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One of the most effective — and most underutilized— ways to communicate directly with members ofCongress is to attend their town hall meetings.These events allow them to gather input from theirconstituents and learn more about their interests. Inan effort to allow even more of their constituents toparticipate, some lawmakers have recently heldtown hall meetings by telephone.

Because members pay particular attention to theattendees of town hall meetings, participating in thisprocess allows you to bring forward concerns andpriorities in a public forum and amplify your voicewith members of Congress. While attending a townhall meeting, either on the phone or in person, mayseem like an unnecessary exercise to you, legisla-tive and political professionals in Washington anx-iously await the reports from their advocates whoattend these meetings. In fact, one of the bestresults from a town hall meeting is for a member ofCongress to return to Washington telling his or herstaff that “those Nurse Practitioner (NP) advocateswere there in full force.”

Members of Congress take to heart what theyhear directly from constituents who make the

effort to participate in a town hall meeting.Attendance from NPs shows both commitmentand organizational ability. From the other side ofthe podium, members see attendees first andforemost as concerned voters. In addition, themedia often attends these meetings, providinganother opportunity to spread the messages ofimportance to NPs. Successful grassroots organi-zations, like the NRA and AARP, effectively utilizetown hall meetings.

As American citizens, it is our constitutionalright to petition the government for “redress ofgrievances,” and town hall meetings are a terrificforum to call upon elected officials to take actionon the issues we care most about, like access tocare in rural and medically underserved areas andthe inclusion of NPs in the Medical Homes. Themore you attend and ask a question or praise amember of Congress for doing something yousupport, the stronger and more meaningful yourrelationship will be with the member and his/herstaff.

So get ready, get involved, and be heard in the111th Congress!

Town Hall MeetingsJodie Curtis, Government Relations Director, Drinker Biddle Reath, Washington, DC

The Medicare Learning Network (MLN), Centersfor Medicare & Medicaid Services (CMS),announced the availability of the Advanced PracticeNursing & Physician Assistants (APN/PA) webpage. This dedicated web page is for Medicare fee-for-service (FFS) advanced practice nurses andphysician assistants who provide services toMedicare beneficiaries.

One of the educational resources featured onthis webpage is the “Advanced PracticeNurse/Physician Assistant Web-Based TrainingProgram.” The interactive web-based trainingprogram provides definitions of Advanced

Practice Nursing/Physician Assistant providers;outlines the qualifications of the AdvancedPractice Nursing/Physician Assistant providers;describes collaboration/supervision requirementsfor Advanced Practice Nursing/PhysicianAssistant Medicare reimbursements; lists theMedicare billing requirements for AdvancedPractice Nursing and Physician Assistants; andidentifies links to Medicare manuals and otherresources.

For more information, see www.cms.hhs.gov/MLNProducts/70_APNPA.asp. This web page isupdated on a regular basis, so check back often.

Do your part to ensure that the NP voice is heard in health care reform! Your ACNP-PAC needs

your support. Visit www.acnpweb.org for more information.

Advanced Practice Nursing & PhysicianAssistants Web Page

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Increased Oversight on Horizon forPharmaceutical Industry

The pharmaceutical industry released their revised vol-

untary restrictions on direct-to-consumer (DTC) drug

advertising at the end of 2008. These new recom-

mendations update those that the Pharmaceutical

Research and Manufacturers Association (PhRMA)

adopted in 2005. Access the principles at:

http://www.phrma.org/files/DTCGuidingprinciples.pdf.

While the pharmaceutical industry confronts slug-

gish growth, low prestige, and the prospect of more

aggressive government oversight, it is preparing to

work on improving its image and align itself with the

goals of President Obama and the Democratic

Congress. The revised Guiding Principles come after

scrutiny from the House Energy and Commerce

Committee, which had said the ads for the choles-

terol drugs Vytorin, co-marketed by Merck and

Schering-Plough; Lipitor, manufactured by Pfizer; and

a Johnson & Johnson anemia drug were potentially

misleading and deceptive. Some of the companies

have responded to the congressional pressure by

agreeing to some restrictions, such as a moratorium

on ads within the first 6 months of a drug's launch.

W.J. “Billy” Tauzin, the Republican former con-

gressman, and CEO of PhRMA said, “We had bet-

ter self-police and stop doing the things that

cause so much criticism, or we’re going to get

legislated and regulated by the government.” In

addition to previous scrutiny from previous

Congress, the new 111th Congress is expected to

add muscle to the Food and Drug Administration

and press for overhaul of the U.S health system.

Representative Henry Waxman (D-CA), the incom-

ing Chair, House Energy and Commerce

Committee supports legislation giving the FDA

power to selectively ban DTC advertising in the

initial years a medication is on the market.

