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Victory in Maryland as New Booster Seat Bill in Maryland Passes

April 2008

The Booster Seat Bill, SB 789, requiring children to ride in car seats/booster seats through age 7, passed thanks to many of you who contacted your legislators and to our special injury prevention advocates for children and ENA-

Emilie Crown

Tamra White

Cyndy Wright-Johnson

We won one for the children of Maryland !

Maryland Emergency Nurses and Maryland ENA should be proud.
We also would like to extend our thanks to our colleagues at the American Trauma Society, Safe Kids and everyone else for their hard work.  It's great to work with such a team.

Mary Alice Vanhoy
MD State ENA President


 

In cooperation with Advocates for Highway and Auto Safety, American College Emergency Physicians (ACEP) and many other agencies, the Maryland Emergency Nurses Association (MD ENA) overcame the last hurdle for the child booster seat bill, with the Senate passing a vote of 38 to 9. The bill was adopted in the Maryland House by a nearly unanimous vote.  The Senate took up the measure late in the evening after the House had added an amendment to restore key provisions extending the law to children through age 7 and including a height and weight restriction.   We now await the bill to be signed into law by Governor O’Malley, which he is expected to do.
 
Jackie Gillan, the legislative Manager for Advocates for Highway and Auto Safety, sent this note to MD ENA Government Affairs Chair, “We are grateful for the tremendous leadership of our sponsors Del. Bill Bronrott and Sen. Jenny Forehand.  Del. Bronrott is a master political strategist.  During this past week and particularly throughout the last 72 hours, he was working furiously with legislative leaders from both chambers to get the compromise amendment included in the House version and to ensure this bill was not abandoned when it became controversial.

Needless to say, this tremendous and miraculous victory is the result of all of your hard work, your untiring dedication to child safety and your relentless efforts to make calls, use your contacts, send emails to Maryland legislators and alerts to your colleagues every time you were asked. As the clock was ticking and the end of the session became our biggest challenge, it was your calls and contacts throughout the final days and hours that made the difference.  Thank you and please know you were an essential part of this victory.”

Maryland’s Emergency Nurses Association (MD ENA) Government Affairs committee has been more re-active rather than actively seeking out legislation.  This year begins a new turn of action as Maryland’s ENA grows politically active. After attending the Government Affairs workshop last year, I realized just important that nurses be involved with the making of the laws that affect us and how we practice medicine.  We have to be politically alert and active, educating our legislators to the medical ramifications of the bills they pass.  Our first initiative this year started off with success of combined efforts from all our members with emails, faxes and legislative visits to educate our elected officials.

MD ENA has represented ENA by testifying on the Helmet Repeal Bill and the Child Booster Seat Bill, this year.  Tamra White, RN, Emilie Crown, RN, and Cyndi Wright-Johnson, RN were given the opportunity to testify before the Annapolis legislators.  Besides being given support from our MD members, the Tennessee ENA, Beth Broering, RN, happily handed over all her research to assist Maryland from losing their helmet law. This type of cooperation and dedication to “fight the good fight”, between members, states and the use of national ENA to connect the experts is what makes nurses strong.  We might not know all the answers, but we know how to get them!   We have strength and power in our numbers and our knowledge. 

This maybe the first time you have heard about Maryland’s political activity, but be sure, this will not be the last. Not everyone has the time to lobby our legislators, but we have to make time to write an email to our legislators.  They do not have the medical knowledge or experience that you do.  You have so much to offer, whether you are a first year nurse or a seasoned expert in a specialty field.  Thankfully, we have our association to ties us together to make our society better.  Look to your government affairs committee and 411program, we have to stay political active for the betterment of our patients lives and ours. 

Tamra White, RN

Maryland Emergency Nurses Association

Government Affairs Chair 2008

President 2006, 2007

Maryland ENA Mobilizes for Alcopop Bill

   On April 24^th, Tamra White met with Governor O’Malley at his request after he received the following letter:
 

Dear Governor O'Malley,

Maryland Emergency Nurses Association and its 800 members would like give support to a VETO of the alcopops bill.  We would like very much for Governor O' Malley not to sign this bill into law.  We do not need any more influence for underage children to be enticed to drink alcohol.  Our 800 Emergency Nurses do not want to see underage teenagers increasing the alcohol abuse and drunken driving problem our state faces.  Please do not make it easier for underage drinkers by making these flavored malt beverages cheaper and easier for them to buy.   These are distilled spirits and should be treated as such.

I understand that the liquor industry has a strong lobby interests and are very generous with their political donations.  Do not let the special interest group of the liquor industry influence your decision to make Maryland a safer place.  Common sense tells you that the target audience, teen underage drinkers, will have tragic consequences.  I have seen too many teenagers drink and drive with fatal outcomes.

