ITAL SIGNS NDANA

North Dakota ssociation of Nurse Anesthetists Fall 2006

NDANA

then CRNA’s deserve to have a say in what those indicators are. Changes in reimburse-ment for teaching an-esthesia providers – A proposed change in reimbursement for providers who oversee students was being discussed. The rule change would provide twice the amount of reimbursement for anesthesiologist resi-dents versus CRNA residents. Continued on Page 7

Mid-Year Assembly Rebecca Heilman, CRNA The Mid-Year Assem-bly of States was held in Washington, D.C. April 23-26. North Dakota was repre-sented by the NDANA President Lori Bazey, board members Heidi Stahl and Rebecca Heilman, and students Blake Griffen, Kevin Buett-ner, and Daphne Steier. Informational meetings on legislative issues affecting CRNAs were held over several days fol-lowed by CRNAs from each state mak-ing visits to the Hill to see our respective Senators and Repre-sentatives. Some of the major issues affect-ing CRNAs on Capitol Hill this year include:

Fee payment cuts in Medicare Part B reim-bursement - These cuts are due to start in 2007 and continue over sev-eral years. We of course were lobbying against any cuts at all due to the ever increasing cost to deliver health care.

Pay for Performance – Pay for Performance is based on the idea that the quality of health care can be measured and therefore reimbursed based on the ability of health professionals or organizations to meet specific quality indica-tors. These indicators could include how you treat an AMI or pneu-monia or even if the anesthetist is giving anti-biotics within 30 min-utes of incision. The AANA’s stance on this issue is that if quality indicators are going to be set for anesthesia,

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NDANA Elections

CRNA Delegation Visits the Capitol and meets with Congressman Pomeroy

President’s Report Lori Bazey, CRNA, MS

Support your Nurse

Anesthetist Political Action

Committee

Strong representation is essential in 2007

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REGISTER NOW! NDANA FALL

EDUCATIONAL MEETING

OCTOBER 20-21, 2006

DOUBLEWOOD INN

BISMARCK, ND www.ndana.org

Thankfully, I am glad to report that this past year has been a quiet one for the NDANA! We have done some housekeeping duties such as updating our bylaws, revamped the travel policy, continued to network with our legislators, attended some of the national meetings to stay informed of national changes as well as learn what is going on in the an-esthesia arena in other states and continue to work on developing relationships with other healthcare organizations within ND. As you know we have a ND legislative year approaching so Ken Tupa and his staff along with the NDANA Board of Directors will again be vigilant in watching for legislation that may adversely affect your practice. Please forward any e-mail, phone number or address changes to APT at: ktupa@aptnd.com or (701) 221-7797 so they may keep our database of members accurate for immediate com-munication of issues that may arise. I can not emphasize enough how important it is for you as members to be reactive to the call for help with an e-mail or letter to support our position when issues arise. Our spring meeting held in Fargo was a huge success with record numbers of members in attendance. It was great to network with all of you, attend some very informative lec-tures and to obtain the hands-on experience with the latest and greatest difficult airway adjuncts. Congratulations to Rebecca Heilman in being selected by the AANA to attend the media training workshop this past spring. She has been our state contact for public relations and media events as well as organizing our state newsletter. Thanks to Buzz Benson for his time and commitment to the ND Board of Nursing. It is great to have a CRNA representative in this position. Congratulations to the UND anesthesia program and students in obtaining a 100% pass rate on national boards for 6 straight years! WOW! This speaks volumes to the job Darla Adams does as Program Director and Heidi Stahl as Clinical Director as well as all of the clinical site coordinators across the state. Of course this all wouldn’t be possible without the individual CRNAs working with the students in the trenches on a daily basis teaching them your skills and clinical judgment. With the anesthesia provider shortage nationwide, we are very fortunate to have such a high quality program within our state. Thanks to all of you for making it happen! In closing, I would encourage you to become more actively involved in your state and national organization by running for a position of leadership on this year’s ballot or sign-ing up for committees within the NDANA or AANA. We all have busy lives, but the livelihood we enjoy is made possible by remaining strong as a group. Thank you for the opportunity to serve as your state President these past 2 years.

