SAN DIEGO REGIONAL MEETING

September 26, 2019Sharp Copley Center

Regional MeetingLIVING OUR PURPOSE

Kimberly Long, DHA, MSN,

FNP, RN, FACHE

President

Kim Tomasi, MSN, RN

Chief Executive Officer

Overview of ACNL

History of ACNL

Established in 1978

Housed in CHA initially

501c6 for two years, then became a 501c3

First Executive Director part time in 1988

Name changes CSNSA, ONE-C, One California and now ACNL

501c3 Status

Public Benefit Nonprofit Corporation• Most groups want 501c3 designation

• 501c3 – charitable, scientific, literary or educational

• All of these purposes are considered charitable under California Law

Purpose StatementACNL IS THE PROFESSIONAL NURSING ORGANIZATION THAT EQUIPS NURSES TO LEAD SELF, OTHERS AND SYSTEMS

Vision StatementPOSITIONING NURSE LEADERS TO CREATE AND INFLUENCE THE FUTURE OF HEALTH CARE

Core Values

INTEGRITY INNOVATION INCLUSIVITY DIVERSITY

Value of Membership

Networking / BuildingRelationships

Annual Program

Regional Meetings

Professional and Personal Connections

Mentoring / Career Development

LifeMoxie ACNL Mentoring Program

Education / Nurse Leader Knowledge

Regional CE Education Events

Quarterly Webinars

Foundations & Advanced Leadership Development Programs

Nursing Voice / Advocating for Health

Capital Legislative Updates and Action

Committee Work / Advancing Leadership

Helping to Shape the Future of Nursing in California

Organizational Structure

2019-2020 Executive Board of Directors

Dennis KneeppelImmediate-Past

President

Kim HortonPresident

Jami de SantiagoSecretary-Treasurer

Kim TomasiCEO

Anitra WilliamsPresident-Elect

ACNL Board of Directors

Chief Executive Officer

Core CACN

Operations

Conference

501c3 Design

Core ACNL

ACNL Committees

Annual Program

Education Programs

Operations

Philanthropy

Office Manager Bookkeeper/Industry Liaison

Administrative AssistantMarketing and Communications Specialist

CACN Board

AONE

AHA

HAONENONL

Region 9

ACNLNWONE

Kern County

Central San Joaquin Valley

Orange County/Long Beach

San Diego

North Central

Los Angeles/Coastal

San Fernando Valley

Alaska

Ventura/Santa Barbara Area

Inland Empire

South Bay

Sacramento/Sierra Region

Greater San Francisco

East Bay

Northern Region Central Region Southern Region San Diego Region

Overview of Operations

Revenue Sources

CACN Management

Industry Partners

Membership Dues

Education

Investments

Executive Leadership Academy

Foundations for Leadership Excellence

Partnerships

CHA

CHPAC

Quad Council

ACNL

CACN

COADN

ANA\C

LifeMoxie

ACNL

CAC

ACNL Chapters

15 Regional Chapters

CALNOC

ACNL

ANA\C

HealthImpact

CAC

NOBC

Educational Partners

12 Colleges and Universities

Committees

Annual Program

Bylaws

Communication/Voice

Health Policy

Healthy Work Environment

Member Experience

Nominations

Nurse Leader Development

Philanthropic, Recognition, and Scholarship

Quality, Safety, and Engagement

Research

Information and Resources

Website

ACNL in Action

Position Papers

Tool Kits

E-Mail Blasts

Regional Forums

Committees

Local Chapters

Annual Conference

Webinars

Educational Offerings

Looking Forward

Areas of Focus

Foundations for Leadership Excellence

Annual Conference

Membership

Executive Leadership Academy

Leverage mentorship through LifeMoxie

Philanthropy

Foundations for Leadership Excellence

Access Leveraging technology

Partnership with Chapters

Professional Networking

Creating a pipeline to Life Moxie

Marketing: Expanding to partners and other

organizations

Faculty development

Annual Program

Content appropriate at all levels of leadership

Purposeful networking

Maintaining relevance

Membership

CNO membership

Support Influence

Enhance chapter infrastructure and support

Speakers Dues Board presenceStandard state

messagingBylaws

Benefits of membership

Leverage regional meetings for professional networking

Membership

Inter-link/connect with Foundations

Procurement of mentors

Align with magnet designation

Succession planning

Experiential learning

Highlight and promote the value

of mentorship

Executive Leadership AcademyPurposeful networking

Mentorship

Professional coach

Executive faculty

Experiential learning

Content appropriate for those whose next step is executive leadership

Mentorship

Inter-link/connect with Foundations

Procurement of mentors

Align with magnet designation

Succession planning

Experiential learning

Highlight and promote the value of mentorship

Philanthropy

Reconnect with our members Connect our purpose and values

WHO Designates 2020 as the Year of the Nurse and Midwife

“I contribute my success to this – I never gave or took excuses.”

