Oregon Nurses’ Association

NPO Quarterly Meeting

February 2, 2008

1000-1300

Members Present:

Bunny Lewis, Chair

Pam DeVisser, Chair Elect

Frances Guthridge, Secretary

Gillian Rosicky, Treasurer

Susan King, ONA Executive Director

Martin Taylor, ONA Lobbyist

Meghan LeNee

Marilee Dea

LuAnn Cook, Nominating Committee Chair

Larlene Dunsmuir, Conference Committee Chair

Nancy Malone, Regional Rep

Meg Portwood, Regional Rep

Terry Mills

Claudia Peterson, Legislative Committee

Karen Reisinger

Linda Hatch, Regional Rep

Roger Fogg

Anne Barry-Lever, Professional Standards

Guests:

Rhonde Busch LIPA Eugene OR.

Pam Mariea-Nason CARE OREGON, Portland

Howard Shemel, FNP student

Bob Clements WSU graduate student

Shannon Richards Western University Health Sciences student

Call to Order and welcome by Chair, Bunny Lewis

Announcements and Introductions: Members and guests introduced themselves.

Minutes

Motion: Meg moved to accept minutes. Gillian seconded.

Motion carried.

President’s report

Bunny shared goal of improving communication. She advised that a variety of choices are there but we need to try to figure out how to communicate with NPs in the state. She will recommend a task force of interested and qualified people to begin work on this.

Treasurer’s Report

Conference: Profit of $24,000.

Doing well on investments. This is expected to change.

Net Profits for the quarter: 828.00

Cash & Equivalents: 96,099.00

Marketable Securities: 138,036.00

Total Assets: 245,926.00

Total Liabilities: 71,356.00

Current Net worth: $192,541.00

Marilee Dea, PNP, presented a request to lead a health care team to Guatemala. A team of 10 people pay their own ways annually to participate in improving health care in the highlands of Guatemala. She has tapped out her friends and colleagues over the past 5 years. This year she is asking for help from her professional organization.

She thanked the members for allowing sales of crafts made by the children from Guatemala at the annual conference. They made $2000.00 this past November. She had not set a specific request but had earlier explained that she needed money to pay for interpreters. Activities include hygiene, safety, health education as well as doing physicals and trying to meet some of the medical needs of the individuals.

There will be a need for volunteers of NPs in the future. Her contact number is 503-771-6088. Decision postponed to the new business.

Committee Reports

Legislative

SB 1062 Formulary Bill: Charley Cheek, Laurie Monnes-Anderson, Jane Sawall, Martin, and Anne BarryLever met to answer questions and delete all reference to use of the formulary in the rules. The hearing is Wednesday, Feb. 4th. This is being treated as an amendment and is being placed in another bill. NPs need to validate that they will like the amendments. Those who were planning on coming on the 12^th should do so, to work on House leaders. This bill has to meet requirements of urgent legislation. This bill will remove the formulary requirement for both NPs and CNS’s.

Home Health: Susan reported that this bill still sits in congress. This was something Gordon Smith helped draft.

ONA PAC, recommended endorsement of Jeff Merkley. ANA intends to make endorsement known. Usually ONA’s recommendations are honored by ANA.

Language problems Bunny reported getting a call from an NP who was not allowed to sign a request to exclude seat belt use for a patient who couldn’t wear one across a port implanted in his chest. There are possibly more areas that need to be identified.

Conference

Larlene: She is pleased to have a large conference committee. They reviewed evaluations. Speakers and topics were well received. The next conference will be Oct 17-19^th. They are planning another kind of social event. This is scheduled for the same time as Harvest Fest, Hood River, OR.

2009 site: Eugene, OR Valley River Inn.

2010 site: Oregon Garden Convention Center. Silverton. OR.

Membership and Marketing

There is a need for a chair for this committee.

