Missouri Nurse News - July 2022

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2 Missouri Nursing News July, August, September 2022 Missouri Nurses Leading the Way Jane Kaiser, RN, BSN & Gina Bufe, APRN, PhD Missouri Nurses Jane Kaiser & Gina Bufe led the way as Flag Bearers for the Missouri Flag during the Parade of States at the 2022 National Senior Games (NSG) in Fort Lauderdale, Florida. It was fitting to have Nurses lead the way in the first National Senior Games that have been held since the pandemic. The NSG were originally scheduled to occur in May of 2021 but due to the pandemic were rescheduled to November 2021 and then rescheduled a second time to May 2022 in an effort to ensure the safety of all Senior Athletes. Both Jane and Gina have previously qualified and participated in past NSG. Jane competes in Track & Field as well as Swimming events and Gina competes in Racewalking and Table Tennis. Both Missouri Nurses find competition in the NSG motivating to maintain health and well-being. During the pandemic, both nurses continued to work as they trained for the games. Jane works as a Case Investigator COVID for the St. Louis County Department of Public Health and Wellness, Flu and COVID clinics, Visiting Nurse Association of Greater St. Louis. Gina continues to work as an APRN in Child & Adolescent Mental Health at Mercy Health System in St Louis. Upon their return from the NSG, both began their qualifying journey to the NSG to be held in Pittsburgh 2023. The journey started with the St Louis Senior Olympics and then participation in the Missouri State Senior Games where both qualified for the National Senior Games in Pittsburgh 2023. The benefits of exercise on healthy aging through improved physical and mental health, socialization, and perceived quality of life have been well documented (Andrews, et. al, 2017; Kinnafick, et. al., 2022.) Jane & Gina experienced first-hand that in addition to the physical benefits, the camaraderie and encouragement are nice mental health benefits from participation in the games that support healthy aging. Jane & Gina encourage other nurses over 50 years old to consider participation. References Andrews RM, Tan EJ, Varma VR, Rebok GW, Romani WA, Seeman TE, Gruenewald TL, Tanner EK, Carlson MC (2017). Positive Aging Expectations Are Associated With Physical Activity Among Urban-Dwelling Older Adults.Gerontologist. Aug 1;57(suppl_2):S178-S186. doi: 10.1093/geront/gnx060.PMID: 28854610 Downloaded June 16, 2022 Kinnafick FE, Brinkley AJ, Bailey SJ, Adams EJ (2021)Is walking netball an effective, acceptable and feasible method to increase physical activity and improve health in middleto older age women?: A RE-AIM evaluation. Int J Behav Nutr Phys Act. 2021 Oct 19;18(1):136. doi: 10.1186/ s12966-021-01204-w.PMID: 34666782. Downloaded June 16, 2022 NOW HIRING Central Ozarks Medical Centers has been providing quality healthcare since 1979. COMC believes that everyone deserves access to high quality healthcare regardless of their insurance status. Check out our website at www.centralozarks.org for our current listing of career opportunities. Gina Bufe (Left) & Jane Kaiser (Right) Biographical Information: Jane Kaiser, RN, BSN Senior Olympics, Local, State, National, Medals, Ribbons and Awards 2001 to present 1971, ADS, RN St. Louis Community College at Meramec, St. Louis, MO BSN, St. Louis University, St. Louis, MO Surgical Intensive Care Unit, St. Mary's Hospital, St. Louis, MO Medical/Surgical Nursing Instructor, Jefferson College, Hillsboro, MO Wife, Mother of four, Grandmother of three Presently working Wellness, Flu and COVID clinics, Visiting Nurse Association of Greater St. Louis, MO Case Investigator for COVID, St. Louis County Department of Public Health Gina Bufe, APRN, PhD Senior Olympics, Local, State, National, Medals, Ribbons and Awards 2016 to present PhD in Nursing, Saint Louis University, St. Louis, MO, 1996 MSN(R) in Psychiatric/Mental Health Nursing-CNS option, Saint Louis University, St. Louis, MO, 1991. BSN, Southeast Missouri State University, Cape Girardeau, MO, 1987 Presently working MERCY HOSPITAL/HEALTH SYSTEM St. Louis, MO April 2013-Present Advanced Practice Registered Nurse, PMHCNS- BC: Collaborative Intensive Outpatient Program (IOP) practice and Psychiatric Hospitalist Team member. Director’s Letter continued from page 1 summer! The application is open to all nurses in the state of Missouri, regardless of MONA membership status. I hope that if you are not a member of MONA, that you will consider it. If every nurse was a member of the association, we would have incredible power at the Missouri Capitol and there would be nothing we couldn’t accomplish. Membership is only $15/month or $174/year and it gives you membership to the Missouri Nurses Association and the American Nurses Association. And if you are a member, thank you for your membership into the Missouri Nurses Association we are excited to have you and we hope that these changes will help to move the Association into the future. Sequoyah & Howard Gratz ONE FAMILY TWO CULTURES and the bond of literacy between them Learn about the creation of the Cherokee Alphabet, the importance of language - and the free press today! Buy on Amazon or at TerryFoody.net. Contact Terry for special group rates: terryfoody@juno.com MONA’s Mission, Vision, Purpose Our Mission