Category: Louisiana

Update from NASL Members, A&A Advocates

Here are the latest news and updates in Oklahoma:

THE LATEST IN OKLAHOMA
Gov. Kevin Stitt has formed a special child welfare task force to research strategies that improve the child welfare system and reduce the number of Oklahoma children in foster care. On Wednesday, Stitt named eight people to the board including Oklahoma Secretary of Human Services Justin Brown.

Gov. Stitt signed the LEAD Act into law on Thursday. The bill modifies the “Project Ocean” legislation adopted last year. The new legislation creates a $698 million incentive package to assist in luring a company code-named “Project Connect” to build a manufacturing facility in northeastern Oklahoma. To qualify for the incentive, the company would be required to spend at least $3.6 billion in its Oklahoma project and add 500 jobs in the first year and 3,500 new jobs in four to five years.

Early voting on State Question 820 – an effort to legalize the use of recreational marijuana in Oklahoma – started on Thursday. Supporters say the initiative will help boost the state economy and build on previous criminal justice reform efforts. Detractors say the initiative would bring more crime to the state. Early voting runs from Thursday to Saturday. On Tuesday, polls open from 7 a.m. to 7 p.m.

Attorney General Gentner Drummond and the state’s utility regulating agency are revisiting the circumstancesthat led to high natural gas prices during a 2021 winter storm after Kansas Attorney General Kris Kobach said this week he is suing a national energy company for market manipulation after it sold natural gas at an inflated rate to local utility companies. Drummond’s office said it was aware of the Kansas lawsuit and that the situation in Oklahoma is being investigated to see if there were similar circumstances.

NEED TO KNOW NEWS

New York Times: Oklahoma Wants to Be the ‘Next Texas.’ Imagine That.
On a stifling July day, Elon Musk sat across from the governor of Oklahoma under a small white pop-up tent, a red Tesla flag waving from a short pole in an otherwise unadorned field.

That the billionaire was even in Oklahoma, seriously considering putting a gigantic new Tesla factory outside of Tulsa, was a major turning point for the frequently overlooked state. Suddenly, Oklahoma could boast of being on par with its much larger neighbor and rival, Texas. The only other city still in the running for the plant, by that point in 2020, was Austin.

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NonDoc: Seeking $30 million for food deserts, innovative grocery store proposal faces oversight questions
A proposal to provide a nonprofit organization $30 million of federal American Rescue Plan Act funding to build four grocery stores in underserved areas is receiving additional review by Oklahoma legislators owing to questions about the nonprofit’s governance board, the executive director’s stake in for-profit companies potentially associated with operation of the planned stores, and ongoing litigation filed by a former business partner.

Aaron “AJ” Johnson is the co-owner and executive director of Oasis Fresh Market, a privately owned grocery store that opened in a north Tulsa food desert in May 2021. Simultaneously, Johnson serves as the executive director of Oasis Fresh Foundation, a 501(c)(3) nonprofit also established in 2021 to provide wrap-around social services for customers.

But although Johnson has the conceptual support of many influential Oklahomans, uncertainty about the governance structure of Oasis Fresh Foundation has raised significant questions about whether the organization is positioned to handle $30 million of public money.

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Oklahoman: She killed her abuser. An Oklahoma House committee passed a bill that could set her free.
In 1998, April Wilkens shot and killed her fiancé, who had handcuffed and raped her in a Tulsa home. A jury convicted her of first-degree murder, and Wilkens was sentenced to life in an Oklahoma prison.

“I knew that I was going to die. I just knew I was going to die,” Wilkens said last year about being abused and why she shot her fiancé with his own gun.

Wilkens has been denied parole four times, but she has never been able to use the evidence of her domestic abuse in her appeal for early release.
But House Bill 1639, which was unanimously advanced by a state House committee on Wednesday, could give Wilkens and other incarcerated women like her a chance at freedom.

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This week, Representative Thomas Albert (R-Belding) and Senator Phil Pavlov (R-Saint Clair) introduced legislation reforming the Michigan Public School Employee Retirement System (MPSERS). “In 2010 the legislature passed the current hybrid system in an attempt to get the ever-growing unfunded liability to the state under control. However, there are current members who don’t believe those reforms were enough to fix the issue and further reform needs to occur,” stated Matt Sowash of MLC.