Florence Nightingale1820-1910

Foundations for Leadership ExcellenceM AY 2 0 1 9

SAN DIEGO REGIONAL MEETING

September 26, 2019Sharp Copley Center

THE BOARD OF REGISTERED

NURSING

PILAR DE LA CRUZ SAMOULIAN, MSN. RN

SHARING TIME

OBJECTIVES

State the purpose of the Board of Registered Nurses

(BRN);

List the common reasons nurses get into trouble with the

BRN;

Discuss the role of the Scope of Practice;

List what personal changes need to be reported to the

BRN.

CA BOARD OF REGISTERED NURSES (BRN)

BRN oversees over 433,000 licensees;

To work as an RN in California, you must have a California license;

In California, nurse practitioners, clinical nurse specialists, nurse

anesthetists, nurse midwives and any and ALL advanced practice

nurses all fall under the auspices of the Board of Registered Nursing.

QUESTION

TRUE OR FALSE

The California Board of Registered Nurses exists to protect

Registered Nurses.

PURPOSE OF THE BOARD

The Board of Registered Nursing protects and advocates for

the health and safety of the public by ensuring the highest

quality of registered nurses in the State of California.

BOARD COMPOSITION

The BRN is comprised of 9 members; 5 RNs and 4 public members

Direct patient care provider (2)

Advanced Practice Nurse (1)

Nurse Educator (1)

Nurse Administrator (1)

BOARD MEMBERS APPOINTMENTS/TERMS

7 members appointed by the Governor;

2 members appointed by the legislature;

Terms of office are generally 4 year terms; can be appointed to an

additional 4 year term;

Long vetting process.

CURRENT BOARD MEMBERS

Michael Jackson, RN President

Donna Gerber, Vice-President

Trande Phillips, RN

Imelda Ceja-Butkiewicz

Elizabeth Woods, RN, FNP

Kenneth Malborough

Currently 3 open positions; one direct patient care provider, one public member

and a nurse administrator position.

EXECUTIVE OFFICER OF THE BOARD

Previous Executive officers:

Ruth Ann Terry

Louise Bailey

Current Executive Officer

Dr. Joseph Morris

BOARD MEETINGS

Held monthly, except July and December;

Held in different areas of the state;

Discipline meetings held every other month;

Committee meeting/full board meetings held monthly;

Meetings are open to the public;

Students encouraged to attend discipline meetings.

BOARD COMMITTEES

Education and Licensing

Discipline

Advanced Practice

Legislative

All board members sit on at least one committee

NURSING EDUCATION CONSULTANTS

Work with nursing programs to ensure compliance;

Serve as consultants to school directors;

All nursing programs have a consultant assigned to their

program;

Make recommendations to Education and Licensibg

committee of the Board on continuing approval of a

program.

NURSING PROGRAM APPROVALS

Board approves all new and existing nursing programs;

Nursing programs are required to get approval from BRN

for any changes to curriculum or major changes;

NECs visit each school every 5 years to ensure

compliance with regulations;

NCLEX SCORES

Board monitors all nursing program NCLEX scores;

School must maintain a 75% passing rate;

Action plan required for any school that drops below 75%

passing rate;

California has the highest NCLEX passing rate in the

nation.

FEES

Fees increased in January, 2017;

Fees allowing BRN to fill open positions to help expedite

their response to inquiries and to serve licensees;

The Board is currently working diligently to fill all needed

positions.

BRN’s COMMUNICATION

.

BRN’s WEBSITE: rn.ca.gov

Information on: Practice, Regulations, Education, FAQs, RN careers,

Verification of licenses;

Information on all BRN meetings;

Forms and publications;

NCLEX scores;

Approved nursing programs;

Updates, etc.

STAYING CURRENT WITH BRN

Need to make sure that BRN has your current address;

If you move, you must notify the BRN within 30 days of

moving;

If you change your name (marriage, divorce, etc.) you

need to notify the BRN of the change within 30 days.

SCOPE OF NURSING PRACTICE

Make sure you are familiar with the California Nursing

Practice Act and that you know your Scope of Practice;

Be familiar with what you can do and what you cannot

do as an RN;

Pay special attention to Article 2, Section 2725, Scope of

Regulations.

