Update from the Statewide Director

A message from Mary Dickow,

Statewide Director, California Action Coalition

May 2013

As the Nurses Week celebrations across the state come to a close we are reminded that every week could be Nurses Week. Your hard work and dedication is evident every day and we certainly appreciate all the contributions you have made to the California Action Coalition in advancing the Future of Nursing Report recommendations here in our state.

Advisory Committee Update:

At the end of March we held our first meeting with the new Advisory Committee for the Action Coalition. It and it was a productive and exciting meeting. We have a diverse and dedicated group ready to help advance this important work in California. We discussed the National Summit, identified five key areas of focus for the coming year, discussed the workgroups and regional efforts and will be addressing the sustainability of the Action Coalition in the coming months.

CA Action Coalition Focus for 2013:

Replicate the Advancing Progression in Nursing Education (APIN) Model

CA is well positioned to replicate the project underway in Los Angeles with the APIN grant funds. Over this past month the National Program Office for the APIN grants pulled together several meetings and broadly shared the projects from all nine states in an effort to leverage visibility and support for the work.

A national meeting was held April 9^th with Community College Presidents’ on Academic Progression in Nursing convened by the Robert Wood Johnson Foundation in Washington DC, and hosted by the American Association of Community Colleges. Each of the 9 APIN states were asked to identify College Presidents to participate from across the country. Farley Herzek from East Los Angeles College was in attendance. The goals of the meeting were to identify opportunities and challenges related to academic progression at the community college level, gain support from community college presidents and define opportunities for collaboration between community college presidents, the Future of Nursing Campaign and the APIN initiative.

CA already had good examples of the California Collaborative Model of Nursing Education (CCMNE) in place before applying for the APIN grant. The APIN project was built off the success of the CCMNE work between the CSU and CCC collaborative. The CA AC will be present at the upcoming regional southern CA meeting of the CCMNE in Los Angeles on June 17^th. This will allow the CA AC to see the progress of current models, get a sense of the planning for expansion of the current program and look at how this group is addressing sustainability of these models.

Host Innovation Summit

We originally saw this summit as an opportunity to look at collaborative models of care and interdisciplinary team based care. During the Advisory Committee meeting on March 28^th the group discussed moving to more of consumer based focus. Exploring issues around access to care and demands for care in health reform by utilizing the skills of nurses (Future of Nursing Campaign vision is for all Americans to have access to high quality patient-centered care in a health care system where nurses contribute as essential partners to achieving success). There are currently six volunteers who have signed up to help pull this summit together (including two people from the San Diego ACNL chapter who have been active in the innovations work in their region).

Scope of Practice

This is an important time for addressing scope of practice in CA. The Senate Business, Professions and Economic Development Committee heard SB491 on April 29^th. The bill passed out of the committee and has now been referred to the Appropriations Committee.

Joanne Spetz and Steve Parente are finishing up a study on cost savings from retail clinics. They found that cost savings are greater in states with more open scope of practice. She will share that report when complete.

The APRN Gap Analysis has been completed and WorkGroup #1 has been asked to get this out as soon as possible. The delay is due to workgroup members’ activities in the current bill hearings and providing materials and information to policy makers.

This past week the Campaign for Action posted a video on their website of Donna Shalala talking about the importance of removing barriers to care and the future of health care delivery click on this link: http://campaignforaction.org/video/donna-shalala-addresses-american-college-healthcare-executives

Connect to Consumer Groups

The CA AC has made a solid connection with our state office of AARP in Sacramento. Thanks to the work of Winifred Quinn at the AARP office in DC email introductions were made on April 10^th between Blanca Castro, Manager of Advocacy and the CA AC. On Tuesday, April 30^th Joanne Handy (CA AC Advisory Committee member) and I met with Blanca Castro at AARP in Sacramento. It was a very productive meeting and it is clear that our relationship will be mutually beneficial. Blanca asked important questions and we shared our desire to have a full partnership with AARP and ideally have a member of the organization serve on our Advisory Committee. We will continue to keep you posted with regard to any new relationships that develop as a result of the AARP connection and their involvement with our work.

