3/22/2018 Michigan Legislative Advocacy Agenda Gretchen Schumacher PhD, GNP‐BC, FNP, NP‐C President, Michigan Council for Nurse Practitioners Region 5 Director, American Association of Nurse Practitioners Nursing Representative, MI Prescription Drug and Opioid Abuse Commission Owner, Advanced Practice Nurse Staffing Associates, LLC/Elder Care of West MI OBJECTIVES • DESCRIBE THE IMPACT OF HB 5400 AND THE 2016 BOARD OF MEDICINE AN BOARD OF NURSING RULES CHANGES • IDENTIFY AT LEAST 1 EFFECTIVE STRATEGY FOR POPULATION HEALTH ADVOCACY IN MICHIGAN WHO AND WHERE ARE WE? Michigan Public Health Institute (2016). Michigan Nurse Practitioners in May 2016. Retrieved from: https://www.minursemap.org/2016/2016_region_NPs.html 1
3/22/2018 NP PRACTICE MICHIGAN NATIONAL STANDARD • Written scope of advanced • No scope of practice practice in law/statute written in Public Health Code • License to perform the scope in law/statute • No license • Full practice authority • Restricted practice NP PRACTICE IN MICHIGAN SCOPE OF PRACTICE • The scope of practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license. • APRN practice is typically defined by a state’s Nurse Practice Act written in law and governed by the State Board of Nursing • PA STATE CODE‐ CRNP HOUSE BILL 5400 Signed by Governor Snyder January 9, 2017 and takes effect April 9, 2017 . 2
3/22/2018 HB 5400 ✓ Defined APRN roles ✓ Authorizes APRNs to prescribe non scheduled medications independently ✓ Authorizes APRNs prescription of PT, speech and restraints ✓ Authorizes APRNs prescribing Schedule II‐V with delegated agreement ✓ Authorizes APRNs to order, receive and dispense a non‐scheduled complimentary starter dose drug without delegation from a physician ✓ Authorizes APRNs who have a delegated agreement with a physician for scheduled medications to give complimentary starter doses ✓ Authorizes APRNs to make calls, round in private homes, public institutions, emergency vehicles, Ambulatory care clinics, hospitals, intermediate or extended care facilities, HMO, nursing homes or other health care facilities, without restrictions on the time or frequency of visits by a physician or APRN. ✓ Added language about APRNs in nursing homes, and added APRNs to the language regarding the rights of nursing home residents ✓ Added CNS to the Public Health Code as APRN ✓ Changed the number of members of the Board of nursing to 24, by adding 1 CNS to the board. Once 1 of the public members has served their term the board will return to 23 members, with only 7 public members instead of the current 8 BOARD OF NURSING RULES CHANGE ✓ Increase in license fees now $60 for RN, no change in specialty certification cost ✓ Added training requirements for human trafficking ✓ Defined nurse practitioner with a scope statement ✓ No temporary certification option ✓ Specialty certification requirements defined ✓ Added renewal requirements for continuing education BOARD OF MEDICINE RULES CHANGE ✓ Allow delegation to APRNS the ability to prescribe Schedule II‐V medications, effective December 6, 2016. ✓ Board of Osteopathic Medicine and Surgery passed the same rule on December 20, 2016. 3
3/22/2018 MICHIGAN LAW 101 PUBLIC HEALTH CODE/STATUTE PROMULGATING RULES • In MI law, rule ‐making is the • A code of law , also called process that executive and a law code or legal code , is a independent agencies use to systematic and comprehensive create, or promulgate , compilaton type of legislation regulations. In general, that purports to exhaustively legislatures first set broad cover a complete system policy mandates by passing of laws or a particular area statutes, then agencies of law as it existed at the time create more detailed the code was enacted, by a regulations to administer the process of codification. statutes/laws through rulemaking. Law Rule WHERE DO WE GO FROM HERE? • PRIMARY FOCUS NOW IS LEGISLATIVE AND AMENDMENT OF THE PUBLIC HEALTH CODE TO ACHIEVE NATIONAL CONGRUENCY • ULTIMATELY FULL LICENSURE AND SCOPE!! • INCREMENTAL STEP APPROACH FOCUS=LEGISLATOR RELATIONSHIP BUILDING UNIFIED VOICE! 4