As I write this, I am returning home from Cleveland, sitting in an airport waiting for flights delayed due to the heightened secu-rity issues. Ah, the joys of flying. I know many of you enjoyed the AANA 75th Anniversary Annual meeting. I was good to see so many of you there. The final meeting attendance numbers are not in, as of now, but the indications are that the numbers will be very good, if not a record! Approximately 4000 people were in the main ballroom to hear the keynote address by President Clinton. I think everyone was impressed. The Annual Business meeting was well attended and had 9 By-laws amendments to deal with in a limited amount of time. The room had to be cleared in time for the Secret Service to sweep it prior to President Clinton’s arrival. I’m happy to say we were able to complete the meeting on time! All nine issues were dealt with in a professional manner.

To access the full text of these bylaws, you can go to: <http://www.aana.com/MemberHome.aspx> and click on the link entitled, "Proposed Amendments to AANA Bylaws and Standing Rules" First of all, the dues increase passed. For this fiscal year, they will increase from $495 to $545. then in 2007, they will increase to $595, and in 2008, to $645. The link referenced above shows how they will be allocated. Most of the in-crease will be returned to the states with a small portion going to the AANA. It is interesting to note that , according to the numbers I wrote down, that 88% of those voting were in favor of this amendment.

The main issues of concern to most were the amendments dealing with setting up new Regions for the AANA. There were 2 dealing with this. One was proposed by the Special Committee on Regional Alignment and one by a number of AANA members. Both failed to garner the 2/3 vote needed to pass. The amendment dealing with voting only for your own Region also failed. Be sure to read the information that is in the AANA Newsbulletin for more specific information on these issues. A couple of amendments affecting students were passed. One allows the President and BOD to appoint student members to non-voting roles on many committees and one increased the one time fee paid by students to the AANA. There were a couple of “housekeeping” type amendments dealing with indemnification and confidentiality passed that you can read about at the link above or in the Newsbulletin. The new Board of Directors for 2006-2007 was announced, and once again the voters have elected a great group to join the AANA Board. The only downside is the voter turn out was almost embarrassing. Only 21% of eligible voters voted in this election. I don’t know what the solution is, but I’m asking each of you not only to vote next time, but get everyone you work with to vote, also. We were hoping that having internet voting would increase this percentage, but so far it has not helped. If you have any ideas on how to get more people involved in electing the leaders of your organization, please let me know. The AANA Board and staff are continuing to work on several issues of interest to all of you: -Discussions are continuing with leaders of the VA Hospital system regarding the plan to re-introduce AA’s into the VA system. Be as-sured that the AANA Board and staff are well aware of the issue and are continuing to work on it. -CMS has announced steep cuts in anesthesia reimbursement in the next couple of years. We need your help to contact your legislators in DC to ask them to help to rescind these huge cuts that will affect us all. Please go to www.aana.com to get the most current information on this issue. Due to the lag time in these publications, it is always best to check the website for updates. -The teaching rules for anesthesiologists and CRNAs involved in teaching students continue to be problematic. Again, since this topic is a fast moving issue, I urge you to check the website to get the latest information. Your Board and staff in DC and Park Ridge are work-ing diligently to get this issue corrected in a fashion that is good for all involved. -Be sure the AANA has your current email address. Many times, alerts of importance are sent out and if we do not have your current email, you will miss a lot of this important information. Also, from time to time I will send out information specific to Region 4. If you want to be included on that list, send me your address. I am excited to be starting my second year on the AANA Board of Directors representing all of you in Region 4. Be sure to look at the AANA Committee list that is published. We have numerous individuals who have committee assignments with the AANA. What a great way to get involved! And, I would be remiss if I did not thank Brian Thorson (from Region 4!) for his leadership this past year as President of the AANA. Brian worked tirelessly for us all and deserves our gratitude. And along those same lines, our new Presi-dent , Terry Wicks, will have a busy year ahead of him, and I ask you all to do what you can to support him and the whole AANA Board of Directors as we work very hard to do what needs to be done. Be sure you contact me any time with any questions or concerns.

