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WRITE YOUR SENATORS!

Posted over 14 years ago by Patricia Crane

 

CNAP Legislative Update #7
Lynda Woolbert, Executive Director
Coalition for Nurses in Advanced Practice
March 27, 2011

In this Issue:
SB 1266 and SB 1339 referred to Senate Finance
3 Bills APRNs Oppose
Next APRN Day at the Capitol on April 14
Vital Constituent Contacts

 

SB 1266 and SB 1339 Referred to Senate Finance Committee

Our APRN prescriptive authority bills got a boost this week when they were referred to the Senate Finance Committee. This certainly supports our position that removing physician delegation as a prerequisite to APRNs diagnosing and prescribing will save significant state dollars.

Now is another opportunity for constituents in the districts of the following members of the Senate Finance Committee to write or call their senators and request that they vote for SB 1266 by Senator Ellis and SB 1339 by Senator West when those bills are heard in committee.

  • Chairman Ogden (R – Bryan, SD #5)
  • Senator Hinojosa, Vice-Chair (D – McAllen, SD #20)
  • Senator Deuell  (R – Greenville, SD #2)
  • Senator Duncan (R – Lubbock, SD #28)
  • Senator Eltife (R – Tyler, SD #1)
  • Senator Estes (R – Wichita Falls, SD # 30)
  • Senator Lucio (D – Brownsville, SD #27)
  • Senator Nelson (R – Flower Mound, SD #12)
  • Senator Patrick (R – Houston, SD #7)
  • Senator Seliger (R – Amarillo, SD #31)
  • Senator Shapiro (R – Shapiro, SD #8, Plano)
  • Senator West (D – Dallas, SD #23) – Reminder: Thank Senator West for authoring SB 1339)
  • Senator Whitmire (D – Houston, SD # 15)
  • Senator Williams (R – The Woodlands, SD #4)
  • Senator Zaffirini (D – Laredo, SD #21)

Please emphasize the ways in which your care can save money. Any savings to the Medicaid Program because of the way you care for Medicaid recipients is particularly important to note.

Also remind your senator that the Legislative Budget Board’s Government Effectiveness and Efficiency Report recommends that the Legislature “Amend the Texas Occupations Code, Chapter 301, to include ‘advanced assessment, diagnosing, prescribing, and ordering’ in the scope of practice for advanced practice registered nurses.” For more information about APRN prescriptive authority legislation, go to CNAP’s website, http://www.cnaptexas.org/displaycommon.cfm?an=1&subarticlenbr=216.

 

Bad Bills

Every session, there are some bills filed that will be bad for APRNs. It is important that each of us understands why APRNs stand united in opposing these bills.

 

Anesthesiologist Assistant (AA) Licensing

This is the third session that legislators filed bills to license anesthesiologist assistants (AAs).  Rep. John Zerwas (R – Simonton, HD #28) filed HB 1893 and Sen. Carlos Uresti (D – San Antonio, SD #19) filed SB 1566. Rep. Zerwas is an anesthesiologist and Sen. Uresti filed the legislation in 2007 and 2009 on behalf of the Texas Society of Anesthesiologists and Texas Academy of Anesthesiologist Assistants.

 

The Texas Association of Nurse Anesthetists (TANA) lists important reasons that this legislation should not pass.

  1. AA licensing is not required for reimbursement or public safety. Anesthesiologists already delegate to AAs under the general authority of physicians to delegate, and hospital and ambulatory surgical center medical staff bylaws regulate any AAs that are privileged to practice in their facilities. Medicare and Medicaid already reimburse the anesthesiologist when AAs provide anesthesia under the anesthesiologist’s supervision.
  2. AAs can only practice under the supervision of an anesthesiologist. Most anesthesiologists practice in suburban and urban areas and therefore licensing AAs would not improve access in rural areas where anesthesia providers are needed.
  3. There are about 30 AAs in the state.  It is not cost effective to start a regulatory process for such a small group, especially in a legislative session in which Texas faces a $27 billion budget shortfall.

CRNAs and anesthesiologists are both proven providers, and there is already a shortage of clinical placements for anesthesiology residents and CRNA students.  There is no need to license a third category of anesthesia providers.

 

Limited APRN Services to Medically Underserved Populations

With good intentions in mind, Senator Dan Patrick filed SB 846. Unfortunately, as introduced, this is a very bad bill for APRNs. The bill identifies certain limited health care services, excludingdiagnosing and prescribing, that APRNs may perform independently in sites serving medically underserved populations. Unfortunately, the listed services are currently provided independently by APRNs in any site. Therefore, this bill does nothing to improve access to health care in sites serving medically underserved population, and implies that delegation and supervision are required in other practice sites for activities such as giving immunizations, providing well child care and offering routine prenatal care.

Kathy Hutto discussed this bill with Suzanne Tomlin, Senator Patrick’s Health Care Policy Analyst. She understands that this is not a bill that should move forward in its current form. However, this bill was referred to Senate Finance Committee and bears the caption, “Relating to the scope of practice of advanced practice nurses at certain sites serving medically underserved populations.”When asked if SB 846 is one of our APRN prescriptive authority bills, all APRNs should be very clear that it is not and the language in this bill would be a huge step backward for APRNs in Texas. Ask your senator to vote “NO” if SB 846 gets a hearing in Senate Finance.

 

APRN Days at the Capitol: Register Now for April 14

Thirty APRNs and students attended APRN Day at the Capitol last Thursday March 24th. They visited 11 Senate and 17 House offices.  The next APRN Day at the Capitol is less than 3 weeks away, on Thursday, April 14th. Then our final APRN day is scheduled the following on May 12th.

If you have not yet been to the Capitol this session, please plan to attend. We begin the day at 9 a.m. in a reserved section of the Capitol Grill for a briefing. Then we visit our legislators from 10:15 a.m. – 3:30 p.m.  Click the link to register, www.cnaptexas.org/displaycommon.cfm?an=1&subarticlenbr=200. 
Remember, physicians will storm the Capitol again on Tuesday, April 5. It is critical that APRNs are there to answer any misconceptions that linger from those physician visits.

 

APRN Constituent Contacts Required

If you cannot leave your practice to come to the Capitol, you can still be part of passing landmark legislation to improve prescriptive authority for APRNs in Texas. No opinion is more important to a State Representative or Senator than those of his or her constituents.

If you need help finding your State Representative or Senator, send your home address and zip code to Lynda@cnaptexas.org.  If you need assistance writing your letter, also describe your practice and where it is located in 2 sentences or less, and list 3 ways in which your patients will benefit if Texas removes the site and physician delegation restrictions on your prescriptive authority.

Also please remember that letters from physicians are especially important. If you know a physician willing to support any of our bills, please talk to the physician and see if he or she would be willing to write or call their state representative and senator to urge their vote in favor of our legislation.

The next 2 months are critical to passing HB 708, HB 1266, HB 915, SB 1260 or SB 1339. All of us must be smart, savvy, and persistent. Please let your legislators hear from you! Our opposition is extremely active. We must be too!