OBJECTIVES DESCRIBE THE IMPACT OF HB 5400 AND THE 2016 BOARD OF - - PDF document

3/22/2018 1 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

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NP PRACTICE

NATIONAL STANDARD

• No scope of practice

written in Public Health Code

• No license
• Restricted practice
• Written scope of advanced

practice in law/statute

• License to perform the

scope in law/statute

• Full practice authority

MICHIGAN

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.

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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.

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MICHIGAN LAW 101

PUBLIC HEALTH CODE/STATUTE

• In MI law, rule‐making is the

process that executive and independent agencies use to create, or promulgate,

• regulations. In general,

legislatures first set broad policy mandates by passing statutes, then agencies create more detailed regulations to administer the statutes/laws through rulemaking.

Law Rule

PROMULGATING RULES

• A code of law, also called

a law code or legal code, is a systematic and comprehensive compilaton type of legislation that purports to exhaustively cover a complete system

• f laws or a particular area
• f law as it existed at the time

the code was enacted, by a process of codification.

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!

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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

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Upper Penninsula

Region 1 (and Eastern Region 2) 106‐Sue Allor (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 NEW 107‐Lee Chatfield ( 108‐Beau LaFave (R) NEW 109‐Sara Cambensy (D) NEW 110‐Scott Dianda (D) 110 109 108 107 106 HOUSE 38 37 36 36‐Jim Stamas (R) 37‐Wayne Schmidt (R) 38‐Tom Casperson (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 SENATE

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Traverse City Area

Region 2

HOUSE

101‐Curt VanderWall (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 104‐ Larry Inman (R) NEW 105‐ Triston Cole (R) 102‐ Michele Hoitinga (R) NEW 97‐ Jason Wentworth (R) NEW 103‐ Daire Rendon (R NEW

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SENATE

RED=TERM LIMITED OUT END OF 2018 UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 35‐Darwin Booher (R) 37‐ Wayne Schmidt (R)

Grand Rapids Area

Region 4

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100‐Scott VanSingel (R) NEW 102‐Michele Hoitenga (R) NEW 70‐James Lower (R) NEW 86‐ Thomas Albert (R) NEW 87‐Julie Calley (R) 89‐Jim Lilly (R) NEW NEW 91‐ Holly Hughes (R) 92‐Terry Sabo (R) NEW HOUSE/ non city NEW RED=TERM LIMITED OUT END OF 2018 UNDERLINED= ELEGIBLE FOR RE‐ELECTION 74‐Rob Verheulen (R) 76‐Winnie Brinks (D) 73‐Chris Afendoulis (R) 75‐David LaGrand (D) 77‐Tommy Brann (R) 72‐ Steve Johnson (R) 88‐Roger Victory (R) NEW HOUSE

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SENATE UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 34‐Geoff Hansen (R) 33‐Judy Emmons (R) 28‐Peter MacGregor (R) 29‐Dave Hildenbrand (R) 30‐Arlan Meekhof (R) 26‐Tonya Schuitmaker (R) 19‐Mike Nofs (R)

Southwest/Kalamazoo Area

Region 4 90‐Daniela Garcia (R) 80‐Mary Whiteford (R) 66‐Beth Griffin (R) NEW 79‐ Kim LaSata (R) NEW 78‐Dave Pagel (R) 60‐Jon Hoadley (D) 61‐Brandt Iden (R) 62‐John Bizon(R) 63‐ David Maturen(R) 59‐Aaron Miler (R) UNDERLINED= ELEGIBLE FOR RE‐ELECTION 18 HOUSE

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26‐Tonya Schuitmaker (R) 19‐Mike Nofs (R) 20‐Margaret O‐Brien (R) 21‐ John Proos (R) SENATE

Central Michigan/ Tri‐Cities and Lansing Areas

Region 3

3/22/2018 13 MICHIGAN HOUSE OF REPRESENTATIVES

94‐ Tim Kelly (R) 95‐ Vanessa Guerra(D) 96‐ Brian Elder(D) 97‐ Jason Wentworth(R) 98‐ Gary Glenn (R) 99‐ Roger Hauck (R) 84‐ Ed Canfield (R) 84‐ Ben Frederick (R)

