Sarah Tidwell, MS, RN KSNA Legislative Chair

1. Kansas State Nurses AssociationLegislative Review 2012 Sarah Tidwell, MS, RN KSNA Legislative Chair

2. Governor Sam Brownback Governor – 2011 Previous Service U. S. Senator Affiliation Republican

3. Governor’s Cabinet Lieutenant Governor Jeff Colyer, M.D. • Head of sub-cabinet meeting on Medicaid funding • Goal – To improve the quality of care for Medicaid beneficiaries while cutting costs to taxpayers. • KanCare Program

4. Kansas Legislature • 40 Senators • 125 Representatives • Senators serve 4 years • Representatives serve 2 years • Redistricting done every 10 years following the census count. • 2012 redistricting year

5. Party Affiliation Senate Republicans 32 Democrats 8 House Republicans 92 Democrats 33 • Democrats generally support that government can provide better services. • Republicans are more likely to reduce costs, wanting more individual responsibility and rights.

6. Committee Assignments • Based on the proportional amount of each party in the respective houses. • For example an 11 member Senate Committee would have: 8 Republicans and 3 Democrats

8. Leadership Elected by the respective houses. • Republicans currently are the leaders in both houses and are chairs of all legislative committees in Kansas.

9. House Leadership Speaker of the House Majority Party – Republican • Mike O’Neal • Hutchinson, Kansas • Attorney Majority Leader • Arlen Siegfreid • Olathe, Kansas • Real Estate

10. House Leadership Minority Party - Democrat Minority Leader Paul Davis – Lawrence Attorney Assistant Minority Tom Burroughs – Kansas City Business

11. Senate LeadershipPresident of the Senate • Party -Republican • Steve Morris • Hugoton, KS • Farmer

12. Senate Leadership Majority Leader - Republican • Jay Emler – Lindsborg • Attorney Minority Leader – Democrat • Anthony Hensley - Topeka • Special Education Teacher

13. HOW A BILL BECOMES LAW Two Houses—The House of Representatives (125 members) and the Senate (40 members). A bill may be introduced in either house. HOUSE OF ORIGIN 1. Bill Introduced 2. Bill Referred to Committee Hearings/Deliberation/Approval (May Include Amendments) 3. House of Origin 4. House of Origin—Committee of the Whole Deliberation/Approval (May Include Amendments) 5. House of Origin VOTE FOR FINAL PASSAGE 6. Bill Messaged to the Second House

14. Both Houses Adopt Conference Committee Report (May Include Amendments)

15. Conference Committee Action Composed of 6 Legislators: 3 from each House. • Conference Committees Discuss and confer, Reach compromise, Report to respective House for approval. • Final bills once approved by both Houses go to the Governor for Signature

16. Legislature Overrides Veto by 2/3 Vote in Each Chamber Bill Becomes Law Bill Filed with Secretary of State

17. Health and Human ServicesRepublican Membership Brenda Landwehr, Chairperson; Wichita, Business Owner Owen Donohoe, Vice Chair; Shawnee, Medical Sales Bob Bethell, Alden Long term care administrator Dave Crum, Augusta; Optometrist Phil Hermanson; Wichita, Human Resource Peggy Mast; Emporia Office Manager Jim Denning, Overland Park Business CEO Kelly Meigs, Lenexa Educator Susan Mosier, Tom Phillips, Manhattan Opthamologist Bill Otto; LeRoy Retired Teacher Stephen Alford, Ulysses Farm Owner and Operator Barbara Bollier, Mission Hills Retired anesthesiologist Terry Calloway, Pittsburg Business CEO Brian Weber, Dodge City Business Owner

18. Health and Human ServicesDemocratic Membership Geraldine Flaharty, Ranking Minority Member, Wichita, Retired Teacher Ann Mah, Topeka Trainer/Speaker Ed Trimmer; Winfield Retired Teacher Jim Ward; Wichita Attorney Valdenia Winn, Kansas City College Professor

19. Senate Public Health and Welfare R- Vicki Schmidt, Chair Topeka, Pharmacist R- Pete Brungardt, Vice-Chair Salina, Optometrist R- Dick Kelsey, Goddard Business Owner R- Roger Reitz, Manhattan Physician R- Chris Steineger, Kansas City Consultant R- Terrie Huntington, Fairway, Retired Marketing R- Mary Pilcher-Cook, Shawnee Book Publisher D- David Haley, Ranking Minority Member; Kansas City, Public Affairs Counsel D- Laura Kelly, Topeka, Association Management

20. Dates of Significance • Last day for individual bills to be introduced • Last day to consider bills in house of origin • Last day to consider bills in opposite house • No bills considered except vetoes and Omnibus appropriations bills • Budget /End of session deliberations • Veto session begins approximately 2-2 ½ weeks after last day of regular session • Sine-Die; official closure of the legislative session

21. Legislative Terms • Exempt committees – House Appropriations, Calendar and Printing, Taxation, House and Senate Federal and State Affairs, Senate Ways and Means • Two year cycle: “carry over bill” in odd years • Re-referred • “germane language” • “gut and go”

22. SB 134 HB 2182 Changes to ARNP Statutes

23. Statute vs Regulation

24. SB 134 HB 2182 Implementation January 2012 • Title Change to APRN (Advanced Practice Registered Nurse) • Requires mandatory continuing education for APRNs in the area of practice • Maintains the responsibility for licensure and regulation of APRNs with the Kansas State Board of Nursing • Includes a Grandfathering clause Specifies that the Kansas State Board of Nursing will develop rules and regulations specific to these statutes

25. Regulation HearingMarch 20, 1:30 p.m. 60-11-113 Certificate License renewal (b) On and after January 1, 2013, each individual renewing a license shall have completed the required 30 contact hours of approved continuing nursing education (CNE) related to the advanced practice registered nurse role during the most recent prior license period…. (c)The number of contact hours assigned to any offering that includes a recognized standard curriculum shall be determined by the board.