The proposal would place all public-school employees hired after September 30, 2017 into a defined contribution retirement plan modeled after the plan that is offered to state employees hired since 1997. Additionally, a public-school employee would have their employer contribute 4% of the employee’s wages into a 401k plan. The employee could then contribute another 3%, which would be matched by the employer. The employer match would be covered by the state. According to an analysis by the non-partisan House Fiscal Agency, the House bill is estimated to increase costs in the 2018-2019 Fiscal Year by $410 million. Over the forty-year amortization period it is estimated to cost up to $46.4 billion. The House bill was referred to the House Education Reform Committee, which is chaired by Representative Tim Kelly (R-Saginaw Twp.).

Senator Pavlov’s bill was referred to the Senate Education Committee, of which he serves as chair. Currently, House and Senate leadership have both expressed support for reforming MPSERS. However, Governor Rick Snyder has stated he would prefer to keep the current hybrid system. As this issue continues, it could have an impact on the budget process for the upcoming 2017-2018 Fiscal Year should the governor and legislative leadership continue to be opposed on the reforms. Additionally, several members of the House and Senate Democratic caucuses have stated they are adamantly opposed to the proposal. Michigan Legislative Consultants is a bipartisan lobbying firm based in Lansing, Michigan. Our team of lobbyists and procurement specialists provide a wide range of services for some of the most respected companies in America.

For more on MLC, visit www.mlcmi.com or connect with us on LinkedIn and Twitter.

For the second time in as many sessions, Republican Gov. Matt Bevin took to the Senate president’s podium to congratulate the legislature for its work. Bevin’s comments echoed the sentiments of Majority Floor Leader Damon Thayer, who preceded the governor in declaring that 2017 was the most productive regular session in modern history. The session was undeniably productive, based on quantity of passed legislation alone. Republicans exercised single-party legislative control for the first time in nearly a century, and released a torrent of bills intended to make the commonwealth more competitive with Southeastern and Midwestern states in job attraction and retention.

The first 28 days of the 30-day session were extremely productive for Bevin, who was successful in passing several dozen bills that were on his agenda. Those bills ranged from government agency reorganizations, to subtle policy initiatives, to sweeping changes such as making Kentucky a right-to-work state and eliminating prevailing wage requirements for publicly funded construction. Bevin and the legislature’s big wins this session included pushing through a tax incentive package for a major Amazon facility in Northern Kentucky (HB 368); curbing drug abuse by outlawing some substances and significantly limiting opioid prescriptions to a three-day supply (HB 333); negotiating a refinance of the KFC Yum! Center in downtown Louisville that was on the verge of default (HB 330); passing additional economic loan pool money for a $1.3 billion aluminum mill investment in Eastern Kentucky (HB 482); killing an effort to separate the County Employee Retirement System from the Kentucky Retirement Systems (SB 226); and personally testifying on behalf of charter schools (HB 520) and right-to-work (HB 1.)

While all of these efforts required legislative buy-in and approval, it is the fulfillment of many of the campaign platforms on which the governor ran in 2015, as well as the agenda of the freshman House GOP class for which Bevin tirelessly campaigned last year.

Despite Republican control across the board, the House, Senate and governor found places to disagree with each other. Those disagreements resulted in the defeat of several significant agenda items the Kentucky business community championed. A year-long effort to produce workers’ compensation reforms (HB 296) died in the final hours without the Senate ever taking the bill up for a hearing or a vote. Legislation to require transparency in attorney general litigation (HB 271) also met a late-night demise in the House.

The newly minted Republican-led General Assembly found occasion to flex some independence of its own. During the veto recess, Bevin vetoed all or parts of four bills – all sponsored by Republicans – similar to what the governor did a year ago in the 2016 session, when the legislature passed a flurry of bills in the last hours of the session, thus foregoing their ability to override any vetoes. This time, House and Senate leadership wasted no time in overriding all four vetoes nearly unanimously.

Among those bills that did not pass were the previously mentioned changes to the workers’ compensation laws (HB 296). Kentucky’s workers’ compensation program is considered a relatively rich benefit for injured workers, particularly due to the length of benefits received. An effort to save the system more than $100 million over the next 10 years was stifled in the Senate after law enforcement agencies expressed serious opposition to limiting partial permanent disability claims to 15 years.