Page 3 Fall 2006

Directors Report: AANA Region 4 Dan Vigness, CRNA, MS

NDANA Fall Meeting Agenda 8:20 Shock Happens: Surviving Cardiac Arrest. Randy Fischer, EMT

9:10 Exhibit Break 9:20 Morbid Obesity and Anethesia Margaret Cannon, CRNA 10:10 Preoperative Assessment of the Severe Diabetic Margaret Cannon, CRNA 11:50 Exhibit Break

12:00. Luncheon & Business Meeting Sponsored by Aspect Medical 1:00 Case Review: What would you do? Case Review morning lectures Margaret Cannon, CRNA 1:50 BIS in Anesthetic Technique Including Case Studies Marc Antoszyk, CRNA 2:40 …...case studies continued

3:30 Exhibit Break

3:40 Outpatient Regional Anesthesia For Upper Extremities Dr. Joseph Pellegrini CRNA, DNS, ,DNP/CAPT, NC, USN 4:30 Outpatient Regional Anesthesia For Lower Extremities Dr. Joseph Pellegrini CRNA, DNS, DNP/CAPT, NC, USN

Friday, October 20, 2006 4:00p.m. Registration

5:30 Welcome and Comments Lori Bazey, NDANA President 5:45 “Shocking” Information ICDs and Pacemakers in the O.R. Doug Harding, PA-C 6:40 Break Sponsored by Metropolitan Medical Services of North Carolina Inc. 7:00 UND Student Presentations UND Graduate Students, College of Nursing, Nurse Anesthesia Program 8:00 UND Student Presentations ………...continued 9:00 NDANA Social and PAC Fundraiser Sponsored by GE HealthcareTechnologies

Saturday, October 21, 2006

7:00a.m. Registration 7:30 Hard & Fast: The rules and science behind HA guidelines 2005. Randy Fischer, EMT

Now Presenting... Doug Harding, PA-C

Certified in Pacer and Defibrillator Management by NASPE

Bismarck, North Dakota

Dr. Joseph Pellegrini CRNA, DNS, ,DNP/CAPT, NC, USN

Director of Research for US Navy Anesthesia Program Woodstock, Maryland

Randy Fischer, EMT Director of Operations, Ringdahl EMS

Fergus Falls, Minnesota

Margaret Cannon, CRNA, MHS Associate Director of the Baylor College of Medicine

Nurse Anesthesia Program, Assistant Professor of Anesthesiology. Texas Association of Nurse

Anesthetists Board of Directors.

Marc Antoszyk, CRNA Manager, Northeast Medical Center

Concord, North Carolina

Page 5 Fall 2006

NDANA Election

Nurse Anesthetists Political Action

Committee (701-221-7797)

2900 E. Broadway Bismarck, ND 58501

CRNA’s Visit Senator Conrad

12

Continuing

Education

Credits

Cast your ballot online at www.ndana.org

Name: ________________________ AANA Membership#: ______________ Address: ________________________ Place of Employment: ______________ City: __________________State: _____Zip: _________ Phone: _________________ Days Attending: Friday Saturday (circle all that apply)

Fall Meeting Registration

Meeting Fees Member Non-member Pre-registration $190.00 $210.00 On-site Registration $210.00 $240.00 Friday only $85.00 $100.00 Saturday only $150.00 $170.00 Students No Charge

Planning to attend Saturday Lunch? ___Yes ___No

Saturday Luncheon Included with Registration Fee

Make Checks Payable to NDANA

Detach & Return to: NDANA,

PO Box 1755 Bismarck, ND 58502-1755

FPD Report: by Katy Kovar

Greetings NDANA Members: This spring a group of NDANA members including Pres. Lori Bazey attended the Mid-Year assembly in Washington, D.C. where they were graciously received by Senators Dorgan and Conrad and Representative Pomeroy. Our organization is particularily blessed (which comes from hard work) by being able to have face to face contact with our legislators. Again this year our delegation expressed the importance of continued federal funding for nurse education including CRNAs in order to meet the health care needs of our citizens into the fu-ture. Our leaders are well aware of the shortage that has been on going. Our delegation discussed our serious concern that the Centers for Medicare & Medicaid Service (CMS) pro-posed rule making adjustments in Medicare Part B practice expenses and relative work values severly cuts Medi-care anesthesia payment. The proposed rule mandates a 7-8% cut in anesthesiology and nurse anesthetist reim-bursement by 2007 and a 10% cut by 2010! Medicare today reimburses for anesthesia revices at approx 37% of market rates, while most providers of services are reimbursed at about 80 percent of market rate. We are already getting the short end of the stick and yet they plan to cut us even further! These cuts if enacted Jan 1 as planned will have drastic effects on people's access to anesthesia services and our delegation urged our ND legislators to ensure congress acts to reverse this. Our legislators were informed about the ASA proposal in HR 5246, 5348 and S2990 which propose to change medicare anesthesia reibursement rules for teaching anesthesiologists. The proposed rule changes would provide a disincentive for CRNA training in that it would reimburse anesthesiologist training at a higher rate making it more attractive for hospitals to be clinical sites for anesthesiology residents instead of nurse anesthesia residents. The AANA has been clear in meetings with the ASA regarding our objections to this proposal and as always is willing to collaborate with them on a FAIR proposal to increase the reimbursment for all. Other topics discussed with the legislators were increasing funding for nurse education by 1 million dollars over 2006 to ensure continued access to health care services for underserved and rural areas. Our legislators did not have to be reminded who provides anesthesia services in these areas. We also reiterated that we as the clinical experts in hands on anesthesia want and expect to be included in Medicare's ongoing quality improvement campaign (pay for performance). We also encouraged our legislators to ensure "nondiscrimination language" in small business health plans leg-islation. Our cost effectiveness and our safety record make us a logical choice for health plan providers and there is real danger that our political advisaries will try to exclude us in legislation concerning those plans. As you can see there is a lot on the federal plate as usual... Hope to see you all in Bismarck at the Fall meeting!

