State renal associations: We can make a difference

Next month, NN&I readers will have the opportunity to vote for a new leader of the United States. It may be hard to disseminate Donald Trump’s or Hilary Clinton’s views on Medicare funding for the End-Stage Renal Disease Program, but you can find out where your state political leadership stands by getting involved in your local renal association. It is an opportunity to help your industry and your patients.

National effort

In the health care industry, and specifically in our kidney community suburb, various trade associations have been formed over the years to support the numerous common objectives of clinicians, managers, caregivers, and patients. Another primary purpose of trade associations is to attempt to influence public policy in a direction favorable to the association’s members to ensure high quality access to care for the patients they serve. They focus on the extensive national scope of regulatory, legislative and clinical quality issues facing providers and patients, with scant resources available to handle regional and state issues. This often results in a gap in education and local community advocacy efforts which dialysis providers must try to fill on their own.

...but state issues are local

While many states in the nation have even more stringent statutory guidelines governing dialysis facility operations than the federal ESRD Conditions for Coverage, only three states currently have what would be considered robust associations: The California Dialysis Council, the Florida Renal Administrators Association, and the Ohio Renal Association. These mature and very active associations help educate stakeholders on state-specific issues impacting ESRD patients and providers and, more importantly, strengthen the collective voice of their members to better influence the decisions being made at the state level.

Some important wins

There are many examples of hard-won victories for all three state associations. Some seem like annual preservation efforts, such as attempting to maintain affordable Medi-gap coverage for kidney patients and funding Medicaid primary coverage for ESRD-related services. Preservation efforts have expanded in recent years from soliciting state budget appropriations to battling the insurance industry as they try to limit the inclusion of kidney patients in their risk pools by refusing premium assistance payments by third party payers.

During the 2016 Florida Renal Administrators Association legislative agenda, a collaborative effort between our group and the Florida Hospital Association to support the Nurse Licensure Compact Bill resulted in a big win for nurses, providers, and patients. Proposed legislation (HB 1061-FL) passed and, once signed by the remaining states (or latest by December 31, 2018), provides for nurses in 27 states to have multi-state license reciprocity. For those of us concerned about the expanding national nursing shortage, this law mitigates state nursing board bureaucracy, eliminates unnecessary barriers for practicing nurses, and benefits the health care industry collectively.

Several additional health care-related initiatives with potential impact to the kidney care community were addressed in Florida this year: five-year intern cap for social workers and mental health counselors; expansion of the scope of practice for ARNP/PA physician extenders to include the ability to prescribe controlled substances to patients under certain conditions (after more than 20 years of advocacy), and Telemedicine expansion.

All they need is…you

Collaboration between state and national trade associations in the kidney community has yielded more opportunities for the exchange of information on issues that potentially cross state lines and impact federal regulations. Kidney care providers of all sizes are working together within these associations, across competitive markets, to advocate for the greater good of the health care recipients who need their services to survive. And they need your volunteerism and support. Common goals, leadership, collaboration, and advocacy are the foundation of any effective trade association, and an uncompromising standard for success. -by Sue Rottura