Democrats, while limited in numbers, were able to exploit fissures between the social conservatives and more moderate Republicans to kill a couple of bills this year. However, during the 11 p.m. hour on the last night of the session, Republicans and Democrats came together to unanimously pass a budget amendment drafted to attract a specific but at that point mystery economic development opportunity in Eastern Kentucky, the aluminum mill announced April 26 in Wurtland. In the final hours, the legislature also addressed the heroin and drug epidemic plaguing the state by passing HB 333. The original bill changed the prescribing authority for opioids; the Senate directed a major policy shift when it added “tough on crime” language with increases in the penalties for minor trafficking of heroin and fentanyl.

The Sine Die adjournment March 30 ended legislative activity until Jan. 2, 2018 – or until the governor calls an extraordinary (special) session. Most signals are pointing to an early fall session to address pension and tax reform. A vote on major tax reform will most certainly be tougher than any vote taken during this past regular session. It may require a substantial sales job from the governor before the new Republican majority in the House and the established GOP majority in the Senate commit to a package that likely will create as many new losers as winners in the tax code.

2017 General Assembly in Review

Here are a few of the 2017 session highlights:

• HB 520: The charter school bill allows publicly funded charters to operate as early as the next school year. It passed with a mayoral provision for Lexington and Louisville, giving the city’s highest executive authority to designate a charter school or schools. School boards will elect for the creation of a local charter, which may be overridden by the state Board of Education. In the final days of session, a late-night vote on HB 471 provided state funding for the charters.

• SB 1: In tandem with the charter school bill, the legislature pushed this comprehensive accountability reform for K-12 education. Performance-based assessment reigns supreme, and review of academic standards will occur next school year.

• SB 4: This bill establishes a pre-trial peer review panel for medical malpractice in an attempt to deter frivolous lawsuits. Complaints can only bypass the panel and accelerate the matter to the court if agreed upon by both parties.

• HB 410: The REAL ID bill allows Kentuckians the option to obtain a travel ID or enhanced driver’s license for interstate travel and admittance onto military bases. Though voluntary, it ensures that Kentuckians who choose not to get the travel ID may simply show multiple forms of identification.

• SB 153: Requires performance-based funding for higher-education institutions. The bill has an emergency clause, making it effective immediately.

• HB 330: Known as the YUM! Center bill, this bill extends the tax increment financing (TIF) program, resulting in increased contributions from the University of Louisville and Louisville Metro.

• HB 1: This right-to-work legislation makes union membership an individual employee choice. This bill was the House’s main priority for the session. Kentucky is now the 27th state to enact right-to-work legislation.

• HB 3: Repeal of the prevailing wage requirement for public works construction projects.

• SB 3: This pension transparency bill requires the disclosure of retirement benefits of current and former members of the General Assembly.

• SB 5: Bans abortions in Kentucky past 20 weeks except in cases that pose serious risk to survival of the mother. It was passed in the early days of the session alongside HB 2, which requires “informed consent,” an ultrasound prior to an abortion, with criminal penalty for violations.

• SB 6: Dubbed the “paycheck protection bill,” it repeals employers’ mandate to withhold union dues from an employee’s salary and sets requirements for labor organizations in collecting and applying dues money for political activities.

• SB 12: Creates a new board of trustees for the University of Louisville and requires Senate confirmation of appointees. SB 207 passed later in the session, expanding that requirement to all public universities.

• HB 100: A win for bourbon and tourism industries alike, this bill allows for the sale of vintage spirits and distilled spirits at fairs, festivals and similar events.

• SB 79: Patients can now enter into contracts with their primary care providers for services. Those in a so-called “direct primary care membership agreement” would not forfeit private insurance or Medicaid.

• HB 112: Known as the “dog bite bill,” it defines the dog owner, not the landlord, as the responsible party in the case of a dog bite on rental property.

• HB 156: This bill establishes the Kentucky Coal Fields Endowment Authority to fund improvement projects in coal severance counties. The bill ensures a $7.5 million installment of coal severance dollars; projects will be awarded based on job creation and economic development potential.

