Fall is here and the Legislature is back at work on retained and re-referred bills after a nice break. The Governor, House, and Senate Leadership have finally come to a resolution for a final budget and it has passed. As you know in June, the House and the Senate passed a  budget that they both agreed upon. The Governor, as predicted, vetoed the budget. The House and Senate then passed a continuing resolution that would allow the State to operate for 3 months under the FY 19 budget dollars. That continuing resolution was expiring at the end of September so the pressure was on to find a compromise; otherwise, the NH State Government would shut down. Are we really becoming Washington? The House and Senate both met on September 19^th for veto day and were assuming they would also have a new budget bill. The Democrats tried to bring in a new budget bill on veto day, however, since neither the Governor nor the Republican leadership was part of the drafting of the new Democratic budget, they refused to vote to let the new budget bill be introduced. The clock was ticking. The House and Senate decided to come back in session on September 25^th hoping to avert a crisis and hoping the Governor, House, and Senate leadership could find a workable budget compromise. The rumors were flying as there still seemed to be no resolution. It was almost the 13^th hour on Tuesday night, the 24^th when the Governor, House, and Senate negotiators finally reached an agreement. Now the chore was to convince the House and Senate to allow a new budget bill to be introduced which means a 2/3rds vote of all present. Then they only needed a majority vote of the House and Senate to pass the compromise budget. With a little theatre from the ultra-conservatives who did not like the compromise budget, the new budget and trailer bill, HB 3 and HB 4, passed both the House and Senate with only a few "no" votes. We have a budget. It is not retroactive, however.  

What is in the new budget of interest to Nurse Practitioners?:

 Monday, July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule for the calendar year 2020 Medicare Physician Fee Schedule. https://www.cms.gov/newsroom/fact-sheets/proposed-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-2

 “To reduce burden, we are proposing broad modifications to the documentation policy so that physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse-midwives could review and verify (sign and date), rather than re-documenting, notes made in the medical record by other physicians, residents, nurses, students, or other members of the medical team.” 

  Nominations are now open for the prestigious 2020 AANP State Award for Excellence. To be considered for the 2020 awards, nominations must be submitted electronically to AANP on the official 2020 State Award Nomination Form no later than October 14, 2019. Thank you in advance for taking the time to nominate deserving nurse practitioners (NPs) and advocates.

NHNPA has extended the deadline to apply for the annual Claire Martin Memorial Scholarship to October 11, 2019.  Applications can be submitted at NHNPA.org.  Please see eligibility criteria below:

Dear NP Colleagues,

I am writing an abstract on telehealth services for next spring's NHNPA conference. I’d like to include a panel of NPs who are currently providing telehealth services in NH to talk about their experience. If you are providing telehealth services, are interested in participating on a panel or in learning more about this presentation, please contact [email protected]. Thanks. 

THIS EVENT HAS BEEN CANCELLED

Although we are in the middle of the summer, the results of the 2019 legislative session are still developing. Here is a recap of where things stand on some of the bills that NHNPA has been focused on this session. 

HB 237 (creating an advisory council on rare diseases) NHNPA supported this bill, which gives NHNPA the power to appoint an APRN to this council. The bill has passed and been signed by the Governor.

HB 359 (warning labels on opiates) This bill also has now been signed into law by the Governor. It amends the controlled drug act to require that any controlled drug containing opiates dispensed by a health care provider or pharmacy shall have an orange sticker with the word "opioid" in easily legible font placed on the cap or dispenser and shall have a warning label stating "Risk of addiction and overdose." A Provider or pharmacist also must provide each person with a handout to be developed and approved by the governor's commission on alcohol and drug abuse, prevention, treatment, and recovery which shall include guidance on associated risks of opioid use and how to mitigate them.  The new requirements do not apply to pharmacists or a pharmacy that dispenses a drug containing an opioid that is administered to a patient treated in a health care facility required to be licensed under RSA 151.  A patient may remove the cap sticker or warning label.

HB 509 (creating the class of “graduate physicians” to allow medical school graduates to practice even without having done a residency) NHNPA opposed this bill, which was killed by the House during the first part of the session.

SB 87 (allowing NHDHHS to disburse funds for syringe service programs) NHNPA supported this bill, which has been signed into law by the Governor.

SB 296 (reducing occasions when live testimony of health care providers is required in court) This bill eliminates the need for health care providers to always testify in person in court to present medical records. As originally filed, the bill only applied to physicians and dentists, but at NHNPA’s urging the bill was expanded to include all licensed health care providers. SB 297 has been passed and signed by the Governor.

SB 308 (health care workforce) This was perhaps the top priority bill for NHNPA this year. It sought to address the health care workforce crisis through a number of measures, including especially a rate increase for Medicaid providers. As introduced, the bill would have provided increases of 5% in year 1 of the biennium and 7 % in year 2. The bill unanimously was approved in the Senate and then tabled so that the provisions of SB 308 could be dealt with in the budget and the budget trailer bill (HB 1 and HB 2). When the budget passed, it was with a more limited but still important 6.2 percent increase across the biennium. Unfortunately, the budget was vetoed by the Governor. Negotiations are still ongoing between the Governor and the legislature concerning a possible budget agreement. Hopefully, the final agreement will leave intact the SB 308-related provisions.

New Hampshire APRN Licensure Survey

Here are the details:

The New Hampshire Division of Public Health Services, in collaboration with the New Hampshire Board of Nursing, will be collecting key practice and capacity data from New Hampshire-licensed providers during the license renewal process, with an online survey. The survey is available for those due to renew between July 1, 2019, and June 30, 2020, and will remain a standardized component of the renewal process. Pursuant to RSA 326-B:9-a, licensees will be “required, as part of the license renewal process,” to complete the survey. However, providers may also opt-out of participation by mailing the NH Health Professions Data Center the opt-out form found on the Center’s website.

Who can take the survey?

Only APRNs due to renew their New Hampshire license will have access to the survey.

Are you interested in health policy and serving on a State of New Hampshire legislative commission?
NHNPA will be appointing an APRN to sit on each of the following committees: 
1) The Commission to Study Environmentally-Triggered Chronic Illness created by SB 85 and 2) The NH PDMP Advisory Council created by SB 120 (applicant should be an active prescriber of opioids in NH).  The time commitment is generally 1 - 2 meetings per month and can be variable Meetings are usually in Concord and during business hours. Specific terms can be obtained directly from the statutes. This is a great opportunity for NPs to shape health policy! If you are interested in either of these seats, please submit a letter of interest and your CV/resume to [email protected] by 7/30/19