A special thanks to all those CRNAs who took the time to

participate in Legislative events over the Summer.

Assembly…(Continued from page 1)

It was felt that this would decrease the number of clinical sites open to CRNA residents and eventually de-crease the number of CRNAs , graduating. The AANA was opposing any change in reimbursement for teach-ing rules. Nurse Anesthesia Education – The AANA was in support and asking for $4 Million for Nurse Anesthesia Education and $65 Million for Advanced Nursing Education as part of a Nursing Education Package of $175 Million. The issues of nursing shortages nation-wide accompanied by an aging baby boomer population were stressed to reinforce the need of more nurses in the future. Medical Liability Reform - The AANA is very much in favor of medical liabilty reform. Many states have seen malpractice premiums skyrocket to the point of an exodus of health care providers in some areas. While the anesthesia profession as a whole has seen relatively small increases in malpractice premiumsthe medical trend is not heading the right direction. These were the major issues discussed in Washington. Other activities included updates from each state on legal issues, office-based anesthesia, opt-out status and nurse practice issues to name a few. We were fortunate enough to meet with Senators Dorgan and Conrad, and Representative Pomeroy. All of our Congressmen were willing to listen to our needs. It was a fabulous opportunity to see CRNAs from all over the nation at work for a common goal.

Page 7 Fall 2006

Complete and return form to NAPAC PO Box 1755, Bismarck, ND 58502-1755

First Name: ________________ MI: ______ Last Name: _________________ Address: ________________________ Email: ___________________________ City: __________________State: _____Zip: _________ Phone: _________________

Contribute to the Nurse Anesthetist PAC

Contribution Levels (Check One)

_____ Gold Level Membership—$200.00 _____ Active Membership—$100.00 _____ Associate Membership—$50.00 _____ Other—$__________

Memberships are payable by check or credit card, if you wish to pay by credit card, please fill out the information below. FOR YOUR PROTECTION, the address you provid should be the same as the billing address of your

Credit Card. Card Type: ____ Visa ____ Mastercard Credit Card Number: ____________________ Expiration Date: ____________ Signature: ________________________________

NAPAC Members A special thanks to all who contributed to the Nurse Anesthetist Political Action

Committee. Your generosity has gone a long way to further the Nurse Anesthesia profession.

Association Bylaws Bylaws Proposed Changes and Amendments

Following are the proposed changes and amendments to the NDANA bylaws. Only the articles and sections with proposed changes have been printed. The bylaws serve as a guide to assist in the governance of the associa-tion. From time to time the bylaws are reviewed and changes are proposed to more closely reflect the operations of the association. The bylaws were last revised in October, 1999. Changes being proposed have been submit-

ted by the Bylaws Committee, Gary Ritter, Chair, and have been approved for distribution by the NDANA board of directors. The bylaws will be voted-on by members at the Fall Educational Meeting. Changes and

amendments approved will be renumbered/lettered accordingly. The full bylaws are available at www.ndana.org or by contacting the NDANA state office at 701-221-7797.