IMPORTANCE OF SCOPE OF PRACTICE

States what nurses can do as a registered nurse;

Should be part of every nursing program curriculum;

Not knowing their scope of practice can get a nurse in trouble;

Only you can protect your license;

Can purchase a California Nursing Practice Act book from BRN.

LICENSURE: INITIAL

Nursing school must submit the individual transcripts;

98% of ALL California nursing schools have successfully completed

the electronic transcript process via the Cloud

The outcomes of the new process have been very positive.

The Board is currently finalizing the process that will allow the

Licensing unit to receive electronic transcripts via the Cloud for

endorsement applicants.

LICENSURE: RENEWALS

When completing your renewal application, please read

instructions carefully as the format has recently changed

INCOMPLETE RENEWALS

Failure to respond to the continuing education, conviction, or

fingerprint compliance questions (or answering “no” to the

fingerprint compliance question on the renewal application will

result in an incomplete renewal

Payment will be processed but the renewal will be delayed until all

required information is received by the Board

CONTINUING EDUCATION UNITS (CEU’s)

Need 30 CEUs every two years to renew license;

CEUs need to relate to nursing practice/health care;

Need to keep certificates for 4 years.

COMNMON REASONS FOR DISCIPLINE

Working outside their scope of practice;

Drug and alcohol issues;

Negligence/Incompetence;

Unprofessional conduct;

Lying on RN application.

WHAT CAN TRIGGER A COMPLAINT?

Several actions can trigger a complaint to the BRN:

Notification from Department of Justice or FBI ;

An arrest or criminal conviction;

Discipline taken by another state licensing agency;

Public complaint alleging unprofessional conduct, gross negligence

or incompetence.

POTENTIAL DISCIPLINE OUTCOMES

Revocation of license;

Suspension of a license;

Probation;

Public reproval;

Dismissal of the accusation;

Revocation/surrender,

HOW IS DISCIPLINE DETERMINED?

It is not to be punishment;

Public protection is the obligation;

The applicable evidentiary standards and burdens apply;

Mitigating or aggravating circumstances can be considered;

Look at what is in the record;

The decision is public.

INTERVENTION PROGRAM

A voluntary and confidential monitoring program for RNs whose

competency may be impaired by substance use disorder or mental

illness;

The program protects the public by providing RNs access to

effective treatment services, monitoring their recovery through an

individualized plan and returning them to safe practice.

A DIFFERENT VIEW

CONTINUING EDUCATION PROVIDER

BRN instructed by a senate committee to conduct a cost benefit

analysis of the BRN’s CEU approval, renewal and course evaluation

process;

BRN currently reviewing the process outlined in the report submitted

and its pans for implementation;

Fees have increased for providers;

If you are a CEU provider, make sure you have all the required

documentation on record.

DUAL ENROLLMENT PILOT PROJECT

Purpose: to allow students enrolled in a pre-licensure associate

degree nursing program to be dually enrolled in the CSU nursing

degree program (s) with the aim of completing their BSN within 1

year or less;

Riverside Community College, Cal State University, San Bernardino

and Cal State University, Fullerton are in a pilot program;

If successful, may be expanded to other programs.

GOING GREEN PROJECT

Elimination of the pocket card has been initiated as of October,

2017

RNs will no longer receive a BRN card. Need to go on the BRN

website (rn.ca.gov) to check for license status.

This will not only save paper but also time and money;

Helps prevent fraud.

WORKFORCE: NEWAC SUBCOMMITTEES

SIMULATION:

NEC staff has reviewed the proposals of NEWAC Simulation subcommittee

The proposals will be submitted to the NEWAC Committee for review with final recommendations regarding the use of simulation

Currently nursing programs are allowed to use up to 25% simulation time in their curriculum

The NEWAC committee will then present the final recommendations to the Education/Licensing Committee of the Board for their recommendation to full board.

NEWAC SUBCOMMITTEE

CLINICAL DISPLACEMENT SURVEY

NEC staff is finalizing the questions of the Clinical Displacement

Survey that will be distributed to the Deans/Directors;

The survey will provide the Board with detail information regarding

clinical displacement;

The data provided to the Board will be gathered, analyzed &

forwarded to the ELC in order to make recommendations

regarding this matter.

YOUR BRN IS WORKING FOR YOU!

