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Kentucky Coalition of NP & NM Legislative Update

2010-03-02T14:50:14-06:00

KCNPNM LEGISLATIVE UPDATE - 3/1/10

We have a new bill: HB 556

Urgent Call to Action

SB 75 is stalled in the Senate. Therefore we have switched gears. With 4 weeks left in this legislative session, we must move quickly if we want to pass legislation this year. Today, Representative Mary Lou Marzian filed HB 556 and is the chief sponsor of the bill. This bill breathes new life into our legislative effort!

Within hours, these Representatives signed on to the bill as co-sponsors: Rep. Keith Hall, Rep. Tom Burch, Rep. Charles Hoffman, Rep. Joni Jenkins, Rep. Charles Miller, Rep. Charles Siler, and Rep. John Will Stacy. Please send a thank you note to Rep. Marzian and to these Representatives. Please ask your Representative to be a co-sponsor!

All provisions in the previous Senate bill related to ARNP prescribing of scheduled drugs have been deleted from this bill. If passed, the current laws governing ARNP prescribing of scheduled drugs will remain the same. We believe this shows our willingness to compromise and our commitment to improving access to health care services.

Here is a summary of HB 556:

The bill improves access, especially in underserved areas, to quality,
cost-effective health care provided to Kentuckians by Nurse
Practitioners (NPs) and Nurse Midwives (NMs)

Makes NO Changes in Any Current Laws Governing ARNP Scheduled Drug Prescribing

Limits on NP prescribing imposed in statute for each level of controlled substances remain unchanged.
The Collaborative Agreement for Prescriptive Authority for Controlled Substances remains unchanged.
The Controlled Substances Formulary Development Committee (CSFDC) remains unchanged.

Removes the Requirement for a Collaborative Agreement for ARNP Prescriptive Authority for Nonscheduled Drugs (CAPA-NS)

Nurse practitioners in Kentucky have never been required to practice under the supervision of a physician. They are considered licensed independent providers. However, Kentucky statute enacted in 1996 has required NPs to have a collaborative prescribing agreement with a physician in order to prescribe nonscheduled (legend) medications. The agreement applies only to prescribing.
Nurse practitioners have been safely writing prescriptions for non-controlled substances since1996.
Nurse practitioners provide care in 116 of the 120 counties in Kentucky, showing a willingness to practice in underserved areas. However, their ability to do so has been adversely affected by the difficulty in finding a physician to sign a collaborative prescribing agreement. Thus, NPs and NMs are increasingly limited in improving access to care,particularly for rural Kentuckians. Nurse practitioners who desire to open a practice must pay a physician a monthly fee to enter into a collaborative prescribing agreement. In some cases, this fee is very high.

Amends a limited number of statutes which currently require a signature, report, examination or order by a physician to allow NPs to perform these functions.

Nine specific statutes which require a physician to sign, report, examine, order or certify such things as a child's immunization record, ordering and reporting HIV tests and results, certifying a family child care home provider's good health, the need for a telephone for the deaf, and reporting communicable diseases would now allow those functions to also be performed by ARNPs.

These statutes currently limit patient access to services and limit the ability of nurse practitioners to provide continuity of care to their patients, consistent with their education and training. By amending these specific statutes, some of those limitations and barriers will be removed, and nurse practitioners will be able to make a greater contribution to protecting the public health of Kentuckians.

TALKING POINTS

Nurse practitioners have been prescribing non-scheduled drugs in Kentucky
for 14 years and have demonstrated that they are safe prescribers of these medications.

Research over 40 years shows that nurse practitioners:

reduce ER visits
reduce hospitalizations
improve access to health care services
reduce health care costs

The simple facts are that physicians do not want to go into primary care; the shortage of primary care physicians is projected to get worse; and NPs provide quality care and are willing help improve access to health care services.

HB 556 is not about competition among health care providers; it is about removing barriers to health care access, particularly in rural areas of Kentucky

CALL EVERY DAY TO SUPPORT HB 556

It is extremely important that Representatives hear from ARNPs, nurses, and the general public. Call each day until further notice and ask others to do the same. Tell the operator that you want to leave your message for your Representative and all Representatives

Legislative Message Line : 1-800-372-7181

The Message:"I am a Nurse Practitioner (nurse, physician, patient, constituent, etc.) and I urge you to support HB 556 to increase access to quality, cost-effective health care.”

FAX LETTERS TO LEGISLATORS

In addition to your calls, FAX letters to Frankfort to all Representatives asking them to support HB 556. Address your letter to "Dear Representative”. On the fax cover sheet, ask that the letter be distributed to all Representatives. You can use points from this message, previous messages, and the talking points on HB 556, which are available on the KCNPNM web site under legislative updates. Limit your letters to one page.

Legislators' Fax Number: 502-564-6543

PLEASE SHARE ANY FEEDBACK

If you receive feedback from Representatives on HB 556, please let us know.

Also, let us know if you have questions.