Advancing the nursing profession by uniting as one strong voice with Missouri nurses Our Vision A healthy Missouri through the power of Nursing Our Purpose To act and speak for the nursing profession and Missouri’s professional nurses and to promote and enhance safe and accountable professional nursing practice. MONA’s Official Publication: The Missouri Nursing News is an official publication of the Missouri Nurses Association (MONA) (a constituent member of the American Nurses Association), published quarterly every January, April, July and October. The MONA provides education, networking opportunities, publications and other products and services to its members and extends its mission to all nurses in Missouri. Phone: (573) 636-4623 Email: director@missourinursess.org Web site: www.MissouriNurses.org Mail: c/o Midwest Multistate Division 3340 American Avenue, Suite F Jefferson City, MO 65109 Questions about your nursing license? Contact the Missouri State Board of Nursing at: (573) 751-0681. This newsletter is a service of the Missouri Nurses Association and your receipt of it does not mean you are automatically a member. Your membership in support of this work is encouraged; please visit www.missourinurses.org. Writer’s Guidelines: • Any topic related to nursing will be considered for publication in the Missouri Nursing News. • Authors are not required to be members of the MONA; however, when space is limited, preference will be given to MONA members. • Photos are welcome, digital is preferred. MONA does not assume responsibility for lost or damaged photos. • Use current APA formatting for any article requiring citation. • Provide a brief author biography indicating the author’s nursing experience and/or expertise with the paper’s content. o Limit the author’s biography to 4-sentences. • Submitted material is due by the 10th of the month in March, June, September and December of each year. • The peer-review is blinded; submit the title page separately from the article • Submit the title page and article as Word documents to info@missourinurses.org For advertising rates and information, please contact Arthur L. Davis Publishing Agency, Inc., PO Box 216, Cedar Falls, Iowa 50613, (800) 626–4081, sales@aldpub.com. MONA and the Arthur L. Davis Publishing Agency, Inc. reserve the right to reject any advertisement. Responsibility for errors in advertising is limited to corrections in the next issue or refund of price of advertisement. Acceptance of advertising does not imply endorsement or approval by the Missouri Nurses Association of products advertised, the advertisers, or the claims made. Rejection of an advertisement does not imply a product offered for advertising is without merit, or that the manufacturer lacks integrity, or that this association disapproves of the product or its use. MONA and the Arthur L. Davis Publishing Agency, Inc. shall not be held liable for any consequences resulting from purchase or use of an advertiser’s product. Articles appearing in this publication express the opinions of the authors; they do not necessarily reflect views of the staff, board, or membership of MONA or those of the national or local associations.
July, August, September 2022 Missouri Nursing News 3 Bringing More Home Health Care RNs to Medicaid Patients in Missouri Sarah Oerther, Ph.D., RN, ANEF Margaret R Benz MSN(R), APRN, ANP-BC, FAANP Season 1 of the Netflix hit series, “Call the Midwife,” begins in 1950s England with Jenny Lee providing nursing care to mothers and their families by riding her bicycle to families’ homes in London. The show follows the nurses, midwives, and nuns from Nonnatus House, who visit families in their homes, providing them with extraordinary healthcare. Fast forward to 2022, and amendments to Bills HB2331, HB2149 and SB710 will help to bring more Home Health Care RNs to the residences of Medicaid patients in Missouri. Currently, in Missouri, a Nurse Practitioner must have a physician document that a face-to-face assessment has been performed and sign the order for Home Health Care verifying the patient’s eligibility for Home Health Care services to be provided to them in their place of residence. Nurse Practitioners in Missouri are not currently able to initiate or make necessary adjustments to medication or treatment for Home Health Care patients without obtaining a physician signature (American Association of Nurse Practitioners, 2019). This outdated process in Missouri generally results in delays in care, especially when physicians are busy, in addition to more costly care or potentially causing further health complications. Missouri Nurses have long been vocal about Missouri’s physician-certification policy, an antiquated and overly rigid law. A priority for the Missouri Nurses Association this year has been elimination of Missouri’s strict physician-certification policy because this policy creates roadblocks that make it more difficult for patients to gain access to Home Health Care services and RNs, resulting in some patients needing to go to long term care facilities. Nurse Practitioners are qualified to certify patient eligibility for Home Health Care by RNs without a physician signature and are already one of the largest home-based primary care providers for Medicaid patients nationwide (American Association of Nurse Practitioners, 2019). The