Develop New Communications Plan

During the first meeting on March 28^th Advisory Committee members suggested that the CA AC must increase outreach efforts and identify opportunities to become more visible. We also need to better articulate the value of our partnerships across the state. The CA AC has more partners than are listed on our website but we have not done a very good job of highlighting the relationships that currently exist. Areas of improvement include: documenting the work that has been accomplished across the workgroups and the regions as well as communicating what is currently happening and where we need assistance across the state. We are looking at the national communication strategy and will disseminate a set of talking points and slides for our work in CA very soon.

Recommendation Work Group Updates:

Last year during our strategic planning session (held in the Summer of 2012) we discussed moving to the National Campaign structure under the 3 pillars: Leadership, Practice and Education. In CA we have been in discussions with the workgroups to streamline the process, move to this pillar structure and advance our work in a more collective fashion.

The 3 pillar descriptions as provided by the National Campaign office are:

Leadership: We need to expand the ability of nurses to influence system change on management teams, in boardrooms, policy debates, and within our communities.

Barriers to Practice and Care: We need to remove barriers that limit nurses and other providers from practicing to the full level of their education and training.

Education and Training: To prepare nursing to meet the challenges of the future, we need to strengthen nurse education and training. 

Recommendation #1 – Remove Barriers to Care

This workgroup has been active with the recent bill in Committee (AB 491). As mentioned earlier in this newsletter the bill is due to be heard by the Appropriations Committee on Monday, May 13, 2013. This is a very exciting time yet there is still much work to do. California has had significant support from AARP at both the state and national level. A thank you goes out to the leadership of workgroup #1 and the many others that have testified and supported this bill. I would list names but fear I will leave someone of the list since so many of you have been hard at work regarding this bill. In addition, the workgroup has been active in pulling together an APRN Summit to be held in Oakland, CA on May 30, 2013. We are looking forward to the Summit and the important discussions that will take place to advance the profession in our state.

Recommendation #2 – Expand Opportunities for Nurses to Lead Improvement Efforts

We are looking for co-leads for this recommendation and will be posting the application for open positions to our site very soon.

Recommendation #3 – Implement Nurse Residency Programs

1. Serve as a catalyst to make transition to practice programs and nurse residency programs available to all California Registered Nurses.
2. Expand programs to align with anticipated demand for RN roles and settings for RN positions in the era of healthcare reform including more ambulatory and community-based opportunities.
3. Conduct a statewide evaluation of current programs to inform next steps.

This workgroup has a large active base of volunteers who will be assisting in the implementation of these goals and exploring funding opportunities.

Recommendation #4 – Increase Number of Nurses with Baccalaureate Degrees

1. Identify and codify immediate system threats to Pre- and Post-Licensure BSN enrollment opportunities in the CCC, CSU, UC and CA private universities
2. Simplify and complete 2012 Goals #1 & 2 (Goal #1 Establish baseline percentage of currently practicing RNs with minimum educational level of BSN (CPRN-BSNs) in CA to enable setting realistic “80%” by 2020 goal for CA and monitor progress. Goal #2 Quantify net balance headcount of CPRN-BSNs in CA annually).

Outcome measures and strategies for obtaining these goals have been identified.

This workgroup goal to hold a statewide meeting for the California Collaborative Model for Nursing Education (CCMNE) from which the final document CCMNE Core Components was generated and now posted to the CINHC website is complete. The Goal to facilitate progress on AB1295 in consultation and support to the CCC and CSU Chancellor’s Offices with relevant CSU Executive Order imminent and CCC-CSU ADN-BSN Roadmaps is also complete and can be found at: http://www.calstate.edu/adn-bsn/roadmaps.shtml

Recommendation #5 – Double the Number of Nurses with a Doctorate

This workgroup has pulled together data around this effort and is in transition due to a co-lead leaving the state for another position. Like workgroup #2 we are looking to fill this open position.

Recommendation #6 – Lifelong Learning

1. Work closely with recommendations #4 and #5 to establish priorities and communications plans for messaging regarding culture change for lifelong learning in the profession of nursing.
2. Create a repository on the CA AC website showcasing service and education partnerships that demonstrate effective models for fostering and supporting lifelong learning.
3. Collaborate with #7 on fostering mentoring as a strategy for creating and sustaining cultures of lifelong learning.
4. Plan and present messaging for community forums.

