Legislative Alert: March, 2002
by Louise Browning, CAE
Executive Director and Lobbyist
Advanced Practice Bill
SB 2488 by Cooper, Harper, Crutchfield & Wilder/HB 2429 by Odom, Black, Bowers, Cole, Harwell, & S. Jones) This bill removes physician supervision and gives sole ownership of prescriptions to APN prescription writers. It provides for legal protection of the title “advanced practice nurse (APN), and lists the four categories of APNs (nurse practitioners, nurse anesthetists, nurse midwives and clinical specialists) in the law for the first time. It clarifies the process of grandfathering those certified nurse midwives (CNMs) and certified registered nurse anesthetists (CRNAs) who do not have a master’s degree.
HB 2429 was considered in the Health Subcommittee on Wednesday, February 20. Rep. Caldwell (MD) offered an amendment to the bill, which TNA can support. The bill was rolled for two weeks (Wednesday, March 6 at 11:00am in Room 31) in order to allow time for the members to study the amendment and receive comments from APNs and MDs. The amendment states: “An advanced practice nurse who has been granted prescriptive privilege by the board shall maintain documented evidence of a medical consulting and referral relationship with a physician licensed under Tennessee Code Annotated, Title 63, Chapters 6 and 9, and shall make that evidence available to the board upon request.”
SB 2488 was also rolled for two weeks and will be heard in the Senate General Welfare Committee at 9:30 am on Wednesday, March 6 in Room 12.
To read the bills, go to www.legislature.state.tn.us and select Bills, then Filed Bills Index, then select either the House bill number or the Senate Bill number. Talk to your Legislators now about the importance of this bill and support for the amendment. See Talking Points.
UAPs Prohibited From Giving Shots or Penetrating the Skin
SB 2489 by Harper/HB 2586 by West states, “No physician, surgeon or other health care professional or any facility licensed by the board for licensing health care facilities shall in any way permit an employee to give a shot or penetrate the skin of any patient with a needle or any other instrument unless the employee is certified or licensed by a regulatory board as a health care professional whose scope of practice lawfully permits such procedure.” Rep. West brought this bill out of concern that unqualified persons are administering injections with poor outcomes as has been reported in the various media, and he fears that this practice will only exacerbate due to the nursing shortage. Action on SB 2489 was deferred in the Senate General Welfare Committee until 3/13/02.
Interstate Compact for Multistate Licensure
SB 2731 by Person/HB 3120 by Armstrong has been introduced providing for mutual recognition of licensed nurses by participating states by adopting an Interstate Nurse Licensure Compact. The House bill passed out of the Health Subcommittee of the Health and Human Resources Committee on Wednesday, February 20, and the full Health Committee on Tuesday, February 26. The Senate bill passed out of the General Welfare Committee on February 20. There seems to be no opposition to the concept of multistate licensure for Tennessee’s nurses.
The 12-page bill sets out the standard language that must be adopted in all of the compact states. The bill applies to RNs and LPNs, but not to nurses in advanced practice as their regulation varies significantly across state lines. The National Council of State Boards of Nursing is working on language that will address the issue of multistate licensure for APNs.
North Carolina, Arkansas, and Mississippi are neighboring states that have passed an interstate compact law (multistate licensure) law. Other states are Arizona, Delaware, Idaho, Iowa, Maine, Maryland, Nebraska, New Jersey, North Dakota (will implement by rule), South Dakota, Texas, Utah and Wisconsin. Visit www.ncsbn.org for more information about the compact.
Surgical Technologists
SB 2173 by Harper/HB 2272 by B. Cooper
HB 2272 was scheduled for the House Government Operations Committee on Tuesday, February 12, but was rolled over for one week. On February 19, after much discussion in the committee, it was again rolled for one week and passed out of the committee on February 26. It will be heard in the Health Subcommittee Wednesday, March 6 at 11:00 a.m. in Room 31. TNA opposes this bill. Contact members of the subcommittee to voice your concerns.
