Minutes

NPO General Membership Meeting

Saturday January 24, 2009

ONA, Tualatin, Oregon

10:00 - 1300

1. Call to Order Pam DeVisser, Chair

Attendees: Pam DeVisser, LuAnn Cook, Mary Grant, Anne Barry-Lever, Teri Gerlt, Dan Sholian, Mariah Taylor, Frances Guthridge, Corlyn Casper, Larlene Dunsmuir, Kat Chinn, Karen Reisinger, Max Tenscher, Roberta Hasui, Tawnya Tompkins. By phone: Meg Portwood, Linda Hatch and Roger Fogg.

2. Announcements and Introductions Pam DeVisser

Meeting minutes from October 2008, where passed around for review. No changes recommended at this time.

3. President’s Report Pam DeVisser No report given.

5. Treasurer’s Report Frances Guthridge

Please refer to the embedded document.

Our total current assets are $159,641.45

5.1 Investment Report (10:15 a.m.) Dan Sholian

Dan presented the annual and quarterly review process. He explained the events of 2008 and recommended that NPO should not change our current allocations. NPO will continue with the socially responsible accounts. Kat thanked him for sharing the events of 2008 in a manner that was easily understood.

6. Committee Reports

6.1 Legislative Teri Gerlt/Jack Dempsey. Information available on line at www.nursepractitionersoforegon.org

Health Care Access and Reform: To improve health care outcomes, we need to reform our health care delivery system to emphasize and reward primary and preventative care. Establishing an Oregon Health Authority to oversee reform and consolidate state oversight will streamline systems and eliminate duplication of work. In addition, we need to maximize the amount of federal match dollars to expand coverage of uninsured Oregonians. One way to do this is with the proposed provider tax.

Support for Additional Nursing Faculty: The Oregon Center for Nursing made major strides expanding the number of practicing nurses and enrolled nursing students. Unfortunately, the nursing faculty needs have not kept pace. To help address this problem we support a loan forgiveness program as an incentive for nurses to pursue a teaching career.

Banning Pay-Per-Visit Reimbursement: Oregon’s home health and hospice nurses care for complex post-surgery and end-of-life patients. Banning pay-per-visit reimbursement, will allow them to make decisions that improve the health of their patients and families and not the bottom line of their employers.

Prescription Dispensing: We must update the Board of Nursing statutes to allow advanced practice nurses to personally hand prescriptions to informed patients. This would be consistent with physicians’ practice and eliminate disruption in the practice setting.

Initiative (Ballot Measure) System Reform: Oregon’s initiative system needs increased oversight and factual reporting. Currently, some initiative proponents practice fraudulent signature gathering and use misleading titles to get the same ballot measures on the ballot year after year. ONA supports greater control on the in initiative system and the insertion of fiscal cost in the measure title to properly inform voters.

Kat Chinn had questions about the dispensing issues. Anne explained that it was to allow NP’s to delegate to their MA rather than having NP’s stop what they where doing and dispense the sample. Senator Monas-Anderson is helping with this initiative.

Psychologists as a group are requesting prescriptive authority. There has been a great deal of conversation about this on Collective X. OMA in the past has been against this and is most likely against it this time around. Brian has recommended watchful waiting. Pam also recommends this as well—important to avoid making enemies if we do not have to.

Jack is now on Collective X and was wondering how much information he should share on the site for everyone. Collective X is the NP Blog site; therefore it is not the official opinion of NPO. The site can be used to share additional information.

The top 5 as listed above have white papers written about them, which are available on the website.

Oregon Health Fund Board. Pam asked Jack to describe House Bill 2009. Expand health care to preventative and have the tobacco tax pay part of tobacco related health issues. It is currently 500 pages. They are looking at breaking it apart in order to address the specifics within this large document.

Process Advisory Group: consists of Bunny, Jack, Tracy and OMG. “Scope of Practice”-started to help legislatures understand our scope of practice. The information is disseminated to the committee; the members are also available to answer questions.

6.1.1 Lobby Day Jack Dempsey. 400 individuals registered. 300 Students and 100 practicing RN’s and NP’s. There is a legislative reception at the Salem Convention Center, 6-8 pm. For directions please email Dempsey@oregonrn.org.

