4/30/2015. CRNA Issues in Action: Our Agenda Today. What Not to Do. Principle #2: Scarcity. Professional Relationship-building 101

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CRNA Issues in Action: Effective Health Policy Advocacy for CRNAs Frank Purcell, AANA Senior Director Federal Government Affairs Our Agenda Today

What Not to Do Professional Relationship-building 101 1. Reciprocation 2. Scarcity 3. Authority 4. Consistency 5. Liking 6. Consensus -Dr.

org/blogs/itsallpolitics/2012/12/03/166429422/obama-and-boehner-are-still-far-apart-on-fiscal-cliff-but-dont-panic-yet Principle #1: Reciprocity

1 CRNA Issues in Action: Effective Health Policy Advocacy for CRNAs Frank Purcell, AANA Senior Director Federal Government Affairs Our Agenda Today How do we communicate issues effectively to legislators? What are our CRNA issues for Capitol Hill? How do we answer questions? How do we follow up? What Not to Do Professional Relationship-building Reciprocation 2. Scarcity 3. Authority 4. Consistency 5. Liking 6. Consensus -Dr. Robert Cialdini Source: NPR, Principle #1: Reciprocity Learn About Who You re Seeking to Educate How does this apply to a member of Congress? How does this apply to a Medicaid director? To the medical director of a health plan? Principle #2: Scarcity How does this apply to a member of Congress? 1

Principle #3: Authority You Are the One Who Knows I particularly admire someone who's able to articulate the opposing argument, that can give a good

Medicare administrative contractor medical director Rule #4: Communicate Consistently, Frequently & Effectively How helpful is it for messages from

Information about the impact the bill would Constituent s reasons for supporting/opposing Personal story related to the bill or issue Message Includes 0%

2 Principle #3: Authority You Are the One Who Knows I particularly admire someone who's able to articulate the opposing argument, that can give a good faith account of the other side. They seem to understand my situation, and I respect that. House Democrat What is CRNA scope of practice? Medicare administrative contractor medical director Rule #4: Communicate Consistently, Frequently & Effectively How helpful is it for messages from constituents to include the following? Information about the impact the bill would Constituent s reasons for supporting/opposing Personal story related to the bill or issue Message Includes 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Helpful Very Helpful Rule #5: The Value of Liking You Ways They Can Like You Fairly address your adversaries arguments. Be gracious and friendly every time. Be prepared. Be reliable. Go the extra mile. With a health plan executive? With a member of Congress? 2

Reciprocation 2. Scarcity 3. Authority 4. Consistency 5. Liking 6. Consensus -Dr. Robert Cialdini www.influnceatwork.com Before You Go: Be Prepared Where are you meeting? Who are you seeing? www.congress.

3 Where is Consensus Found? Rule #6: Build Consensus Where you and the person you are seeking to influence come to agreement. Where you come representing a coalition of people and organizations who agree on an issue. With a health plan executive? With a member of Congress? Does Your Advocacy Respect These? 1. Reciprocation 2. Scarcity 3. Authority 4. Consistency 5. Liking 6. Consensus -Dr. Robert Cialdini Before You Go: Be Prepared Where are you meeting? Who are you seeing? Their own sites & postings Document on CRNA issues Who s saying what? Who s taking notes? Who s following up? Your Workplace vs. Theirs Security Basics The operating room Busy schedule Secure location High pressure You re the expert Sterile environment Congressional office Busy schedule Different kind of security Different kind of high pressure You re the expert Not a sterile environment Similar to the airport No gifts No signs Extra shoes OK Ask before indoor photos 3

Introduce Yourself to Build Trust Make a plan Make a connection Constituent CRNA or SRNA Make a case Patient-centered

Kevin Cramer - R 2016 2018 2016 Appropriations Agriculture Natural Resource Indian Affairs Indian Affairs Science, Space,

We are your partners in implementation Strengthen Veterans access to care by supporting full practice authority for VHA s

nurse workforce development funding For our Seniors For our Veterans For our Future Issue 1: Thank You on SGR Message to