Advanced Practice Bill
TNA asked the sponsors to roll the advanced practice bills for one more week in both the House Health Subcommittee and the Senate General Welfare Committee. We are continuing to work on compromise language. Continue to talk to your legislators about this bill—particularly the members of these two committees. SB 2488 will be heard in General Welfare on Wednesday, March 13 at 9:30 am in Room 12/14. HB 2429 will be heard in Health Sub the same day at 11:00 in Room 31.
Surgical Technologist Bill
The surgical tech bill (HB2272) was rolled for one more week in the House Health Subcommittee. Contact members of this committee to voice your concerns. The Senate bill has not been placed on the calendar.
UAPs Prohibited from Giving Shots or Penetrating the Skin
SB 2489 was rolled to March 13 in the Senate General Welfare Committee.
Interstate Nurse Licensure Compact
The interstate compact bill passed the Senate 32-0 on February 28. The House has not been meeting in regular sessions, so HB 3120 is still in the Calendar & Rules Committee.
Glucagon Administration
The emergency administration of glucagon bill was amended and passed out of the Senate Education Committee February 27. The amended version of SB 2525 passed the Senate 31-0 on March 4. HB 2105 is scheduled to be heard in the House Health Subcommittee Wednesday March 13. Read the amendment to the bill at www.legislature.state.tn.us. The amended version is much better than the original language, but not perfect.
Advanced Practice Bill
The APN bill has been rolled for one more week in the Senate General Welfare Committee. We did not have the votes to pass the bill last week. It will be heard Wednesday, March 20, in this committee at 9:30 in Room 12/14. It is the second bill on the calendar. Senator Cooper will be offering two amendments to the bill. Amendment No. 1 rewrites the bill and includes only the title protection/grandfathering section of our original bill. Amendment No. 2 is written to take the place of a very bad amendment written by the medical lobbyists, and it is to assure the Legislature there are no hidden agendas in Amendment No. 1. APN Amendment (Please note that if a username/password command appears when you click this link, click the Cancel button. The doc will open okay.)
The House bill was rolled for one more week in the Health Subcommittee. Rep. Odom discussed these two new amendments last Wednesday, but any new amendments are rolled for one week in Rep. Pruitt’s subcommittee. The bill will be heard in this subcommittee Wednesday, March 20 at 11:00 in Room 31.
These amendments make up the final compromise TNA will make on this bill. If we cannot get a majority to support us, the bill will fail in the Senate committee and the House subcommittee this week. Please call and talk to these committee and subcommittee members before Wednesday. Flood their email and telephones as you did with the medical technician bill.
Surgical Technologist Licensure Bill
The surgical tech licensure bill was rolled again for one week, and will be heard next Wednesday in the House Health Subcommittee. There is a 16-page amendment to the bill that has been circulated, which does not look any better than the original bill. TNA is opposed to this bill which removes the surgical tech from nursing supervision in the operating room and places them under the supervision of the surgeon. Contact members of the subcommittee on this bill. The Senate bill has not been scheduled for a committee hearing.
Glucagon Bill
The bill that will authorize emergency administration of glucagon by unlicensed school personnel was rolled for one week in the House Health Subcommittee. Contact members of this subcommittee with your comments. TNA does not support the bill as originally written. The amendment is better, but could use further refinement. If you are interested in school health, this bill has been discussed on TNA’s school health listserv. You may subscribe to the listserv on TNA’s Web site on the homepage.
Cigarette Tax Increase Bill
The bill to increase the tax on cigarettes from $.13 per pack to $.43 per pack has failed in the Senate Finance Ways and Means Committee with 5 ayes, 2 nays, and 3 present and not voting. One member was absent. Senator Kurita will no doubt work to try to bring this bill back up in this committee before the session is over. The House bill by Maddox is scheduled for the Subcommittee on Agriculture Resource & Industry on March 19. Contact members of this subcommittee to express support for this bill. Studies show increases in cost of cigarettes do deter teen smoking.
