Legislative Update 2010 Wrap Up
2010 SESSION WRAP
SPECIAL SESSION Called12:01am May 17th, 2010 ends by 12:01 pm.
In This Issue:
- Health and Human Services
- Governor’s Refusal To Accept MA Expansion is Bad for Patients and Nurses
- Mental Health Services and State RN Jobs Saved in SOS redesign
- MNA Works to Ensure Midwives Receive Same Payment for Services as Physicians
- Pension Bill-graduated vesting changes made in final hours
- Other Bills
- MNA Amends Bill creating a Surgical Technologist pilot
- Interstate Compact-Defeated This year
- Paramedic/EMT-introduced
- Contract Action Team (C.A.T.) visits success!
- Interim Work
- electoral
- legislative
Governor’s Refusal to Accept Medical Assistance Expansion in End Budget Deal is Bad for Patients and Nurses
MNA is deeply disappointed with the outcome of the session that failedto cover the poorest of our state’s residents through Medical Assistance (MA), an option available to Minnesota with the passage of federal health care reform. Instead, the end budget deal allows our governor to exercise this option by executive authority, although it is unlikely he will do so. Accepting our nation's offer to help Minnesota expand MA by paying half the cost is much better for all Minnesotans than the patchwork plan that the “General Assistance Medical Care fix” has been reduced to because of our governor’s ambition.
It has become clear that the new GAMC fix, passed earlier this session, will not provide adequate, sustainable health care to the population it was designed to serve, and a shift to MA is needed. The final GAMC proposal is rationing in the worst sense. The program would only pay sometimes, for some care, for some sick people, in some places. That is not a prescription for a healthy state. So far only 4 hospitals (HCMC, North Memorial, Fairview, Regions) have signed up to deliver care through the newly enacted “Coordinated Care Delivery Systems.” This means half of the population who do not fall into one of these systems will have no guarantee of receiving care beyond prescription drug coverage. Additionally, the deep cuts in the GAMC fix have resulted in dramatic changes to nurses’ work schedules threatening patient safety at HCMC and most likely will result in the loss of jobs for our nurses too.
Coverage for the GAMC population under Medical Assistance (MA) offers a far better alternative and would provide:
A stable, secure benefit set for all women and men currently covered under GAMC
Better reimbursements for providers. In fact for every $1.00 invested, Minnesota receives $7.00 in return
A 50% match from the federal government, money that Minnesota would otherwise leave on the table.
MNA will keep the pressure on the governor to accept MA expansion while he is in office, but will put most of our energy in working to elect MNA endorsed House Speaker Margaret Anderson-Kelliher who has pledged to implement MA expansion when elected.
Mental Health Services and State RNs Jobs Saved in DHS’s Redesign of State Mental Health Services
MNA moved into action this year when we learned the Department of Human Services (DHS) revealed their so-called redesign of mental health services. The plan would have decimated services for people with mental illness and resulted in the loss of numerous State RN jobs.
Many thanks to MNA members Linda Rossow, RN in psychiatric nursing at Immanuel St. Josephs, and Becky Romosz, State RN working in psych mental health for testifying against these changes in House and Senate Hearings. Also many thanks to Representative Paul Thissen (DFL, Mpls) and Senator Linda Berglin (DFL, Mpls) for working against these cuts and saving state jobs.
The final bill includes the following:
State jobs are protected in the transformation at the Anoka Regional Treatment Center and METO (Minnesota Extended Treatment Options) redesigns.
MNA has been named to a new Transformational Task Force which will help in the development of the community based services and all individuals employed by the community based facilities must be State employees.
Legislative approval is required for the closure of any State Operated Services (SOS) with the exception of state operated enterprise services-- if the State and Bargaining Units do not arrive at a mutually agreed upon plan.
The Commissioner shall recruit recently laid of State RNs at the Mankato Crisis Center to staff the new crisis center.
Changes at the Eveleth Campus and changes to the Wadena and Willmar facilities must be staffed by State employees.
Maintain the building in Eveleth that currently houses community transition services and to establish a psychiatric intensive therapeutic foster home as an enterprise activity.
Convert the Minnesota Neurorehabilitation Hospital in Brainerd to a
Neurocognitive psychiatric extensive recovery treatment service.
Stay Tuned to future Updates on Transforming State Mental Health Services.