Article IV

Recognitions Section 3. Contributors

A. Contributors of one hundred dollars ($100.00) or more shall be known as Benefactors B. Contributors of less than one hundred dollars ($100.00) shall be known as Donors. C. The names of such Contributors shall be place in the permanent records of this Association.

Article V Government

Section 1. Officers C. ELIGIBILITY OF OFFICE

1. The candidate for the office of President-Elect must have previous Board experience. To be eligible to hold a Board Of-fice, the individual must be a member in good standing of the NDANA & AANA.

D. DUTIES OF OFFICERS 1. The President shall: a. Preside at meetings of this Association and of the Board of Trustees. b. Appoint special committees subject to the approval of the Board of Trustees. c. Be a member (ex-officio) of all committees, except the nominating committee. d. Prepare for each annual meeting of the North Dakota Association of Nurse Anesthetists a report of the work of the year.

e. Approve bills expenses for payment not exceeding $500.00 for a board or committee member acting in their offi-cial capacity before payment is made by the Treasurer.

f. Shall represent this Association at all official functions and at the AANA annual meeting.

g. Appoint tellers and registrars prior to voting. h. Keep the President-Elect informed of Association affairs.

i. With the exception of the Nominating Committee, appoint all committee chairs. j. Notify members of meetings.

k. Notify members of the Board of Trustees of meetings of the Board. 2. The President-Elect shall: a. Assume the duties of the President after one (1) year (or in the event of the latter’s inability to serve). b. Be responsible for the preparation of an annual history of this Association. c. Be responsible for the important records of this Association. d. Be Co-chair of the state Government Relations Committee 3. The Secretary shall:

Bylaws Continued

a. Keep the minutes of the meetings of this Association and the Board of Trustees. b. Notify officers of their election and committee chairs of their appointments. c. Notify members of meetings. d. Notify members of the Board of Trustees of meetings of the Board. e. Send to the Executive Director of the American Association of Nurse Anesthetists the names and addresses of the officers and trustees after their election, names of committee members after their appointment, and reports of meetings (or other activities). f. Send copies of important correspondence and information regarding matters of general business of this Association to the President. g. Keep an alphabetical list of members and their addresses. h. Give a written report at the annual meeting and/or upon the request of the President to the Board of Trustees.

i. Send copies of this Association’s Bylaws to new members. Make copies of association bylaws available to new members upon request and post the bylaws on the association website.

4. The Treasurer shall: a. File federal income tax for a tax-exempt corporation and is authorized to sign the necessary Internal Revenue forms for this Association. b. Receive moneys of this Association, pay debts, and disburse funds as directed by the Board of Trustees. c. Act as liaison for depositing funds predesignated by the Board of Trustees. d. Give a written report of Treasurer’s statement at the annual meeting and/or request of the President to the Board of Trustees. e. Orientate the incoming Treasurer to the duties of the office for a period of six (6) months.

Section 2. Board of Trustees C. DUTIES 1. Control and management of funds and property of this Association. 2. Selection of place for deposit of funds. 3. Provide for auditing of the books at least once every four years and before the annual meeting, or at such times as the Board may deem advisable. Books must be audited before turning them over to a successor.

4. Prescribe the amount of expenses that shall be allowed for speakers at annual and regular meetings and Prepare the annual association budget including amounts to be allowed toward defraying expenses of representatives to the annual meeting of the American Association of Nurse Anesthetists or to other meetings.

5. Conduct the general business of this Association and further conduct Association business between meetings by mail or other means of communication. 6. Fill all officer and Trustee vacancies to serve the duration of the term.

Article VI Committees and Appointments

Section 2. How Appointed B. Except for the Nominating Committee, each committee chair will appoint his or her own committee members. Each com mittee shall be composed of not less than three (3) members.

Section 5. Specific Duties

A. BYLAWS 1. This committee shall receive proposed amendments and present them to the Board of Trustees and to the members for consideration and approval.

2. Amendments to the Bylaws must be published and distributed to NDANA members at least one (1) month prior to the annual meeting. This may be done in the Vital Signs or to members via electronic format or on the association website.

Bylaws Continued 3. Voting for amendments to the Bylaws will take place at the NDANA annual meeting and will be pursuant to a two- thirds (2/3) majority of those present. 4. This committee must submit the Bylaws, upon any revision, to AANA annually. B. EDUCATION

1. This committee shall assist in the development of educational standards and consistently endeavor to further the educa-

tional program of this association and that of the American Association of Nurse Anesthetists. 2. The chair of this committee shall be known as Continuing Educational Coordinator of this Association.