3/22/2018 Legislation to watch • Sen Marleau has been working on legislation to amend the Mental Health Code to address lack of inclusion of NPs, CNS and PAs as providers‐‐‐final draft expected soon • Language allowing NPs to open a PLLC/PC • Opioid package bills What can you do? COMMUNICATE TO LEGISLATORS AND STAKEHOLDERS • Know the facts! • Build relationships! (Also with the STAFF!) • Elected officials care about the people who put them in office. This is why it’s critical to communicate your message and build positive relationships. Most elected officials hold district hours, have toll‐free telephone numbers, and provide office contact information in their newsletters, and online. • Don’t be discouraged if you meet with a staff member • Invite legislators to keep arenas or to speak 5
3/22/2018 Upper Penninsula Region 1 (and Eastern Region 2) HOUSE NEW 109‐Sara Cambensy (D) 110 107‐Lee Chatfield ( 109 107 108 110‐Scott Dianda (D) 106 NEW NEW 108‐Beau LaFave (R) 106‐Sue Allor (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 SENATE 38 37‐Wayne Schmidt (R) 37 38‐Tom Casperson (R) 36 36‐Jim Stamas (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 6
3/22/2018 Traverse City Area Region 2 HOUSE 105‐ Triston Cole (R) 104‐ Larry Inman (R) NEW NEW 103‐ Daire Rendon (R 101‐Curt VanderWall (R) NEW NEW 97‐ Jason Wentworth (R) 102‐ Michele Hoitinga (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 7
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3/22/2018 SENATE 35‐Darwin Booher (R) 37‐ Wayne Schmidt (R) RED=TERM LIMITED OUT END OF 2018 UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 Grand Rapids Area Region 4 9
3/22/2018 HOUSE/ non NEW NEW city 102‐Michele Hoitenga (R) 100‐Scott VanSingel (R) NEW 91‐ Holly Hughes (R) 70‐James Lower (R) NEW NEW 92‐Terry Sabo (R) 86‐ Thomas Albert (R) NEW NEW 89‐Jim Lilly (R) 87‐Julie Calley (R) HOUSE 76‐Winnie Brinks (D) 74‐Rob Verheulen (R) 73‐Chris Afendoulis (R) 75‐David LaGrand (D) NEW NEW 88‐Roger Victory (R) 72‐ Steve Johnson (R) 77‐Tommy Brann (R) RED=TERM LIMITED OUT END OF 2018 UNDERLINED= ELEGIBLE FOR RE‐ELECTION 10
3/22/2018 SENATE 33‐Judy Emmons (R) 34‐Geoff Hansen (R) 28‐Peter MacGregor (R) 30‐Arlan Meekhof (R) 29‐Dave Hildenbrand (R) 26‐Tonya Schuitmaker 19‐Mike Nofs (R) (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 Southwest/Kalamazoo Area Region 4 HOUSE 90‐Daniela Garcia (R) 80‐Mary Whiteford (R) NEW 62‐John Bizon(R) 66‐Beth Griffin (R) NEW 63‐ David Maturen(R) 79‐ Kim LaSata (R) 59‐Aaron Miler (R) 60‐Jon Hoadley (D) 61‐Brandt Iden (R) 78‐Dave Pagel (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 11
3/22/2018 SENATE 19‐Mike Nofs (R) 26‐Tonya Schuitmaker (R) 20‐Margaret O‐Brien (R) 21‐ John Proos (R) Central Michigan/ Tri‐Cities and Lansing Areas Region 3 12
3/22/2018 MICHIGAN HOUSE OF REPRESENTATIVES 94‐ Tim Kelly (R) 98‐ Gary Glenn (R) 95‐ Vanessa Guerra(D) 99 99‐ Roger Hauck (R) 96‐ Brian Elder(D) 84‐ Ed Canfield (R) 97‐ Jason Wentworth(R) 84‐ Ben Frederick (R) (Interested in VA issues) MICHIGAN SENATE DISTRICTS 36‐ Jim Stamas (R) 36‐ Mike Green (R) 25 32‐ Ken Horn (R) 25‐ Phil Pavlov (R) NEW HOUSE 93- Tom Leonard (R)/ Speaker NEW 85- Ben Frederick(R) 87-Julie Calley (R) 69- Sam Singh (D)/ minority leader 71-Tom Barrett (R) 67- Tom Cochran (D) 68-Tom Barrett (D) RED=TERM LIMITED OUT END OF 2018 UNDERLINED= ELEGIBLE FOR RE-ELECTION 18 13
3/22/2018 SENATE 24- Rick Jones (R) 19-Mike Nofs (R) 22-Joe Hune (R) 23- Curtis Hertel Jr (D) RED=TERM LIMITED OUT END OF 2018 UNDERLINED= ELEGIBLE FOR RE-ELECTION 18 Red circle= health policy committee 14
3/22/2018 HOUSE 67‐ Tom Cochran (D) 62‐ John Bizon (R) NEW 65‐ Brett Roberts (R) 64‐ Julie Alexander (R) 58‐ Eric Leutheuser (R) SENATE 22‐ Joe Hune (R) 18‐ Rebekah Warren (D) 16‐ Mike Shirkey (R) 17‐ Dale Zorn (R) SW Michigan/ AA and Detroit Region 5 15
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