DELAY in Pension Eligibility AVOIDED with Compromise
Changes to the various state employee pension plans were completed on Saturday, May 15th when Gov. Pawlenty signed the Omnibus Retirement and Pension bill, SF 2918. https://www.revisor.mn.gov/bin/bldbill.php?bill=S2918.4.html&session=ls86
The changes were recommended as financial sustainability provisions by the governing boards of the various plans. The changes included employer and employee increased contributions, decreased payouts and increases in vesting years required for eligibility. Specifically for registered nurses, for all new hires after July 1, 2010 into the state corrections pension plan. Under the new bill vesting would have required 10 years instead of the current 3. After expressing MNA’s grave concern on the impact this drastic change would have on the ability to recruit new hires an amendment was offered which MNA saw as a reasonable compromise. Details can be found in the link above, (specifically section 10 lines 9.17-9.34). The result is a graduated vesting scale for benefit eligibility. For example, if a nurse hired after 7/1/2010 chooses to retire after vesting for 5 years, the nurse would be eligible for 50% of the payout, 6 years=60%, 7=70% up to 10years=100%. Special Thanks to Representatives Mary Murphy and Paul Thissen for raising the issue on MNA’s behalf in the conference committee and the whole committee for accepting the amendment.
MNA Works to Ensure Midwives Receive Same Payment for Services as Physicians
Late in the evening of the Health and Human Services Conference Committee, MNA learned of a provision that would have resulted in a 35% reduction in payment for Certified Nurse Midwives (CNMs)! The provision would have aligned Medical Assistance payments with Medicare payments which were based on historically discriminatory fees which paid CNM’s 35% less than physicians for the same services. The new federal health care reform law would have brought CNM’s up to 100% in January 2011, but the provision in the health bill would have cut CNM’s for 6 months. Many thanks to Representative Maria Ruud (DFL, Minnetonka) and all the Midwives for pressing lawmakers to delete this provision!!!
Surgical Technologist Pilot Resurfaces in Higher Education Bill-MNA Amends Language
After working to defeat the surgical technologist bill in the House Licensing Committee this year, MNA learned late in session that a pilot project for surgical techs resurfaced in the House Higher Education Bill (HF 3448). MNA worked to defeat the most onerous provisions in the Higher Education bill, which we viewed as a backdoor way to licensure. We also worked to insert language that all surgical technologists must work in accordance with any laws and contract language in order to ensure that Surgical Technologists are supervised by an RN. As Registered Nurses, we are required by our license to supervise the work of surgical technologists. Additionally, the Centers for Medicare and Medicaid (CMS) require that surgical technologists be supervised by a qualified RN as a condition of payment for hospitals Federal Law title 42, sect 482.51. Despite this, the lobbyist for Surgical Techs continues to oppose this, and we believe their ultimate goal is to have Surgical Technologists working under the supervision the Surgeons. This summer MNA will want to talk with Operating Room RNs about organizing against further legislative action to license surgical technologists. Below is a copy of the statute:
Sec. 32. SURGICAL TECHNOLOGISTS PILOT PROJECT.
Subdivision 1. Surgical technologists; training and employment pilot project. The Board of Trustees of Minnesota State Colleges and Universities shall establish a pilot project to develop partnerships and training and employment opportunities for surgical technologists. The pilot project must develop partnerships between a health care facility located within 25 miles of an accredited surgical technologist program offered by a Minnesota State Colleges and Universities institution and the institution. The partnerships must promote the employment and retention of surgical technologists, working in accordance with law, regulations, including Code of Federal Regulations, title 42, section 482.51, and contract provisions, who have successfully completed an accredited educational program and who hold and maintain a certified surgical technology credential from a nationally recognized and accredited surgical technologist certifying body. This subdivision expires June 30, 2014.
Interstate Compact Legislation Defeated This Year
HF 3194 (Rep. Norton, DFL-Rochester); SF 0513 (Sen. Gerlach, R-Apple Valley)
The Nurse Licensure Compact legislation introduced last year by Senator Gerlach in the Senate was introduced this year in the MN House of Representatives by Representative Norton. MNA was successful in keeping the bill from being heard.
MNA continues to opposethe compact because it takes away our state’s constitutional right to monitor and regulate nursing practice through the legislative process. In addition, MNA has many concerns around due process for nurses. MNA will work to maintain the integrity of the state licensing system which is designed to protect the public and assure them that nurses working in Minnesota are properly trained and licensed.
