san diego regional meeting - cdn.ymaws.com · history of acnl established in 1978 housed in cha...
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SAN DIEGO REGIONAL MEETING
September 26, 2019Sharp Copley Center
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Regional MeetingLIVING OUR PURPOSE
Kimberly Long, DHA, MSN,
FNP, RN, FACHE
President
Kim Tomasi, MSN, RN
Chief Executive Officer
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Overview of ACNL
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History of ACNL
Established in 1978
Housed in CHA initially
501c6 for two years, then became a 501c3
First Executive Director part time in 1988
Name changes CSNSA, ONE-C, One California and now ACNL
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501c3 Status
Public Benefit Nonprofit Corporation• Most groups want 501c3 designation
• 501c3 – charitable, scientific, literary or educational
• All of these purposes are considered charitable under California Law
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Purpose StatementACNL IS THE PROFESSIONAL NURSING ORGANIZATION THAT EQUIPS NURSES TO LEAD SELF, OTHERS AND SYSTEMS
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Vision StatementPOSITIONING NURSE LEADERS TO CREATE AND INFLUENCE THE FUTURE OF HEALTH CARE
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Core Values
INTEGRITY INNOVATION INCLUSIVITY DIVERSITY
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Value of Membership
Networking / BuildingRelationships
Annual Program
Regional Meetings
Professional and Personal Connections
Mentoring / Career Development
LifeMoxie ACNL Mentoring Program
Education / Nurse Leader Knowledge
Regional CE Education Events
Quarterly Webinars
Foundations & Advanced Leadership Development Programs
Nursing Voice / Advocating for Health
Capital Legislative Updates and Action
Committee Work / Advancing Leadership
Helping to Shape the Future of Nursing in California
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Organizational Structure
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2019-2020 Executive Board of Directors
Dennis KneeppelImmediate-Past
President
Kim HortonPresident
Jami de SantiagoSecretary-Treasurer
Kim TomasiCEO
Anitra WilliamsPresident-Elect
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ACNL Board of Directors
Chief Executive Officer
Core CACN
Operations
Conference
501c3 Design
Core ACNL
ACNL Committees
Annual Program
Education Programs
Operations
Philanthropy
Office Manager Bookkeeper/Industry Liaison
Administrative AssistantMarketing and Communications Specialist
CACN Board
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AONE
AHA
HAONENONL
Region 9
ACNLNWONE
Kern County
Central San Joaquin Valley
Orange County/Long Beach
San Diego
North Central
Los Angeles/Coastal
San Fernando Valley
Alaska
Ventura/Santa Barbara Area
Inland Empire
South Bay
Sacramento/Sierra Region
Greater San Francisco
East Bay
Northern Region Central Region Southern Region San Diego Region
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Overview of Operations
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Revenue Sources
CACN Management
Industry Partners
Membership Dues
Education
Investments
Executive Leadership Academy
Foundations for Leadership Excellence
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Partnerships
CHA
CHPAC
Quad Council
ACNL
CACN
COADN
ANA\C
LifeMoxie
ACNL
CAC
ACNL Chapters
15 Regional Chapters
CALNOC
ACNL
ANA\C
HealthImpact
CAC
NOBC
Educational Partners
12 Colleges and Universities
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Committees
Annual Program
Bylaws
Communication/Voice
Health Policy
Healthy Work Environment
Member Experience
Nominations
Nurse Leader Development
Philanthropic, Recognition, and Scholarship
Quality, Safety, and Engagement
Research
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Information and Resources
Website
ACNL in Action
Position Papers
Tool Kits
E-Mail Blasts
Regional Forums
Committees
Local Chapters
Annual Conference
Webinars
Educational Offerings
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Looking Forward
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Areas of Focus
Foundations for Leadership Excellence
Annual Conference
Membership
Executive Leadership Academy
Leverage mentorship through LifeMoxie
Philanthropy
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Foundations for Leadership Excellence
Access Leveraging technology
Partnership with Chapters
Professional Networking
Creating a pipeline to Life Moxie
Marketing: Expanding to partners and other
organizations
Faculty development
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Annual Program
Content appropriate at all levels of leadership
Purposeful networking
Maintaining relevance
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Membership
CNO membership
Support Influence
Enhance chapter infrastructure and support
Speakers Dues Board presenceStandard state
messagingBylaws
Benefits of membership
Leverage regional meetings for professional networking
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Membership
Inter-link/connect with Foundations
Procurement of mentors
Align with magnet designation
Succession planning
Experiential learning
Highlight and promote the value
of mentorship
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Executive Leadership AcademyPurposeful networking
Mentorship
Professional coach
Executive faculty
Experiential learning
Content appropriate for those whose next step is executive leadership
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Mentorship
Inter-link/connect with Foundations
Procurement of mentors
Align with magnet designation
Succession planning
Experiential learning
Highlight and promote the value of mentorship
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Philanthropy
Reconnect with our members Connect our purpose and values
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WHO Designates 2020 as the Year of the Nurse and Midwife
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“I contribute my success to this – I never gave or took excuses.”