• HB 14: Otherwise known as the “Blue Lives Matter” bill, attacks on first responders will now be considered a hate crime. Previous law defines hate crimes as those committed because of a victim’s race, color, religion, sexual orientation or national origin.

 

Author: Sean M. Cutter, Director

Running a network enterprise is exceedingly complicated. The global network of an airline like United makes the business particularly fraught. Industry pressures exacerbate problems and translate to frustration for passengers. What happened two weeks ago in Chicago was an unmitigated reputational disaster. Given the nature of the airline business today, passengers are well aware that operational disruptions can happen. However, this incident was extreme in every way. Today’s media landscape dictates that carriers need to be prepared with much better protocols than those employed at O’Hare.

First things first – flying is more affordable and more popular than it has ever been. Since the federal government deregulated the airline industry in 1978, fares have fallen by nearly 50 percent and passenger traffic has tripled. As much as we the flying public like to complain about the flying experience, the fact that it is uniquely accessible in the United States today can’t be denied.

Among the factors that keep ticket prices down is the practice of “capacity discipline,” an industry buzzword which roughly translates to “fuller flights.” In order to keep costs down, airlines do their best not to have more seats on a route or frequency than the market demands. In the United case ORD > SDF, that was 70 seats, as evidenced by the full flight. And while full flights can sometimes lead to boarding denials, most passengers would rather have a lower fare and take a chance on getting bumped than subsidize a bunch of empty seats. In rare cases, passengers need to be “re-accommodated.”

Other, external factors further complicate matters. While much has been made about United’s overbooking procedures, the flight in question was not technically oversold. Rather, a crew of four needed to be repositioned at the last second in order to work another flight out of Louisville. Any number of factors could have necessitated the deadheading crew including weather, a mechanical failure, poor scheduling or a growing and soon-to-be cataclysmic shortage of pilots.

The airlines remain a mystique industry. There is a certain amount of magic involved in hurtling through the sky at 500 miles per hour and ending up on the other side of the continent, the ocean, or the world in a matter of hours. The airlines need to do a better job of explaining that it isn’t magic, but rather the product of tens of thousands of employees constantly solving a giant and color-changing Rubik’s cube which get passengers to their destinations quickly, safely, and affordably.

So, too, do the airlines need to improve their communications and protocols. In the aftermath of this disgraceful episode, consumer advocates are rushing to push for improved federal regulations and lawmakers in Congress are introducing legislation. But certain problems are never going to go away. That means all carriers, not just United, need to take a hard look not only at what they’re doing but how they’re explaining their decisions. Social media has transformed the media. United’s bad month (including the “leggings incident” before the infamous “re-accommodation”) was made terrible by the wall-to-wall coverage provided by Twitter, Facebook, YouTube, and other channels. Social Media means there’s a reporter in every seat today, and their content can go viral in minutes. Book-aways, a plunging share price, and irreparable brand damage can result. The once iconic “Fly the Friendly Skies” is now and forever a punch line to a bad joke. All carriers would be wise to examine their crisis plans and employee training manuals to ensure they are up to 2017’s standards.

Washington is working overtime this week to characterize the president’s first 100 days following the April 29th milestone. With the spotlight on the White House, it is easy to ignore Capitol Hill. As the 115th Congress reconvenes after a two-week recess, many Members will be smarting from tough town halls and other public appearances back in their districts. Pressure on Speaker Paul Ryan and Majority Leader Mitch McConnell to pass legislation is mounting. With the president having outlined his vision for tax reform, it looks like a much-anticipated tax bill will be the next policy item on Congress’ agenda.

If the goal of re-writing the federal tax code seems ambitious, it’s because it is. The last time a tax reform bill was enacted was 1986 – three days before the ball rolled through Buckner’s legs – a lifetime ago (in both politics and sport). Despite a divided government then, Washington was less polarized. Democrats in the House including Speaker Tip O’Neill and Ways and Means Chairman Dan Rostenkowski worked with Republicans like Senate Majority Leader Bob Dole, Finance Chairman Bob Packwood, and President Ronald Reagan to pass the first comprehensive changes to the tax bill code in 32 years.