Making positive changes;

Increasing the use of technology to improve services;

Adding much needed staff positions;

Re-aligning of staff to better meet your needs;

Working closer with DCA & legislators to help them better understand the BRN’s work;

Looking for opportunities to better serve you in the future.

IN CONCLUSION

SUMMARY

Know you Scope of Practice;

Always keep BRN informed of address/name changes;

Make sure license renewal is complete;

Keep CEU certificates for a minimum of 4 years;

Remember the purpose of the board.

THANK YOU!

QUESTIONS????????????????????

SAN DIEGO REGIONAL MEETING

September 26, 2019Sharp Copley Center

Networking Break

SAN DIEGO REGIONAL MEETING

September 26, 2019Sharp Copley Center

Thank-you to today’s sponsor

www.usa.edu#uofstaug

Clinical Excellence Through Graduate Education

The mission of the University of St. Augustine for Health Sciences is the development of

professional health care practitioners through innovative, individualized, and quality classroom,

clinical and distance education.

4th Annual SDACNL Networking Event October 3, 2019 6PM - 9PM

Riverwalk Golf Club 1150 Fashion Valley Road

San Diego, CA 92108

This is a fun evening of mingling and networking with nurses in San Diego County and from around the state in an informal, relaxed setting.

Featuring a welcome from state and local nurse leaders

Free food and drinks, and raffle prizes!

If you or anyone you know are a member or are interested in learning about the ACNL, please join us for this hosted event!

20th Annual ACNL Innovations Conference

APRIL 4, 2020

Save the Date!

Online Registration Coming Soon!

Overview of the Legislative Process

and Advocacy

Alice Martanegara, DNP, RN

September 26, 2019

82

Overview of California Legislative Process

Advocacy – WHAT

Advocacy encompasses a wide range of activities that

influence decision makers.

Advocacy includes traditional activities such as litigation,

lobbying, and public education. It can also include capacity

building, relationship building, forming networks, and

leadership development.

84

Advocacy - WHAT

Voting

Professional Organization Legislative Days

Political campaigns

Writing – editorials, newsletters, publications

Knowing your legislators/policymakers, city,

county, state/Federal

Political Action Committee

85

Advocacy - How!

Know your legislator and or the one you are visiting (party,

leadership position committees, previous legislative/issue

decisions

Find your district elected officials

If you are a constituent of the legislator make sure to

address = message leverage

86

Communication as a Representative of a

Professional Organization

Visit your legislator

Meeting with your legislators is one of the most

effective ways to influence

Regardless of whether you are meeting with your

legislator by yourself or with a group, you should be

clear about: Your message

The resources you want to leave behind

Your ultimate “ask”

Overview of an Effective Visit With Your Policy Maker

It is important to know- Who are you representing! Hospitals- Typically have a government relations department or person. Meet with them first to

clarify if needed. Hospitals may have a tax status that prevents them from lobbying.

Do not use hospital letterhead or address unless approved

Professional Organization- Understand their Tax Status and their position on any issues that

may be discussed with a legislator.

Self- You may visit a legislator as a voter/constituent/concerned citizen.

Identify that you are representing yourself

Okay to use your professional title and workplace to establish credibility

Be sure to use a disclaimer that you are not representing a specific hospital organization.

*Title for Identification Purposes Only* - Consider adding to letters

Tax Status is important-ACNL is a 501(c)(3)

• In general, no organization may qualify for

section 501(c)(3) status if a substantial part

of its activities is attempting to influence

legislation (commonly known as lobbying).

• A 501(c)(3) organization may engage in

some lobbying, but too much lobbying

activity risks loss of tax-exempt status.

• Organizations may involve themselves in

issues of public policy without the activity

being considered as lobbying.

Organizations may conduct

educational meetings, prepare

and distribute educational

materials, or otherwise consider

public policy issues in an

educational manner without

jeopardizing their tax-exempt

status.

https://www.irs.gov/charities-non-profits/lobbying

Introductions

Remember- they need your nursing intelligence

Content expert- Bear more weight than lobbyists

In-person visits, letters, emails are the most persuasive if the legislator

has not made a firm decision on an issue

How do you make your visit stand out? Know what your are in support of, not just against

Know the voting history

Come prepared

Be kind to the staffers

Be on time, dress professionally, leave behind materials

Tell a personal story or concrete example

92

Health Policy and Politics:

An Agenda for Achieving the Triple Aim

What is the Triple Aim?