Florence Nightingale1820-1910
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Foundations for Leadership ExcellenceM AY 2 0 1 9
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SAN DIEGO REGIONAL MEETING
September 26, 2019Sharp Copley Center
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THE BOARD OF REGISTERED
NURSING
PILAR DE LA CRUZ SAMOULIAN, MSN. RN
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SHARING TIME
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OBJECTIVES
State the purpose of the Board of Registered Nurses
(BRN);
List the common reasons nurses get into trouble with the
BRN;
Discuss the role of the Scope of Practice;
List what personal changes need to be reported to the
BRN.
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CA BOARD OF REGISTERED NURSES (BRN)
BRN oversees over 433,000 licensees;
To work as an RN in California, you must have a California license;
In California, nurse practitioners, clinical nurse specialists, nurse
anesthetists, nurse midwives and any and ALL advanced practice
nurses all fall under the auspices of the Board of Registered Nursing.
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QUESTION
TRUE OR FALSE
The California Board of Registered Nurses exists to protect
Registered Nurses.
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PURPOSE OF THE BOARD
The Board of Registered Nursing protects and advocates for
the health and safety of the public by ensuring the highest
quality of registered nurses in the State of California.
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BOARD COMPOSITION
The BRN is comprised of 9 members; 5 RNs and 4 public members
Direct patient care provider (2)
Advanced Practice Nurse (1)
Nurse Educator (1)
Nurse Administrator (1)
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BOARD MEMBERS APPOINTMENTS/TERMS
7 members appointed by the Governor;
2 members appointed by the legislature;
Terms of office are generally 4 year terms; can be appointed to an
additional 4 year term;
Long vetting process.
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CURRENT BOARD MEMBERS
Michael Jackson, RN President
Donna Gerber, Vice-President
Trande Phillips, RN
Imelda Ceja-Butkiewicz
Elizabeth Woods, RN, FNP
Kenneth Malborough
Currently 3 open positions; one direct patient care provider, one public member
and a nurse administrator position.
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EXECUTIVE OFFICER OF THE BOARD
Previous Executive officers:
Ruth Ann Terry
Louise Bailey
Current Executive Officer
Dr. Joseph Morris
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BOARD MEETINGS
Held monthly, except July and December;
Held in different areas of the state;
Discipline meetings held every other month;
Committee meeting/full board meetings held monthly;
Meetings are open to the public;
Students encouraged to attend discipline meetings.
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BOARD COMMITTEES
Education and Licensing
Discipline
Advanced Practice
Legislative
All board members sit on at least one committee
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NURSING EDUCATION CONSULTANTS
Work with nursing programs to ensure compliance;
Serve as consultants to school directors;
All nursing programs have a consultant assigned to their
program;
Make recommendations to Education and Licensibg
committee of the Board on continuing approval of a
program.
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NURSING PROGRAM APPROVALS
Board approves all new and existing nursing programs;
Nursing programs are required to get approval from BRN
for any changes to curriculum or major changes;
NECs visit each school every 5 years to ensure
compliance with regulations;
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NCLEX SCORES
Board monitors all nursing program NCLEX scores;
School must maintain a 75% passing rate;
Action plan required for any school that drops below 75%
passing rate;
California has the highest NCLEX passing rate in the
nation.
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FEES
Fees increased in January, 2017;
Fees allowing BRN to fill open positions to help expedite
their response to inquiries and to serve licensees;
The Board is currently working diligently to fill all needed
positions.
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BRN’s COMMUNICATION
.
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BRN’s WEBSITE: rn.ca.gov
Information on: Practice, Regulations, Education, FAQs, RN careers,
Verification of licenses;
Information on all BRN meetings;
Forms and publications;
NCLEX scores;
Approved nursing programs;
Updates, etc.
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STAYING CURRENT WITH BRN
Need to make sure that BRN has your current address;
If you move, you must notify the BRN within 30 days of
moving;
If you change your name (marriage, divorce, etc.) you
need to notify the BRN of the change within 30 days.