4 Introduce Yourself to Build Trust Make a plan Make a connection Constituent CRNA or SRNA Make a case Patient-centered Patient safety Cost-efficiency Make it brief North Dakota in Congress Sen. John Hoeven - R Sen. Heidi Heitkamp - D Rep. Kevin Cramer - R Appropriations Agriculture Natural Resource Indian Affairs Indian Affairs Science, Space, Tech Bismarck Mandan Bismarck Our CRNA Issues Our CRNA Issues Thank you for permanent SGR repeal! We are your partners in implementation Strengthen Veterans access to care by supporting full practice authority for VHA s APRNs Support rural healthcare, oppose provisions that add to rural anesthesia costs and burden rural hospitals Advance nurse workforce development funding For our Seniors For our Veterans For our Future Issue 1: Thank You on SGR Message to Congress: Thank you for permanently repealing SGR cuts! We are prepared and ready to ensure HR 2 is implemented to make healthcare work better and cost less. 4

Issue 2: Support Our Veterans VA updating Nursing Handbook to recognize CRNAs & other APRNs to full practice authority Supported by AANA, AVANA, APRNs, AARP Opposed by ASA Helping the VA to finish

S. Senate: S 297 (Kirk) recognizes three of four APRN types to FPA in VHA not CRNAs Sen. Durbin Dear Colleague letter supporting all four Sen.

Urge the VHA to publish its Nursing Handbook update for APRN full practice authority. Cosponsor HR 1247.

5 Issue 2: Support Our Veterans VA updating Nursing Handbook to recognize CRNAs & other APRNs to full practice authority Supported by AANA, AVANA, APRNs, AARP Opposed by ASA Helping the VA to finish this important work Veterans Issue Status VHA: Working to complete Nursing Handbook revision, publish in Federal Register U.S. House: HR 1247 (Graves-Schakowsky) introduced to recognize all four APRN types to Full Practice Authority in VHA U.S. Senate: S 297 (Kirk) recognizes three of four APRN types to FPA in VHA not CRNAs Sen. Durbin Dear Colleague letter supporting all four Sen. Merkley proposed bill supporting all four Veterans Issue: House Ensure Veterans access to the high quality care by supporting Full Practice Authority for APRNs including CRNAs Message to Congress: Urge the VHA to publish its Nursing Handbook update for APRN full practice authority. Cosponsor HR Veterans Issue: Senate Message to Congress: Urge the VHA to publish its Nursing Handbook update for APRN full practice authority by signing onto Sen. Durbin s Dear Colleague. Support legislation by Sen. Merkley supporting Veterans access to care through APRN Full Practice Authority. Refrain from supporting S 297 until it includes all four APRN specialties, not just three. 5

ASA on Full Practice Authority This proposed policy change would lower the standard of care for Veterans in a surgical setting where seconds count and could put the health and lives of Veterans at

your support from H.R. 1247 until controversial provisions in section 4 can be revised.

6 ASA on Full Practice Authority This proposed policy change would lower the standard of care for Veterans in a surgical setting where seconds count and could put the health and lives of Veterans at risk. Please ensure our Veterans have the high-quality, physician-led surgical anesthesia care they need by opposing the surgery/anesthesia changes within the VHA Nursing Handbook and withholding your support from H.R until controversial provisions in section 4 can be revised. - from ASA to legislators, 4/15/2015 Common VHA Q & As Issue 3: Rural Anesthesia Opponents Question Quality of care? End team care? Overturn anesthesia handbook? Support? AANA Answer Outstanding. Same for all anesthesia professionals. Committed to the whole team of professionals providing care. No. Many members of Congress, nursing organizations including NCSBN, AARP, Veterans from around the country. What is the Part B reasonable cost rural anesthesia passthrough program What is being requested by ASA What problems are associated with that request HR 4781 (Jenkins-Cleaver, 113 th Congress), S 1444 (Wyden-Isakson, 113 th Congress) Action for Congress: Oppose problematic anesthesiologist-only legislation that increases costs to Medicare & rural hospitals without increasing access Issue 4: Nurse Workforce Title 8 authorization and funding Advanced Education Nursing Nurse Anesthetist Traineeships Message for Congress: Request FY 2016 Labor-HHS- Education Appropriations provides $244 million for Title 8, including $66 million for Advanced Education Nursing and Nurse Anesthetist Traineeships. Reauthorize Title 8. 6

