December 2015 FNPN Newsletter Bullets

Good Morning!
We would like to bring you up to date on what's new in your own backyard of Florida. In this newsletter you will find the following:

Contents:

• Happy Holidays
• FNPN Elections
• FNPN Legislative update
• Become an FNPN Volunteer
• FNPN PAC Update
• Job Announcement
• Membership update
• Message from AANP
• Around the State and Around the Nation
• News You Can Use

---

Quote of the Month

"Life is only as good as you decide to make it. So stand up, be bold, and don't let everyone else define it."
― Unknown

---

Happy Holidays
We are truly grateful for our members and community advocates. As the holidays approach, we would like to thank you for your time, donations, and community support that positively impact the Florida Nurse Practitioner Network each and every day.

FNPN Elections
As FNPN enters its thirteenth year of advocacy and leadership in representing the Nurse Practitioners of Florida, we are pleased to announce that Board of Directors for the upcoming year.

The FNPN election results have been certified by the nominations/election committee and we congratulate the new officers.

---

They are as follows:

Vice President of Legislative Affairs:

• Doreen Cassarino, DNP, ARNP-BC, ADM-BC, FAANP

Secretary:

• Gail Fox MS, ARNP-BC

Membership Chair:

• Cindy Parsons, DNP, ARNP, BC

Nominating Committee:

• Jeanne Anne Abdou, DNP, MSN, ARNP, ANP-BC
• Jennifer Cittadino PhD, MSN, ARNP-BC
• Victoria Framil DNP, MSN, ARNP

Thank you to all of our members who voted already and FNPN sincerely appreciates the willingness of those who chose to run for office, as well as our appreciation of the hard work of our nominations committee.

---

FNPN Legislative Update-Get Ready for the 2016 Legislative Session

Dr. Jean Aertker VP Legislative Affairs

Dear Fellow FNPN members,
It's been an amazing journey! I am sending this, my final legislative update as 1st VP of FNPN. As a founding member of this organization in 2002, its time to open the doors for our up and coming leaders to take the helm. My tenure with FNPN has helped to achieve great progress for NPs in Florida, yet we have much more to do together. We welcome our new Board of Directors as we now renew our membership in support of FNPN to help us achieve FPA for NPs in Florida. I will continue to a strong advocate for NPs in my AANP Region Director role by creating new projects and opportunities for NPs. Thank you for allowing me to be a part of your professional world! Best wishes to all for a joyful and successful 2016, Jean Aertker, DNP, ARNP, FAANP

State Legislative News: As you know the 2016 Regular Legislative session starts early, January 12, 2016, not in March. The session runs for 60 calendar days. Both chambers have been under Republican control since 1996. At the end of last regular session in May, you saw the House and Senate were at a serious impasse about Medicaid Expansion, Congressional election voting lines and the budget. There have been 2 special sessions since the end of the regular 2015 session, and committee work began in the summer until early December. Several bills of importance to NPs have moved through early review. The Senate President is Andy Gardner (Orlando) and the House Speaker is Steve Crisafulli (Merritt Island).

The Main Legislative Committees of Interest to NP bills are as follows. Check to see if your local legislators are on these committees too, but these are the votes we need to pass bills.
I have placed links to all pages for you.

Senate:

• Health Policy (HP)
• Banking and Insurance (BI)
• Appropriations Subcommittee on Health & Human Services (AHS)
• Rules Committee (RC), and
• Appropriations (AP)

House:

• Health and Human Services Committee
• Health Quality Sub-Committee and
• Appropriations Committee
• Health Care Appropriations Sub-Committee

Its always interesting to see the first bills filed for each legislative session: HB 1 by Rep Hill- Physician Admitting Privileges that creates "Women's Health Protection Act"-a pro life type bill and SB 6- State Minimum Wage. The House has filed 536 bills and the Senate has filed 570 bills for 2016. Bill search there are 156 bills with term Health,

---

NP Bills Filed for 2016:

Drug Prescription by Advanced Registered Nurse Practitioners & PA: SB 210 by Grimsley / HB 423 by Pigman (CO-SPONSORS) Combee; Fresen; Latvala; Rouson; Van Zant). Both bills would enable NPs to write C-Sub. Senate has more detail to review-eliminates the current NP-MD joint board, requires BON oversight, time limits for C-Sub Rx, PMHNPs only for writing peds Rx, More CE to Rx C-sub, but none of the current elements problematic - FNPN supports the major provisions of this bill and continues to monitor progress:

ACTION: Senate filed bill September 2015- referred to 3 Senate committee– none have placed it on calendar yet Health Policy; Banking and Insurance; Rules.

