Louisville Medicine Volume 62, Issue 4 | Page 32

(continued from page 29) serve), it seems as if it needs at least two, and preferably all three, of the following key components: a champion in Government (for the purposes of this article, Government will refer to the legislature, although executive and judicial champions are needed as well); effective professional lobbying; and robust member (physician) engagement across the specialties and in partnership with other groups and organizations. Our local pediatric colleagues in the Kentucky chapter of the American Academy of Pediatrics and at the University of Louisville benefited from a strong grassroots movement, negotiation and cooperation with other physician groups, and a dedicated legislative champion as they succeeded in helping Pediatric Abusive Head Trauma become law. Prescription eye drops, not as overwhelmingly popular with legislators initially, ultimately benefited from all three key components: a great lobbying team with McBrayer, McGinnis, Leslie and Kirkland (MMLK), actively engaged ophthalmologists of the Kentucky Academy of Eye Physicians and Surgeons and other physicians of the GLMS Policy and Advocacy Team and other groups, and Senator Julie Denton, who sponsored the bill energetically. Although the bill had an excellent chance of passing from the outset because it offered to help many people with little cost to the state, it is still a great model to follow for all of our legislative and regulatory goals. Politically charged issues, where there is division among lawmakers, professionals, organizations, and the public, are stressful and challenging. However, the right combination of legislative leadership, professional lobbying, and grass roots physician involvement can make all the difference in these areas as well. The story of the Advanced Practice Registered Nurse (APRN) compromise legislation (SB 7) speaks to this concept on many levels. Most all Kentucky physicians are by now somewhat aware of the new state law that significantly expands the prescriptive authority of APRN’s in the Commonwealth. Our Policy and Advocacy Team did not actively try to influence this legislation during the session because lengthy negotiations between the Kentucky Medical Association, the Kentucky Academy of Family Physicians (KAFP), and the Kentucky Coalition of Nurse Practitioners and Nurse Midwives (KCNPNMW) were finalized well before the 2014 session began in January. However, since the GLMS took the initiative in moving KMA policy toward developing a model for the physician-led team approach to patient care several years ago, and also considering that 2 GLMS members -- myself and Dr. Ron Waldridge, II -- were very involved in the process that led to the compromise legislation, a few more details of the behind-the-scenes events that led to SB 7 deserve reporting in this context. I have devoted several paragraphs in an attempt to tell the story. KCNPNMW has displayed a fantastic effort, strong and persistent, over many years in its aim to eliminate the statutory requirement for collaboration between APRNs and physicians in the area of prescription writing. (The group had already won the right for APRNs to practice and order tests independently without physician collaboration or supervision in 1996.) Their organization has extremely strong member participation at the grass roots level. Most every state legislator and regulatory leader has heard repeatedly from APRNs 30 LOUISVILLE MEDICINE on this issue. The group also works with very effective lobbyists - a retired psychologist Democrat who believes fully and passionately in the organization’s mission and a Republican who enjoys strong relationships with most every GOP legislator in both the House and Senate. Both of them are respected and hard-working. Also critically important, KCNPNMW has had legislative champions on this and other issues. Representative Mary Lou Marzian, a Louisville Democrat and nurse, was devoted to the effort from the time the collaborative prescribing agreement was established as a condition of independent practice in 1996 until well after the first call for its elimination in 2010. Later, Senators Gary Tapp and Paul Hornback, both Republicans from Shelby County, were tireless and vocal leaders in the legislature and helped sway a bipartisan effort on the issue. The proposal to move away from supervisory and collaborative requirements steadily became accepted