Thanks for all your efforts,

Beth Partin epartinfnp@aol.comSheila Schuster advocacyaction@bellsouth.net

2009-11-22T10:26:15-06:00

This is what's needed in healthcare environments and law firms. A "no gossip" policy. If you are a nurse then you know what gossip can do in the workplace. Nursing is a female dominated profession and alot of the esteem and self-worth issues the profession has stems from this in my opinion. The law firm environments I worked in were no better with the gossip. I don't like to bring my personal life to work so it was easy for me not to provide TMI but for some their entire life and the lives of their co-workers are an open book. See this article in the NY Times and try practicing "no gossip" in your workplace. http://www.nytimes.com/2009/11/15/jobs/15pre.html?ex=1274245200&en=4ed581eee5d6aff0&ei=5087&WT.mc_id=JO-D-I-NYT-MOD-MOD-M124-ROS-1109-HDR&WT.mc_ev=click

2009-11-21T09:34:44-06:00

I read this article in the WSJ last weekend and I have been thinking about this article all week. Its Life on Severance and what is being referred to as the Severance Economy. I know alot of us are just one paycheck or illness away from losing it all but for whatever reason this article hits home on so many fronts. See http://online.wsj.com/article/SB125780714976639687.html

2009-11-21T07:14:33-06:00

I am looking forward to the remainder of November and December 2009. I am going to spruce up my blogs, twitter account, and law firm facebook account and start a virtual law practice complementary to my traditional law practice.

Are You a Nurse and considering law school?

2009-09-24T18:28:46-05:00

See this article. http://www.abajournal.com/news/a_traditional_legal_jobs_dry_up_students_can_mold_unique_careers

25 Value Added Services to Offer Clients

2009-07-06T08:39:00-05:00

See this article. http://www.law.com/jsp/law/sfb/lawArticleSFB.jsp?id=1202431410700&_ValueAdded_Free_Services_to_Offer_Your_Clients

Do you think this is applicable to consumer-oriented law firms such as nurse license defense firms?

Pro Bono work and Attorneys: Are You Providing Pro Bono Services to Clients?

2009-07-02T08:36:50-05:00

See this article.

http://www.law.com/jsp/article.jsp?id=1202431941833

Kentucky Bar Association Executive Director is Leaving and the President is Facing a Disciplinary Complaint

2009-03-05T14:08:34-06:00

I received my January 2009 Kentucky Bar Association Bench and Bar magazine which mentioned the limitation (this is first in the history of the KBA) of President Barbara Bonar's power as a president and then mentioned the resignation of the current Executive Director, Jim Deckard who hasn't been in the position very long. The last ED, Bruce Davis served in the position 24 years.

Bar Association ED are usually boomers and lifers, you stay in those position until you die or for twenty to thirty years and when you leave those positions you receive a blurb in the Bar Association magazine, a party with punch, cake and ice cream, a pension, small wood clock or cheap gold plated watch, and a plaque.

I don't follow bar associations as closely as I follow nursing associations, but maybe I should. What's up the Kentucky Bar Association? Things are on and popping it seems as the KBA.

See these links and make sure you read the comments. I thought it was interesting that one commenter mentioned Kentucky being a unitary bar as the problem. One blog speculated that Deckard being a Republican when the majority of Kentucky attorneys are Democrats was the issue:

http://www.courier-journal.com/article/20090206/NEWS01/902060397/1008/ARCHIVES

http://news.cincinnati.com/article/20090206/NEWS0103/902060411/-1/TODAY

http://bluegrassbulletin.typepad.com/bluegrass_bulletin/2009/02/ky-bar-association-exec-director-leaving-raises-questions.html

I didn't realize so many folks were making six figures in this country

2009-03-01T13:38:02-06:00

Call me something, but I didn't realize there were so many positions that paid six figures in this country until I started reading the online articles via USA Today, NY Times, and CNN about the people who have lost these positions and who are accepting positions earning alot less.

I guess I didn't realize it because in my two professions, you don't start off or hit six figures without alot of time, education, experience, and developed expertise in general. Now of course, this does not include those law firms in NYC paying 160k to first year associates.

I would dare say from what I am reading, the average attorney in the United States does not make 100k a year.

So let me ask again, what's up with all the six figure positions in this country and why has nursing and law been left behind?

Are You A Specialist?

2009-02-14T09:43:46-06:00

In Ohio, starting this Spring, you can't call yourself a specialist in a particular area unless you are a certified specialist in a particular area. See http://www.ohiobar.org/pubs/insideosba/?articleid=1373.

Specialization and certification is tricky especially if you are licensed in more than one jurisdiction. I am licensed to practice law in Ohio, Kentucky, and Indiana and only Ohio has a certified specialty in administrative law.

I don't plan to become a certified specialist in any state even if all three states where I practice offer the same specialization.

In my opinion, its not worth the confusion and the disclaimers I will have to make on my business cards, brochures, website, and other marketing materials to say I am certified by one state in a particular area and not in the other states. Specialists are also held to a higher standard of practice and care, not that I am planning to make mistakes....But that's just me.

I don't say I am a specialist now, it sounds funny and its discourged by the State Bars. You also have to be careful calling yourself an expert.

I say my law practice is limited to representing, counseling, and advising nurses or that I am a nursing licensure defense attorney. This accurately sums up and defines my law practice. My marketing and advertising notes I am a RN and that my law practice focuses on nurses.

I have a very distinct niche for my law practice as I focus exclusively on assisting LPNs, RNs, and APRNs (nurses) in professional practice and licensure matters. I have never referred to myself a specialist and I think its vain to refer to yourself as expert.