Governor Susana Martinez Calls on Federal Government to Pass Legislation Allowing Nursing Professionals to Certify Home Health Care and Hospice…

Governor Susana Martinez Calls on Federal Government to Pass Legislation Allowing Nursing Professionals to Certify Home Health Care and Hospice Services

SANTA FE, N.M., May 7 -- Gov. Susana Martinez, R-N.M., issued the following news release:

Governor Susana Martinez has called on the federal government to allow nursing professionals to certify home health care and hospice services for Medicare beneficiaries. In a letter to U.S. Secretary of Health and Human Services Kathleen Sebelius, Governor Martinez called on the Obama Administration and the U.S. Congress to pass legislation that allows nurse practitioners to certify and make changes to home health plans of care to make these services eligible for Medicare reimbursement. National Nurses Week runs from Tuesday May 6 to Monday May 12.

"Nursing professionals are critical to meeting increasing demand for health care services," said Governor Martinez. "To help meet these needs, the federal government must empower nurse practitioners to take a leadership role in home health and hospice care, in particular. These changes are important to ensuring that our families and communities have access to the high- quality health care they need and deserve, particularly in rural and underserved areas."

The Home Health Care Planning Improvement Act of 2013, introduced in the U.S. House of Representatives by Representative Greg Walden (R-OR-2) as H.R. 2504 and in the U.S. Senate by Senator Susan Collins (R-ME) as S. 1332, seeks to amend the Social Security Act to allow nurse practitioners, physician assistants, clinical nurse specialists, and certified nurse midwives to certify and make changes to home health plans of care. "We applaud Governor Martinez's continuing support of New Mexico's patients and providers," said New Mexico Association for Home and Hospice Care Executive Director Joie Glenn. "This legislation is so important to our home care and hospice patients, particularly in rural and underserved areas where often times there aren't physicians available to certify and make changes to plans of care. Our nursing professionals are highly trained and skilled, and this legislation will allow them to help provide better care to patients." New Mexico is a very competitive state for nursing professionals, and Governor Martinez has consistently worked to maximize this strength. Unlike other states such as Oklahoma, Texas, and Utah, New Mexico offers full, independent practice and prescriptive authority for licensed nurse practitioners, and was the first state in the nation to establish family nurse practitioners. This model has become an example for other states across the country. Governor Martinez recently signed several important pieces of legislation and appropriations to further utilize nursing professionals to improve health care in New Mexico, including: legislation to require the state to license any qualified nurse or nurse practitioner who wants to move to New Mexico to practice within five days or less; $1.655 million to expand the number of nurse practitioner slots at UNM by 24 students per year including: family and pediatric nurse practitioners and certified nurse midwives; and $726,000 to loan-for-service programs and loan repayment efforts to attract more health care professionals to serve in health shortage areas.

"Governor Martinez's initiatives will go a long way toward addressing the shortage of health care professionals in New Mexico," said Santa Fe Community College School of Health, Math, and Sciences Dean Jenny Landen. "Together, these initiatives will encourage more students to seek education and training in the health care field, and allow those already practicing to advance their education and career opportunities. This will help to ensure that New Mexicans will have better access to more high-quality care from skilled, well-trained professionals."

Prior to the 2014 legislative session, the Governor also announced the establishment of a common nursing curriculum across the state so that credits can transfer more easily and colleges and universities can train more qualified nurses. This initiative also allows colleges throughout the state to offer bachelor's degrees in nursing in their own communities - keeping more aspiring nurses in rural areas and ending the requirement that they move to an urban area to attain their higher education. "We set ourselves apart from the rest through how we respond to challenges," said Governor Martinez. "By empowering our nursing professionals and bolstering our health care workforce, we can better ensure the high-quality care New Mexico's families deserve - creating new jobs in a critical sector of our economy in the process."

Governor Martinez also recently signed into law several important initiatives to create new well- paying health care jobs while addressing the challenges posed by health care reform. Among these are: establishment of a statewide voluntary community health worker training and certification program; $600,000 to connect more rural-area patients and providers with access to specialists and physicians in other parts of the state; expansion of residency slots at the University of New Mexico School of Medicine in the areas of medicine, psychiatry, general surgery, and family and community medicine; and $146,000 to add six additional New Mexico dental slots in Western Interstate Commission for Higher Education (WICHE), to increase the number of practicing dentists once they have completed their studies. Read Governor Martinez's letter to Secretary Sebelius below: The Honorable Secretary Kathleen Sebelius

U.S. Department of Health and Human Services

200 Independence Avenue, S.W.

Washington, DC 20201

Dear Secretary Sebelius,

Communities all over the country are beginning to experience the effects of shortages of physicians and other primary care providers. Here in New Mexico, 32 of our 33 counties are identified as health professional shortage areas, and the problem is expected to become more profound as upwards of 130,000 people newly eligible for Medicaid coverage, and as many as 83,000 additional people obtain health insurance through the New Mexico Health Insurance Exchange in 2014 alone. Certified nurse practitioners play an essential role in providing primary health care services in New Mexico, particularly in rural and underserved areas, and will help us address this expanded demand for services. Around the country, many states are broadening the ability of nurse practitioners to practice independently, an authority that is already enjoyed in New Mexico. A report recently produced by the National Governor's Association (NGA), The Role of Nurse Practitioners in Meeting Increased Demand for Primary Care, supports an increased use of nurse practitioners to address the serious challenges states face in meeting this increased demand for services. Additionally, a seminal report published by the Institute of Medicine (IOM) in October 2010, The Future of Nursing: Leading Change, Advancing Health, recommends that nurse practitioners and clinical nurse specialists be allowed to certify a patient for home health services. Barriers remain, however, that prevent nurse practitioners from extending care to a particular and important part of the population - those in need of home health care and hospice services. This particular barrier can only be addressed at the federal level. As far back as 1997, the federal government authorized payment for nurse practitioners for Medicare patients. However the Centers for Medicare and Medicaid Services (CMS) continues to prohibit nurse practitioners from certifying home health and hospice services to Medicare beneficiaries.

According to CMS, the Medicare statute requires "physician" certification on a home health plan of care. Patients who are unable to receive home health and hospice services are at grave risk of deteriorating conditions and resulting admission to higher levels of care, such as hospitalization at a far greater cost to the Medicare program. Access to hospice services is likewise hindered; CMS allows nurse practitioners to function as a patient's hospice attending physician, but they may not certify a patient's terminal illness.

Legislation has been introduced in each session of Congress for the last four years that would permit nurse practitioners, certified nurse midwives, clinical nurse specialists and physician assistants to order these essential services and to certify the plans of care. In the 113th Congress, the bill numbers are S. 1332 and H.R. 2504.

In New Mexico, we are already aware of the valuable service provided by nurse practitioners. Unlike other states, including Oklahoma, Texas, and Utah, New Mexico offers full, independent practice and prescriptive authority for licensed nurse practitioners, and was the first state in the nation to establish family nurse practitioners. This model has become an example for other states across the country. My administration is actively working with the nursing community to expand educational and licensing opportunities to expand the supply of nurse practitioners.

Changes to the Medicare law, however, cannot be resolved at the state level. I urge you to join with me in advocating for the passage of S. 1332 and H.R. 2504 to allow nurse practitioners and other mid-level providers to certify and make changes to home health plans of care. Sincerely,

Susana Martinez Governor

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