There is no doubt that politics is more partisan today than during the Reagan-O’Neill era. And with Republicans in control of Congress and the White House, one would expect the Democrats’ role to be insignificant. But as we learned during the recent attempt to repeal and replace the Affordable Care Act, House Republicans are deeply divided. So if congressional leadership is serious about passing a tax bill, they will need rank and file Democrats to support it, especially Congressman Richard Neal of Massachusetts.

Mr. Neal has served on the House Ways and Means Committee, which has jurisdiction over the tax code, for over 20 years. He is now the top or Ranking Democrat on the panel. It will be up to Mr. Neal and Chairman Kevin Brady (R-Texas) to hash out the details of a viable tax bill.

Among President Trump’s campaign promises and early proposals was a border adjustment tax, or BAT, which would impose a steep tax on goods coming into the United States from abroad. In theory, the BAT would encourage corporate investment at home and create jobs in the manufacturing sector. But as the president found out, tax proposals often make strange bedfellows and while the BAT has some bipartisan support, it also has bipartisan opposition. It appears that the vocal opposition from key Republican senators prompted Trump to shelve the BAT proposal. As other suggestions are considered and tweaked, Mr. Neal will be responsible for determining their viability within his caucus.

In recent history, the medical device tax has been the key tax issue for Massachusetts, thanks to the booming medtech industry. But with a comprehensive bill up for consideration, and a critical seat at the table, Massachusetts interests will play a more central role. Changes to the corporate tax rate will not only affect the 13 Fortune 500 companies based in Massachusetts, but the thousands of small businesses and startups in bio, tech, and other sectors. Consolidating tax brackets and changing eligible deductions should get the attention of the state’s growing millionaire class and the thriving middle class alike. And if Congress is serious about paying for lower taxes by creating savings in the healthcare system, Massachusetts’ research facilities and its dominant healthcare sector will need to sit up and take notice.

While not the low-hanging legislative fruit that would count as an easy win, tax reform is certainly high on Speaker Ryan’s agenda. As the focus turns to legislative action, and the Speaker seeks a win after an early failure on healthcare, we expect to see a tax bill move. There is a narrow political path for the legislation to tread, and it goes right though the Commonwealth.

The recent announcements of two major private initiatives, RIZE Massachusetts and the Grayken Center at Boston Medical Center, focused on the treatment and prevention of substance use disorders are welcome additions in the fight against opioid addiction in Massachusetts. The misuse of opioids continues to take lives at a frightening pace in the Commonwealth and presents a complicated challenge to elected officials and policy makers across the United States.

Early data from the Massachusetts Department of Public Health indicate that 2016 was another devastating year as opioid overdose fatalities will approach or exceed 2,000 deaths, the deadliest year thus far. As of now, 1,465 deaths are confirmed with another 469 to 562 estimated to be designated as an overdose fatality. Equally shocking is that these numbers would have been much worse if not for the availability of the drug naloxone, used to reverse an overdose, which was administered approximately 12,000 times in 2015 (the last year data was available). Most recently, a report by the US Office of Health and Human Services found that the Commonwealth had the highest rate of opioid related Emergency Room visits among 30 states included in the study.

The sheer scope of the opioid epidemic in Massachusetts will require a sustained effort over many more years to bring under control. For over a decade the Commonwealth has increased resources, made significant policy changes and raised awareness about stigma in an effort to curb the epidemic. The Legislature has passed a series of omnibus bills over the last several legislative sessions to address different but interrelated aspects of the epidemic. Laws and regulations have been strengthened to mandate prescriber education, to encourage regular queries of the Prescription Monitoring Program by prescribers, to provide education to students, to improve access to quality treatment and to supplement treatment capacity. The implementation of the Commonwealth’s 1115 Medicaid waiver will add new resources and capacity in critical areas of the continuum of care and the system of five Recovery High Schools offer students with substance use disorders a safe and supportive environment to continue their education.

