lioce alabama legislative workshop
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Dr. Lori Lioce, CRNP September 30, 2010
Alabama State Nurses Association Legislative Workshop
Update: Alabama’s Health and Legislation
Alabama Statistics Alabama Legislature Overview
State Health Authority Overview Strategies/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 (49th/32.2%)
ALABAMA LACK OF INSURANCE (18th/11.9%)
ALABAMA CHILDREN IN POVERTY (47th/27.3 %)
ALABAMA SMOKING (41st/22.2%)
Alabama Medicare Patients w/ ICU stay in last 6
months: AL 38%
AL Health
Rankings (-0.546)
States with
+ Changes 2008-09
Alabama’s Infant
Mortality 2009
48th
Alabama All
Determinants vs. US
43rd
ALABAMA OVERALL (48th)
Alabama vs. U.S.
All Outcomes 2001-09
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)
Governor's 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
House Districts
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 House, first reading, and referral to appropriate
committee.
Committee hearings, discussion, etc. Bill may die in committee from
lack of action or by vote.
Reported from committee, second
reading, and placement on calendar.
Amendments, debate, third reading and vote on
passage.
If bill passes, it is sent to the Senate. If not, bill may
receive no further consideration, unless
reconsidered.
SENATE BILL PASSAGE
First reading and referral to appropriate committee in the
Senate.
Committee hearings, discussion, etc. Bill may die in committee from lack of action or by vote.
Reported from committee, second reading, and placement on
calendar.
Amendment, debate, third reading and vote on passage. If it
fails to pass, it may receive no further consideration, unless
reconsidered.
If Bill passes… In 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.
BILL BECOMES LAW
If Governor signs;
If Governor fails to sign while Legislature
is in session, as provided by the Constitution; or
If, having been vetoed by Governor, it is re-passed by a majority
vote of both bodies. If not re-passed, bill is
dead.
Alabama Statistics Alabama Legislature Overview
State Health Authority Overview Strategies/Issues/Recommendations
Letter Writing NP Update
Nursing
Association
• ASNA • NPAA • ALANA • Coalition • Black Nurses Association • Schools Nurses • ENA • AANS • NLN
Medical Association
• MASA • ALAPAC
AL Health
Regulation
• BME • Dept. of Public Health • MASA • ABON • Joint Committee
Nursing 65,000 <3%
1500
Medicine 7,000 >90%
6200
DPH
BME
MASA
Legislature
NPAA
ASNA
Coalition
"The Board functions through the State Committee of Public Health as constituted by Code of Ala. 1975, §2224, which is composed of 12 members of the Medical Association of the State of Alabama and the chairman of each of four councils provided for by statute. The 16 members function under the leadership of a chairman and a vice chairman elected by the membership for a term of four years.” [2]"The State Committee of Public Health meets monthly. Agendas are available to any interested persons not less than seven days in advance of the meeting, if available, in accordance with the Alabama Open Meetings Act. All meetings will be open to the public unless closed in accordance with the Alabama Open Meetings Act." "Minutes of the Committee meetings are prepared and are available at the Board of Health offices for inspection during regular business hours."
Duties of the Board: Certify that initial applicants meet the statutory requirements for a license to practice medicine or osteopathy or as assistants to physicians in Alabama. Issue Alabama Controlled Substances Certificates and annually renew. With the Alabama Board of Nursing, approve applications for collaborative practice in Alabama. Investigate and review complaints against practitioners and pursue disciplinary action when appropriate. Establish and review compliance with continuing medical education requirements for physicians and assistants to physicians. Duties of the Commission: Issue licenses for physicians to practice medicine or osteopathy in Alabama and annually renew licenses. Adjudicate formal charges brought by the Board against physicians and determine appropriate disciplinary resolution.
MASA ALAPAC
Understanding the State Legislative Process
How a Bill Becomes Law
Development 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 Overview Strategies/Issues/Recommendations
Letter Writing NP Update
Let’s 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 legislator's response (you are entitled to
this information).
Alabama Department of Public Health C/O Dr. Donald E. Williamson
P.O. Box 303017 Montgomery, AL 36130-3017
Alabama State Legislature OR Alabama State House Senator ____ OR Representative _____
11 South Union Street Montgomery, AL 36130
Where are
Alabama
Nurses
now?
FEDERAL SUMMARY The 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 O’Bama-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 Trustees
Donna 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 care—in both the
private and public sectors—in 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 crisis Nurses Make-up the largest number
healthcare providers in this state Our job is to ADVOCATE for our patients,
families, friends Public 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 Committee 2. Participate: Calls, Emails, Letters 3. 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: lorilioce@comcast.net
4. Please submit a story at www.alabamanp.com 5. 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 Connections Document patient issues www.alabamanp.com
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