Looks much the same as 2011 Same leadership - Lt. Gov. Dewhurst 19 Republicans; 12 Democrats Republicans 2 short of 2/3 majority of 21 6 new members – 20% 3 physicians; 1 pharmacist 2

Looks somewhat different than 2011 Leadership same – Speaker Strauss 40 new members – 27% 66 freshman or sophomore legislators – 44% More ideologically driven 95 Republicans; 55 Democrats Republicans 5 short of 100 needed for super majority 3 RNs ; 3 physicians; 1 paramedic Rep. Donna Howard (D-Austin) Rep. Susan King (R-Abilene) Rep. Stephanie Klick (R-Ft. Worth) 3

Number of bills expected to be filed 2011 Session HBs; 1931 SBs 5796 Total 2009 Session HBs; 2583 SBs 7419 Total Deadline to file bills - 60 th day (Friday, March 8) Number of bills filed as 2/8/ HBs; 460 SBs Expected to be filed – bills 4000 bills in next 28 days (141 bills/day including Sat & Sun) Monitoring of Bills 4

Number of bills filed in previous sessions 2011 Session HBs; 1931 SBs 5796 Total 2009 Session HBs; 2583 SBs 7419 Total Deadline to file bills (60 th day ) was March HBs; 1816 SBs 5668 Total Bills Passed (HBs & SBs) 2009 Session1459 (19.7%) 2011 Session1379 (23.8%) 2013 Session?? 5

Appreciating that process does affect substance Key hurdles controlled by a very few legislators Delay can kill a bill 7

Collaboration/compromise encouraged Must know opposition and support for bill Opportunities must be exploited Long term, multi-session presence favored Long term, multi-session strategies needed 8

Letting desire for perfect prevent achieving good Reluctance to identify alternatives that might represent significant progress towards desired “perfect” Believing that “educating” legislators will be enough Lack of effective and efficient decision-making 9

TNA Governmental Affairs Committee Nursing Legislative Agenda NLACContent Nursing initiated legislation Nursing supported health policy legislation Oh my gosh! Did you see that bill? Nursing can’t live with that! 10

Preventing violence against nurses Bill covers ER personnel Some mental health advocacy groups likely will oppose Assuring publicly-employed nurses equal right to access courts to redress retaliation Not issue of making illegal – is already illegal to retaliate Issue is should publically-employed nurses have same remedies as privately-employed nurses Notification of parents if no school nurse

First Success of 2013 Session! Agreement with medicine to replace current site-based approach with a simpler, more flexible prescriptive authority agreement model SB 406 by Nelson; HB 1055 by Kolkhorst SB 406 passed on Local & Uncontested Calendar on 3/13 Will now go to House 12

NPA Amendments Mandatory criminal background checks for students Making deferred disciplinary action pilot permanent Confidentiality of BON orders referring nurses to TPAPN Self-Directed, Semi-Independent Status (“SDSI”) TMB, TSBP, BON Initiative of coalition of professional associations BON Appropriations Executive director salary TPAPN funding 15

Maintaining Special Funding $30.0 mil – Professional Nursing Shortage Reduction Fund 16

RNs administering meds & treatments ordered by therapeutic optometrists Loan repayment for nursing faculty Uniform admission system 17

Unknown but there always are some “Oh my gosh! Did you see that bill!” Some that have been filed Mandated ratio bill by CNA/NNOC Anesthesiologists assistants licensing BSN offered by community college pilot 18

BSN offered by community college pilot APRN Medicaid services paid at APRN rate 19

Texas Public Health Coalition Immunizations Smoking Cessation Healthy Eating Cancer Prevention & Cure Texas Women’s Health Coalition Preventative care for women CHIP Coalition Mental Health Advocacy Coalition

Whether or not nursing participates, decisions affecting nurses and their patients will still be made But …without nursing input Nursing has benefited from participating Not happen otherwise What if nursing had not been involved since 1907 Health care policy needs nursing’s perspective 21

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