Dr. Lori Lioce, CRNP, FNP-BCAANP 26th Annual Conference

PresentationLas Vegas, Nevada

June 25, 2011

Restrictive Collaboration

One States Story

Init. Apps Active 9-30 CNM CRNA

2009 182 1863 3/19 81/14872008 202 1744 0/27 151/14202007 126 1633 2/26 118/14062006 220 1600 4/28 219/13192005 190 1259 0/23 98/11312004 167 1388 2/33 189/1389

Alabama CRNP statistics

Alabama State Health Facts statehealthfacts.org by Kaiser

1726 NPs (2010) 1% of US total36 NPs per 100,000 (U.S 54)MDs 21.6 per 10,000 (2008)73 Rural Health Clinics (2011)16 FFQH Clinics (2009)887,591 citizens live in underserved

areas (2008)15.8% Sought NO health Care r/t Cost (2009)

Physician REQ for Dx/Tx 1:27Physician REQ for Rx 1:35

America’s Healthcare Rankings

2010

ALABAMA OUTCOME

S49th

Alabama

OverallHealth

AL Public Health Funding 13th

http://www.americashealthrankings.org/Measure/2010/AL/Public%20Health%20Funding.aspx

Alabama Lack of Insurance 18 -> 26

http://www.americashealthrankings.org/Measure/2010/AL/Lack%20of%20Health%20Insurance.aspx

Alabama Legislative FactsQuadrennium (4-year period)Regular Annual Session

No more than 30 legislative days, within a 105 Calendar day period annually

Priority is on BudgetCareer LegislatorsNP regulation formally began 1995no

scope of practice in statue

Authority for Health Care Decisions Governor’s Office

Statewide Health Coordinating Council (SHCC) AL Code - Section 22-4-7

State Health Planning and Development Agency (SHPDA) Certificate of Need Review Board (CON)

LegislatureAlabama Department of Public HealthU.S. Government

Restrictive Collaboration1. ADPH Committee on Public Health/ABME (S)2. 10 % on-site MD Requirement (R)3. Mandatory Reimbursement (PP)4. Sign Handicap Parking Permits (S)5. Sign Sports Physicals (PP)6. Order Physical Therapy for Patients (S)7. Regulatory Authority (S)8. Scope of Practice (R)9. Remove Ratio for MD/NP Collaboration 1:3(R)10. Primary Care Provider Recognition (S/R)11. Prescriptive Authority (R)12. Nursing Data RX/Workforce (S)

Strategic PlanSHORT TERM

1. Adhere to 2010 Strategic Plan

2. Recognize & Publicize NPs

3. Educate Public/NPs4. Participate/Influence

the Legislative Process5. Expose

Rules/Regulations6. Build Allies7. Collect NP Data

LONG TERM1. Establish NP Organization

by transitioning to staff support of Volunteer Board

2. Build Allies 3. NP Data collection4. Inclusiveness5. Educate Public/NPs6. Participate/Influence the

Legislative Process7. Research

Rules/Regulations

We

MUST….

 

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

ADVOCACY MUST CONTINUE FOR CHANGE TO PREVAIL