2013 Legislative Session: A Nursing Perspective

Overview of the Session - Senate

Looks much the same as 2011Same leadership - Lt. Gov. Dewhurst19 Republicans; 12 DemocratsRepublicans 2 short of 2/3 majority of 21 6 new members – 20%3 physicians; 1 pharmacist

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Overview of the Session - House

Looks somewhat different than 2011Leadership same – Speaker Strauss40 new members – 27%66 freshman or sophomore legislators – 44%More ideologically driven95 Republicans; 55 DemocratsRepublicans 5 short of 100 needed for super majority3 RNs ; 3 physicians; 1 paramedic

Rep. Donna Howard (D-Austin)Rep. Susan King (R-Abilene)Rep. Stephanie Klick (R-Ft. Worth)

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Overview of the Session - Bill Volume

Number of bills expected to be filed2011 Session - 3865 HBs; 1931 SBs 5796 Total2009 Session - 4836 HBs; 2583 SBs 7419 Total

Deadline to file bills - 60th day (Friday, March 8)Number of bills filed as 2/8/2013 - 1146 HBs; 460 SBs Expected to be filed – 6000-7000 bills

4000 bills in next 28 days (141 bills/day including Sat & Sun)

Monitoring of Bills

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Overview of the Session - Bill Volume

Number of bills filed in previous sessions2011 Session - 3865 HBs; 1931 SBs 5796 Total2009 Session - 4836 HBs; 2583 SBs 7419 Total

Deadline to file bills (60th day ) was March 83852 HBs; 1816 SBs 5668 Total

Bills Passed (HBs & SBs)2009 Session 1459 (19.7%)2011 Session 1379 (23.8%)2013 Session ??

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Legislative Process

Appreciating that process does affect substanceKey hurdles controlled by a very few legislatorsDelay can kill a bill

Strategy for Legislative Success

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Collaboration/compromise encouragedMust know opposition and support for billOpportunities must be exploitedLong term, multi-session presence favoredLong term, multi-session strategies needed

Strategy Implications of Process

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Letting desire for perfect prevent achieving goodReluctance to identify alternatives that might represent significant progress towards desired “perfect”

Believing that “educating” legislators will be enough

Lack of effective and efficient decision-making

Some Potential Strategy Pitfalls

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TNAGovernmental Affairs Committee

Nursing Legislative AgendaNLACContent

Nursing initiated legislationNursing supported health policy legislationOh my gosh! Did you see that bill? Nursing can’t live with that!

TNA & Nursing’s Legislative Agenda

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Nursing Initiative - WorkplacePreventing violence against nurses

Bill covers ER personnelSome mental health advocacy groups likely will oppose

Assuring publicly-employed nurses equal right to access courts to redress retaliation

Not issue of making illegal – is already illegal to retaliateIssue is should publically-employed nurses have same remedies as privately-employed nurses

Notification of parents if no school nurse

Nursing Initiative - APRN Rx Authority

First Success of 2013 Session!

Agreement with medicine to replace current site-based approach with a simpler, more flexible prescriptive authority agreement model

SB 406 by Nelson; HB 1055 by Kolkhorst

SB 406 passed on Local & Uncontested Calendar on 3/13

Will now go to House12

Diagram of current law

Diagram of SB 406 Rx Agreement Model

Nursing Initiative – Regulation of NursingNPA Amendments

Mandatory criminal background checks for studentsMaking deferred disciplinary action pilot permanentConfidentiality of BON orders referring nurses to TPAPN

Self-Directed, Semi-Independent Status (“SDSI”)TMB, TSBP, BONInitiative of coalition of professional associations

BON AppropriationsExecutive director salaryTPAPN funding

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Nursing Initiatives - Education

Maintaining Special Funding$30.0 mil – Professional Nursing Shortage Reduction Fund

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Initiatives by Others - Nursing Supports

RNs administering meds & treatments ordered by therapeutic optometrists

Loan repayment for nursing faculty

Uniform admission system

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Initiatives by Others - Nursing Opposes

Unknown but there always are some“Oh my gosh! Did you see that bill!”

Some that have been filedMandated ratio bill by CNA/NNOCAnesthesiologists assistants licensingBSN offered by community college pilot

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Initiatives by Others - Nursing Undecided

BSN offered by community college pilot

APRN Medicaid services paid at APRN rate

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Health Care Policy Coalitions

Texas Public Health CoalitionImmunizationsSmoking CessationHealthy EatingCancer Prevention & Cure

Texas Women’s Health CoalitionPreventative care for women

CHIP CoalitionMental Health Advocacy Coalition

Why Should Nursing Participate?

Whether or not nursing participates, decisions affecting nurses and their patients will still be made

But …without nursing input

Nursing has benefited from participating

Not happen otherwiseWhat if nursing had not been involved since 1907

Health care policy needs nursing’s perspective

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