One night a few years ago, two sisters aged 13 and 15, from Urbana, MD were involved in a vehicular crash.  The 15 year old was so drunk; she had her sister drive home from the party.  Neither were old enough to drive, but took their parents second car when they were at a dinner party.  The 15 year old was flown to shock trauma and lived.  The 13 year old had sustained such major head injuries that she was placed on a respirator until her parents could say good bye, after the doctor's determined that she was brain dead. 

Being an Emergency Department nurse, I see tragedy every shift.  When I teach high schoolers about drinking and driving, I tell them about the sisters from Urbana.  This night scarred me for life.  When the father came into the room with his daughter, tears streamed down his face.  I thought he was going to be angry with her for driving and drinking.  He leaned over and kissed her.  He said, "I thought I would have more time with you, more time to teach you from doing something like this.  I just needed more time."  The sister that survived has never fully recovered.  She dropped out of school and has been through rehab all before the ripe old age of 16.

Please do not let another father say good bye to his daughter.  These teenagers do not need to get alcoholic drinks any easier or cheapert.  Veto this ALCOPOPS bill.

Sincerely yours,

Tamra White, RN

Maryland Emergency Nurses Association

Government Affairs Chair 2008

President 2006, 2007

Fortunately, it was also “take your daughter to work with you” day so Tamra took her daughter with her as she wanted her to see her mother at work for Maryland ENA and the children. It is the governor, Tamra’s daughter and Tamra you see pictured below.

The next day, the Baltimore Sun ran an article noting that the day after Gov. O’Malley announced he would “sign a bill ensuring that “alcopops” would continue to be taxed and distributed the same way as beer”.

‘The advocates, who had spent the past three months arguing that the bill would make it easier for teens to get fruity drinks such as Mike's Hard Lemonade, sprang into action. Within hours, the national leader of Mothers Against Drunk Driving was on a plane from Dallas for a meeting with the governor, activists and two Marylanders whose children were killed by drunken drivers. Additionally, the Maryland Association of County Health Officials, representatives of Advocates for Highway and Auto Safety and the Maryland Emergency Nurses Association were present.

By the time the governor emerged, he "had a lot to think about," he said, and he decided to shelve the bill. O'Malley said yesterday that he wanted to consider the extent to which the drinks are "gateway" alcoholic beverages for teenagers, a contention the manufacturers deny.’

Wakefield Act Passes the House

April 2008

The U.S. House of Representatives passed H.R. 2464, the Wakefield Act, a bill to reauthorize the Emergency Medical Services for Children (EMSC) program.  The bill passed by an overwhelming margin, 390-1, with 40 Members not voting. 

The bill's author -- Representative Jim Matheson (D-UT) -- delivered excellent remarks on the House floor and mentioned ENA''''s support of the legislation.  Representative Earl Pomeroy (D-ND) delivered a moving tribute to his constituents, the Wakefield family, for whom the bill is named.  No one spoke in opposition.  This strong vote for passage sends clear messages to both the Senate and the White House that the program has the full support of the House.  As a result, we are hopeful that the Senate will act speedily upon the bill and that it can move on to the White House.

The corresponding bill in the Senate is S. 60 introduced by Senator Daniel Inouye (D-HI) on January 4, 2007.  The current Senate co-sponsors are:

Akaka, Daniel K. [HI]
Boxer, Barbara [CA]
Brown, Sherrod [OH]
Clinton, Hillary Rodham [NY]
Conrad, Kent [ND]
Dodd, Christopher J. [CT]
Dorgan, Byron L. [ND]
Durbin, Richard [IL]
Hatch, Orrin G. [UT]
Kennedy, Edward M. [MA]
Landrieu, Mary L. [LA]
Sanders, Bernard [VT]

To move this bill to the Senate Floor, it is critical that we get more Senators to co-sponsor S. 60.

ACTION REQUIRED: PLEASE FAX, CALL, OR E-MAIL YOUR SENATORS TODAY ASKING HIM/HER TO SIGN ONTO S. 60 AS A COSPONSOR.  PERSONALIZE YOUR MESSAGE BY TELLING YOUR SENATORS WHAT THIS BILL MEANS TO YOU, YOUR PATIENTS, AND THE FACILITY IN WHICH YOU WORK.

EN411 Capitol Brief
April 15, 2008

Advocacy Tip - Calling Your Legislators
If there is not time to e-mail or fax your letter stating your concerns/support about an ENA legislative priority, make a phone call instead. To find your legislator's phone number, go to ENA's searchable online congressional directory contained in the Legislative Action Center at http://capwiz.com/ena/dbq/officials/. Many Congressional offices have stated this year in meetings with ENA that hearing from constituents is vital to their support of ENA legislative priorities.

