CNAP LEGISLATIVE UPDATE #1

CNAP Legislative Update #1

Lynda Woolbert, Executive Director

Coalition for Nurses in Advanced Practice (CNAP)

January 25, 2010

 Exciting Times As 82nd Texas Legislature Convenes

Hopes are high among APRNs for the 2011 Texas Legislative Session. Never have prospects for APRN-backed legislation looked so bright. Pre-filing bills for the 82nd Session began on November 8, 2010, and the Session began January 11th. CNAP, our member organizations, and many dedicated APRN volunteers are already hard at work.

 Public Support could Shift the Balance of Power

Even before the legislative session began, you may have seen editorial exchanges between physicians and APRNs in the Dallas Morning News and Austin American Statesman. The article by AANP head, Timothy Knettler, was excellent exposure for nurse practitioners.

 However, what separates the 2011 Legislative Session from any session in the past is the fact that many consumer, political think tanks, and even certain legislative bodies are beginning to weigh in on the side of APRNs. We thank AARP Texas State Director, Bob Jackson, for expressing his organization’s support in his letter to The Dallas Morning News editor, A health care solution. The National Alliance on Mental Illness (NAMI) San Antonio, the Texas Public Policy Foundation and the Texas Association of Business are also lending support.

Legislative Committee Recommendations Support Change

We are also excited that two legislative committees issued reports to the 82nd Legislature containing recommendations that support legislation to remove delegated, site-based prescriptive authority. The House County Affairs Committee’s Interim Report recommends, “The Texas Legislature should adopt measures that remove barriers to the full utilization of Nurse Practitioners (NPs), Physician Assistants (PAs) and other health providers.” We owe many thanks to Chairman Garnet Coleman (Houston HD#147), for submitting an Interim Charge to Speaker Straus that included APRNs, inviting testimony from APRNs at many County Affairs Committee interim hearings, and including a very supportive recommendation in the Interim Report.

The Legislative Budget Board (LBB), a permanent House and Senate Joint Committee, published the LBB staff’s Texas State Government Effectiveness and Efficiency report on January 19th. After a thorough review of the evidence on safety and practice in other states, LBB staff recommends the Texas Legislature include advanced assessment, diagnosing, prescribing and ordering as part of an APRN’s scope of practice in the Nursing Practice Act (page 297). We were disappointed that recommendation #2 suggests APRNs should only have independent prescriptive authority after they complete 3600 hours of delegated prescriptive authority agreement with a physician or fully authorized APRN. However, the LBB’s report will help many legislators take a serious look at changing Texas law despite continued diligent opposition from the medical associations. (To see more on TMA opposition, see the video posted on TMA’s Website.)

Constituent Support is the Key

However, no organization has as much influence as a legislator’s constituents. Some of you visited your legislators in your home district before the legislative session began. Now is the time to be sure that your state representative and senator hear from you about individual bills that are important. In the meantime, read more about the 82nd Texas Legislature, what we expect, and the message we ask you to deliver to legislators and staff on CNAP’s Website.

HB 708: First Independent Prescriptive Authority Bill Filed

Representative Kelly Hancock (Fort Worth, HD #91) filed HB 708 on January 18th. This bill would grant full prescriptive authority to APRNs, and remove physician delegation. Lobbyists for Texas Nurse Practitioners approached Rep. Hancock and asked him to file the bill, and we are very pleased that Rep. Hancock is committed to fully support our efforts to remove physician delegation and include full authority for APRNs to diagnose and prescribe in the Nursing Practice Act.

If you are in Rep. Hancock’s district, please write, email or phone his office and thank him for the support he is showing APRNs and his dedication to improving access to health care in Texas. You can access Rep. Hancock’s contact information on the House of Representatives Website. Tips on communicating with legislators and addressing letters are available on CNAP’s Website.

We anticipate that several other bills will be filed this session. Representative Garnet Coleman will file an additional independent prescriptive authority bill on behalf of APRNs. In addition, LBB is seeking sponsorship for a bill it drafted to implement its recommendations for autonomous APRN prescriptive authority.

 APRN Legislative Day is Full but Capitol Opportunities Remain

With 452 APRNs and APRN students registered for Legislative Day, registration is closed for this event next Monday, January 31st. However, there will be plenty of opportunities to come to the Capitol. We need APRNs visiting legislators every week. Please contact me to plan your guided Capitol visit with your legislators any Tuesday through Thursday.

 In addition we have 4 APRN Days at the Capitol planned for one day each month of the Legislative Session: February 17, March 24, April 14, and May 12. Each day is limited to 50 participants. Registration is open, and more information is available on the registration Webpage.