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SCOPE OF NURSING PRACTICE
Make sure you are familiar with the California Nursing
Practice Act and that you know your Scope of Practice;
Be familiar with what you can do and what you cannot
do as an RN;
Pay special attention to Article 2, Section 2725, Scope of
Regulations.
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IMPORTANCE OF SCOPE OF PRACTICE
States what nurses can do as a registered nurse;
Should be part of every nursing program curriculum;
Not knowing their scope of practice can get a nurse in trouble;
Only you can protect your license;
Can purchase a California Nursing Practice Act book from BRN.
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LICENSURE: INITIAL
Nursing school must submit the individual transcripts;
98% of ALL California nursing schools have successfully completed
the electronic transcript process via the Cloud
The outcomes of the new process have been very positive.
The Board is currently finalizing the process that will allow the
Licensing unit to receive electronic transcripts via the Cloud for
endorsement applicants.
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LICENSURE: RENEWALS
When completing your renewal application, please read
instructions carefully as the format has recently changed
INCOMPLETE RENEWALS
Failure to respond to the continuing education, conviction, or
fingerprint compliance questions (or answering “no” to the
fingerprint compliance question on the renewal application will
result in an incomplete renewal
Payment will be processed but the renewal will be delayed until all
required information is received by the Board
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CONTINUING EDUCATION UNITS (CEU’s)
Need 30 CEUs every two years to renew license;
CEUs need to relate to nursing practice/health care;
Need to keep certificates for 4 years.
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COMNMON REASONS FOR DISCIPLINE
Working outside their scope of practice;
Drug and alcohol issues;
Negligence/Incompetence;
Unprofessional conduct;
Lying on RN application.
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WHAT CAN TRIGGER A COMPLAINT?
Several actions can trigger a complaint to the BRN:
Notification from Department of Justice or FBI ;
An arrest or criminal conviction;
Discipline taken by another state licensing agency;
Public complaint alleging unprofessional conduct, gross negligence
or incompetence.
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POTENTIAL DISCIPLINE OUTCOMES
Revocation of license;
Suspension of a license;
Probation;
Public reproval;
Dismissal of the accusation;
Revocation/surrender,
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HOW IS DISCIPLINE DETERMINED?
It is not to be punishment;
Public protection is the obligation;
The applicable evidentiary standards and burdens apply;
Mitigating or aggravating circumstances can be considered;
Look at what is in the record;
The decision is public.
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INTERVENTION PROGRAM
A voluntary and confidential monitoring program for RNs whose
competency may be impaired by substance use disorder or mental
illness;
The program protects the public by providing RNs access to
effective treatment services, monitoring their recovery through an
individualized plan and returning them to safe practice.
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A DIFFERENT VIEW
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CONTINUING EDUCATION PROVIDER
BRN instructed by a senate committee to conduct a cost benefit
analysis of the BRN’s CEU approval, renewal and course evaluation
process;
BRN currently reviewing the process outlined in the report submitted
and its pans for implementation;
Fees have increased for providers;
If you are a CEU provider, make sure you have all the required
documentation on record.
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DUAL ENROLLMENT PILOT PROJECT
Purpose: to allow students enrolled in a pre-licensure associate
degree nursing program to be dually enrolled in the CSU nursing
degree program (s) with the aim of completing their BSN within 1
year or less;
Riverside Community College, Cal State University, San Bernardino
and Cal State University, Fullerton are in a pilot program;
If successful, may be expanded to other programs.
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GOING GREEN PROJECT
Elimination of the pocket card has been initiated as of October,
2017
RNs will no longer receive a BRN card. Need to go on the BRN
website (rn.ca.gov) to check for license status.
This will not only save paper but also time and money;
Helps prevent fraud.
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WORKFORCE: NEWAC SUBCOMMITTEES
SIMULATION:
NEC staff has reviewed the proposals of NEWAC Simulation subcommittee
The proposals will be submitted to the NEWAC Committee for review with final recommendations regarding the use of simulation
Currently nursing programs are allowed to use up to 25% simulation time in their curriculum
The NEWAC committee will then present the final recommendations to the Education/Licensing Committee of the Board for their recommendation to full board.
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NEWAC SUBCOMMITTEE
CLINICAL DISPLACEMENT SURVEY
NEC staff is finalizing the questions of the Clinical Displacement
Survey that will be distributed to the Deans/Directors;
The survey will provide the Board with detail information regarding
clinical displacement;
The data provided to the Board will be gathered, analyzed &
forwarded to the ELC in order to make recommendations
regarding this matter.
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YOUR BRN IS WORKING FOR YOU!
