body", rules concerning length of debate are more liberal than those of the House of Representatives. Alabama Senate is precisely one-third the size of the House of Representatives Lieutenant Governor of Alabama is ex officio President of the Senate Elects President Pro-Tempore (for a time) Article IX, Sections 197 and 198
  • ALABAMA LEGISLATURE PASSAGE OF A HOUSE BILL Introduction in the Committee hearings, Reported fromHouse, first reading, and discussion, etc. Bill may committee, secondreferral to appropriate die in committee from reading, and placement committee. lack of action or by vote. on calendar. If bill passes, it is sent to the Senate. If not, bill may Amendments, debate, receive no further third reading and vote on consideration, unless passage. reconsidered.
  • SENATE BILL PASSAGE First reading and referral to Committee hearings, discussion, appropriate committee in the etc. Bill may die in committee Senate. from lack of action or by vote. Amendment, debate, third reading and vote on passage. If itReported from committee, second fails to pass, it may receive no reading, and placement on further consideration, unless calendar. reconsidered.
  • If Bill passesIn identical form by both houses, it is returned to House, enrolled, signed by presiding officers of both bodies, and sent to the Governor.With a Senate amendment and the House concurs, it is enrolled, signed by presiding officers of both bodies, and sent to the Governor.With a Senate amendment and the House does not concur, bill may be sent to conference committee composed of members of both bodies.And Conference committee agrees to a compromise, report of conference committee is sent to both bodies. If not, bill dies from lack of action or another conference committee may be appointed to try to resolve differences.And both bodies accept compromise, bill is enrolled, signed by the presiding officers of both bodies, and sent to the Governor.
  • ES LAW BEC OMB ILL If, having been vetoed If Governor fails to by Governor, it is re- sign while Legislature passed by a majorityIf Governor signs; is in session, as vote of both bodies. If provided by the not re-passed, bill is Constitution; or dead.
  • Alabama Statistics Alabama Legislature Overview State Health Authority OverviewStrategies/Issues/Recommendations Letter Writing NP Update
  • ASNA NPAA ALANA Nursing Coalition Black Nurses AssociationAssociation Schools Nurses ENA AANS NLN Medical MASA Association ALAPAC BMEAL Health Dept. of Public Health MASARegulation ABON Joint Committee
  • Nursing 65,000 Medicine 7,000 90% 1500 6200 Legislature Coalition MASA ASNA BME NPAA DPH
  • "The Board functions through the StateCommittee of Public Health as constituted byCode of Ala. 1975, 2224, which is composed of12 members of the Medical Association of theState of Alabama and the chairman of each of fourcouncils provided for by statute. The 16 membersfunction under the leadership of a chairman and avice chairman elected by the membership for aterm of four years. [2]"The State Committee of Public Health meetsmonthly. Agendas are available to any interestedpersons not less than seven days in advance of themeeting, if available, in accordance with theAlabama Open Meetings Act. All meetings will beopen to the public unless closed in accordancewith the Alabama Open Meetings Act." "Minutesof the Committee meetings are prepared and areavailable at the Board of Health offices forinspection during regular business hours."
  • Duties of the Board:Certify that initial applicants meet thestatutory requirements for a licenseto practice medicine or osteopathy oras assistants to physicians inAlabama.Issue Alabama Controlled SubstancesCertificates and annually renew.With the Alabama Board of Nursing,approve applications for collaborativepractice in Alabama.Investigate and review complaintsagainst practitioners andpursuedisciplinary action when appropriate.Establish and review compliance withcontinuing medical educationrequirements for physicians andassistants to physicians.Duties of the Commission:Issue licenses for physicians topractice medicine or osteopathy inAlabama and annuallyrenewlicenses.Adjudicate formal charges brought bythe Board against physicians anddetermine appropriate disciplinaryresolution.
