Minutes Legislative Committee March 2Nd
Minutes Legislative Committee March 2nd
J. Stanik-Hutt
B. Lang
V. Gutchall
S. Nettina
R. Velez
ME Connelly
Julia
L. Scudder
A. Schram
J. Stanley
L. Murray
K. Woodruff
C. Chapman
C. Bodie
Elena
S. Idzik
Insurance section
Telemedicine for psych NPs
Dept has offered to reimburse psych NPs; this fall a bulletin will go out
Abuse determined opiod/analgesic
Were asked to join Med Chi and others since there is no coverage for reimbursement for naloxone (narcan); a joint statement will be drawn and sent to us.
HB 990 Pharm Manufacture Of America (ABC) bill making sure insurances are transparent; Julia states it is a good bill, but it is vast and Julia will watch it closely; likely will not weigh in now but it is good for providers; first bill anywhere in country like this, impetus behind this bill is big pharma companies; Julia says pharma has felt they were on the defensive side and they want to improve access to care; it addresses cost and network adequacy for providers; slight controversy with pharma pushing the bill
Licensure for Direct Entry for CNM; Julia expressed the argument involves the VBAC issue; NPAM does not want to weigh in closely; we are split on this bill as NPAM members. Bad outcomes may cause loss of licensure.
This week is the school of pharmacy bill; we have been opposed to letting them become full scale prescribers. Second piece is drug therapies; MDs only involved with this part. On the SOP bill, it is going to be replaced with rx medications and they will be allowed to administer glucagon, epi, tobacco cessation; std protocols will be developed by them. With the amendments, APRNs and MDs will be only involved with this. Might start out with just MDs and then APRNs will be allowed to participate. J. Stanik-Hutt provided feedback to Julia re: this bill. Should we watch it or commit with amendments being provided. Julie believes we should be included. Pharm Ds are well equipped with this knowledge.
Professional Midwife bill J. Stanik Hutt American College of nurse midwives will have to become licensed; this is a backward way of forcing way
Mental Health new secty has many task forces; Julia is not sure if maternal mental health will go through; the data is being gathered are we looking at right risk factors for postpartum depression; Julia wants to know if we should recommend on psych NP?
Scope Issues Julia thinks the bill may not go through;
Cultural Competency NPAM has not had to take a stance. Years ago, we had to do all the work; we had CEUs; we have to let providers decide what is best to maintain licensure. To put a mandate on each provider is difficult; finally Board is taking a stance. We are working on this bill. MNA may be opposing that bill.
Our bill is next week; conference call was last week. MEd Chi is coming in favorable with amendments; Julia has spoken to Shirley at BON
1. Add failure to collaborate as a disciplinary offense (no)
2.Keep the attestation for new grads for 4 years (no)
Does not sound like Med Chi is going in with a favorable amendment
We are trying to establish our own bill; after bill hearing we will likely need to send an extra email to senators; we will have a committee there next week.
Addy Eckert’s bill
PA lobbyist did not call Julia so she spoke to committee staff; she explained psych NP curriculum to them as an advanced practice degree.
Imunet Bill Laurie provided info we use the info in the schools; we will not oppose but Julia states maybe we should mandate the bill.
Senate Bill 516 J. Stanik Hutt states we should look at supporting that bill (making narcan available to responders and families with people with drug problems); this is implemented in western MD; troopers are able to carry narcan but county police cannot; Julia states she will read the bill more closely; MD or APRN may prescribe Naloxone to a pt who is believed to be at risk of opiod OD.
Health dept does provide training on Naloxone use; it is being pushed and more info will be obtained by ?
In AA county, 4 ODs a day….per J. Stanik Hutt.
Staying alive prevention program Balt. Health Dept.
Julia and Veronica will read the bill
- HB 724 Provider malpractice
- Senate version
- 2003/4 coverage for defense for disciplinary procedures was an issue; was not enforced for 10 years; last year the law became enforced; this bill allows you to add on a provider for coverage for disciplinary procedure at the board. Julia states we should all have a lawyer; bill died because trial lawyers killed the bill.
