Get Involved - Legislative Action

Remember: If you're not at the table, you're on the menu.

One role of the Washington Chapter of ACNM is to inform midwives and the public of legislative issues that affect the practice of midwifery as well as the women and children we care for. Our legislative team keeps on top of federal and state issues and legislation and notifies members of the WA Chapter when action is needed.

Current Legislative Efforts:

The Midwifery Care Access and Reimbursement Equity Act of 2007
On August 1st, 2007, the U.S. House of Representatives passed the “Children’s Health and Medicare Protection (CHAMP) Act of 2007” (H.R. 3162), which expands health care coverage to pregnant women and their children.

In CHAMP, ACNM members are a step closer to achieving their long-standing number one federal legislative priority: requiring Medicare reimbursement for services by midwives to be 100% of the Medicare fee schedule, beginning April 1, 2008.

Currently Medicare reimburses CNMs at 65% of the physicians’ rate. Other NPs are paid at 85%. Although midwives have few Medicare clients (mostly disabled women of childbearing age), Medicare fees tend to set a low bar for fee schedules that are often copied by other payors for health services.

The battle is not over. The Senate has not passed a Medicare bill, and a bill cannot become law until both houses agree on a joint bill. Our mission at this point is to gain cosponsors for S.507, the Senate bill that would address the payment inequity for midwives in the Medicare program and enable certified midwives to bill within the program.  Support in the Senate for S.507 will strengthen the likelihood that Sec. 603 from the House bill will be in the final joint Medicare bill that goes to the President.

Currently, both Senators Patty Murray (D-WA) and Maria Cantwell (D-WA) are cosponsors of the bill. Please send a thank you note to both Senators for their support of this important legislation. Learn more here.

Learn more about current legislative efforts:

1. ACNM’s CapWiz: Members are encouraged to frequently visit CapWiz through ACNM's home page. This site offers very easy access to elected officials, legislative alerts and updates, and information on Capitol Hill Basics. The Media Guide through CapWiz allows you to contact local and national newspapers, TV and radio stations.
   
   
2. In ACNM’s monthly legislative newsletter, The Advocate, ACNM members have access to a members-only publication written by the ACNM Government Affairs Committee, the Midwives-PAC, and ACNM staff.
   
   
3. ARNPs United of WA State: This non-profit organization is dedicated to promoting ARNP practice by coordinating educational, legislative, and networking activities of nurse practitioners throughout Washington State. Learn more about current state legislative efforts, past legislative successes, and other legislative topics by clicking on “legislative” on the home page. You can also learn how to obtain prescriptive authority by clicking on “Rx Authority” on the home page.
   
   
4. Our chapter’s legislative team:
   
   1. Ann Darlington, CNM, ARNP, President of ARNPs United of WA State
   2. Heather Bradford, CNM, ARNP, Chair and Region VI Representative of the ACNM Government Affairs Committee, and Legislative Chair of ARNPs United of WA State

Passage of "72 Hour" Bill!

...and a goodbye

Heather Bradford, CNM, ARNP
Chair, Legislative Committee, ARNPs United of WA State

Another year, another bill passed by ARNPs United of WA State (AUWS). How exciting! I know it hasn’t always been this way, but I feel lucky to have witnessed so many legislative successes in such a short time. On March 5th, Senate Bill 6267 (which eliminates the 72 hour limitation on dispensation by ARNPs of controlled substances) made its final passage through the House, and was signed by the Governor into law on March 25th. The law becomes effective June 12th, 2008. Our bill was quickly out of the blocks during this short (60 day) session—it was heard by both the Senate and House Health Care Committees on the first day of session, and passed out of the House unanimously.

It then hit a stumbling block in the Senate when Senator Linda Evans Parlette (R-Wenatchee), a pharmacist, decided we did not need unlimited dispensing for Schedule II drugs because these do not come in samples, and offered an amendment that would continue the dispensing limitation on Schedule II meds. We circumvented that move via several phone calls and emails from ARNP constituents, effective lobbyist efforts by Tammy Warnke, and strong leadership from our legislator sponsors. The bill passed out of the Senate 44-2 (3 excused) unamended and then moved to the House, where it passed 95-1 (2 excused).

We now have full prescriptive authority in Washington state with no exceptions, and can look forward to reading the 2008 Pearson Report published in The AJNP, which ranks states based on scope of practice and patients’ access to care by nurse practitioners (see the June 2007 issue of AUWS’ monthly newsletter, ARNP Care, to read more). We believe we will now be tied for first with Arizona’s NPs!

And now for Goodbyes: As Legislative Chair, it has been my privilege to work with ARNPs across the state and to participate in the legislative process firsthand. This experience began after graduating from the University of Pennsylvania and then moving to Kirkland, WA in early 2002. I joined the AUWS Legislative Committee that year and became Co-Chair with Marty Couret in 2004, and then Chair in 2007. After 6 legislative sessions, 6 Nurse Legislative Days in Olympia, over 50 visits with legislators, and 5 bill passages, I feel a good balance between what I have given and received through these years. I am exhausted by the amount of work it has taken, but have grown professionally and learned so much about the political process. So I think it is a good time to step aside and let someone else take the reins.

I am therefore delighted to announce that Louise Kaplan, ARNP, PhD, from Olympia, WA, will be assuming the role as Legislative Chair on July 1st, 2008. She comes with extensive experience in legislative and health policy work, and already has developed excellent relationships with many legislators in Olympia. I will continue to serve AUWS as Vice President of the Board of Directors, and will “mentor” Louise as she takes over the Legislative Chair role for the next legislative session, although in many ways, she has been the one mentoring me all along.