Legislative History

Legislative History 2017-10-05T13:37:38+00:00

2017

  • Introduced and lobbied for to remove collaborative practice barriers to care for Advanced Practice Registered Nurses, such as mileage restraints, chart reviews, one-month preceptorships, etc.
  • Introduced and lobbied for bills to give prescriptive authority to APRNs for Schedule II medications containing amphetamine or methylphenidate
  • Lobbied in support of the Narcotics Control Act (PDMP).
  • Lobbied the State Board of Healing Arts and the State Board of Nursing to repeal rules and regulations relating to APRNs in a collaborative practice arrangement.
  • Successfully lobbied to stop Senate Bill 28 which required Missouri to apply for a Medicaid “global waiver” from the federal government. The bill did not expand Medicaid and could have meant substantial cuts to federal Medicaid funding; including a loss of coverage for vulnerable seniors, people with disabilities, children, pregnant women, and low-income parents who now depend on Medicaid.
  • Lobbied in support of a change in the laws regarding funding for 911 services

2016

  • Successfully lobbied for nurse practitioner reimbursement for mental health services from the Crime Victims Compensation Fund.
  • Introduced and lobbied for Full Practice Authority Bill to remove collaborative practice arrangements (CPA) and allow Advanced Practice Registered Nurses (APRN) to practice to their full scope of practice. The bill also added a definition, license, and scope of practice for APRNs to the Board of Nursing Chapter 335.
  • Introduced and lobbied for bills to give prescriptive authority to APRNs for all Schedule II medications.
  • Successfully lobbied to allow the State Board of Nursing (and other providers) to collect and analyze workforce data from its licensees for the purpose of future workforce planning and to assess the accessibility and availability of qualified health care services and practitioners in Missouri.
  • Successfully lobbied to update the Nurse Licensure Compact for registered nurses (RN) to require background checks.
  • Lobbied in support of the Narcotics Control Act (PDMP).
  • Successfully lobbied for a Missouri Telehealth Network for all practitioners. This act also defines “telehealth” or “telemedicine” as the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care while such patient is at the originating site and the health care provider is at the distant site.

2015

  • Introduced and successfully lobbied for APRNs to prescribe Schedule II – Hydrocodone.
  • Successfully lobbied for APRNs to be added to specified phases of the death certification process, including data provision, certification of death, and authorization for the final disposition of the decedent’s body.
  • Successfully lobbied to allow a board or commission to only address topics relating to the qualifications, functions, or duties of the profession they license or regulate.
  • Supported that when a physician reviews pursuant to a collaborative practice arrangement an advanced practice registered nurse’s delivery of health care services, which includes chart review, the collaborating physician need not be present at the health care practitioner’s site.
  • Introduced and lobbied for support legislation to create Missouri Healthcare Professional Workforce Data Collection.
  • Lobbied in support of the Retail Clinics legislation to remove various barriers to care for APRNs in a collaborative practice arrangement.
  • Lobbied in support of the Prescription Drug Monitoring Program (PDMP).
  • Introduced legislation to repeal the Assistant Physician statute.
  • Lobbied the State Board of Healing Arts and the State Board of Nursing to repeal rules and regulations relating to APRNs in a collaborative practice arrangement, specifically to allow referrals of patients to physicians other than those who serve as the collaborating physician.

2014

  • Supported APRN Scope of Practice and Licensure Bill
  • Supported removing barriers to APRN practice bill
  • Supported the Oral Chemotherapy Bill
  • Supported Medicaid Transformation
  • Supported Prescription Drug Monitoring Bill
  • Opposed Assistant Physician Bill
  • Opposed the repeal of the MOHealthNet Committee

2013

  • Lobbied for “APRN Access to Care” Legislation
  • Successfully lobbied in support to establish “Utilization of Telehealth” by APRNs in certain rural areas
  • Successfully lobbied for change to MOHealthNet statute to add APRNs to the list of those who can prescribe drugs covered by MOHealthNet payments
  • Successfully lobbied in support of “Prompt Credentialing” requiring health carriers to credential healthcare practitioners within 60 business days of receiving a completed application and to pay the practitioner for treatment services pending approval
  • Lobbied in support of Medicaid Transformation
  • Lobbied in support of the Prescription Drug Monitoring Program

