1. Arkansas Nurses Association Mary Garnica, DNP, APRN, FNP-BC Chair, ARNA Health Policy Committee

2. Objectives Identify key bills filed or expected this session that affect nursing practice and healthcare delivery. Learn how to advocate for the nursing profession.

3. The Legislative Steps for Healthcare Laws: Legislator files a bill House Public Health, Welfare, & Labor Committee 11 votes needed House of Representatives 51 votes needed Senate Public Health, Welfare & Labor Committee 5 votes needed Senate 18 votes needed Governor for signature

4. Advocates for Nursing Issues Arkansas Action Coalition Arkansas Advocates for Children & Families Arkansas Assisted Living Association Arkansas Home Health Care Association AARP Community Health Centers HomeCare Association of Arkansas March of Dimes

5. Bills to promote full scope nursing practice

6. HB 1160 - The certified nurse practitioner medically underserved permit program Sponsor: Rep. Kim Hammer (R-Benton) Co-sponsor Rep. Justin Gonzales (R-Arkadelphia) What the bill does Establishes an “opt in” permit in MUAs CNPs with > 2000 hrs/2 years collaborative practice may apply to have CPA removed CNP with fewer than 2000 hours/2 years have collaborative practice until they reach 2000 hrs/2 years ARNA SUPPORTS

7. HB 1165 – Schedule II prescriptive authority for APRNs with DEA# Sponsors: Rep. Justin Gonzales (R-Arkadelphia) Rep. Kim Hammer (R-Benton) What the bill does: Authorizes APRNs with DEA to prescribe Schedule II medications, including: Hydrocodone combinations ADHD medications (stimulants) Pain control narcotics (Percocet, morphine) ARNA SUPPORTS

8. AR bills filed which could adversely affect patients and healthcare delivery

9. HB 1136 APRN RX authority: Hydrocodone combos only Sponsor Steve Magie (R-Conway) What the bill does Allows APRNs and physician assistants to prescribe hydrocodone combination products if authorized by a physician under the collaborative agreement. No authorization for anything other than hydrocodone combinations ARNA OPPOSES

10. HB 1162 Creates the Arkansas Graduate Registered Physician Act Sponsors: Rep. Deborah Ferguson (D-West Memphis) Sen. Missy Irvin (R- Mountain View) What the bill does Allows physicians who have reached a certain step in the national licensure process but not yet matched for a postgraduate residency to practice under a supervising physician. ARNA OPPOSES

11. HB 1120 – Anesthesiolgist Assistant Sponsor Rep. Steve Magie (R-Conway) What the bill does Establishes procedures for examining and licensure as an anesthesiologist assistant; outlines the duties an anesthesiologist assistant may perform under supervision of a licensed anesthesiologist. ARNA OPPOSES

12. HB 1133 - Community Paramedic Sponsor – Rep. Scott Baltz (D-Pochahantas) What the bill does: Establishes requirements for licensure as a community paramedic, including existing licensure as a paramedic and completion of an additional training program; authorizing community paramedic to perform particular services. ARNA opposed to current language

13. SB 133 Creates Telemedicine Act Sponsors: Sen. Cecile Bledsoe Rep. Deborah Ferguson (D-West Memphis) What the bill does Requires coverage for healthcare services delivered through telemedicine on the same basis that in-person services are covered. Does not recognize APRNs or other allied health professionals as able to be reimbursed for covered services under the Act. ARNA opposed to current exclusionary language

14. HB 1395 The American Diabetes Association has stated they will seek bill to allow school personnel to administer Insulin. Bill filed 2/17/15 Senate bill in 2013; defeated in House Education committee. ASNA and ARNA oppose

15. Act 414 of 2013 Recognized the important role of the school nurse and established the Public School Health Services Committee 2014 report presented to AR General Assembly More school nurses are needed!

16. AR Healthcare Independence Act of 2013 – ACT 1498 An expansion of Medicaid to ~ 250,000 Arkansans. Allows the state to use Medicaid dollars to buy private insurance plans for low-income Arkansans. Also called the “Private Option” and requires an annual ¾ majority vote from law makers to re-authorize funding.

17. ACT 1498 ARKANSAS IMPACT 100% of costs federally funded through 2015; AR assumes a share starting in 2016; Maxes out at 10% in 2020 90% covered by the federal government ACT 1498 provides Subsidies for health coverage to an estimated 200,000 Arkansans earning 139–400 percent of FPL, and Approximately 250,000 Arkansans earning up to 138 percent of the FPL are eligible for the Medicaid “private option.”

18. Gov. Hutchinson’s plan SB 96 Arkansas Health Reform Act of 2015 (Sen. Hendren, R-Gravette) Keeps private option through 2016 Forms a bipartisan legislative task force to consider alternatives.

19. Progress of Arkansas Health Reform Act of 2015 – SB 96 Passed Senate PH Jan. 28 Passed Senate Jan. 29 Passed House PH Feb.3 Passed House Feb. 5 Governor has signed

20. Bills still out there which would: 1. Repeal the private option; terminate program prior to Dec. 2016 2. No form of Medicaid expansion further considered Failed in Committee: SB 144 Sen. Collins- Smith HB 1181 Rep. Copeland Filed, not heard yet: SB 178 Sen. Clark HB 1262 Rep. Miller

21. Ways YOU can help us! Send email to arnagrassroots@gmail.com Become knowledgeable of the issues. Become a key contact for your legislators regarding healthcare issues Respond ASAP when an alert is sent out by ARNA Health Policy Come to the Capitol; meet the legislators Attend a committee hearing Enlist the help of your nurse colleagues

22. For more information and updates, visit: Arkansas Nurses Association www.arna.org Contact: arnagrassroots@gmail.com