1. The APRN Legislative Message Lynda Woolbert, MSN, RN, CPNP-PC www.cnaptexas.org

2. Delivering the APRN Message Stay at 50,000 feet. (Detail on Rx Authority is confusing and derails message.) Avoid negativity & return to your message. (In a year with a $26.8 billion shortfall, physicians have a non-solution.) Do not respond to negative assertions in detail. Leave them feeling good about you. “APRNs just want to be part of the solution.”

3. The APRN Message 1.Texas is facing an unprecedented health care crisis. 2.APRNs can be part of the solution. APRNs already Dx & Rx, but can do more. 3.Texas should join 18 other states and allow APRNs to practice to the full extent of their education by removing bureaucratic barriers in Texas law.

4. The APRN Message 1.Texas is facing an unprecedented health care crisis – Budget Shortfall in the Billions – Texas already ranks 47 th in ratio of primary care physicians per 100,000 population (42 nd in ratio of all physicians) – Texas ranks dead last in access to health care

6. The APRN Message 2. APRNs can be part of the solution. APRNs already diagnose and prescribe. – Research established safety – Think tanks report same outcomes in states with narrow or full scope of practice laws – No cost to Texas

7. The APRN Message 3. Texas should join 18 other states and allow APRNs to practice to the full extent of their education by removing bureaucratic barriers.

8. The APRN Message 3. Texas should join 18 other states and allow APRNs to practice to the full extent of their education by granting full authority to diagnose and prescribe in the Nursing Practice Act.

9. Independent Collaborative Delegated

10. The APRN Message 3. Texas should join 18 other states and allow APRNs to practice to the full extent of their education. – Not asking to do anything we are not already fully educated & trained to do. – APRNs must pass national certification exams. – Educated to national standards so Texas APRNs can move to any state to practice.

11. The APRN Message 3. Allow APRNs to practice to the full extent of their education by removing bureaucratic barriers. – Eliminates 2 nd Step (physician delegation & site-based restrictions are not related to patient safety)

13. The APRN Message 3. Texas should join 18 other states and allow APRNs to practice to the full extent of their education by removing bureaucratic barriers. – Both physicians and APRNs must practice as efficiently as possible. – Simply asking to remove physician delegation & supervision so APRNs can reach their full potential to make health care more accessible and affordable.

14. The APRN Message Texans recommend laws to allow APRNs to practice to the full extent of their education: – Texas Legislative Budget Board (LBB) – House County Affairs Committee – AARP Texas – NAMI San Antonio – Texas Association of Business (TAB) – Texas Public Policy Foundation (TPPF) – & 9 other Texas organizations

15. The APRN Message National consumer & policy organizations: – Institute of Medicine (IOM Future of Nursing) – Association of Academic Health Centers (Out of Order Out of Time) – AARP (2010 Policy Supplement) – Josiah Macy, Jr. Foundation – Bipartisan Policy Center (Crossing Our Lines) – Brookings Institution (Bending the Curve) – Center for American Progress (Closing the Health Care Workforce Gap) – CATO Institute (Medical Licensing: Obstacle to Affordable, Quality Care) – Heritage Foundation (November 29, 2010) – Pew Health Professions Commission (1998) – NCSBN (Model APRN Legislation & Regulation)

16. REMEMBER Stay at 50,000 feet. (Detail on Rx Authority is confusing and derails message.) Avoid negativity & return to your message. (In a year with a $26.8 billion shortfall, physicians have a non-solution.) Do not respond to negative assertions in detail. Leave them feeling good about you. “APRNs just want to be part of the solution.”