The Legislature also authorized a study, the Chapter 55 report, by the Department of Public Health in cooperation with other state agencies that utilizes pooled state data to try to identify patterns and gain a more comprehensive understanding of the underpinning issues of opioid misuse in Massachusetts. For many years, hard data about the opioid epidemic was hard to come by, either siloed in agencies across state government or simply not collected. The data and analysis in the Chapter 55 report confirms that we are not facing an epidemic of misuse of only one class of drug, rather an evolving epidemic of misuse of many substances. The surge of fentanyl use in particular, identified in 75% of overdose fatalities in one set of recent data, combined with the emergence of carfentanil and the presence of benzodiazepines in postmortem overdose reports all illustrate the dangerous mix of chemicals that are being misused and are a driving factor in these fatalities. The changing nature of the epidemic over time has made it a moving target for providers, regulators and law enforcement.

As the Legislature considers its next policy priorities on opioids, we’re likely to see an emphasis on adding tools to sustain a client’s long term recovery in their community, one of the more elusive and frustrating aspects of this chronic disease. In many ways, policy makers have worked through many of the immediate challenges but the buildout of a comprehensive response is not yet complete. While many of the pieces are in place or coming online, pulling all of the components of treatment together to create a streamlined continuum of care that will be evidenced based, efficient and effective for clients remains a work in progress. The workforce challenges faced by the provider community could also present a chilling effect to the state’s response. As new programs open or expand the demand for qualified professionals in the field is a pressing need across the state and attracting significant numbers of new staff will be critical to building a sustainable network. Additionally, training more medical professionals in addiction medicine and training existing staff in the latest advances in the field will help improve provider capacity. While much was done through the STEP Act around prevention, research and policy continues to develop around how to best identify opioid misuse at the earliest stages. The use of data to target resources and analyze trends is a new and important resource and some hope the application of mobile technology could be part of the solution.

Many of the remaining opioid policy issues are also intertwined with other challenges we face in Massachusetts but are crucial to the opioid epidemic as well. Affordable housing and homelessness, gaps in education, lack of job skills or work experience, complicated family dynamics, criminal records, co-occurring disorders and collateral health issues can all face clients as they work to sustain recovery. With the additional attention and resources that have now been brought to bear, perhaps we’ve reached a critical mass and a more robust understanding of what it will take to treat this public health crisis.

This past January, O’Neill and Associates was approached by Teamsters Local 633, a New Hampshire-based labor union of employees in the transportation and delivery industry. The Teamsters were concerned by the pending passage of “Right to Work” legislation in the New Hampshire State House. The proposed bill was expected to significantly weaken the strength of labor unions in NH. With only a few weeks until a final vote, O’Neill and Associates was able to launch a high-impact, month-long campaign to mobilize the Teamsters’ 4,700 members against Right to Work. O’Neill and Associates, in collaboration with the Teamsters, focused engagement efforts on three areas: traditional media, social/digital media, and member-to-member communication.

O’Neill and Associates helped generate news stories and editorials urging the House of Representatives to vote Right to Work down by targeting outreach to reporters, editors and freelance journalists on the hazards of the bill.

In addition to targeting traditional media outlets, O’Neill and Associates helped Teamsters Local 633 leverage their Facebook account to create and maintain online activism – motivating supporters and providing them with easy-to-understand action items. The Teamsters’ Facebook page was used to post low-dollar paid promotions as well as organic content, and served to amplify the key messages of the campaign and convert awareness into targeted action.

Finally, O’Neill and Associates was able to engage the union’s own members through an internal email campaign. This campaign provided members with news updates, calls to action and contact information for key legislators.

The energy and enthusiasm throughout this one month campaign against Right to Work paid off. On the day of the vote, a significant minority of New Hampshire House Republicans joined almost all House Democrats to block passage of the bill, in spite of a last-minute lobbying push by the Governor and Speaker of the House. The final outcome in New Hampshire was an outlier to the national trend of Republicans efforts to successfully implement Right to Work in many states, This campaign can now be a model for other labor unions around the country on how to defeat Right to Work in their communities.

On April 5, the Massachusetts Coalition of Nurse Practitioners (MCNP) hosted its annual Health Policy Breakfast, inviting nurse practitioners from across the state to discuss current health care challenges facing the Commonwealth and the goals of their bill, H.2451/S. 1257, An Act to Contain Health Care Costs and Improve Access to Value Based Nurse Practitioner Care as Recommended by the IOM and FTC.