Brochure

Discussion involved possible changes to the brochure:

a. Avoid the use of personal names on the back. Drive the person to the website….for NPO regional rep.

b. Achievements: reverse the order?

c. Avoid the people on the bottom. Don’t like caricatures? Consider collage of real people? Join US on the front? Make a Difference….

d. Focus on why join…be more concise. Make comments very short. Less busy.

e. Use N P O with acronym points. N… networking P promoting and protecting practice. O..opportunity

f. Use key words… Repeat throughout

g. Reference to sign up and pay on line? Application?

h. Make it clear that ONA is known as the membership. Need to have ability to do on web site.

Public service announcement: AANP hasn’t seen it according to Roger Fogg.

Web site

There has been a change to the web site. We have our own domain nursepractitionersoforegon.org The site will redirect for a while.

The concern about redesign of the home page is limited by the need to keep it uncomplicated so that new posting can be accomplished easily. It has been recommended by the chair that a technology committee is set up, including Scott from the ONA office. 2-3 other people will be appointed.

Chair for Membership and Marketing committee

Pam DeVisser recommended that we consider asking the past chair to be the person that would move into the coordination role to the regional reps. That person would know about the organization. The current past chair is Kat Chinn. This will be tabled to the Executive Committee.

Professional Standards

Anne Barry-Lever summarized the Barriers to Practice Survey 11/07

There were 65 surveys, the majority were FNPs, and a few were PMHNP/ANP. 14 reported difficulty in obtaining provider status. Specific companies mentioned were :Aetna, Cigna, Great West, MVIPA, United Health Care and Lifewise. Twelve people reported prescriptive authority problems. Twenty-two reported home health and long term care problems with orders, visits.

There was no overriding barrier to liability insurance, but some commented on the cost NSO was most frequently mentioned as carrier, but some were with Marsh. A large number don’t have liability insurance.

There was an interest in CE for establishing a business practice. Suggestions included offering this either in face to face course or online. Coding, and support for private practice were mentioned.

Susan: discussed the cost issue with liability insurance. NPs costs have gone up. There is concern about the “going bare” issue.

Primary Care Home

Guests: Pam Mariea-Nason, Care Oregon; Rhonda Busek, LIPA

Martin introduced the topic with complimentary comments about how these plans have distinguished themselves with representative lobbyists. These plans push the reform of how patient care is delivered. This discussion began two years ago with the access to health care for all kids a priority. Insurance is not the same as health care, the delivery system needed to look different which led to the primary care home concept.

LIPA: Rhonde Busek discussed community collaborative perspectives of her company. . She stressed the concept of community partnerships and shared responsibility with everyone in the community: hospital, provider groups, and social service agencies. They have seen an increased access to health care. This is team based care that takes advantage of nursing services. Their idea is to create primary care homes to coordinate all services for patients.

Care Oregon: Pam’s company has set up 5 sites for primary care homes since 2006. They have created learning collaboratives that encompass five elements for team based care: clinician, RN, role of care coordinator, behaviorist, pharmacist, dental hygienist. They created shared space, addressed panel management. The work is the health of the population. They work at max-packing visits, with providers practicing at the top of their license. What is payment for these services? She discussed the development of CPT codes for care coordination. There needs to be a new model of payment, and are trying to test some of these codes on a joint basis.

575,000 people in this state do not have health insurance. Having insurance doesn’t mean they will have access.

Bunny acknowledged that the invitation to these guests was prompted by the concern that physicians talk Primary Medical/Care Homes in terms the physician being the leader of the team based rather than the leader being any provider, or management model.

The guests encouraged our group to avoid becoming polarized against MDs. Also that RN colleagues can be an important revenue center. New codes would allow this to happen.

Susan: focus needs to be on delivery of service. Urged that we be engaged in this work. There needs to be more voices about the way we deliver service…not who does it.

It was recommended that there be something on the web site to be a summary of this discussion.

