THE STATE OF PLAY IN THE BELTWAY 2017 COLLEEN LENERS DNP APRN FAANP DIRECTOR OF POLICY
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1 THE STATE OF PLAY IN THE BELTWAY 2017 COLLEEN LENERS DNP APRN FAANP DIRECTOR OF POLICY
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3 OBJECTIVES»Understand the healthcare depth of the 115 th Congress»Examine the 2018 election possibilities (House & Senate)» Utilize advocacy tools to interact with congress»review current legislation
4 WHO IS DRIVING FEDERAL POLICY? Administration=White House & HHS, VA, OMB, (etc.) Congress = Senate & House
5 ADMINISTRATION VA & HHS THE HONORABLE DAVID J. SHULKIN M.D. SECRETARY OF VETERANS AFFAIRS ERIC D. HARGAN ACTING SECRETARY OF HEALTH AND HUMAN SERVICES. SEEMA VERMA ADMINISTRATOR OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES GEORGE SIGOUNAS, MS, PH.D. ADMINISTRATOR HEALTH RESOURCES AND SERVICES ADMINISTRATION
6 PRESIDENT TRUMP FY 18 BUDGET BLUEPRINT» Decrease spending in Cabinet Level Departments except (VA, DOD, and Homeland security)» HHS: Decrease by $610 Billion from Medicaid in Block Grants -$12 billion to discretionary spending -$146 million from nursing workforce development and -$5billion from NIH» VA : Increase by $ 4.3 Billion for VA health are and improve access to care
7 *One vacant seat in the House: Utah s 3 rd district
8 CONGRESSIONAL LEADERSHIP PAUL RYAN (R-WI) NANCY PELOSI (D-CA) MITCH MCCONNELL CHUCK SCHUMER (D-NY) SPEAKER OF THE HOUSE MINORITY LEADER (R-KY) MINORITY LEADER SENATE MAJORITY LEADER
9 : Physicians: 14 Dentists: 4 Veterinarians: 3 Psychologists: 3 Optometrist: 1 Pharmacist: 1 Nurses: 2 Rep. Diane Black (R TN 06) Rep. Eddie Bernice Johnson (D TX 30) Source: Congressional Research Service. (2017). Membership of the 115 th Congress: A Profile. Retrieved from:
10 COMMITTEES OF JURISDICTION HOUSE» Energy & Commerce Chairman Greg Walden (R-OR) Ranking Member Frank Pallone( D-NJ)» Ways & Means Chairman Kevin Brady (R-TX) Ranking Member Richard Neal (D-MA)» Education & Workforce Chairmen Virginia Foxx (R-NC) Ranking Member Bobby Scott (D-VA)» Veterans Affairs Chairman Phil Roe (R-TN) Ranking Member Mark Takano (D-CA)
11 » Finance COMMITTEE OF JURISDICTION SENATE Orrin Hatch, Utah, Chairman Chuck Grassley, Iowa Mike Crapo, Idaho Pat Roberts, Kansas Mike Enzi, Wyoming John Cornyn, Texas John Thune, South Dakota Richard Burr, North Carolina Johnny Isakson, Georgia Rob Portman, Ohio Pat Toomey, Pennsylvania Dean Heller, Nevada Tim Scott, South Carolina Bill Cassidy, Louisiana» Health, Education, Labor and Pension (HELP) Ron Wyden, Oregon, Ranking Member Debbie Stabenow, Michigan Maria Cantwell, Washington Bill Nelson, Florida Bob Menendez, New Jersey Tom Carper, Delaware Ben Cardin, Maryland Sherrod Brown, Ohio Michael Bennet, Colorado Bob Casey, Pennsylvania Mark Warner, Virginia Claire McCaskill, Missouri Lamar Alexander, Tennessee, Chair Mike Enzi, Wyoming Richard Burr, North Carolina Johnny Isakson, Georgia Rand Paul, Kentucky Susan Collins, Maine Bill Cassidy, Louisiana Todd Young, Indiana Orrin Hatch, Utah Pat Roberts, Kansas Lisa Murkowski, Alaska Tim Scott, South Carolina Patty Murray, Washington, Ranking Member Bernie Sanders, Vermont [4] Bob Casey Jr., Pennsylvania Al Franken, Minnesota Michael Bennet, Colorado Sheldon Whitehouse, Rhode Island Tammy Baldwin, Wisconsin Chris Murphy, Connecticut Elizabeth Warren, Massachusetts Tim Kaine, Virginia Maggie Hassan, New Hampshire
12 2018 MIDTERM ELECTIONS» Senate Seats» 23 Democrats, 2 independents, and 9 Republicans 5 Democrats hold seats that President Trump won by 18 points Democrats need 3 seats to flip majority Republicans need 8 seats to get to 60 vote super -majority» 435 House of Representative seats (every 2 years)» Democrats need 24 seats to flip majority