Nurse practitioners were joined by co-sponsors of the bill Senator Marc Pacheco, Representative Paul Donato, Representative Kay Kahn and Representative Pat Haddad as well as Senator Walter Timilty, Representative Joan Meschino, and Representative Solomon Goldstein-Rose. The offices of Senator Mike Brady, Senator Jason Lewis, Representative Paul Brodeur, Representative Jay Kaufman, and Representative Jerald Parisella also came out in support of the nurse practitioners.

H. 2351/S. 1257 will allow nurse practitioners in Massachusetts to practice to the full extent of their education and training and will update the Massachusetts Nurse Practice Act by removing antiquated and unnecessarily restrictive licensing requirements. Despite leading the nation’s healthcare reform initiatives, Massachusetts has among the most restrictive and antiquated licensing requirements and is the only New England state that has yet to remove them.

Nurse practitioners are registered nurses with advanced Master’s or doctoral level education and nationally certified in advanced practice nursing specialties. They provide comprehensive health care services including performing physical examinations, prescribing medications, ordering and interpreting diagnostic tests, and treating and managing acute, episodic, and chronic conditions. Nurse practitioners work closely with physicians and other members of the healthcare team and like physicians, consult with specialists when needed.

Although MA nurse practitioners have legal authority to prescribe medications, current MA regulations require a supervising physician to oversee their prescribing practices. This requirement would be removed if H. 2351/S. 1257 passes.

Nurse Practitioners are well recognized for delivering high quality, cost effective healthcare. Passage of H.2451/S. 1257 would align the Massachusetts Nurse Practice Act with 22 states plus D.C, where Full Practice Authority legislation for Nurse Practitioners has already been advanced. Such a change here in Massachusetts would ensure greater consistency in practice and better care for patients.

Increased reliance on nurse practitioners can be a more cost-effective approach to healthcare. As the cost of care continues to rise – for both the Commonwealth and patients – shifting to a Full Practice Authority model would better position the state and employers to leverage the workforce of Nurse Practitioners to identify cost-savings. The average cost of a visit with a nurse practitioner can be between 20 and 35 percent lower than the average cost of an office-based visit with a physician.

At 109 days, a recent Merritt Hawkins study reports that Boston has the longest wait times in the country for those patients seeking new appointments with a family medicine provider. Massachusetts boasts the greatest number of physicians per capita and spends the most dollars on care. By positioning Nurse Practitioners to work to the full extent of their education and training, passage of H. 2351/S. 1257 will create cost effective access to care for the residents of the Commonwealth.

About Massachusetts Coalition of Nurse Practitioners

The Massachusetts Coalition of Nurse Practitioners (MCNP) represents the professional voice of the Commonwealth’s nearly 9,000 nurse practitioners. Advancing a patient centered agenda, MCNP seeks to create recognition for the key role that NPs can play to improve and ensure access to high quality and cost-effective care for all.

The Administration has released the President’s budget, now to be considered and modified by Congress. While the President’s budget — no matter who is President — is never the final budget, it does signal strategic intent and policy preferences by the Administration.

Cure Alzheimer’s Fund is deeply concerned about several provisions of this budget, specifically, the approximately 21% cut to the National Institutes of Health in general; and the approximately 36% cut to the National Institute on Aging.

The NIH is the primary funder of basic medical research in the United States. Neither pharmaceutical companies nor philanthropy comes close to the amount of funding provided by the NIH for the basic, necessary research from which virtually all therapies originate.

Progress has been made in recent years to improve funding for NIH and therefore for more high quality basic research into numerous diseases, including Alzheimer’s disease. Cure Alzheimer’s Fund has worked very closely with both Democrats and Republicans in Congress and other Alzheimer’s disease advocacy organizations to champion increases in Alzheimer’s disease research funding at NIH. Working together, we have all been successful in more than doubling research funding in the last few years to more than $1.4 billion in Fiscal Year 2017 at NIH. As we have repeatedly said, independent experts have called for $2 billion a year in funding and we are continuing to work with all partners to reach this goal.

The proposed cuts not only threaten this bipartisan progress, but will without a doubt set back and diminish the hard-earned pace of discovery.

Cure Alzheimer’s Fund will continue to work with allies in Congress from both parties to prevent these devastating cuts from becoming reality and ensure robust funding for Alzheimer’s disease research.