2012

  • Lobbied for “Barrier Free Care” for APRNs and Missouri Citizens
  • Successfully lobbied  in support of periodic review of state administrative rules every five years
  • Lobbied in support of the Prescription Drug Monitoring Program
  • Successfully lobbied in opposition of sweeping future nursing fees from the State Board of Nursing and other Professional Registration groups

2011

  • Successfully lobied for legislation to add a nurse to MO HealthNet Committee
  • Supported legislation for the Nursing Incentive Program
  • Lobbied for legislation to protect health care workers against workplace violence making it a felony
  • Successfully defeated all amendments that threatened nurses use of the title “doctor”, if they have earned the title

2010

  • Successfully lobbied to add Advanced Practice Registered Nurses (APRNs) to the list of approved health care providers who physical therapists are able to accept an order/ prescription
  • Successfully lobbied for employers of nurses be required to have a system in place for verifying that the applicant for a position as a registered, licensed practical, or advanced practice registered nurse has a current valid license and verify the licensure status at each license renewal
  • Successfully lobbied to support prompt pay of insurance claims
  • Lobbied for legislation to modify the membership of the MO HealthNet Oversight Committee by adding a licensed registered nurse
  • Successfully lobbied to support allowing expedited partner therapy under certain conditions by dispensing and prescribing medications for the partner of a person diagnosed with certain sexually transmitted diseases even when there is no existing physician/patient relationship

2009

  • Successfully lobbied to revise the definition of “eligible student” as it relates to the Nursing Student Loan Program to allow individuals seeking doctoral degrees in nursing or education on a full-time or part-time basis to participate
  • Lobbied to support physical therapists accepting orders for therapy from Advanced Practice Registered Nurses (APRNs)
  • Lobbied for legislation to modify the membership of the MO HealthNet Oversight Committee by adding a licensed registered nurse
  • Lobbied to support an increase in school nurses pay equivalent to school teachers
  • Successfully supported adoption of the interstate compact for multi-state licensure

2008

  • Successfully lobbied for the ability of advance practice registered nurses (APRNs) to prescribe controlled substances
  • Lobbied to oppose legislation and/or regulation that reduce patient access to health care and prescription medications
  • Lobbied to support the elimination of the “step-therapy” clause that many health plans enforce in health insurance plans
  • Lobbied for an increase in school nurses pay equivalent to school teachers
  • Lobbied for legislation to modify the membership of MO HealthNet Oversight Committee by adding a licensed registered nurse

2007

  • Lobbied for the ability of advance practice registered nurses (APRNs) to prescribe controlled substances
  • Lobbied to oppose legislation and/or regulation that reduces patient access to health care and prescription medications
  • Lobbied to support out-of-hospital due not resuscitate legislation
  • Lobbied to amend the Nurse Loan Repayment Program to include employment at for-profit facilities in eligibility criteria

2006

  • Introduced legislation expanding APRN prescriptive authority to include schedule II-V controlled substances
  • Successfully opposed a proposed joint rule enacting further restrictions and combining APRN collaboration & physician assistant (PA) supervision
  • Successfully lobbied for revisions to the MO Student Nurse Loan Repayment Program
  • Successfully lobbied for a sunset date extension for Technical Advisory Committee on Quality of Patient Care & Nursing Practices
  • Successfully lobbied for APRN authority to certify handicapped placard eligibility for patients
  • Successfully lobbied for APRN authority to prescribe pseudoephedrine products
  • Successfully opposed adoption of the interstate compact for multi-state licensure

2005

  • Introduced legislation expanding APRN prescriptive authority to include Schedule II-V controlled substances
  • Successfully opposed adoption of the interstate compact for multi-state licensure
  • Participated in developing hospital licensure rules limiting the use of mandatory overtime as a staffing tool.
  • Lobbied for expungement of certain records in select circumstances following Missouri State Board of Nursing complaint investigations
  • Lobbied to require health plans to cover all services provided by registered nurse first assistants (RNFAs) and to require the Board of Nursing to determine which specialty nursing organization certification will be recognized for RNs seeking RNFA titling, allowing those practicing as independent contractors to achieve direct reimbursement

2004

  • Successfully opposed adoption of the interstate compact for multi-state licensure
  • Lobbied to require health plans to cover all services provided by registered nurse first assistant (RNFAs) and to require the Board of Nursing to determine which specialty nursing organization certification be recognized for RNs seeking RNFA titling, allowing those practicing as independent contractors to achieve direct reimbursement

