West Virginia actions for 2015 and plans for 2016

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West Virginia actions for 2015 and plans for 2016. IN recommendation #1- removal to barriers of practice. 
Bill Number
SB 21/HB 2450  for 2015 session- will renew 2016, timed out for 2015 
Full practice authority for prescriptive authority, controlled substance prescribing and global signature---
of APRNs revised codes for advanced nurse practitioners and certified nurse-midwives .  
Roll over 1/14/2015 - To Senate Health and Human Resources- Never  put on the agenda- DIED due to inaction of Senate Health Chair
alternate bill proposed as a compromise This was base on PERD recommendation for most part BUT
 created a new board APRN board as a compromise

PERD - presented 2/1/2012 in House Gov org committee. 1st 21 pages of report supportive.
 BUT recommendation do not match PERD findings and recommendation state: 
NP should retire written collaborative agreements if regulated by the Board Of Medicine. No change for CNM, 

No full prescribing abilities and no global signatures. 

The state legislative auditor challenged that NP are safe in study with written collaboration 

and would reconsider if evidence that independent NP practices are safe with professional collaborative expectations not regulated.
  immediately sent  rebuttal and nursing response BUT no changes in recommendation to date- 

State auditor questioned on his recommendation and stated it is his professional opinion not based on the facts.  
Bill Plan
1. Fact sheet to educate new legislators on misinformation given during senate testimony
2. Social media campaign.
3. Collect evidence for antitrust law suit.
4. Request interim study of full practice authority- June and July 2015
5. Request legislation advance in 2016 with single reference 
6. Advance media coverage of WV access to care crisis areas.
7. Develop grassroots campaign of at least 135 APRN 1 per each legislator to continue to work on educating and securing votes.
8. Work with stake holders groups and continue to build outside support. (nonnursing & nursing)
9. identify APRN leaders to testify to each issue questioned in the legislative session : like education, 5 roles, and personal testimony. 


 3 points needed in WV--Removal of written collaboration requirement  for prescribing. Full prescribing allowance and global signatures.  

Bill Number
HB 4280
Make Tramadol scheduled medication schedule 4
Now must have DEA to prescribe
Passed March 8, 2014; in effect ninety days from passage
Bill Plan
Educate APRNs must have DEA.

Bill Number
Joint Study Resolution - request for 2015
The resolution means that the Joint Standing Committee on Government Organization 

will re evaluate APRN issues the summer 2015.  
These steps are critical so that the Committee on Government Organization
 can recommend moving forward in removing the barriers to practice for all APRNs 2016 legislation. 

This bill should be voted on in government Organization committee in November interim session. 
Followed by recommendation by a vote of the  full joint government organization committee in December for an interim sponsored bill.
Proposal- 1. retire written collaboration for all APRNs in WV and up date code so consistent for all APRNs. 
2. Allow Prescribing to the full extent of education and prescribing for professional APRN roles.
3. Signature allowance for APRN paper work. 
time out did not pass.
Bill Plan
Work gov. org subcommittee. For positive vote.
Work in stake holder group to come up with negotiations with WV organized medicine. 
Need Public input and outcry from every district and county to their legislative representative.
 We are facing big money stake holders with Huge names at the state capital. Only votes can beat this kind of money. 
Have- WV IOM, WV BON, WV for affordable health care, APRNs from UOV, ADDNE, Funeral directors,
 WV center for budget and policy, Joint healthcare and rural healthcare groups.
Working on -NEED HELP with any contact to pressure support.--End of life Medicine as advocates,  

Hospice state wide, AARP, WV hospital association, Pharmacists, Pharmaceutical  company reps, MORE Physicians as alias.


Bill Number
SB 516
Compromise bill
Developed by Legislative leaders as a solution and a proposal of the PERD report. With the exception of the bill actually
 created a seperate APRN board instead of trying to regulate nursing under the BOM.
Allowed autonomous prescribing after 5 years and approval.
Slightly expanded prescribing laws- WV some of worst prescribing laws in the country.
Allowed death certificates. 
  Amendment to put APRNs under the BOM for full autonomous prescribing.-added
APRN community from outside the state and internally decided to dangerous and we must kill the bill.
Supportive legislator wanted to continue to fight and were VERY upset with this decision. 
Bill died this session at APRNs insistence 
Bill Plan
Must get one strong voice of nursing join again.

Need support of APRNs and develop expert testimony

Bill Number
HB 2239- 
Creating a logistical advisory committee. Initially proposed to creat joint health care boards.
Concerns following BON lead FOR advisory roles to board and shared staff. 
boards may share staff. 
Bill Plan
watch for future bill to put nursing under medicine. 
Republican party proposal.
decreased over sites regulatory boards. 

Bill Number
HB 2776
 Relating to prescribing hydrocodone combination drugs for a duration of no more than three days  
                72 hour no refills 30day. 
pass but governor Vetoed

Bill Number
HB 2497 
Rewriting the licensing requirements for the practice of medicine and surgery or podiatry              
                nurses added 2/6 Need changes concerns with felony to practice medicine.
                APRNs added to tele-health 
Bill Plan
May need to review rules bill
concerned with felony wording. 

Is your state participating in the Multi-State Reimbursement Alliance? Yes
Please comment on any issues, concerns or action taken regarding NP credentialing 
with insurance carriers/payers and patient access to insurance-covered services provided by NPs.
WV get 100% reimbursement from medicaid but must bill always under own number
APRN may lead health care home if approved by federal medicare/ medicaid
Aetna- claims they will credential APRNs BUT no space for APRNs in the state- I know of ZERO
The health plan will not independently credential APRNs-
Insurance still charging copay as specialist for private insurers.
Meet with WV insurance 9/2013 to discuss non discriminatory clause in ACA, WV current law for equal providers
 of care and support of enforcement by the WV insurance commissioners office.- results noncommittal and will take
 all under advisement with lawyers and get back with response.

Plan actions: 
WVNA recruiting Nurse policy advocates- redistricting by Senatorial districts.
Grassroots efforts- Continue to ID every member and categorize by senatorial districts to be able to
 contact strong trained  nurse leaders in each district willing to be trained and participate in grass root efforts as
 personal contacts to local politicians.
  Meet with advocates  this summer 8/15 at a retreat to develop, write and strategies with Future of Nursing support

Choosing wisely
Choosing Wisely- Working with joint health care provider to establish 
Provider neutral group and language to be introduced in WV. 
WVNA, WV Hosp. association, West Virginians for affordable health care, WV ONE,