• Decide whether to direct your calls to the Washington or district office. Call the Washington office to respond to an ENA action alert or to discuss legislation with Congressional staff. Call the district office for other non-DC legislative activities such as when you want to make a political statement by contacting your legislator's top political person in the district.
• Remember that telephone calls are most often taken by the Health Legislative Assistant (LA), not the Member of Congress. Ask to speak with the Health LA about the issue on which you wish to comment.
• After identifying yourself, tell the aide you would like to leave a brief message, such as: "Please tell Senator/Representative (Name) that I support/oppose (S.___/H.R.___)."  State the reasons for your support or opposition to the bill. Ask for your Senator's or Representative's position on the bill. You may also request a written response to your telephone call.

Since 2008 is an election year, Senators and Representatives are holding town hall meetings to hear from their constituents. For a list of upcoming Congressional town meetings during April, please click here.

House Passes Wakefield Act; More Cosponsors Needed in the Senate
On April 9th, the House of Representatives passed the Wakefield Act (HR 2464) sponsored by Representative Jim Matheson (R-UT-2). The bill passed by an overwhelming margin, 390-1, with 40 Members not voting. This strong vote for passage sends clear messages to both the Senate and the White House that the program has the full support of the House. As a result, we are hopeful that the Senate will act speedily upon the bill and that it can move on to the White House.

The Wakefield Act reauthorizes the Emergency Medical Services for Children (EMSC) program at the Health Resources and Services Administration (HRSA). The purpose of the EMSC program is to reduce child and youth morbidity and mortality by supporting improvements in the quality of all emergency medical care children receive. For more information on the Wakefield Act, please visit http://capwiz.com/ena/issues/bills/?bill=9916931.

The Senate version of the Wakefield Act (S 60) sponsored by Senator Daniel Inouye (D-HI) has 13 cosponsors. For more information on S 60 and a list of the current cosponsors, visit the Legislative Action Center at http://capwiz.com/ena/issues/bills/?bill=9287531. To move this bill to the Senate Floor, it is critical that we get more Senators to co-sponsor S 60. Visit the Legislative Action Center at http://capwiz.com/ena/issues/alert/?alertid=193016to contact your Senators about cosponsorship of S 60. 

Study Looks at the Insured vs. Uninsured in EDs
The uninsured have been blamed in recent years for driving up medical costs by crowding emergency rooms. But a national study published by the Annals of Emergency Medicine found that more patients with money, health insurance, and a personal physician fill emergency rooms than those without insurance. Some of the reasons, researchers found, include a growing, aging population that has more complex medical problems that need attention after business hours and on weekends when people can't see their physicians.

The percentage of uninsured patients going to emergency departments actually dropped from 15.5% in 1996 to 14.5% in 2004, the study found. During the same time, the percentage of people with higher incomes, health insurance and a family doctor seeking emergency care grew from 22% to 29%.

Studies such as this one provide rich opportunities for key contacts. Busy legislators and their health legislative assistants welcome receiving information from experts, especially experts such as their own EN411 key contact. To read the report, please visit http://www.annemergmed.com/webfiles/images/journals/ymem/ejweber.pdf.

Christine Murphy
ENA Senior Public Policy Specialist
703-738-6139
enagov@aol.com

The standards interpretation division of the Joint Commission has held that under MM.3.20 EP1:

"Protocols can be initiated by a registered nurse once the protocol is ordered by a licensed independent practitioner. Initiation of a protocol which includes a medical intervention (i.e. decision to administer a medication) requires an order by an independent licensed practitioner. "

It is clear that this interpretation of MM.3.20 EP1 can delay patient treatment, exacerbate crowding, and is an infringement on nursing's scope of practice as well as on the authority of the state boards of nursing to regulate the scope of nursing practice in their respective states.

The letter requests that The Joint Commission immediately reverse its position on nurse initiated protocols in the ED and offers the Joint Commission the opportunity to meet face to face with representatives from each of the signing organizations to discuss the consequences the implementation of this standard causes in the ED.

I encourage all ENA members to read the letter in its entirety so that you can fully understand the issues we face under this interpretation of MM.3.20 EP1.

To see a copy of the letter, go to: http://www.aaem.org/emtopics/NurseInitiatedProtocols.pdf  

ENA will continue to monitor this situation and keep all of our members informed.

Sincerely,
Donna Mason, RN, MS, CEN
2007 President, ENA

Sign Up for E-Mail Alerts on Issues Related to Your State

New features have been added to ENA's Legislative Action Center that enable "E-Mail Alerts" to be sent directly to those ENA members who reside in the state or district of the congressional members that we need to target. These alerts provide strategic information to affect key policy issues of interest to ENA and emergency nursing. Go to http://capwiz.com/ena/home/ to sign up for future alerts.