House filed bill 10/22/15- bill moving. Dec 1, 2015 the House Quality Sub-Committee passed 12 - 1. Now in Health Care Appropriations Subcommittee. Still has a way to go. The Staff Analysis- Summary Analysis is very PRO NP!!

Ordering of Medication SB 152- by Sen Grimsey. Ordering v. prescribe C-Subs in a facility/hospital. Same bill as last yr. Referred to 3 committees- Health Policy (HP), Appropriations Subcommittee on Health and Human Services (AHS), Appropriations (AP). ACTION: Passed out of Health Policy 9 – 0 on 10/20/15, and Passed out fo AHS on 11/18/15, 8-0. FNPN waived in support. Now in AP.

Authorized Practices of Advanced Registered Nurse Practitioners and Licensed Physician Assistants. S 0946 – by Sen Grimsley - Last Action: 12/11/2015 Referred to Health Policy; Appropriations Subcommittee on Health and Human Services; Appropriations. Similar to clarify authorization to Rx.

Health Care (C-Sub Bil): SB 676: by Grimsey – Last action: 11/18/2015 Senate - Referred to Health Policy; Banking and Insurance; Appropriations Subcommittee on Health and Human Services; Appropriations. Action: No progress in committees.

Baker Act: Involuntary Examinations under the Baker Act: HB 325 by Rep Campbell and SB 572 by Sen. Altman. Bill enables PA's and advanced registered nurse practitioners to execute a certificate that finds that a person appears to meet the criteria for involuntary examination under the Baker Act of persons believed to have mental illness, etc. Legislation passed last year specifies that only PMHNPs to initiate and release individual from the psych facility in certain situations. PA's have been permitted to order only for several years by Attorney General ruling not in statute.

Action: Senate version referred to 3 committees: Health Policy (HP), Judiciary (JU), Appropriations (AP)-passed out of Health Policy in mid-Nov 7-0. Now in Judiciary.

House version referred to 3 committees: Health Quality Subcommittee; Civil Justice Subcommittee; Health and Human Services Committee. On 12/2/15 passed by Civil Justice Subcommittee 12- 0. Now in Health and Human Services Committee

---

Other Health Care Bills to Watch:

Physical Therapy Bills: Companion bills HB 107 by Cummings and SB 450 have been filed. Deals with plan of care by DPT/RPT and defines a new term "Practitioner of record" – that is not used in FL law other than in this one physical therapy statute and another physical therapy regulation. No move to add NP as one able to sign plan of care.

SB 664 - Physician Orders for Life Sustaining Treatment: POLST - Sen Brandes. Excludes NPs esp those in Hospice care as attending providers- FNPN will monitor.

SB 852 Medical Marijuana by Sen. Brandes and companion HB 63 Medical Use of Low-THC Cannabis: by Rep. Greg Steube: Two Marijuana bills filed: Senate bill allows House bill allows physicians to order low-THC cannabis ordered in 30-day supplies to patients diagnosed with cancer, HIV/AIDS, epilepsy, ALS, multiple sclerosis, Crohn's disease, Parkinson's disease, or a terminal illness for which life expectancy is not more than a year. SB 616 by Sen Bullard and HB 4021 by Rep. Vasalinda - Removes cannabis from schedule of controlled substances-all still in committees.

Also, the Florida Right to Medical Marijuana Initiative may appear on the November 8, 2016 ballot as an initiated constitutional amendment. The measure, upon voter approval, it would legalize medical marijuana for those with debilitating medical conditions only if determined by a licensed Florida physician only. Florida Right to Medical Marijuana Initiative, Amendment 2 (2014) was defeated.