Expanding Scope of Paramedics Delayed- Interim work necessary
HF 3211 (Representative Thissen DFL-Mpls); SF 2975 (Senator Lourey DFL- Kerrick)
HF 3211/ SF 2975, companion bills to include a new health care worker called a community paramedic to the list of community health workers was introduced early this session. MNA is opposed to this bill as it was written. MNA understands and even supports the intent to increase access to care to underserved areas of the state and better utilize existing health care workers. However expanding workers’ scope without considering its impact on patient safety is not the answer. MNA is committed to working with the bill’s stakeholder’s and authors over the interim to create a solution to address this issue and the relationship with other health care workers and health care professionals. MNA will need volunteers to help define our position and work on this issue. If you are interested please contact the MNA Governmental Affairs Dept.
Contract Action Teams at the State Capital
Unprecedented MNA member activity at the Capitol this year: Not only did MNA have a large Day on the Hill in February, nurses in red became a common sight at the Capitol in April and May when we talked to legislators about the contract campaign and patient safety. Over 50 nurses talked with over 50 legislators over 5 weeks for a rough total of 150 hours! To everyone who came to the Capitol this session to build support for nurses, great work!
Interim Work
Legislative
With the 2010 Legislative Session now history, it is time to look ahead to 2011. What we are able to achieve will rely heavily on who is elected Governor and who maintains or gains control of the MN House and Senate. For this reason we need to dedicate significant time and resources to working for elected officials who support our nursing issues. After we have elected these individuals to office we need to educate them further so they can advocate on our behalf at the legislature. Many members of the public, including elected officials, still do not fully understand what nurses do. This is why we see bills such as the interstate compact, the surgical technologist and community paramedic (which MNA oppose as written). The work we have to do over the interim includes, but is not limited to, educating our elected leaders on nurse to patient ratios, RN and LPN Scope of Practice, the role of surgical technologists in the operating room, the interstate compact and finally the community paramedic. Please consider volunteering to serve on work groups and committees to jointly develop solutions and attend town hall meetings and in-district meetings to educate these leaders and the public.
Electoral
MNA endorses Margaret Anderson Kelliher for Governor: DFL Primary August 10!
The MNA Political Committee has endorsed Margaret Anderson-Kelliher for Governor. “We are proud to unite behind Margaret’s leadership for the vision we all share of social and economic justice, human rights and compassion,” states MNA PC chair, Linda Slattengren.
If elected, Margaret is committed to a law requiring maximum patient assignment limits to ensure sufficient RN staffing based on patient acuity nursing intensity. According to Margaret, “Adequate RN staffing can reduce medical errors, patient mortality, and length of time a patient stays in the hospital.” She has also pledged her support for the Minnesota Health Plan.
This year, the DFL primary will be held on August 10, a change from previous years. For information on how to obtain an absentee ballot, you can visit the Minnesota Secretary of State’s office at http://www.sos.state.mn.us/index.aspx?page=211.
Margaret needs the help of RNs to win! For information on volunteering, please contact MNA Political Organizer at andrea.ledger@mnnurses.orgor (651)414-2872.
Updates: Staffing for Patient Safety and MN Board of Nursing RN/LPN Scope of Practice
Staffing for Patient Safety-Proposal in 2010 Contract Negotiations.
Staffing for Patient Safety remains a top priority for the MNA which is evident from the proposal put forth in the Twin Cities (and now Duluth) 2010 contract negotiations. The proposal put forth to the employers closely resembles the Staffing for Patient Safety Bill introduced in 2008 and re-introduced in 2009. We are hopeful that the negotiations produce the basic patient assignment limits nurses need to deliver safe care and are the starting point for fruitful discussions between nurses and management for each local hospital. We will also re-introduce the staffing bill in 2011 to achieve sufficient staffing for all patients and nurses across the state of MN.
RN and LPN Scope of Practice –Board of Nursing (BON) action – 2010
The Board of Nursing has proceeded with their plan to “clarify” assessment and delegation for LPN and RN scope of practice. MNA’s position is that this is not clarification, but rather a re-definition of scope and as such would require legislative authority to change the statute. The Board of Nursing’s Practice Committee continues to meet to refine this document which is a visual chart as well as an explanation of their position. MNA members attended several BON Practice Committee meetings to express their concerns about this proposal and to answer questions from BON members and staff. In addition, MNA has presented their concerns formally to BON members, both in written and verbal testimony. Letters outlining MNA’s opposition to this BON proposal were sent to all MN legislators. The Board of Nursing has not outlined its plan for recommendation or implementation of this proposal to date. Your active involvement and continued investment in this issue has made a difference. Please continue to stay in touch and monitor their website www.nursing.board.state.mn.us and ours for future meetings.