Making positive changes;
Increasing the use of technology to improve services;
Adding much needed staff positions;
Re-aligning of staff to better meet your needs;
Working closer with DCA & legislators to help them better understand the BRN’s work;
Looking for opportunities to better serve you in the future.
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IN CONCLUSION
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SUMMARY
Know you Scope of Practice;
Always keep BRN informed of address/name changes;
Make sure license renewal is complete;
Keep CEU certificates for a minimum of 4 years;
Remember the purpose of the board.
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THANK YOU!
QUESTIONS????????????????????
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SAN DIEGO REGIONAL MEETING
September 26, 2019Sharp Copley Center
Networking Break
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SAN DIEGO REGIONAL MEETING
September 26, 2019Sharp Copley Center
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Thank-you to today’s sponsor
www.usa.edu#uofstaug
Clinical Excellence Through Graduate Education
The mission of the University of St. Augustine for Health Sciences is the development of
professional health care practitioners through innovative, individualized, and quality classroom,
clinical and distance education.
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4th Annual SDACNL Networking Event October 3, 2019 6PM - 9PM
Riverwalk Golf Club 1150 Fashion Valley Road
San Diego, CA 92108
This is a fun evening of mingling and networking with nurses in San Diego County and from around the state in an informal, relaxed setting.
Featuring a welcome from state and local nurse leaders
Free food and drinks, and raffle prizes!
If you or anyone you know are a member or are interested in learning about the ACNL, please join us for this hosted event!
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20th Annual ACNL Innovations Conference
APRIL 4, 2020
Save the Date!
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Online Registration Coming Soon!
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Overview of the Legislative Process
and Advocacy
Alice Martanegara, DNP, RN
September 26, 2019
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Overview of California Legislative Process
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Advocacy – WHAT
Advocacy encompasses a wide range of activities that
influence decision makers.
Advocacy includes traditional activities such as litigation,
lobbying, and public education. It can also include capacity
building, relationship building, forming networks, and
leadership development.
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Advocacy - WHAT
Voting
Professional Organization Legislative Days
Political campaigns
Writing – editorials, newsletters, publications
Knowing your legislators/policymakers, city,
county, state/Federal
Political Action Committee
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Advocacy - How!
Know your legislator and or the one you are visiting (party,
leadership position committees, previous legislative/issue
decisions
Find your district elected officials
If you are a constituent of the legislator make sure to
address = message leverage
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Communication as a Representative of a
Professional Organization
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Visit your legislator
Meeting with your legislators is one of the most
effective ways to influence
Regardless of whether you are meeting with your
legislator by yourself or with a group, you should be
clear about: Your message
The resources you want to leave behind
Your ultimate “ask”
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Overview of an Effective Visit With Your Policy Maker
It is important to know- Who are you representing! Hospitals- Typically have a government relations department or person. Meet with them first to
clarify if needed. Hospitals may have a tax status that prevents them from lobbying.
Do not use hospital letterhead or address unless approved
Professional Organization- Understand their Tax Status and their position on any issues that
may be discussed with a legislator.
Self- You may visit a legislator as a voter/constituent/concerned citizen.
Identify that you are representing yourself
Okay to use your professional title and workplace to establish credibility
Be sure to use a disclaimer that you are not representing a specific hospital organization.
*Title for Identification Purposes Only* - Consider adding to letters
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Tax Status is important-ACNL is a 501(c)(3)
• In general, no organization may qualify for
section 501(c)(3) status if a substantial part
of its activities is attempting to influence
legislation (commonly known as lobbying).
• A 501(c)(3) organization may engage in
some lobbying, but too much lobbying
activity risks loss of tax-exempt status.
• Organizations may involve themselves in
issues of public policy without the activity
being considered as lobbying.
Organizations may conduct
educational meetings, prepare
and distribute educational
materials, or otherwise consider
public policy issues in an
educational manner without
jeopardizing their tax-exempt
status.
https://www.irs.gov/charities-non-profits/lobbying
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Introductions
Remember- they need your nursing intelligence
Content expert- Bear more weight than lobbyists
In-person visits, letters, emails are the most persuasive if the legislator
has not made a firm decision on an issue
How do you make your visit stand out? Know what your are in support of, not just against
Know the voting history
Come prepared
Be kind to the staffers
Be on time, dress professionally, leave behind materials
Tell a personal story or concrete example
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Health Policy and Politics:
An Agenda for Achieving the Triple Aim
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What is the Triple Aim?