  • Understanding the State Legislative Process How a Bill Becomes LawDevelopment of an Effective Chapter Legislative Program Interacting With Your State Legislators How to Introduce Legislation Key Contact Program Working With a Professional Lobbyist Working With Your State Medical Society Building Successful Coalitions Campaign Involvement State Political Action Committees Legislative Receptions Nurse-of-the-Day Programs Nursing Resolutions and Proclamations Regulatory Agencies The Mini-Internship Programs The Legislative Seminar Media Relations
  • Alabama Statistics Alabama Legislature Overview State Health Authority OverviewStrategies/Issues/Recommendations Letter Writing NP Update
  • Lets Write! Structure of the letter should include: The focus of your letter (preferably an action statement informing your legislator what you want done). If a bill, identification by name and number. Your credentials or why you have special knowledge about the issue. Major consequences of the proposed legislation. Rationales for your point of view (facts and statistics). Observations, personal anecdotes, or concrete examples supporting your rationales. A reiteration of what you want the legislator to do (vote yes, vote no, introduce legislation, encourage others to act). The effects proposed legislation will have on constituents (not just nursing). A request for your legislators response (you are entitled to this information).
  • Alabama Department of Public Health C/O Dr. Donald E. Williamson P.O. Box 303017 Montgomery, AL 36130-3017Alabama State Legislature OR Alabama State House Senator ____ OR Representative _____ 11 South Union Street Montgomery, AL 36130
  • re areW he a A lab am urs es N n ow ?
  • FEDERAL SUMMARYThe Affordable Care Act:Immediate Benefits for Alabama Improved Access to Care Patients choice of doctors will be protected Strengthening community health centers More doctors where people need them Consumer Protection New consumer protections in the insurance market when families renew or purchase coverage on or after September 23, 2010 Coverage Expansion New Medicaid options for States Support for early retirees Extending Coverage to Young adults Small Business Tax Credits Affordable Insurance for pre-existing conditions Support for Seniors Closing Medicare Part D donut hole (gaps) Free preventative services (804,000 Alabama enrollees)
  • Political Candidate Endorsement Criteria
  • Alabama RN Legislators: April Weaver(Bibb County 49th District) Focus on Healthcare Protect healthcare rights for seniors Fight for lower prescription drug costs Work for choice for Healthcare providers Fight OBama-care Continue her support of the healthcare industry
  • Alabama Nurses Nationally Paula Gasser, MSN, RN ANA CNPE 2010-2012 Lori Lioce, DNP, CRNP ANA PAC Board of TrusteesDonna Herrin, PhD, RN Immediate Past President AONE Fay Raines, PhD, RN Immediate Past President AACN Richard Brown, CRNP, JD - Alabama State Rep to AANP Cindy Cooke, MSN, CRNP - Region 11 Director AANP
  • Alabama Challenges 1. How will the state adjust to changes in the federal rules? 2. Will Alabama be able to expand managed carein both the private and public sectorsin a way that does not under- mine the safety net? 3. Insurance Monopoly 4. Will the state reduce reimbursement rates, and what will be the consequences of doing so? 5. Concierge Medicine 6. Legislature 7. Public Interest 8. Nursing Advocacy - organization 9. Scope of Practice
  • DID you know? ASNA/NPAA members sent over ____ emails to legislators in through our online email system? Nearly _____ members participated online in lobbying their elected leaders? Over ____ nurses and nursing students flooded Montgomery on Nurse Legislative Day? Over ____ members connected to their legislators through ASNA/NPAA phone call program? WERE YOU ONE OF THEM?
  • Why should YOU get involved?Alabama is in a healthcare crisisNurses Make-up the largest number healthcare providers in this stateOur job is to ADVOCATE for our patients, families, friendsPublic Policy priorities MUST include ensuring full-scope of nursing practice and addressing the nursing shortage in our State.
  • How can you make a difference in Alabama?1. Donate to NPAA or ASNA Political Action Committee2. Participate: Calls, Emails, Letters3. Please ask your physician to write a letter to Don Williamson, Director of Public Health supporting Nurse Practitioners use in Public Health *Send a copy to NPAA President: [email protected] Please submit a story at www.alabamanp.com5. Set up a meeting for an NPAA Officer and you to meet with any of the physicians on the BME or Committee on Public Health.
  • Participation Opportunities ASNA District Committees ASNA Governmental Health Committee Board of Directors local & national ASNA Annual Legislative Day MARCH 9 Nurses Day at the Capitol Letters and ConnectionsDocument patient issues