Note: The Florida Handbook is a good guide to state government, has the history and how it works. Visit the MyFlorida.com Website for bill and legislative information and learn more about this process. Sign up and Track all bills in Florida here. FNPN website – Legislative News if for members only, so please join and help us advocate for you!

---

Federal Legislative News:

Florida is still in a quandary about the Florida Supreme Court ruling December 1st on a 5-2 decision to use the League of Women Voters' (LWV) proposed map for congressional redistricting Democrats have three prime opportunities to pick up seats currently held by Republicans. The GOP has an excellent chance under the new map to pick off a Democrat in North Florida and Republicans can also flip a seat in a swing district. That decision will be soon!

---

Federal Bills of Interest that AANP posted are:

S. 578/ HR 1342: Home Health Care Planning Improvement Act of 2015: Sponsor: Senator Susan Collins (R) from Maine. Our MAJOR BILL!! Amends title XVIII (Medicare) of the Social Security Act to revise conditions of and limitations on payment for home health care services. Allows payment for home health services to Medicare beneficiaries by: (1) a nurse practitioner, (2) a clinical nurse specialist working in collaboration with a physician in accordance with state law, (3) a certified nurse-midwife, or (4) a physician assistant under a physician's supervision. Currently assigned to a congressional committee on February 26, 2015, which will consider it before possibly sending it on to the House or Senate as a whole, but it needs more co-sponsors! History: This bill was introduced on June 21, 2007, in a previous session of Congress, but was not enacted. Failed to gain enough sponsors in all these years. Previous versions had different Bill # assigned yet the language and intent has not changed. # of co-sponsors in 2007=6; 2009=10; 2011=17; 2013=24, and currently 2015= 42---with only Mississippi Senators from Region 11 signing on. Only Mississippi - Senators Roger Wicker and Thad Cochran co-signing in 2015! No other Senator co-sponsor yet from AL, GA, or Florida. Please contact your Senators! The only way to may this a win is to get all Senators engaged. States getting FPA will help too, but the law must be changed until that happens! Have you read the full text? It only 8 pages, S. 578. On the House version: HR 1342: Sponsor is Rep. Walden, Greg [R-OR-2] was introduced 03/06/2015) Referred to House Committees: Ways and Means, Energy and Commerce, Sub Committee on Health. So far in 2016 we have 139 Co-sponsors so far!! From Region 11 –co-sponsors from FLORIDA are Rep. Hastings, Alcee L. [D-FL-20], Rep. Brown, Corrine [D-FL-5] . Last action (Sponsor introductory remarks on measure: CR S1163-1164)

H.R. 1247/S. 297 - Support Full Practice Authority in all VA Settings: Frontlines to Lifelines Act of 2015. Sen. Kirk, Mark Steven [R-IL] (Introduced 01/28/2015) A Senate committee VA bill. Directs the Secretary of Veterans Affairs (VA) to revive, for a three-year period, VA's Intermediate Care Technician Pilot Program that was carried out between January 2013 and February 2014. Requires VA to: (1) expand the pilot program to include at least 250 intermediate care technicians, and (2) give priority in assigning those technicians to VA facilities at which veterans have the longest wait times. Requires the Secretary of Defense (DOD) to transfer credentialing data regarding DOD health care providers that are hired by VA to VA. Authorizes VA to allow a covered nurse to practice independently, without the supervision or direction of others, under a set of VA-approved privileges, regardless of the state in which VA employs the covered nurse. Defines a "covered nurse" as an advanced practice registered nurse who is employed by VA as: (1) a nurse midwife; (2) a clinical nurse specialist, with respect to the provision of mental health care; or (3) a nurse practitioner. Co-Sponsors so far this year: Sen. Manchin, Joe, III [D-WV]* 01/28/2015 Sen. Udall, Tom [D-NM]* 01/28/2015 Sen. Blunt, Roy [R-MO] 01/29/2015 Sen. Scott, Tim [R-SC] 01/30/2015, no co-sponsors from region 11 so far!