The Triple Aim

Developed by the Institute for Healthcare Improvement in 2008

Framework for optimizing health system performance by simultaneously pursuing

three dimensions

Improving patient care experience (quality and satisfaction)

Improving the health of population

Reducing per capita cost of health care

Patient Experience

Improving Patient Experience

Improved communication between providers

Patient centered care coordination

Reduction/elimination of Hospital Acquired Conditions

Collaborative Transition of Care

Reducing Cost

United States Healthcare is most expensive in the World

By 2020 – 20% of the GNP will be healthcare

Why? –Aging Population

Chronic Health Problems

Longer life expectancy

The NEED is to improve the health of the population served while

optimizing costs and delivering excellent quality careTreat the people holistically (mind, body and soul) to ensure that they are getting the

right care in the right place

Improving Population Health

Key Driver: Focus on identifying & addressing risk in communities

Everyone living in the community could potentially become a patient

Identify specific sub-population

Include factors such as food, clothing, housing, ability to pay for

medications

Do you have the following available:

Recuperative Care Programs for Homeless

Proactive outreach to high-risk patients and complex case management programs available

What about patients with chronic pain

How to Start?

Figure out the unique needs of the community

and identify your at-risk populations

Establish organization/system specific goals

Develop a way to measure, track and

demonstrate progress

Involvement of Community Leaders and

Executive Team

IHI online survey to help assess where you are

and are you ready to pursue a Triple AIM

http://www.ihi.org/Topics/TripleAim/Pages/GettingStarted.aspx

Just one More Thing

Institute for Healthcare Improvement

addressing the Triple Aim and the Social

Determinants of Health

100

Just one More Thing

Health Policy and Politics – An Agenda for

Achieving the Triple Aim – Part II

Janice White

Reminder - What is the Triple Aim?

What are the Studies Showing?

California’s New Budget $209 Billion

Undocumented young adults (<26y/o) enroll in Medi-Cal

Mandated health insurance including insurance subsidies to

assist with insurance affordability

$650 million to “aid” homeless population

$500 million for affordable housing

The Vital Link

• Medicaid

Sensing the need to involve the National,

State and Local governments in meeting

SDOH.

Published a series of seven briefs on key

Medicaid issues for state policymakers

series is designed to assist new state leaders in

understanding the Medicaid program and their role

in using it to improve the health of their states’

residents and communities

Medi-Cal Managed Care Programs

Cover more social services needs of patients though

covered S.S. benefits

use value-based payments to support provider investment

in social interventions

use incentives and withholds to encourage plan

investment in social interventions

integrate efforts to address social issues into quality

improvement activities

reward plans through higher rates for effective

investments in social interventions.

Health Policy - Where Do We Come In?

We can provide information on where to find resources in our

communities:

35% of Americans lack confidence that they could identify the best resource if

they or a family member needed to use community resources relating to

transportation, food, housing, or social isolation

80% of Americans would find it helpful for their medical provider to share

information about community resources, recommend specific resources, follow

up, and help them apply for resources

Health Policy - Where Do We Come In?

We are the key resource for our community through:

Meeting with legislators on health policy to discuss

SDOH

The need for community, local and state involvement

Ask the questions of our patients and community on

Safe housing

Reliable transportation

Healthy meals

Supportive social relationships

Kimberly Tomasi, MSN, RNCEO, ACNL

Ratio Penalty LegislationNursing Hot Topic

Margarita Baggett, MSN, RNChief Clinical Officer, UC San Diego Health

Intergenerational Collaboration to Facilitate Gaps in Patient Care Excellence

Nursing Hot Topic

Alice Martanegara, DNP, RNACNL Health Policy Committee

Clinical PlacementNursing Hot Topic

QUESTIONS?

SAN DIEGO REGIONAL MEETING

September 26, 2019Sharp Copley Center

Thank-you to today’s sponsor

www.usa.edu#uofstaug

Clinical Excellence Through Graduate Education

The mission of the University of St. Augustine for Health Sciences is the development of

professional health care practitioners through innovative, individualized, and quality classroom,

clinical and distance education.

4th Annual SDACNL Networking Event October 3, 2019 6PM - 9PM

Riverwalk Golf Club 1150 Fashion Valley Road

San Diego, CA 92108

This is a fun evening of mingling and networking with nurses in San Diego County and from around the state in an informal, relaxed setting.

Featuring a welcome from state and local nurse leaders

Free food and drinks, and raffle prizes!

If you or anyone you know are a member or are interested in learning about the ACNL, please join us for this hosted event!

20th Annual ACNL Innovations Conference

APRIL 4, 2020

Save the Date!