13 WHY IS IT IMPORTANT $$$$$$$$
14 ACHA = REPEAL & REPLACE
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16 Nearly every expert I ve spoken with Republican or Democrat, old or young, adherent of Milton Friedman or Karl Marx has theoretical explanation as to why the United States spends nearly 20 percent of its gross domestic product on health care more than twice than average of developed countries. But each one also has a story of personal exasperation about the last time a family member or a loved one was hospitalized or rushed to an emergency room or received an incomprehensible, outrageous bill. Elisabeth Rosenthal An American Sickness: How Healthcare became Big Business and How you Can Take it Back
17 Influence: The ability to of an individual to sway or persuade another person or group based on Authority, Communication Traits, Knowledge Based Competence, Status and Time & Timing Copyright 2014 Jeff Adams LLC Source: Adams, JM (2009). The Adams Influence Model (AIM): Understanding the factors attributes and process of achieving influence. Saarbrüken, Germany: VDM Verlag.
18 Gallup, 2014, 2015 How do Americans View Nurses
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20 EMERGING ISSUES» Primacy care» Opioid (SUD)Treatment» Tele-health» MACRA implementation (Regulatory)» EHR /provider attestation» Rural Health» Funding &/or Reauthorization Chip NHSC Title VII & VIII
21 LEGISLATIVE SCAN» H.R To amend the Controlled Substances Act to establish additional registration requirements for prescribers of opioids, and for other purposes. Roe (R-TN)» H.R Emergency Nursing Supply Relief Act of 2017 To amend the Immigration and Nationality Act to provide for the admission of certain health care workers as immigrants, and for other purposes. Sensebrenner (R-WI)» S Veterans Emergency Room Relief Act of 2017 This bill directs the Department of Veterans Affairs (VA) to enter into contracts under which the VA pays health care providers the reasonable costs of urgent care provided to eligible veterans at non-va facilities. Cassidy (R-LA) H.R Veterans Emergency Room Relief Act of 2017 Higgins (R-LA)» H.R Reducing Unnecessary Emergency Room Visits under Medicaid Act. To amend title XIX of the Social Security Act to reduce unnecessary emergency room visits under the Medicaid program. Collins (R-NY)» S Health Care Safety Net Enhancement Act of This bill amends the Public Health Service Act to deem a hospital or an emergency department and a physician or physician group of a hospital or emergency department to be an employee of the Public Health Service with liability protection provided by the United States for purposes of any civil action that may arise due to providing emergency or post-stabilization services on or after January 1, 2018.
22 ORGANIZATIONAL RESPONSE» Join Coalitions Inter-professional APRN» Speak with one Voice Power in numbers» Don t be a free rider» Give to your organizations» PAC s» Get involved» Vote» Be a Voice
23 BE A VOICE FOR CHANGE» Interact with your member ESP if they are a committee of jurisdiction!» Send them a letter» Meet with them State/District office» When you visit DC make an appointment to see your representative» Invite them to you practice» Use research and data when making points» Tell your story» You are the expert» Common Etiquette
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26 EXTRAORDINARY PROVIDERS
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