(Interested in VA issues)

99

MICHIGAN SENATE DISTRICTS

36‐ Jim Stamas (R) 32‐ Ken Horn (R) 36‐ Mike Green (R) 25‐ Phil Pavlov (R)

25

HOUSE

RED=TERM LIMITED OUT END OF 2018 UNDERLINED= ELEGIBLE FOR RE-ELECTION 18 87-Julie Calley (R) 71-Tom Barrett (R) 68-Tom Barrett (D) 69- Sam Singh (D)/ minority leader 67- Tom Cochran (D) 85- Ben Frederick(R) 93- Tom Leonard (R)/ Speaker

NEW NEW

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SENATE

RED=TERM LIMITED OUT END OF 2018 UNDERLINED= ELEGIBLE FOR RE-ELECTION 18 Red circle= health policy committee 19-Mike Nofs (R) 23- Curtis Hertel Jr (D) 22-Joe Hune (R) 24- Rick Jones (R)

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67‐ Tom Cochran (D) 62‐ John Bizon (R) 64‐ Julie Alexander (R) NEW 65‐ Brett Roberts (R) 58‐ Eric Leutheuser (R) HOUSE 16‐ Mike Shirkey (R) 17‐ Dale Zorn (R) 18‐ Rebekah Warren (D) 22‐ Joe Hune (R) SENATE

SW Michigan/ AA and Detroit

Region 5

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1‐ Young II (D) 2‐ Johnson (D) 3‐ Hood III (D) 4- Smith (D)- No Conyers (D) 5- Knezek (D) 6- Hopgood (D) 7- Colbeck (R) 8‐ Brandenburg (R) 9- Bieda (D) 10‐ Rocca (R) 11‐Gregory (D) 12- Marleau (R) 13- Knollenberg (R) 14‐ Robertson (R) 15- Kowall (R) 25‐ Pavlov (R) 27-Ananich (D) 32- Horn (R)

SENATE

UNDERLINED= ELEGIBLE FOR RE-ELECTION 18

ONE NEW SENATOR IN YOUR AREA

1‐Yancey (D) 2-Cook Scott (D) 3‐Byrd (D) 4‐Robinson (D) 5‐Durhal (D) 6‐Chang (D) 7‐Garrett (D) 8‐Gay‐Dagnogo (D) 9‐Santana (D)*** 10‐Love (D) 11‐Jones (D) 12‐Geiss (D) 13‐Liberati (D) 14‐Clemente (D)*** 15-Hammoud (D) 16‐Kosowski (D) 17‐Bellino (R) 18-Hertel (D) 19‐Cox (R) 20-Noble (R) 21‐Pagan (D) 22‐Chirkun (D) 23-Camilleri (D) 24-Marino (R) 25‐Yanez (D) 26‐Ellison (D) 27‐Wittenberg (D) 28‐Green (D) 29‐Greimel (D) 30-Farrington (R)*** 31-Sowerby (D) 32‐Hornberger (R) 33‐Yaroch (R) 35‐Moss (D) 36‐Lucido (R) 37-Greig (D) 38‐Crawford (R) 39‐Kesto (R) 40‐McCready (R) 41‐Howrylak (R) 43‐Tedder (R) 44‐Runestad (R) 45‐Webber (R) 46-Reilly (R) 51‐Graves (R) RED-TERM LIMITED OUT Underlined= newly elected 2017 ***= filled husband’s seat

HOUSE

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Youngest elected Healthcare Advisor to Henry Ford System Special Assistant to President of BCBC

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Pastor at Praise Baptist Church

Heading legislation (HB 4426) in the house barring the state from enforcing its rule requiring parents to receive information from local public health officials about vaccines if they want a nonmedical waiver to exempt their children from vaccine requirements at public schools

Wants to combat public health issues Firefighter/Paramedic

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WHAT ELSE CAN YOU DO?

• PARTICIPATE IN FUND RAISER
• “BIG SHOW” WHEN NEEDED IN LANSING

– Advocacy Day, Wed October 10, 2018

• JOIN MICNP
• RECRUIT MEMBERS TO MICNP!!
• CONTRIBUTE TO THE MICNP

PAC!!