3. Maintain records of C.E. units for state membership as received from AANA Continuing Educational Committee. 4. The chair of this committee shall: a. Designate Program Planners for the NDANA regular and annual meetings. b. Provide AANA Program Standards and Guidelines. C. GOVERNMENT RELATIONS 1. This committee shall work with and under the direction of the Board of Trustees and the National Government Relations committee in matters relating to the best interests of the association members.

2. Chair of this committee shall be the President-Elect and the Immediate Past President, and at least one of the chairs shall be encouraged to be a member of the North Dakota Nurses Association.

D. NOMINATING

4. The nominating committee shall provide for an electronic or mailing a ballot to each active member not less than three (3) weeks prior to the annual meeting.

E. PUBLIC RELATIONS

1. Membership d. It shall send a copy to the region director Executive Director of the American Association of Nurse Anesthetists.

e. This committee shall be responsible for recruitment and retention of nurse anesthetists not currently members of this Association. F. CHEMICAL DEPENDENCE 1. This committee shall provide information to all NDANA members regarding substance abuse and dependency in Nurse Anesthetists.

2. This committee shall be responsible for referring chemically dependent nurse anesthetists to appropriate assistance programs administered by the North Dakota Board of Nursing or the American Association of Nurse Anesthetists an avenue for assistance to those nurse anesthetists identified as chemically dependent to become independent.

Article VII

Meetings, Quorums, Voting C. METHOD OF VOTING 1. A registrar and two (2) assistants shall be appointed by the President and shall certify credentials before issuing ballots to voting members. 2. Three (3) tellers shall be appointed by the President and shall be responsible for the election process and making an official report to the members. The tellers shall also be responsible for counting election ballots and other votes on any business transacted.

Bylaws Continued 3. Matters submitted for vote to the voting body shall be determined by the majority unless otherwise specified.

4. Election of the Officers and the Board of Trustees shall be by mail ballot or electronic ballot. 5. A vote may be cast for a person not on a ballot by writing in the name. 6. A plurality vote shall elect a member to the Board of Trustees. D. MAILED AND ELECTRONIC BALLOT

1. The election of officers and trustees may be held by mailed or electronic vote if so determined by the Board of Trustees. 2. If the voting is by mail, ballots Ballots shall be mailed or sent electronically to members qualified to vote three (3) weeks prior to the annual meeting, said ballots to be marked and returned not later than one (1) week prior to the annual meeting.

3. The methods of conducting the mailed ballot shall be determined by the Board of Trustees. 4. Names may be written in on a mailed ballot if a written consent of a candidate has been given. 5. In the event of a tie vote by mailed ballot, the tie may be broken by a written ballot at the annual meeting.

Article VIII

Finance

Section 2. Fiscal Year January 1 to December 31

Article IX Official Publication

Section 1. Name: Vital Signs

The newsletter bulletin, VITAL SIGNS, shall be issued at least semi-annually. The newsletter and other association communications may be mailed or sent electronically and may be posted on the association website.

Section 2. Purpose

The purpose of this newsletter bulletin is to keep the members informed of the activities of their Association and stimulate interest in the Association.

UND Student Update Kevin Buettner

NDANA

PO Box 1755

Bismarck, ND 58501 Greetings from the Nurse Anesthesia Students at the University of North Dakota, College of Nursing. August is proving to be a very busy month with 14 students preparing to take their certification exams, 12 students moving into their 2nd year of the program, and another class beginning their studies. Our graduates continue to excel. The class of 2005 passed their licens-ing exams on the first attempt. This marks six years running that UND nurse anesthesia graduates have attained a 100% passage rate!! Also, the inaugural issue of the UND Nurse Anesthesia Specialization newsletter was mailed out in April. If you missed it, you can find it at: http://www.nursing.und.edu/alumni. We would like to take this opportunity to express our gratitude to the members of the NDANA for its support of the UND students and es-pecially to those nurse anesthetists who serve as our clinical preceptors. Your contributions are essential to the strength of the UND program and for the future of the nurse anesthesia profession.

NDANA PO Box 1755

Bismarck, ND 58502-1755

Phone:701-221-7797 Fax: 701-224-9824 bill@aptnd.com

We’re on the web:

www.ndana.org

NDANA