2003

  • Lobbied for safer staffing through prohibition of mandatory overtime in hospital settings
  • Lobbied in opposition to the interstate compact for multi-state licensure
  • Lobbied to require health plans to cover all services provided by registered nurses first assistants (RNFAs) and to require the Board of Nursing to determine which specialty nursing organization certification be recognized fro RNs seeking RNFA titling, allowing those practicing as independent contractor to achieve direct reimbursement
  • Began participation in the Technical Advisory Committee on Quality Patient Care & Nursing Practices addressing: establishment of training requirements for unlicensed assistive personnel (UAP); development of regulations for prohibiting mandatory overtime; analysis of the need for a statewide nursing center to address future nursing workforce needs
  • Lobbied in opposition to efforts to require a second licensure process for APRNs
  • Lobbied in opposition to anesthesia assistant (AA) legislation
  • Successfully opposed adoption of the interstate compact for multi-state licensure

2002

  • Lobbied for requirements that all hospitals utilize a reliable and valid acuity method for determining safe & effective nurse staffing levels, including limiting the number of hours nurses can work in efforts to reduce the number of fatigue-related errors and strengthening current whistleblower protections
  • Lobbied to require health plans to cover all services provided by registered nurse first assistants (RNFAs) and to require the Board of Nursing to determine which specialty nursing organization certification be recognized fro RNs seeking RNFA titling, allowing those practicing as independent contractors to achieve direct reimbursement
  • Lobbied in support of APRN authority to order physical therapy services within the context of a collaborative practice agreement
  • Instrumental in negotiating protection of the Board of Nursing from having funds swept from the licensure fee-based fund to general revenue, resulting in “double taxation” for nurses licensed and residing in Missouri
  • Successfully opposed adoption of the interstate compact for multi-state licensure
  • Lobbied in support of increased nurse staffing in long term care settings

2001

  • Negotiated a Statement of Clarification of Licensed Paramedic Scope of Practice clearly delineating in the event an EMT/P provides care within non-emergency medical settings, they do so as an unlicensed assistive personnel
  • Successfully opposed adoption of the interstate compact for multi-state licensure

2000

  • Developed legislation and successfully lobbied for whistleblower protections, creation of the Technical Advisory Committee on Quality Patient Care & Nursing Services, and a mandate to develop uniform UAP training requirements
  • Successfully lobbied for requirements to use of safe needle devices for public (state) entities not subject to federal requirements
  • Promoted Patients Bill of Rights legislation, including participation in announcement and press conference with President Clinton
  • Presented a legal opinion to the Board of Nursing that supporting the Board’s position that “finger sticks” were a nursing assessment and did not require a physician’s order to perform

1999

  • Worked with Representatives Joan Barry and Steve Gaw (Speaker of the House) to establish the Interim Committee on Quality of Patient Care and Nursing Services, charged with examining nurses’ concerns about the quality of nursing care being provided in hospitals throughout Missouri
  • Successfully opposed legislation that would have published detailed information about licensed nurses including names, addresses, and employment history
  • Successfully lobbied for language requiring all health insurers, health maintenance organizations (HMOs) and non-profit health service plans to reimburse APRNs within a claim for services within the scope of practice of the APRN
  • Supported the Federal Patient Safety Act requiring public disclosure of the number of RNs and LPNs providing direct patient care, average number of patients per RN, patient mortality rates, and the methods utilized to determine staffing

1998

  • Successfully lobbied to require license & credentials be prominently displayed on all hospital employees’ name badges ensuring patients ability to easily recognize who is providing their care
  • Testified before the State Interim Legislative Committee on Managed Care on the need for patient safeguards in managed care plans
  • Supported reimbursement for Registered Nurse First Assistants (RNFA)

1996

  • Successfully lobbied for expansion of the Missouri Medicaid Program
  • Promoted the “Every Missouri Patient Deserves an RN” campaign

1993

  • Successfully lobbied for legal recognition of APRNs and the authority to write prescriptions in collaboration with a physician

1988

  • Filed an amicus brief with the Missouri Supreme Court (Sermchief v. Gonzales), upholding the evolution of nursing practice in the context of the Nurse Practice Act

1976

  • Organized the first override in 112 years of the Governor’s veto related to the Nurse Practice Act