Kat Chinn asked about the LPN programs. Most are certificate programs. Pam asked about Governor Kulongowski plan to cut monies for the center for nursing education. That is the case. Tom from NW health foundation stated that monies are drying up to help support nursing education.

6.2 Membership and Marketing Patti Brandon/Mary Grant

Membership is down to 374. The NP survey is completed, awaiting Sue Davidson to complete the analysis and get the final version to us for review.

6.2.1 Goal

Increase membership by 5% in 2009. Goal is for each of us to recruit and encourage colleagues to join and those who have fallen away to re-engage.

6.2.3 NPO Survey Susan King Susan King absent due to illness. The NP survey is completed, awaiting Sue Davidson to complete the analysis and get the final version to us for review.

Oregon Office of Rural Health—Meg Portwood. Meg is looking for a replacement for the Rural Health Initiative position. There is an interested individual. She however can not afford the dues and is asking her employer to pay a portion. Meg wanted to know if there was an opportunity to help this individual; similar to what is done for the conference committee members. Larlene shared that the conference committee members do not have their membership paid for and they receive ½ of the registration of the conference.

After group discussion is was recommended to look for interest in other parts of the state. Linda Hatch, thought she may know of some individuals who may be interested. It will also be posted on Collective X. Corlyn Caspers will also ask around in the Klamath Falls area.

Please review the attached document for full detailed information.

Regional Representative Reports:

Corlyn Caspers has initiated a monthly meeting for the NP’s in the Southern Region. There are approximately 30 NP’s, PA,s and nurse midwives in attendance.

Meg Portwood—Coastal—No information.

Linda Hatch—Central—No information.

AANP—Roger Fogg—state representative.

The annual meeting will be held June 17-21 in Nashville, TN. The state is given 2 complimentary registrations. Pam mentioned that this could be used as an incentive to some interested people. Travel is not included.

AANP is asking NP’s to avoid contacting the legislators on the Medical Home Model for now.

Hugh Downs has done a special on NP’s. Everyone can be looking for it.

The regional meeting for AANP will be in Boise ID on March 14, 2009. Pam will not be able to attend; LuAnn will attend in her place.

10 minute break===

6.3 Professional Standards Anne Barry-Lever

This was covered under the legislative discussion.

6.4 Strategic Planning Meeting Update Pam DeVisser

In the past there sentiment has been that there is poor follow through. The goal going forward is to keep this on the agenda and address it with each meeting.

The two main goals are improved communication and membership growth. At present we have fewer members than we have had in the past. Goal is to increase membership by 5%.

Pam attended the ONA board meeting and presented our strategic planning goals in person. ONA was impressed that the NPO chair was present. They were in agreement with our goals.

Membership: Encourage colleagues to join Collective X. Non members will be approached by the chair via a letter inviting them to join. The group discussed how each of us could invite one to tow members and we would meet our goal. Corlyn has started a Klamath Falls meeting. She had 31 NP’s, some PA’s and 2 midwives. 6 of those where NPO members.

This year the NPO executive team will take the group on the road for regional meetings. The goal to meet other NP’s and encourages them to join, along with showing interest to the other regions. NPO has been seen as more of a Portland or Willamette Valley organization rather than a state organization. It is the hope that this will dissolve some of this sentiment.

The first on the road meeting will be Saturday March 14, 2009 in Lane County.

Journal Club: Larlene Dunsmuir and Karen Reisinger (Portland area Rep) are working together to initiate the first meeting. There have been some challenges in getting together to finalize the first meeting. The goal was for February 2009. It will most likely be in March. Larlene did complete some research on how to conduct the meetings. Teri Gerlt has an example of what the OHSU School of nursing uses. She will share with Larlene. The regional representatives all expressed an interest and Larlene will share with them as well so that they can initiate the meeting as well.

6.4.2 Collective X Pam DeVisser; Collective X has 105 members, not all are ONA/NPO members. Non members will be approached by the chair via letter.

6.4.3 Face book Pam gave update. More interest at this point in Collective X. People are still encouraged to open a face book page to see if we can reach the younger NP professionals.

6.4.4 Email lists/blasts

6.4.6 Letters to new NPs in the state Susan King/Patti Brandon

These will now be sent out on a quarterly basis.