All committees are listed on the legislative Web site under House or Senate at www.legislature.state.tn.us, as are email address for all legislators. The House Health Subcommittee is one subcommittee nurses need to become very well acquainted with, as many of the bills nursing is interested in are heard in this subcommittee before going to the House Health & Human Resources Committee. The House Health & Human Resources Committee has three subcommittees–Health, Health Access, and Human Services & Mental Health. If bills don’t make it out of these subcommittees they are never heard in the full committee, so it is important to let these subcommittees hear from you. In the Senate the General Welfare Committee does not use subcommittees, so these nine members are the only ones who hear health bills in the Senate. Get acquainted with them.
Advanced Practice Bill
The APN bill has been rolled once again for one more week in the Senate General Welfare Committee. It will be heard Wednesday, March 27, in this committee at 9:30 in Room 12/14. It is once again the second bill on the calendar. Senator Cooper will be offering two amendments to the bill. Amendment No.1 rewrites the bill and includes only the title protection/grandfathering section of our original bill. Amendment No. 2 is written to assure the Legislature there are no hidden agendas in Amendment No.1.These amendments make up the final compromise TNA will make on this bill. Please talk to these committee and subcommittee members before Wednesday. APN Amendments (Please note that if a username/password command appears when you click this link, click the Cancel button. The document will open.)
The House bill was also rolled for one more week in the Health Subcommittee. Rep. Odom discussed these two new amendments on March 13, but it was his choice to roll the bill again on March 20, since he had another highly controversial bill to present that day. The bill will be heard in this subcommittee Wednesday, March 27 at 11:00 in Room 31.
Nurses who are planning to attend the TNA Health Policy Summit will have the opportunity to hear both bills discussed in these committees March 27.
Surgical Technologist Licensure Bill
The surgical tech licensure bill was rolled again for one more week, and will be heard Wednesday, March 27, in the House Health Subcommittee. There is yet another new amendment to the bill that had been circulated among the lobbyists, but the committee did not receive it until Wednesday morning. This new amendment does remove the language that placed the surgical techs under the supervision of the surgeons, which we requested, but we are still looking at other language in the amendment and have not determined if there are other parts of the amendment we can support. Contact members of the subcommittee on this bill. The Senate bill has not been scheduled for a committee hearing.
Glucagon Bill
The bill to authorize emergency administration of glucagon by unlicensed school personnel passed out of the House Health Subcommittee with the Senate amendment on March 20. It will be heard in the House Health and Human Resources Committee on Tuesday, March 26, at 12:00 noon. TNA does not support the bill as originally written. The amendment makes the bill, and will require the Department of Health to develop guidelines to govern this process.
Cigarette Tax Increase Bill
The bill to increase the tax on cigarettes from $.13 per pack to $.43 per pack has failed in the Senate Finance Ways and Means Committee with 5 ayes, 2 nays, and 3 present and not voting. One member was absent. The House bill by Maddox was taken off notice in the Subcommittee on Agriculture Resource & Industry on March 19.
UAPs Prohibited From Giving Shots or Penetrating the Skinl
SB 2489 by Harper/HB 2586 by West states, “No physician, surgeon or other health care professional or any facility licensed by the board for licensing health care facilities shall in any way permit an employee to give a shot or penetrate the skin of any patient with a needle or any other instrument unless the employee is certified or licensed by a regulatory board as a health care professional whose scope of practice lawfully permits such procedure.” This bill was placed in the General Subcommittee of the Senate General Welfare Committee on 3/13/02, which usually means it will die there. It was referred to the House Health Subcommittee, but has not been placed on the calendar.
All committees are listed on the legislative Web site under House or Senate at www.legislature.state.tn.us, as are email address for all legislators. The House Health Subcommittee is one subcommittee nurses need to become very well acquainted with, as many of the bills nursing is interested in are heard in this subcommittee before going to the House Health & Human Resources Committee. The House Health & Human Resources Committee has three subcommittees–Health, Health Access, and Human Services & Mental Health. If bills don’t make it out of these subcommittees they are never heard in the full committee, so it is important to let these subcommittees hear from you. In the Senate the General Welfare Committee does not use subcommittees, so these nine members are the only ones who hear health bills in the Senate. Get acquainted with them.