S. 737/H.R. 2253 Alignment of Medicaid to Medicare Primary Care Reimbursement Rates: The Ensuring Access to Primary Care for Women & Children Act Sponsor: Sen. Brown, Sherrod [D-OH] (Introduced 03/12/2015) Committees: Senate – Finance - Latest Action:03/12/2015 Read twice and referred to the Committee on Finance. Amends title XIX 19 (Medicaid) of the Social Security Act (SSAct) to require that the primary care services furnished in the two years after enactment of this Act by a physician with a primary specialty designation of family medicine, general internal medicine, or pediatric medicine be paid at a rate that is not less than 100% of the payment rate that applies under Medicare part B (Supplementary Medical Insurance), but only if the physician self-attests as being Board certified in those areas. Extends this 100% of Medicare payment floor, subject to certain conditions, to the following providers: (1) physicians with a primary specialty designation of obstetrics and gynecology, and self-attesting they are Board certified; (2) advanced practice clinicians; (3) rural health clinics, federally-qualified health centers, or other specified health clinics; and (4) nurse practitioners, physician assistants, or certified nurse-midwives. Co-Sponsors now at 13 – None from Region 11!

S. 1456 Allowing NPs Patients to be assigned to ACOs – Bill titled - Rural ACO Improvement Act of 2015 Sponsor: Sen. Cantwell, Maria [D-WA] (Introduced 05/22/2015) Committees: Senate – Finance Latest Action: 05/22/2015 Read twice and referred to the Committee on Finance. Only 2 cosponsors from Sen. Thune, John [R-SD]* 05/22/2015Sen. Murray, Patty [D-WA]* 05/22/2015- but at least bi-partisan

This bill amends title XVIII 18 (Medicare) of the Social Security Act to establish additional requirements for assigning Medicare fee-for-service beneficiaries to accountable care organizations (ACOs) under the Medicare shared savings program. The program enables ACOs to receive payments for savings stemming from care coordination and management.

Specifically, the bill requires the basis for assignment to reflect beneficiaries' utilization of not only primary care services provided by ACO physicians, but also those provided by other ACO practitioners, and those furnished in federally qualified health centers or rural health clinics. Other ACO practitioners include physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, certified nurse-midwives, clinical social workers, clinical psychologists, and registered dieticians or nutrition professionals.

So as you can see, Both State and Federal Health policy issues in 2016 are critical for NPs in Florida. Join us at the AANP Health Policy Conference on March 20-22, 2016 in DC and help us advocate for NP choice for our patients. Join all nurses in Tallahassee for FNA Advocacy Days on January 19-20, 2016 - sign up on www.floridanurse.org

---

FNPN Shining Star

Pamela V Johnson DNP, ARNP, FNP-BC has represented Florida Nurses at various levels (LPN, RN, ARNP) and through various organizations and positions (FNA Bylaws Chair, two time Delegate to ANA through FNA). She has been a member of FNPN since 2005. Dr. Johnson was appointed FNPN Membership Director in 2012 and elected for the term of 2013-15. She has been published in The Journal for Human Caring. Recently the Nurse Practitioner Council of Palm Beach County presented Dr. Johnson with the Nurse Practitioner of the Year award. Congratulations Dr. Johnson!! Thank you for all you do for the profession.

---

Volunteer Your Time -Become A Committee Member

FNPN offers meaningful and varied opportunities for all members to be involved. We are all working professionals with limited time to give back to the profession so one needs to choose the best fit for your passion and your time. Whether you seek career building projects, job seeking, or simply want to network and meet new colleagues in your practice area or in an area of interest, FNPN can link you that way. Volunteerism with FNPN can be short-term as a member of a small task force group or contributing to an urgent need committee. You can adjust the time you can give at the start up and flex as your time permits too! One recent example of a quick working group was to secure the Governors NP week proclamation! Time investment minimal but PR impact huge!

Volunteers with FNPN gain from volunteering, such as learning new skills and experience in health, social services and education, which can often help advance your career or assist in deciding how to really focus your career. Volunteer programs are offered year-round and statewide.