27. Legislative Platform • Main areas: - Nursing Practice - Workplace Advocacy - Consumer Advocacy - Occupational and Environmental Health - Financing Health Care • Board makes final decisions • Philip ledge photo

28. Nursing Practice • Promoting role and protecting practice of RN’s • Representation on interdisciplinary bodies • Recognition of KSBN as sole regulatory authority for nurses • Ensuring composition of KSBN includes qualified members • Efforts aimed at nursing shortage • Funding for: nursing research, nursing education, advanced education

29. Consumer Advocacy • Evidence-based health policy that ensures equal access • Safeguards for all citizens, especially children, senior citizens, handicapped and economically and socially disadvantaged • Efforts at health promotion, early intervention • Select provider of choice • Eliminating substance abuse (tobacco and alcohol)

30. Workplace Advocacy • Collective bargaining right • Maintenance of laws germane to the practice of nursing • RN staffing standards • Protection of economic and employment rights of nurses • Violence prevention

31. Occupational and Environmental Health • Resources related to disasters • Legislation that assures workplace safety and environmental health • Research and education for prevention and treatment of occupational health policy initiatives

32. Financing Health Care • Funding for persons in need • Recognition of nurses’ unique role in delivery of care • Ensuring funding for state and public health • Affordable health care system that is monitored • Use of evidence based cost containmentincentives

33. 2012 Session

34. KSNA 2012 Legislative Priorities 1. Support efforts to improve the ability of Registered Nurses in the State to adequately provide mental health services. 2. Support adequate funding for the Kansas State Board of Nursing and preservation of licensure services. 3. Advocate for legislation that protects and promotes the 2010 Kansas Indoor Clean Air Act.

35. Legislative Priorities State Hospitals Board of Nursing • Governor’s 2013 budget includes recognition of the increased census at State Hospitals. • Recommends increase to fund additional FTE’s. Governor’s Budget: Adds 4 FTE’s to KSBN • Moves licensing and credentialing of CNA, CMA, HHA • and Nurse Registry Act Governor’s ERO: Moves all to new Department of Aging and Disability Services

36. Clean Indoor Air Sub for HB 2340. Remove the gaming floor exemption; add an exemption for annual smoking events conducted for charitable purposes by certain not-for-profit organizatons. H Sub for SB 216. Removes the casino exemption and adds the exemption for cigar benefit events. Currently on General Orders in the House. HB 2039: Removes the casino exemption. Remains in HHS committee

37. HB 2324 • E-cigarettes under the same regulations/penalties as cigarettes and tobacco products. • New tobacco and nicotine-based products placed into the law to prohibit youth possession, attempts to possess, purchase or attempts to purchase as well as to ensure retailers could not sell these new products to youth under the age of 18.

38. Sub for HB 2178 • Granting professional licenses to nonresident individuals. Would require a state licensing agency (e.g. Board of Nursing) to issue a license to a nonresident military spouse in order for the spouse to lawfully practice a regulated profession in Kansas.

39. HB 2490: SB 326: Washburn University Doctor of Nursing Practice degree as eligible to receive payments of state grants from the State General Fund. Adds children who have not been seen by a dentist during the previous 12 months for a dental examination to those that dental hygienists can provide serevices to with the consent of the patient or legal guardian.

40. HB 2094: exemption for administration of vaccinations • Adds exemption for child care facilities and schools • Current exemptions: • physician statement that tests or inoculations would seriously endanger the life of the child • parent statement that child is adherent of a religious denomination whose religious denomination oppose • “a written statement signed by a parent or guardian of the child that the parent or guardian of the child declines immunization for reasons of conscience or personal beliefs.”

41. Affordable Care Act • Allow providers organized as ACO’s that voluntarily meet quality thresholds to share in the cost savings they achieve for the Medicare program. • Reduce Medicare payments to hospitals by specified percentages for excess (preventable) hospital readmissions. • Create state-based health benefit exchanges • Individual mandate to obtain health insurance

42. Kansas Response to ACA • HCR 5007. Constitutional amendment to preserve right to choose health care services and participate in health insurance plan • HB 2129, Enacting the health care freedom act Citizen has the right to purchase health insurance or refuse to purchase health insurance. The government shall not interfere with a citizen's right to purchase health insurance or with a citizen's right to refuse to purchase health insurance. • Attorney General joined Kansas in Florida lawsuit claiming individual mandate for insurance is unconstitutional

43. ANA Response • Joined five other health care groups representing millions of health care professionals in filing an amicus brief with the U.S. Supreme Court in support of the Affordable Care Act’s (ACA) “minimum coverage provision.” • The provision is essential to the ACA’s goal to make health insurance universally available and affordable. • ANA believes that health care is a basic human right, and that all individuals should have access to essential health care services.

44. ANA Public Comment Opportunities Principles for Delegation by RN’s to UAP’s. • Focusing on delegation to unlicensed assistive personnel including a revised Decision Tree for Delegation. • Deadline for comments - March 16, 2012. Care Coordination and Nurses’ Essential Role • Articulates the essential role of the RN in the care coordination process. • Deadline for comments - March 15 at 5 p.m. E.T. www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Call-for-Public-Comment

45. What can I do?

47. Know your legislator • Contact your legislator • Keep track of what is happening in: • Your state • Legislative Update • Kansas Nurse • Kansas Student Nursing Association • Your nation • ANA