CNAP 09 Legislative Update #6 – SB 680 Hearing
Lynda Woolbert, Executive Director
Coalition for Nurses in Advanced Practice
March 23, 2009
Register Now for April 2nd APN Day at the Capitol
Thursday, April 2nd will be another day for APNs to gather at the Capitol. The lobbyists are working hard, but no one has more influence than constituents, so we need you! We still have many offices from Houston, Dallas, the Valley and a few from east and central Texasthat have not had an APN constituent visit. Those offices are listed in the table below.
SENATEDISTRCT/NAME/CITY6 Mario Gallegos - Houston
HOUSE DISTRCT /NAME /CITY
2 Dan Flynn - Canton
7 Tommy Merritt -Longview
8 Byron Cook –Corsicana*
11 Chuck Hopson- Jacksonville*
14 Fred Brown - Bryan
16 Brandon Creighton-Conroe*
18 John Otto - Dayton
19 Mike Hamilton-Mauriceville
22 Joe Deshotel - Beaumont
25 Dennis Bonnen - Angleton
31 Ryan Guillen – San Diego
36 Kino Flores -Mission / HOUSE DISTRCT /NAME /CITY
40 Aaron Peña - Edinburg
57 Jim Dunnam - Waco
59 Sid Miller - Stephenville
67 Jerry Madden - Plano
68 Rick Hardcastle - Vernon
75Chente Quintanilla-Tornillo
76 Norma Chavez – El Paso*
90 Lon Burnam – Ft.Worth
92 Todd Smith - Bedford
93 Paula Pierson - Arlington
95 Marc Veasey – Ft.Worth
100 Terri Hodge - Dallas
103 Rafael Anchia - Dallas
108 Dan Branch – Dallas
109 Helen Giddings- De Soto / HOUSE DISTRCT /NAME /CITY
110 Barbara Mallory Caraway-
Dallas
119 Roland Gutierrez –
SanAntonio
131 Alma Allen - Houston
132 Bill Callegari - Houston
133 Kristi Thibaut - Houston
139 Sylvester Turner- Houston
140 Armando Walle - Houston
141 Senfronia Thompson-
Houston
142 Harold Dutton - Houston
143 Ana Hernandez - Houston
144 Ken Legler - Houston
145 Carol Alvarado - Houston
148 Jessica Farrar - Houston
All of these legislators are important but those with an asterisk by their names serve on either the House Public Health or House Calendars Committees. Both of these committees are critical to APNs as we move forward.
APN Days at the Capitol are less structured than Legislative Day. We begin the day at 9 a.m. in the Capitol Grill on the 1st Floor of the Capitol Extension. While we request that all participants register, there is no fee. To register go to and click on the APN Day of your choice in the upper right navigation bar.
We will have some new handouts available on April 2nd. There will be plenty of experienced APNs to help those first time visitors talk with legislators and staff. Since committees are meeting, you may even be able to see the Legislature in action.
If you cannot come on April 2nd, please plan to spend another day at the Capitol as soon as possible. Please email to make arrangements for your day at the Capitol now. We are already beyond the half way point in the 81st Regular Session, and bills must move quickly or they have very little hope of passage. Momentum is created by constituent contact.
Constituent Power Gets SB 680 a Hearing
Week before last ended with a bang when we found that SB 532 was set for a hearing in the Senate Health and Human Services Committee on March 17th. SB 532 is the retail clinic bill by Senator Dan Patrick. Since APNs much prefer SB 680, the delegated prescriptive authority bill that ends site-based restrictions and allows physicians to delegate Schedule II drugs, we supported Senator Hegar‘s efforts to get SB 680 set for a hearing on the same day.
Some of you who live in the districts of members of the Senate HHS Committee received urgent messages asking you to contact your Senator and encourage him or her to ask Chairman Nelson to also put SB 680 on the agenda for March 17th. By Monday afternoon, we found we had been successful in that effort. The next job was to find someone to testify for the bill.
We are very thankful to Judy LeFlore, PhD, CPNP-AC, NNP, who heard the message asking her to testify at 6:45 a.m. on Tuesday morning and was on a plane headed to Austin by 8:20 a.m. Judy got a crash course in testifying and she did a fabulous job. Unfortunately, by the time Judy and I testified, most members were in other committee meetings, and the retail clinic bill had already been passed and recommended for the Senate Local and Uncontested Calendar. If you wish to listen to the testimony, go to and click on “March 17, 2009.” To hear the testimony on SB 532, move the hour marker to 2:43. The testimony on SB 532 ends at 3:11. The testimony on SB 680 begins at hour 3:34 and ends at 3:52.
If you listen to the hearing on SB 532, you will note that the FNP testifying for the bill is the Director of Field Operations for Minute Clinic. She makes it very clear in one of her responses that there is a single purpose for SB 532. Passing SB 532 improves the ability of convenient care clinics to expand practice in this state. It is very important that we help legislators understand this fact. Especially if SB 532 is the only bill that passes this session, we can expect TMA to declare this a huge favor for all APNs and willtell legislators not to pass any legislation to change the way physicians and APNs work together next session because they already did so much for APNs in 2009.In fact, SB 532, as introduced, makes a few changes that will help some APNs, but does so at the cost of making a difficult system even more confusing. It does very little to substantially help most APNs and the physicians who delegate prescriptive authority to them. To make a complex situation even worse, there is a lot of misinformation being spread about the effects of SB 680 and HB 696, the delegated prescriptive authority bills.
Last Tuesday, prior to the hearing, the Texas Academy of Family Physicians (TAFP) circulated a letter to members of the Senate Health & Human Services (HHS) Committee. That letter makes many unfounded and outrageous claims about SB 680 by Senator Glenn Hegar. Later that day, the testimony by Dr. Gary Floyd at the HHS Committee meeting on behalf of the Texas Medical Association (TMA) and the Texas Pediatric Society (TPS), as well as TAFP repeated many of those misconceptions. Therefore, we know that several medical associations are part of this misinformation campaign. In addition, we know that House members, especially those on the Public Health Committee, have seen similar claims about the companion bill, HB 696 by Representative Rob Orr. Reading the bill reveals that medical associations’ claims are misleading and some are blatantly false.
Listening to Senator Patrick’s comments at the hearing, it sounds like he is also receiving misleading information. When Senator Patrick laid out SB 532, and again later in his comments at the end, he stated his belief that APNs and PAs were included as stakeholders in the negotiations on SB 532. In fact, APNs and PAs, even those representing retail clinics, were barred from the negotiations on this bill.
Responding to this misinformation is important so I am preparing a document that will address the accusations with facts. That document will be posted on our Website. Also on the CNAP Website you will find a very helpful summary of the comparison among the three types of APN prescriptive authority bills filled this session. I think that side-by-side comparison will be very helpful to legislators and staff members, as well as to many of you. To find these documents, go to and then scroll down through the documents for distribution. These two will be at the end of the list.
Despite a few setbacks, never doubt that I remain energized and inspired by the work you do every day to improve health care for Texans. Your lobbyists are working harder and more closely than I have ever seen a team work. They all believe in the inevitability that one day Texas APNs will diagnose, prescribe and order drugs and medical devices under the authority granted by the Board of Nursing. We have the right message. Every APN in Texas just has to learn to deliver that message more effectively.
I will send more about who to contact and the messageto deliver later this week.