Some real needs now are members to help with the Conference, Practice and PR committees. Volunteering here can be a small investment of time by simply web clipping and sending NP's in the news articles to share or be really involved working closely with the Board to move us in the direction you want FNPN go over the next 10 years!

As you review the current list of committees to choose from, let me ask you this one question posed to me by Dr. Imogene King, nursing advocate and theorist, "So what are you doing for your profession?" I did not have a great answer back then, but it got me into my long career of being a NP advocate. Is today that starting day for you too?

Click here to contact us about volunteering

---

FNPN PAC Update

Dr. Laureen M. Fleck Chairperson - Political Action Committee

As voters, we are in a position to support the candidate of our choice by promoting their campaign not only on Election Day but by participation and promotion of the candidate's campaign promises.

Advanced practice nurses in Florida have not been able to practice to the full extent of our scope of practice and education because of political restrictions imposed on us in the House and Senate.

Our PAC committee will be traveling throughout the state to raise money and participate in fund raising efforts to build OUR VOICE in the Florida political arena. We will also support the candidates that support our issues by monetary contributions to their campaigns.

We need your help! Money is Power!! A brilliant legislative session is expected and we are closer than ever to reach our goals. We have a lobbyist working with us. We are well informed and networked in Tallahassee. She keeps the constant flow of information current. We cannot achieve our goals with this disruption of policy and politics! Without you, your patients, family and community support we are invisible. Become a member of the FNPN PAC Committee.

Consider your commitment to our profession. We are ARNPs in private practice, hospital settings, colleges, universities and clinics throughout the state! We are YOU !

If each person in our membership donated $10 and asked 5 more people to donate $10 we would be on our way to political success! We have a membership of 4,300 ARNPs in Florida. We are solid, we are YOU!

To make a contribution please click here

---

Job Announcements!

There have been many new job postings around the state on our web site at www.fnpn.org for those of you that may have an interest. On our new website, the most recent postings are on the front page. A new feature will allow postings to be visible for 90 days. Please feel free to pass this along to your colleagues who may be interested in it as well, or who may have an interest in finding out more about our network. For those of you that have found jobs on our website, please be sure to let us know!

Do you know an employer who might find the FNPN Job posting a worthwhile site? If so, please be sure to tell them about the website and the fact that on average 20 or more jobs are posted each month. The traffic to our website is incredible and we have more and more folks seeking employment through this site than ever before. Let them know you saw it on the FNPN Website!

---

Membership Update

Dr. Pamela Johnson-Membership Chair

It has been an honor and of pleasure to service as Membership Chair of Florida Nurse Practitioners Network. FNPN is committed to enhancing membership growth, as well as benefits offered through is organization. FNPN's BOD is goal directed as a statewide leadership organization.

Goals of FNPN are:

1. To share and promote advanced practice nursing in Florida in the context of an ever-changing health care environment and in consideration of diversified patient populations.
2. To impact health policy through articulation as the authoritative resource and voice on issues of advanced practice nursing in this state.
3. To improve health of citizens by ensuring ongoing professional growth and development through provision of educational activities for advanced practice nurses, which includes deployment of programs that maximize organizational and fiscal sound resources, in addition.
4. To utilize strategic planning to assure organizational effectiveness as statewide leadership for advance practice nursing.

As of December 5, 2015 FNPN is 894 active members strong! Our goal is to be 1000 members strong by December 31! There are 9172 followers of FNPN, who are not members. If you are one of the 894, THANK YOU!! 2016 promises to be an exciting year and the BOD will continue to maximize efforts as leaders of Advance Practice Nursing throughout Florida. If you are among the 9172 followers and believe goals of FNPN are attainable, BECOME AN ACTIVE MEMBER! Cost of full membership is $75 a year, student and retiree memberships are $50 a year, organization/group memberships cost $120 a year

---

Around the State and Around the Nation

News You Can Use

The Florida NP Network has taken the next step to keep our members informed. Keep abreast of changes in your practice around the state and around the nation. You can join us today on Facebook under Florida Nurse Practitioner and Twitter under FloridaNP. We hope to hear from you.

CE Broker
Did you know that full members can get a discount to CE Broker?
Click here to find out more