Format for Printing     Student Name: Kathleen Lange Grant Advisor: Diane Magyary Student Status: Masters Student Quarter: Spring 2003 PART I. Leadership Activity: Follow up to WSNA PAC activity: I was able to review a bill to be submitted to the WA state legislature about mental health parity. This bill EXCLUDED NP's from those eligible to be reimbursed for mental health services. I was concerned about this, and brought it up with the President of AAPPN, and also with the speakers at Nurse Legislative Day. The process of bringing this concern to light was interesting. The spokesman from the coalition introducing and supporting the bill was very anxious to NOT have this brought to light. My feeling was that nursing could not support legislation that so blatantly excluded NP's, who are providing much of the mental health care anyway. Unfortunately, despite my concerns, WSNA had already been added to the list of supporters of this legislation. I am unsure how WSNA decided to sign on to this legislation. Perhaps the decision to support this was made prior to anyone reading the actual bill. At nurse legislative day the spokesman from the colatition who created the bill asked that we not "rock the boat". The President of AAPPN did not agree with this approach. Several members from AAPPN when to the legislator who would be introducing this bill and discussed the lack of NP reimbursement. The legislator was very receptive, and agreed that NP's should be listed as eligible providers of mental health services. For me, I wonder how a coalition of concerned mental health providers was formed that excluded nursing until the last minute. Is nursing hard to find? Are nurse practitioners somehow under the radar screen when primary providers join to promote increasing coverage of needed services? Or is nursing, and NP's in particular, not taking up the invitation to join coalitions who are drafting important legislation? After the experience with the "completion of prescriptive authority" which ended with NP's being able to prescribe schedule drugs, but only after entering into a "collaborative agreement" with a physician or osteopath (!), I am becoming a believer in AMA policy and practice of curtailing the independant practice of nurses. And I felt during this process that perhaps nurses were purposely excluded from the planning phases of this mental health parity legislation. I plan to continue my membership on the WSNA PAC. This organization is a way to keep abreast of current legislation and to include nursing in health policy. Infrastructure Building Policy Developmental/Implementation Outcome: This experience increased my awareness of the importance of political action. If this bill had sailed through the legislature and been passed into law, there would have been many NP's scrambling to find a way to bill or collaborate with a physician or clinic, in order to be reimbursed. I plan to continue on the WSNA PAC, and follow other health care legislation. I also follow national legislation related to pediatrics from emails from NAPNAP PART II. Cultural Competence Conscious of Dynamics Inherent when Cultures Interact Additional Activity: Although not ethnic cultures, certainly the cultures that collide in "turf battles" over categories of providers providing services, is certainly a cultural interaction. Recognizing the needs and fears of various health care providers is important, especially if nursing is to be represented on some of these coalitions. Outcome: I understood the request of the coalition spokesman to not "rock the boat" with this mental health parity legislation. Having accepted the concessions of the completion of prescriptive authority legislation, I do understand how legislation is often a consensus, and usually nobody gets exactly the bill they want. However, for this legislation to have other categories of mental health care providers represented, and NP's excluded seemed beyond consensus building. The skill that was strengthened for me was to actually take a stand and decide that an issue is worth bringing up, and not to quietly let this oversite stay buried. Add Faculty Comments