Not This Year s Issues Our CRNA Issues - 2015 Supervision Drug shortages SGR cuts Provider nondiscrimination For our Seniors For our Veterans For our Future Our CRNA Issues - 2015 Follow-Up:

We are your partners in implementation Strengthen Veterans access to care by supporting full practice authority for VHA s APRNs Support rural healthcare, oppose provisions that add to rural

7 Not This Year s Issues Our CRNA Issues Supervision Drug shortages SGR cuts Provider nondiscrimination For our Seniors For our Veterans For our Future Our CRNA Issues Follow-Up: Your Power Tool Thank you for permanent SGR repeal! We are your partners in implementation Strengthen Veterans access to care by supporting full practice authority for VHA s APRNs Support rural healthcare, oppose provisions that add to rural anesthesia costs and burden rural hospitals Advance nurse workforce development funding Thank-you notes on paper & Complete lobby report forms online Effective social media advocacy Follow up! Within AANA, What s Your Role? Membership AANA Mid-Year Assembly Coordinated Advocacy Programs: FPD, Key Contacts, SRS, CRNAdvocacy CRNA-PAC 7

Coordinated Advocacy Programs CRNAdvocacy, answering AANA email alerts to contact Congress Key Contacts, a CRNA relationship with each federal

promote value of CRNA services to health plans and payors Protect. Advance. Commit. Largest federal nursing PAC in the country.

$20/member each year would total $940,000. >$1 million impact on the November elections bipartisan support of congressional candidates.

CRNAs Strong Voice in Washington We ve Learned About Communicating our issues on Capitol Hill And now it s time for your questions Thank You from

Federal Government Affairs Romy Gelb-Zimmer, Associate Director Federal Regulatory and Payment Policy Randi Gold, Associate Director Federal

8 Coordinated Advocacy Programs CRNAdvocacy, answering AANA alerts to contact Congress Key Contacts, a CRNA relationship with each federal lawmaker Federal Political Directors (FPDs), in each state to coordinate advocacy activity State Reimbursement Specialists (SRSs), in each state to promote value of CRNA services to health plans and payors Protect. Advance. Commit. Largest federal nursing PAC in the country. Top ten among all health professionals. $1.8 million fundraising goal 8% of AANA membership donates. $20/member each year would total $940,000. >$1 million impact on the November elections bipartisan support of congressional candidates. CRNA-PAC s Mission Statement: Advancing the profession of nurse anesthesia through federal political advocacy. CRNAs Strong Voice in Washington We ve Learned About Communicating our issues on Capitol Hill And now it s time for your questions Thank You from Your AANA FGA Frank Purcell, Senior Director Federal Gov t Affairs Kate Fry, Associate Director Political Affairs Emily Forrest, Assistant Director Federal Government Affairs Romy Gelb-Zimmer, Associate Director Federal Regulatory and Payment Policy Randi Gold, Associate Director Federal Regulatory and Payment Policy Ralph Kohl, Associate Director Federal Government Affairs Octavia Thompson, Administrative Assistant AANA Division of Federal Government Affairs 25 Massachusetts Ave., Suite 550 Washington, DC // // info@aanadc.com 8

4/30/2015. Our Agenda Today. Nurse Anesthesia Reimbursement: Medicare-eligible Population

4/30/2015. Our Agenda Today. Nurse Anesthesia Reimbursement: Medicare-eligible Population Nurse Anesthesia Reimbursement: Trends and Issues for CRNAs Frank Purcell, AANA Senior Director Federal Government Affairs Our Agenda Today What is shaping health policy? What is shaping health politics?