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The Triple Aim
Developed by the Institute for Healthcare Improvement in 2008
Framework for optimizing health system performance by simultaneously pursuing
three dimensions
Improving patient care experience (quality and satisfaction)
Improving the health of population
Reducing per capita cost of health care
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Patient Experience
Improving Patient Experience
Improved communication between providers
Patient centered care coordination
Reduction/elimination of Hospital Acquired Conditions
Collaborative Transition of Care
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Reducing Cost
United States Healthcare is most expensive in the World
By 2020 – 20% of the GNP will be healthcare
Why? –Aging Population
Chronic Health Problems
Longer life expectancy
The NEED is to improve the health of the population served while
optimizing costs and delivering excellent quality careTreat the people holistically (mind, body and soul) to ensure that they are getting the
right care in the right place
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Improving Population Health
Key Driver: Focus on identifying & addressing risk in communities
Everyone living in the community could potentially become a patient
Identify specific sub-population
Include factors such as food, clothing, housing, ability to pay for
medications
Do you have the following available:
Recuperative Care Programs for Homeless
Proactive outreach to high-risk patients and complex case management programs available
What about patients with chronic pain
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How to Start?
Figure out the unique needs of the community
and identify your at-risk populations
Establish organization/system specific goals
Develop a way to measure, track and
demonstrate progress
Involvement of Community Leaders and
Executive Team
IHI online survey to help assess where you are
and are you ready to pursue a Triple AIM
http://www.ihi.org/Topics/TripleAim/Pages/GettingStarted.aspx
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Just one More Thing
Institute for Healthcare Improvement
addressing the Triple Aim and the Social
Determinants of Health
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Just one More Thing
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Health Policy and Politics – An Agenda for
Achieving the Triple Aim – Part II
Janice White
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Reminder - What is the Triple Aim?
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What are the Studies Showing?
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California’s New Budget $209 Billion
Undocumented young adults (<26y/o) enroll in Medi-Cal
Mandated health insurance including insurance subsidies to
assist with insurance affordability
$650 million to “aid” homeless population
$500 million for affordable housing
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The Vital Link
• Medicaid
Sensing the need to involve the National,
State and Local governments in meeting
SDOH.
Published a series of seven briefs on key
Medicaid issues for state policymakers
series is designed to assist new state leaders in
understanding the Medicaid program and their role
in using it to improve the health of their states’
residents and communities
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Medi-Cal Managed Care Programs
Cover more social services needs of patients though
covered S.S. benefits
use value-based payments to support provider investment
in social interventions
use incentives and withholds to encourage plan
investment in social interventions
integrate efforts to address social issues into quality
improvement activities
reward plans through higher rates for effective
investments in social interventions.
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Health Policy - Where Do We Come In?
We can provide information on where to find resources in our
communities:
35% of Americans lack confidence that they could identify the best resource if
they or a family member needed to use community resources relating to
transportation, food, housing, or social isolation
80% of Americans would find it helpful for their medical provider to share
information about community resources, recommend specific resources, follow
up, and help them apply for resources
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Health Policy - Where Do We Come In?
We are the key resource for our community through:
Meeting with legislators on health policy to discuss
SDOH
The need for community, local and state involvement
Ask the questions of our patients and community on
Safe housing
Reliable transportation
Healthy meals
Supportive social relationships
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Kimberly Tomasi, MSN, RNCEO, ACNL
Ratio Penalty LegislationNursing Hot Topic
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Margarita Baggett, MSN, RNChief Clinical Officer, UC San Diego Health
Intergenerational Collaboration to Facilitate Gaps in Patient Care Excellence
Nursing Hot Topic
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Alice Martanegara, DNP, RNACNL Health Policy Committee
Clinical PlacementNursing Hot Topic
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QUESTIONS?
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SAN DIEGO REGIONAL MEETING
September 26, 2019Sharp Copley Center
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Thank-you to today’s sponsor
www.usa.edu#uofstaug
Clinical Excellence Through Graduate Education
The mission of the University of St. Augustine for Health Sciences is the development of
professional health care practitioners through innovative, individualized, and quality classroom,
clinical and distance education.
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4th Annual SDACNL Networking Event October 3, 2019 6PM - 9PM
Riverwalk Golf Club 1150 Fashion Valley Road
San Diego, CA 92108
This is a fun evening of mingling and networking with nurses in San Diego County and from around the state in an informal, relaxed setting.
Featuring a welcome from state and local nurse leaders
Free food and drinks, and raffle prizes!
If you or anyone you know are a member or are interested in learning about the ACNL, please join us for this hosted event!
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20th Annual ACNL Innovations Conference
APRIL 4, 2020
Save the Date!