1. Virginia Nurses Association Legislative Day, February 16th “Type a quote here.”

2. Andrew Lamar Principal, Lamar Consulting Originally from North Carolina; 9 year resident of RVA Graduate of the University of Mary Washington and the Sorensen Institute for Public Policy at UVA 10+ years of experience in Virginia state government Former Dep Director of Legislative Affairs for VA Governor Come from a family of health care prof, including nurses

3. Welcome to Richmond This is the 34th day of a 60-day legislative session Even numbered years, meet for 60 days to write budget Convened on January 13th; Adjourn Sine Dié March 12th Today is “Crossover” day, considered half-way point Each chamber approves their budget on February 25th

4. Virginia General Assembly Established July 30, 1619, it is the oldest continuous law-making body in the New World The House of Delegates is made up of 100 members, elected every 2 years… 66 Republicans, 34 Democrats. The Senate of Virginia is made up of 40 members, elected every 4 years… 21 Republicans, 19 Democrats.

5. Governor of Virginia Terry McAuliffe is the 72nd Governor of Virginia Elected in 2015 to a single 4- year term 15 members of his Cabinet oversee all state agencies He proposed his first biennial budget on December 17th, 2015

6. Governor’s Budget As introduced, first biennial budget to exceed $100 Billion Includes money related to Medicaid expansion, which the General Assembly has said will be removed Includes $17 million for a 2% faculty pay raise to take effect on July 10, 2017, if state revenues are sufficient Governor proposes budget in December, House/Senate approve their version of the budget February 25th, and the final budget is completed by March 12th. Governor gets opportunity to offer amendments to be considered during reconvened session on April 20th, and has ability to line-item veto.

7. Legislative Process A bill is introduced by a member of the House/Senate Legislation is referred to a committee If approved by committee, it is sent to full chamber Legislation must crossover by today, and then continue through the same process on opposite side The governor receives approved legislation and can sign, amend, or veto legislation

8. 2016 Legislative Statistics Delegates introduced 1,391 pieces of legislation 429 passed the House as of Monday night Senators introduced 781 pieces of legislation 372 passed the Senate as of Monday night Including resolutions, 2,805 measures were introduced

9. Visiting A Legislative Office Senators and Delegates have an administrative assistant to greet you Delegates share, Senators have their own Each legislator has at least one legislative assistant who is responsible for managing the member and the office Whether meeting with the legislator or their staff, it’s important to quickly introduce yourself and note if you are a constituent, and get to the purpose of your meeting Always try to complete your meeting in 5-10 minutes at most

10. 2016 Legislative Items Nurse Licensure Compact Scope of Practice for Advance Practice Nursing Nurse Midwives Nurse Anesthetists Clinical Nurse Specialists Nurse Practitioners

11. Nursing Compact Legislation Senate Bill 265 amends and reenacts the Nurse Licensure Compact in the Code of Virginia, which allows for multi-state nursing license Promotes increased participation by non-compact states, increases telehealth opportunities, and allows rule making for implementation by the Commission on Compact Administrators All current license holders will be grandfathered Passed the Senate of Virginia 39-0

12. Nurse Midwives Legislation SB 463 removes the requirement for nurse midwives collaboration in a physician-led patient care team. Instead requires CNMs to have practice agreements specifying physician availability for routine and urgent consultation on patient care. This will ensure that CNMs always have a physician available for consultation while increasing access to care. Will help increase access to care. 70 counties do not have a certified nurse midwife. 61 do not have an OB/GYN.

13. Nurse Anesthetists Legislation HB 580 provides a standard definition for Advanced Practice Registered nurses A registered nurse who has completed an advanced graduate level education program in a specialty category of nursing and has passed a national certifying examination for that specialty Removes the requirement for a CRNA practice agreement given that the supervising practice standard is in place

14. Clinical Nurse Specialist Legislation HB 330 defines a Clinical Nurse Specialist to clarify that a CNS is an Advanced Practice Registered Nurse Codifies requirements for an applicant to be registered by the Board as a CNS: Graduate-level clinical nurse specialist program within a regionally accredited college or university that meets all educational qualifications and standards established by national certification guidelines and holds a national clinical nurse specialist certification that prepares the professional nurse to deliver advanced nursing services

15. Nurse Practitioners Legislation Governor McAuliffe supported HB 581 and SB 264 that would have enabled a nurse practitioner to practice outside of a collaboration agreement with a physician, if: the NP has 2000 hours of post-licensure experience the NP is working in a free-clinic type setting, or in an underserved area of the Commonwealth Legislation was amended to instead allow NP to continue seeing patients and prescribing for 60 days if a physician who is serving as a patient care team physician leaves the practice for a number of reasons, with an option for an additional 60 day period.

16. Nurse Practitioners Legislation SB 269 and SB 620 would allow nurse practitioner to practice without the requirement of a collaboration agreement with a physician SB269 would change just for underserved areas SB620 would remove requirement statewide, but this bill was carried over for the year SB 269 was amended to instead implement a pilot-program to allow nurse practitioners to utilize a physician via telemedicine for purposes of the collaboration agreement when otherwise unable to find one.

17. Other Legislation of Interest Supported HB 825/SB 437 to create a pilot program to allow military medical personnel to practice in health care setting under the supervision of a licensed physician. SB 212 increases the Board of Nursing by one member, which shall be a Nurse Practitioner.

18. Ongoing Policy Issues Increasing state nursing school faculty compensation so that we are able to retain faculty sufficient to meet the growing demand for nurses in the Commonwealth Addressing the issue of workplace safety for nurses

19. Contact Me Andrew T. Lamar andrew@Lamar-Consulting.com (804) 464-8610 www.Lamar-Consulting.com