Regional and Organizational Reps Reports

Regional Reps

Nancy: Distributed draft transition to practice. Gave to NP students at SOU, site for OHSU. Plan to meet again. The web site is working well. She has had contacts looking for jobs, students. She has received positive comments locally from people who attended the NPO conference. There is one new member because of the conference. She is working on another.

Meg: Has an OSU student with her.

Linda: Gonzaga U student’s contacts. There have been hits looking for jobs.

AANP regional meeting: Bunny Lewis has been invited. Roger will contact AANP regarding additional member participation. Jan Towers will be there, March 29^th.

Rural Health Coordinating Council

Meg is working with the Oregon State Rural Health Scholarship Committee reviewing rural health providers as candidates for awards. The next meeting is March 4. One award to each discipline: dentist, pharmacist, physician, NP and PA - awardees must be working in a rural area in order to get loan repayment assistance.

The next Rural Heatlh conference will be in Bend, next September.  The Office of Rural Heatlh is interested in ideas to streamline the conference, for example, topics related to rural health. Contact Meg or the Office of Rural Heatlh for information.

The Rural Health malpractice assistance started in January and will be administered by SAIF; contact Linda Peppler at the Office of Rural Health for application information. Providers must be working in approved rural areas to qualify.  Tricare is seeking rural providers who will be eligible for a tax credit or payment of some sort - the rules are being written; Linda Peppler is the contact.

Old Business

Terri Mills described the National Nurse Act of 2006. She sees this as a step up to plate to deliver prevention in our own communities. She has joined efforts with parish nurses, others, including a healthy living fair. She provided handouts. She wants the national nurse to elevate the importance of prevention in all communities. Refers to National nurse.org

New Business

ONA Convention

April 9-11^th The 9^th is a CE day. Refer to website.

There will be a focus on our future professionals, new graduates in the past 3 years.

The conference is in Bend at River House. You are urged to go back to your area and volunteer to be a delegate from your district.

Oregon Health Fund

Tabled for discussion at a later date due to time constraints.

Update on National Issues

Susan reported that ONA has disconnected from one of the organizations. Oregon was a founding member of the UAN from bylaws. Withdrew because of a change in focus that was no supported by ONA. There are some legal maneuvers that could happen. This was done to protect this association. There is more detail in Oregon Nurse.

Scope of Practice assessment report done by Oregon Consensus program.

This is a follow up to the legislation that Senator L Monnes-Anderson submitted in the last session, and was ultimately defeated.

Martin summarized the five recommendations as outlined on the document. It is recommended that we should give them a statement advising that there is already a process in place for this purpose. Susan King will draft the letter and send it to Bunny to review.

Charitable contributions/use of funds.

Motion was made by Pam DeVisser:

Policy regarding support of individuals or groups requesting funds from NPO:

1. Be a member of ONA.
2. Prepare a written proposal and submit to the executive committee requesting NPO support.
3. Provide an in person presentation to the membership. This could be waived under special circumstances.
4. Membership vote supports project and determines amount of financial support at a quarterly meeting after recommendation from the Executive Committee.
5. Provide a report/article/pictures at completion for the website or Oregon Nurse or other venue.
6. Offer public acknowledgement of NPO support by recipient if appropriate.

NPO to set aside $10,000 for special projects, and $10,000 for scholarships and develop an application for scholarship based on ONA application. This would be a flexible line item reviewed annually and dependent upon funds.

Larlene seconded.

Motion carried.

Guatemala Project:

Larlene submitted motion to send $4000.00 to Marilee Dea for Guatemala project. Seconded by LuAnn.

Motion carried.

Oregon Nursing Foundation:

Anne Barry Lever moved to donate a $200.00 basket for the ONF auction at the ONA convention.

Pam seconded. Motion carried.

Larlene offered to arrange for the basket, and make it available by April.

Next Meeting

May 31, 2008 Executive Meeting 8AM, membership meeting 10-1PM

Adjournment

Respectfully submitted,

Frances Guthridge