Death for Dignity Act NPAM has no position currently; it is a MD central bill; it is a bill that will likely not work due to Maryland being a large Catholic state; if NPAM has a member who feels strongly, please feel free to weigh in; most likely it will be an interesting debate. Julie states these are there personal feelings when members speak; these bills, per Julie, come about due to inadequate use of hospice care; avg LOS is 36 days in hospice; also having no MOLST form documented. NPs need to remain attentive to needs of pt who are in palliative care and be attentive to quality of care. We can watch this bill per Julia. Best interest of the patient is our goal, and Julia will relay that message. We hope that APNs should be included in all bills re pt care. We have barriers to practice at the federal level re: EOLC. We can’t order the hospice but we can broadly say that as we move forward include us on all practice bills. Shannon will help Julia.
Psych NPs we have many emails per Julia that came in after the hearing and are weighing in to support the bill.
Andrea and Julia were at IP meeting, and attached to a bill tracker. Andrea says this is an opportunity to collaborate;
Measles vaccine- idea was to propose to encourage people to get measles vaccine; was sent out to Julia; language is simplistic; we should support per Andrea
Torture bill came about likely from a nurse who was involved in a military situation; AMA has a policy on torture; MEDCHI developed a simple statement on torture; they are trying to get signers to support treatment of torture victims. Should we endorse? We should join Med Chi in support of measles bill as we support prevention of illness; motion from all is to support measles vaccine bill
We can hold off supporting torture bill; we are signing on to the statement of torture in Maryland. Med Chi sent out one statement against torture in any country for any reason; we support that; the additional AMA policy on torture we are not agreeing on. Using this bill as a support for prisoners who are withheld food. This is a position statement; it is not regulatory.
Julie states they are discussing this in NY in the last year. It was statute that would prevent providers from participating in torture. Ques would be could potentially legislation be introduced that we would have to support? Concern is what is the definition of torture? Is there a downside with supporting the bill? How does the ANA code of ethics relate to this bill? We should support this per Andrea. There are a lot of political issues affecting this bill. Julia states our opinion means a lot and MED Chi asks for our weigh in as a credible organization. We need a yes or no for our stance. All support except for Shannon who obstained
Meeting adjourned 9:15 pm began 8pm
Below is the conversation with the pharmacist should you want to add anything to the minutes.
Spoke with Meghan, who is a pharmacist; she spoke with the delegate last night
pg 2 line 4 striking out; entire bold would be deleted;
pg 4 line 20
what they hear from community pharm D; there are pt who on self administered injections (lovenox); if cognitive defects or RA and they can't inject, pharm D curriculum currently covers how to teach pt to administer the med; pharm who are currently practicing may need remedial training; the training for pharm D became mandatory 2001 currently the pharm D can use saline but not the real drug
only for self administered medication
previous BS training can't do this; board of pharmacy is developing a curriculum to get pharmacist who are not pharmD to train for this
bill came out way broader than they liked
2. provide med for urgent issue for
today pharm D would have training to self administer medications
Pharm D trained years ago
the board would detail out
12510 pg 3 line 8
tobacco cessation-increase pt access to these products; protocols would be adopted with BOM and pharmacist
epi albuterol and naloxone, glucagon
now they have to call 911
they should be able to provide in the pharmacy ; once the protocol is developed by the BOM and pharm board, they will spell out what the scenarios this
12508 this is what is currently existing in SOP; this is the old
Bill 716 Prescriber Pharm Agreements
currently in MD pharm can enter into drug therapy mgmt with MDs (coagulation)
MD in Hopkins refers pt with coumadin and lovenox to Megan; this can only be done with physicians;
NPs are interested in working with this agreement with pharms
this bill would allow NPs to work with this scenario
a. protocol would be developed bet NP and Pharm D
b. agreement signed bet the NP and pharm D; the pharm entering the agreement would have to have post grad residency training or board certified; agreement can be multiple protocols; can state in agreement which protocol you want to use
c. contract; notifies pt I am your provider and am collaborating with pharm D. pt signs the contract; this can occur in the NP office or NP can partner with an independent community pharmacy and contract can be ; usually occurs in PCMH
It is up to the NP is he/she wants to use this; this does include PAs
ie; can use with insulin.
Respectfully submitted,
Roseann Velez, DNP, FNP-BC