current laws in Missouri put patients at risk for avoidable complications and delay access to treatment. Delays in care are particularly challenging for Home Health Care Medicare and Medicaid beneficiary populations patients in Missouri who suffer from more chronic conditions and report more limitations on activities of daily living than the non-Home Health Care Medicare and Medicaid beneficiary populations (American Association of Nurse Practitioners, 2019). When patients can’t get access to a Home Health Care RN in a timely manner, those delays drive up costs in Missouri and result in negative health outcomes for vulnerable patients in Missouri. It is important to note that the Cares Act (Coronavirus Aid, Relief, and Economic Security Act) legislation that was passed in March 2020, included a provision authorizing a Nurse Practitioner to certify and recertify their patients for Home Health Care, permanently retiring the federal barrier to Nurse Practitioner practice for patients requiring Home Health Care services (Centers for Medicare and Medicaid Services, 2021). This legislation made it possible on the federal level for Nurse Practitioners to be able to provide necessary quality care services for their patients requiring Home Health Care. Because of this federal legislation, in most states, Nurse Practitioners were immediately able to activate this legislation and begin certifying and recertifying their patients for Home Health Care. Unfortunately, in Missouri, Nurse Practitioners are not able to implement this federal legislation because of an outdated law that specifically required a physician to sign Home Health Care orders. Now — thanks to amendments to Bills HB2331, HB2149 and SB710 — Nurse Practitioners will be able certify patient eligibility for Home Health Care by RNs. Consistent with the Future of Nursing report 2030, amendments to Bills HB2331, HB2149 and SB710 update laws in Missouri to authorize Nurse Practitioners to perform admission assessments, as well as certification of patients for Home Health Care RNs (Institute of Medicine, 2020). Expanding the role of Nurse Practitioners to certify patients should improve patient access to RNs who are qualified to identify new health problems or needs, such as medication education, prevention services, or nutrition counseling (American Association of Nurse Practitioners, 2019). This also makes Missouri consistent with federal legislation allowing Nurse Practitioners to certify Home Health Care for their patients. Moving ahead, advocacy will continue to be important to help get more of Missouri’s antiquated and overly rigid state laws that restrict Nurse Practitioner practice to catch up with federal law. For instance, Missouri is one of only three (3) states with mileage restrictions for Nurse Practitioners. With a variety of communication methods now available YOUTH DEVELOPMENT SPECIALIST GRADUATE CERTIFICATE that are timelier and more efficient, and with the Governor’s expansion of broadband, the mileage barriers are outdated. Though the rules have been modified, all Nurse Practitioners in the state of Missouri are still held to a 75-mile radius unless they are working in a Department of Corrections Facility, in which case, they have a 200-mile radius for a four to six month period, which can be renewed upon review. Additionally, over the last two (2) years Missouri implemented waivers to allow telehealth to be provided across the state in all settings by all providers if Nurse Practitioners were within the 75-mile radius. This allowed timely and safe access to care to all Missourians no matter where they reside. This allowed many people to receive ongoing care and preventative screening, even when movement was restricted. With the end of the waivers December 31, 2021, that included elimination of mileage restrictions, telehealth flexibility, chart review and the one-month supervisory rule came to an end. Missouri Nurses will continue to pursue elimination of these barriers in future legislative sessions, so our patients have access to safe and affordable care. References American Association of Nurse Practitioners. (2019). Improve Medicare patient access to home health services. Retrieved from https://www.aanp.org/advocacy/federal/ federal-issue-briefs/improve-medicare-patients-accessto-home-health-care Centers for Medicare and Medicaid Services. (2021). Home health PPS. Retrieved from https://www.cms. gov/Medicare/Medicare-Fee-for-Service-Payment/ HomeHealthPPS Institute of Medicine. (2020). The Future of Nursing 2020- 2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. https:// doi.org/10.17226/25982. Enhance your skills and credentials working directly with youth with this 12-credit-hour stand-alone graduate certificate • Understand the unique developmental period of adolescence • Partner with youth in the health care setting • Learn how to engage youth and help them thrive • Understand youth context and engage stakeholders Take courses such as: • Adolescents and their Families • Foundations of Youth Development • Youth Mental Health • Adolescent Health and Sexuality Contact Ashlie Lester, PhD at hdfsgrad@missouri.edu. HTTPS://HDFS.MISSOURI.EDU/DEGREES/YOUTH-DEVELOPMENT/
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Missouri Nurse News - July 2022

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