Each of the 4 Goals has a team of volunteers and a set of deliverables to meet the stated goal.

Recommendation #7 – Prepare Nurses to Lead Change

1. Mentor Program – the Life Moxie on-line tool has been developed and is in a test phase with 48 pairs of mentors/mentees. Once this phase is completed access to the tool will be launched for others to participate. Information regarding how to sign up can be found at www.acnlmentoring.org and will also be posted to the CA AC website.
2. Student Engagement – A survey of the NSNA Chapters is being conducted to determine involvement and best practices for student engagement.
3. Media Training – development of a program to carry the message to diverse audiences as a first to board training.
4. Leadership competency development.

Like the other workgroups each of these goals has a full team of people committed to carrying out the necessary action steps.

Recommendation #8

This workgroup plans to continue to build the data sets to inform the work and has offered to partner with all other recommendation workgroups to assist in their data gathering or evaluation needs.

Regional Update:

The CA AC has an eight Region structure. There continue to be conversations to find ways to better distribute the work over large geographic areas and identify additional volunteers that are more strategically spaced to better serve the regions. Most of the regions have held at least one Town Hall event to highlight their Region and bring the Future of Nursing message to their communities. We still have more to do in the Regions but the recent California Wellness Foundation project at the California Institute for Nursing & Health Care (CINHC) exploring nursings’ role in health care reform has brought new attention to the Regions and greater exposure for both the CA AC and CINHC. This has been a very successful project to date and has provided positive outreach that we had not expected. The Regional Champions for the CA AC in each of the targeted areas for the CINHC project have hosted the meetings, encouraged participation in their region and have been an active part of the conversations. We are in further discussion regarding how to best facilitate the necessary changes.

Other News:

The CHCF Health Care Leadership Program is seeking applicants for their next cohort. The goal of the program is to improve the health of Californians by developing and sustaining a network of visionary, effective health care leaders who will shape a more responsive and effective health care system. Since 2001, over 300 health professionals have participated in the program.

Curriculum:

This rigorous part-time, two-year fellowship addresses essential leadership, management, as well as health practice and policy topics, including building and leading teams, forming political coalitions, using financial management tools, developing organizational strategies and goals, and investigating future trends, such as new technologies, changing demographics, and the social context of health care.

Eligibility:

The fellowship is available to clinically trained health care professionals who live and work in California and currently serve in management or leadership roles.

Cost and Fee Waivers:

The CHCF Health Care Leadership Program is sponsored by the California HealthCare Foundation, which covers most of the costs.  A program fee of $2,500 per year or $5,000 over the course of fellowship will be paid by the fellow’s employer/organizational sponsor. Full and partial fee waivers are available to qualifying representatives of safety-net and non-profit organizations, educational institutions and governmental agencies for which this fee would present a hardship. Requests for fee waivers are due at the time of application submission and will not influence the selection process.

Applications:

All applications are due May 15, 2013. You can find out more information about the program at and start the application process by clicking here

Message from Mary Foley:

As the nurse lead I am pleased to report that the California Action Coalition is moving forward in a positive direction.  As captured by our superb Statewide Coordinator Mary Dickow, we are taking the guidance provided by the national campaign to evaluate our stakeholder, expand our coalition, and set some clear priorities.  All that work is underway and our new Advisory Committee reflects those features perfectly. 

We so appreciate your stable leadership across the work groups, and during this exciting time in CA we are all watching healthcare reform and practice legislation unfold before our eyes. Fortunately for the citizens of CA, there has been a tremendous amount of excellent work in many of these arenas over the years, and you are all on-duty to guide this work in the future.

Be sure to let us know how we can better communicate the work of the CAC in the next few months, and thank you again for all your support!

In Closing:

Thank you all for your continues support – we have some very exciting things on the horizon and much to do here in California. I know we have said this over the past year or so but we are in such a unique time in the state with the Future of Nursing report, the Affordable Care Act, over 401,000 RN’s and a group of dedicated partners to collaborate with and lead the work necessary to see that all Californians have access to the care they deserve!

Mary