6.4.7 List of responsibilities for each NPO job Pam DeVisser

Pam has found a template from the Oregon Nurses Foundation. Each current member of the executive committee will be the task team leader to write the job description. They are to reach out to those individuals who have had the position in the past. Those people in attendance who are on the phone or present may send their ideas to the current representative.

An introductory packet with welcome letter and the job description will be given to the new officers at the NPO conference.

The goal is to have this completed by next meeting. Each person has been encouraged to have it completed by mid-February.

6.5 Nominating Committee Mariah Taylor

Mariah introduced herself and stated she was excited to participate. No other information to share at this time.

6.6 Conference Committee Larlene Dunsmuir

2008 was a great success. The conference made $40,000.00 and had 250 attendees. Evaluations were mainly positive.

2009 dates are October 22-25 in Eugene at the Valley River Inn. The first meeting is scheduled for today after the general meeting. The co-chair will be Kat Chinn.

2010 meeting will be held in Silverton at the Oregon Gardens.

Roberta Hasui, thought another day added to the program would be great so that there would be closer to 38 hours. Larlene stated she would take it to the committee to discuss.

Pam shared that we saved $16,000.00 in printing and by doing our own AV.

8. Old Business: no old business to discuss.

9. New Business

9.1 NP Scholarship Larlene Dunsmuir

Larlene has put forward a proposal for an NP scholarship for $5000.00. The group had discussion around adding a 500 word essay on how they would benefit from the monies. Teri Gerlt will send a copy of OHSU criteria for review. It was also discussed about having the scholarship pass through the foundation. Kat asked that the phrase “development of NP leaders” be added. Pam and Corlyn also wanted to add “the individual must remain active for 3 consecutive years in a leadership role”.

Frances moved that we make the aforementioned changes to the first page. Kat second the motion. Pam called for the vote. All I’s, and no nays. Motion moved and passed.

Please refer to the embedded documents for the final approved first page of the scholarship application. Larlene Dunsmuir and Teri Gerlt will complete the second page of the application process.

9.2 OSBN Report Susan King/Pam DeVisser

Susan King is unavailable today. Pam provided the report.

Ann Berry-Lever presented the NP sanctions by the OSBN. There was an NP that asked to speak with Pam DeVisser and Susan King at the NPO conference in Oct 2008. There have been several cases and a number of complaints from members regarding how they treated. Many of the licensees have been told not to obtain legal representation when a complaint has been lodged and they are having their initial meeting with the board. Most of these NP’s have stated that they have been treated as if they are guilty from the onset. The investigators are not peers for the NP’s, rather they are RN’s or LPN’s. One investigator is a retired police officer. Tracy Klein is occasionally brought in to assist with the review of the case.

Susan King and Jim McDonald had a conversation involving the following:

-licensee not given enough information to defend or refute the claim.

-investigators do not understand the scope of NP practice.

-OSBN does not bring in NP consultants.

-assumed guilty prior to review.

-told not to bring attorney to the initial discussion, because who would want an attorney to hear the horrible things one is accused of.

-during an investigation of one complaint against an NP, the reviewer did not agree with treatment strategy another NP was giving and initiated a complaint and investigation into that NP.

Max then asked what the process entails. Pam and Anne explained the following process.

Someone lodges a complaint.

OSBN contacts the site and asks for records

The site manager usually lets the NP know that records have been requested.

Then the OSBN contacts the NP and sets up a meeting.

Meeting between OSBN and the NP occurs.

OSBN investigator then compiles a report and takes it to the disciplinary board.

OSBN then reviews.

Remediation then takes place. Currently involves letter of apology, possibly taking classes and or writing reports following.

Action: There will be a formal meeting on 2/26/09. Pam, Anne and Susan will represent NPO. The discussion will be with Jim McDonald and Holly Mercer of OSBN.

It was discussed to add information on Collective X, letting NP’s know that they should have representation at a meeting that stems from a complaint that OSBN is investigating. As members we have access to 30 minutes of free consultative time. Susan King is compiling additional names of attorneys for us. If anyone has experience with an attorney which represented NP’s well, please share.

Next meeting scheduled for Saturday April 4, 2009.

10. Adjournment

Respectfully submitted,

LuAnn Cook