Transcript Slide 1

Unleashing the Potential of CA APRNs:
A View from ANA
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Lisa Summers, CNM, DrPH
Senior Policy Fellow, Department of
Nursing Practice & Policy
April 30, 2011
APRN Summit
San Pedro, CA
Overview
ANA Advocacy on APRN Issues (a national - or
perhaps “inside the beltway” - perspective)
Four Thoughts to Offer (as a supportive
“outsider”
Discussion
ANA Advocacy on APRN Issues
With limited seating at many policy tables, ANA is often in a
position to be the sole voice of nursing.
This position has become increasingly crucial, yet sensitive,
with the growth of nursing specialties and the increasing
importance of varied nursing roles. As a historical convener of
the larger nursing community, ANA seeks to fully and
accurately represent the nursing community.
Each of the following is prefaced with “work with other
organizations representing APRNs and key stakeholders to
….”
ANA Advocacy on APRN Issues
Ensure the ability of APRNs to practice to the full
extent of their education and training.
ANA’s “Regulatory Rapid Response Team” is being
vigilant with regard to the implementation of the
Affordable Care Act, including a host of issues that
impact APRNs.
– Hot topic: 475 pages of regulatory language on
implementation of the provision establishing Accountable
Care Organization
ANA Advocacy on APRN Issues
Embed IOM definition of primary care in all legal
and regulatory work on health system reform,
particularly the medical (or primary care) home.
– Lots of recent activity on Joint Commission Primary Care
Home Standards and EPs
Facilitate a widespread understanding of and
acceptance for the Consensus Model for APRN
Regulation and work to implement the model.
ANA Advocacy on APRN Issues
Advocate for increased funding for advanced
practice nursing education, including expansion of
recently enacted graduate nurse education (GNE)
demonstration project
Achieve equitable reimbursement for APRNs
Provide a legal challenge to arbitrary practice
restrictions
Facilitate the ability of APRNs to be privileged as LIPs
in institutions.
ANA Advocacy on APRN Issues
Ensure that nurses are involved in the design,
development and implementation of HIT systems,
and that APRNs are eligible for funding to enhance
adoption of HIT.
Ensure that ANA’s expansive work in the national
quality enterprise is in concert with APRNs efforts to
be included in national performance measurement
programs currently designed for physicians.
Gather and disseminate workforce and payment
data
Kudos to CA APRNS
Goal: create a strong coalition to address
barriers to APRN practice in CA
White paper: to create a unified message for
CA legislators about how APRNs can help fill
healthcare needs in CA
Four Thoughts
Carpe diem!
Continued coalition building is key
Carefully consider the role of the white paper
Be forward looking
Carpe diem
Unique moment in time…open door…tipping
point …harmonic convergence
Consensus Model for APRN Regulation – solutions
to long-standing problems; everyone gave a little
Healthcare reform – unity in the Nursing Community
was fruitful; can be leveraged despite a legislators
view of ACA
IOM report: Future of Nursing – potential impact of
Flexner Report?
Unprecedented consumer engagement
Coalition building
“Usual” challenges of APRN coalition building
– 4 unique professional roles
– multiple organizations
Unique challenges of coalition building in CA:
– Geography
– Statutory language
– Somewhat rocky history and interorganizational
relationships; “fragmented”
– Board of Nursing in the headlines
Coalition building
A coalition is an alliance of organizations that come
together to address a specific problem and reach
common goals.
Within a coalition, groups attain
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Strength in numbers
Increased credibility
Professional networking opportunities
Increased knowledge-sharing
Better media reach
Better access to legislators and regulators
Coalition building
A state coalition – particularly one that is broadbased (beyond nursing) provides a unique platform
to be heard
Helps audiences understand that it’s not just
individual professions fighting for turf...
it’s a bigger access issue.
Building partnerships beyond nursing
The Coalition for Patient’s Rights – formed to
counter the AMA Scope of Practice
Partnership
– www.patientsrightscoalition.org
AARP – 2010 policy statement
– http://championnursing.org/resources/aarp-2010-policy-supplementscope-practice-advanced-practice-registered-nurses
Citizen Advocacy Center – Reforming Scope of
Practice Toolkit
– www.cacenter.org/cac/SOP
The white paper
The white paper
Recall that it was part of an overall strategy.
It is a means to an end, not an end in itself.
Don’t be burdened by it.
Don’t let the perfect be the enemy of the good.
The process has been important and valuable.
Remember the ultimate audience, as you appreciate
what it has done for you internally.
The white paper – key messages
From the legislators perspective
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Californians need health care
It’s expensive
They have to balance the budget
Lobbyists and $$ fuel the process, but
They have a broad constituency in the voters
Scope of practice: it’s not a doctor-nurse turf war;
it’s about responding to the need for increasing
access and controlling costs
Be forward looking
It’s all about the relationships (positive and negative)
Let go of hard feelings and ancient past; focus on the
future
Each of the 4 APRN roles faces unique problems and
opportunities,
as does each of the 4 LACE entities.
ANA seeks to represent the interests of the entire
nursing profession, including the each of the 4 APRN
roles.
The coalition looking forward
Narrowing the focus, defining the mission
• Know your allies/opponents
“Step 1: What needs changing?
– There are a host of complex rules and regulations that
need to be carefully analyzed to determine what needs
changing.
– The answer to this key question will not always be the
same for each the 4 APRN roles – again, effective coalition
building in the states will be key!”
ANA’s February Consensus Model Update for our state associations
The coalition looking forward
Devise a strategy for action
– Very difficult to do without talented lobbyists who
collaborate and facilitate communication
– “The hesitancy in some states/organizations to ‘implement
the Consensus Model’ is a result of a well-founded concern
that we ‘first, do no harm.’”
– For those reluctant to “open the practice act,” remember
that whenever the legislature is in session, anyone can
introduce legislation to change your practice
The coalition looking forward
5 Golden Rules of a Coalition
Coalition for Patients Rights State Based Coalition Building Program
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Be inclusive not exclusive
All members must be treated as equals
Participation is required, not always agreement
Diplomacy always wins
Communicate often and be transparent
Understand the differences; act on the
commonalities.
Thank you!
Questions? Discussion
Lisa Summers, CNM, DrPH
Senior Policy Fellow, Department of Nursing Practice & Policy
[email protected]
301-628-5058