Senator Chuck Grassley (R-IA) intends to re-intro-

duce a bill requiring drug companies to report to the

federal government all gifts of payments to physicians

for research, speeches, travel, consulting, or anything

else. Companies failing to report would face financial

penalties. The bill is in response to lavish industry

spending, which critics maintain creates conflicts of

interests for doctors.

Attendees from 2008 commented:

• The plenary sessions were excellent, especially

the “Policy In Action” session, which was very

empowering!

• It’s great to see such unity of NPs at a large

conference!

• The variety of presentations was great for my

clinical practice.

• The speakers were experts in their fields and

covered all ranges of skills and interests. Even

the workshops had wonderful leaders!

• I appreciated ACNP’s focus on NP issues on a

variety of topics.

• I also liked being able to print my handouts and

CE certificate online.

• This conference motivated me to become more

politically involved.

• This is the best conference I have ever attended!

• I like the focus that NPs should excel and pick up

the slack in primary care

• The range of clinical topics was most impressive

Mark Your Calendar to Attend the NationalClinical Conference during the Albuquerque

International Balloon Fiesta October 7 – 11, 2009

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A Legacy from President Bush: Expansion ofCommunity Health Clinics

President Bush left office with a health care legacy inbricks and mortar, doubling federal financing for com-munity health centers (CHC), enabling the creation orexpansion of 1297 clinics in medically underservedareas. It was reported that President Bush came toadmire the cost-efficiency of the not-for-profit com-munity health centers while he was governor ofTexas. During his presidency, he proposed openingor expanding 1200 clinics over 5 years, which he did,and proposed doubling the number of patientsserved at the centers. This expansion reflects thelargest since the program was launched duringPresident Johnson's war on poverty.

Despite unprecedented growth of these clinics,there are areas of the country that remain withoutaccess to affordable primary care, and the economicrecession has only magnified this need, as hundredsof thousands of Americans have lost their employer-sponsored health insurance along with their jobs.According to the Health Resources and Services

Administration data (http://www.hrsa.gov/), fundingof the clinics has been reduced as governmentgrants currently account for 19% of clinic funds,compared with 22% in 2001. In addition, nationwidestaffing shortages are a concern in the clinics as else-where.

In response to the growing need for CHCs, con-gressional Democrats are proposing to increase fed-eral funding of the clinics, effectively making the cen-ters a likely feature of any health care deal struck byCongress and the Obama administration. As aSenator, President Obama was a sponsor of aSenate bill in August 2008 that would have quadru-pled federal spending on the program from $2.1 bil-lion to $8 billion. As the 111th Congress and theObama administration work on details of health carereform, it may turn out that the vast expansion ofcommunity health centers may again serve as astopgap while universal coverage waits for a morestable economy.

ACNP Policy Perspectives About taking risks

Nurse practitioners have a long history of being

risk takers. From the first day of the first NP pro-

gram, nurses whose goal was to become an NP

had to step forward and claim the right to practice

in a new and unique environment. Likewise, NPs

involved in public policy or health policy have also

had to step forward, put themselves on the line,

and stand up for the causes and issues that are

important to their practices and their patients.

In 2009, health care reform is extremely impor-

tant to all NPs. NPs have the primary care skills

needed to fulfill a critically needed role in this coun-

try. Now, more than ever, NPs must step forward

and audaciously claim the authority to deliver pri-

mary care services wherever needed. ACNP, with

its Public Policy Committee, its strategic plan, its

public policy agenda, and all of its committed state,

national, group, and individual members, must

strive to promote the effective utilization of NPs.

But, what can I do, just one person? You can

stand up and proclaim your willingness to work for

passage of sound public policy at local, state, and

national levels. Want to get in on the inside? Start

with building a relationship with your elected offi-

cials, visit your Congresspersons at home, attend a

town hall meeting, and be sure to volunteer as a

resource to their offices on health care issues.

Remember, a relationship takes more than one

meeting. Apply for legislative or regulatory office

positions, or run for office yourself. State your affil-

iations clearly. Don’t give up! If you see a position

you are interested in — persevere! Learn the

ropes, learn the system, work your way in. Make

friends; build relationships. Aspire to even higher

positions once you’re in. Work, HARD, for your

favorite candidate. Help them win! Build your own

resume as a willing team player who will help oth-

ers win. They will help you when your turn comes

up! Plan on it. Set a date, move ahead, and make

your next career move into the public policy arena.

Before long it will be YOU —— the one who was

not afraid to take risks. One more NP on the inside,

making public policy!

1555-4155/09/$ see front matter© 2009 American College of Nurse Practitionersdoi:10.1016/j.nurpra.2009.01.007