The Mission of the Maine Nurse Practitioner Association is to:
Unite and advocate for nurse practitioners in political, professional and policy arenas.
Develop and coordinate educational and networking opportunities.
Advocate for the health of all the people of Maine.

Congratulations to two Maine Nurse Practitioners
 Recognized for their Excellence at the

Deborah Ann Hoch was recognized with this year's NP State Award for Excellence.  Deb, a resident of Kennebunk, works at Maine Medical Center where she specializes in Nephrology and Infectious Disease.  Deb was recognized for her clinical work and research skills.

Kathleen Forti-Gallant was awarded this year's Advocate State Award for Excellence.  Kathy resides in Stetson, Maine, and is employed at Eastern Maine Medical Center in Bangor where she specializes in orthopaedic surgery, pain management, spine issues and sports medicine.  Kathy was recognized for her long-standing advocacy on behalf of the profession, as well as her policy expertise.  
__Nominations are now open for the 2017 AANP State Awards. 
For more information, click here.

AANP Inducts Two New Members from Maine
     June 23rd, 2016 - Two Maine Nurse Practitioners were inducted as Fellows of the American Association of Nurse Practitioners during the AANP 2016 National Conference at the Henry B. Gonzalez Convention Center in San Antonio, Texas. The Fellows of the American Association of Nurse Practitioners (FAANP) impacts national and global health by engaging recognized nurse practitioner (NP) leaders who make outstanding contributions to clinical practice, research, education, or policy to enhance the AANP mission.
Nancy Tkacz Browne MS, PPCNP-BC, CBN, FAANP - Nancy is a nurse practitioner provider at WOW, an American Academy of Pediatrics Stage 3 multidisciplinary weight management program at Eastern Maine Medical Center.  She has practiced as a PNP in pediatric surgery and pediatric weight management for 22 years and is a member of AANP, MNPA, NAPNAP, APSNA, AAP, and several weight management organizations.  Her research includes pediatric weight management, victimization and bias. She is the author of numerous publications and presents nationally on pediatric surgical and weight management topics.  Nancy is the 2006 Founder's Award winner from the American Pediatric Surgical Nurses Association.

Nancy Tkacz Browne (center) with her sponsors Dr. Mary Salter (left) and Dr. Carmel A. McComiskey (right). Photo credit: Bob Smithing
Valerie J Fuller DNP, AGACNP-BC, FNP-BC, CWON-AP, FAANP - Valerie is an Acute Care, Family and Gerontological Nurse Practitioner and Assistant Professor of Surgery at Tufts University School of  Medicine. She is the  President of the  Maine State  Board of  Nursing,  Maine State Representative to the American Association of Nurse Practitioners and Past President of the Maine Nurse Practitioner Association.  She is actively involved in APRN practice and policy issues at both the state and national level.  Her clinical and research interests are vascular surgery, wound care and delirium.  She was recently selected as a Hanley Health Leadership Fellow working to improve healthcare quality and access in Maine.

Dr Valerie J. Fuller (center) with her sponsors Dr. Rene Love and Dr. Theodore Rigney. Photo credit: Bob Smithing

 President Obama Signs Comprehensive Addiction and Recovery Act (CARA)
Qualified NPs Authorized to Prescribe Suboxone

    With the support of U.S. Senator Angus King (I-Maine), the U.S. Senate in July passed the Comprehensive Addiction and Recovery Act (CARA), legislation that will help fight back against the opioid and heroin crisis raging across Maine and the nation. The legislation, which earlier passed the House includes several provisions backed by Senator King.
     In a statement following the vote, Senator King applauded the Senate for its work but said that more must be done because CARA does not actually appropriate any new funding to stem the epidemic.  “There’s no question that this legislation and the policy changes it enacts are a significant and important step forward – but it can’t be our last,” Senator King said. “What is happening across Maine – the overdoses, the deaths, the broken families, the struggling communities – demands more from us. It demands real funding right now. Without it, we’re failing to meet our obligation to stand by our friends and neighbors in fighting this epidemic. I am pleased the Senate passed this bill, but I hope we will back it up with actual money – not just talk – because this is about saving peoples’ lives.”
     The legislation provides for a community-based response to heroin and opioid addiction that incorporates law enforcement, the criminal justice system, the public health system, and the recovery support community. It includes several provisions backed by Senator King including:

  • Elements of the Recovery Enhancement for Addiction Treatment (TREAT) Act that would allow nurse practitioners and physician assistants who are trained and who meet other criteria to obtain a federal license for providing buprenorphine therapy (also called suboxone). Senator King is a cosponsor of the TREAT Act, which would expand access to this potentially life-saving therapy.
  • Elements of the Nurturing and Supporting (NAS) Healthy Babies Act, legislation Senator King introduced with Senators Shelley Moore Capito (R-W.V.) and Sherrod Brown (D-Ohio) that directs the Government Accountability Office (GAO) to examine the rising rate and treatment costs of neonatal abstinence syndrome, or NAS, a withdrawal condition in newborns often caused by the prenatal use of opioids in pregnant women.
     More generally the legislation would also:
  •     Expand prevention and educational efforts to prevent the abuse of opioids and heroin and to promote treatment and recovery.
  •     Expand the availability of opioid overdose reversal medicine like naloxone to first responders to help in the reversal of overdoses to save lives.
  •     Expand disposal sites for unwanted prescription medications to keep them out of the hands of our children and adolescents.
  •     Launch an evidence-based opioid and heroin treatment and intervention program.  While we have medications that can help treat addiction, there is a critical need to get the training and resources necessary to expand treatment best practices throughout the country.
  •     Strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.

     The bill was the final version of CARA that was the product of negotiations between House and Senate leaders to reconcile differences in the bills passed by both chambers earlier this year.
     The bill, known as S. 524: Comprehensive Addiction and Recovery Act of 2016, was signed into law by President Obama on July 22nd, and became Public Law 114-198.  
     The full title reads: "To authorize the Attorney General and Secretary of Health and Human Services to award grants to address the national epidemics of prescription opioid abuse and heroin use, and to provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes."
     Its summary begins:  "Overdoses from heroin, prescription drugs, and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control. Deaths have reached their highest levels of the 21st century in 2014, the most recent year for which data is available, according to the National Institute on Drug Abuse. Heroin overdoses have more than tripled in the last five years, an issue receiving outsize attention nationally but especially during the presidential campaign season as New Hampshire has been one of the hardest-hit states.
Marge L. Kilkelly, Senior Policy Advisor for Senator Angus S. King Jr provided MNPA President Evelyn Kieltyka  with an update on the process at SAMHSA regarding the new waiver to include NPs.   Izzy Rosen from Senator King’s office reached out to SAMHSA to ask them about their schedule for implementation of Section 303 of newly passed CARA law. SAMHSA Staff informed him that they are working to very quickly get a new waiver form through OMB – which is a requirement of any federal form.  There also needs to be a comment period on the form- to assume that the form does indeed do what is intended.  After the comment period and their review of the comments- it should be ready to go. 
     Senator King’s staff will continue to monitor the progress and as soon as the form is listed in the federal register will let us know.   They are confident that SAMHSA staff are working to move this process forward as quickly as possible- understanding the interest on the part of the provider community.
For more information on the new law, click here.  The full text of the law can be viewed here.

Are you interested in Integrative/Functional Medicine?
Long-standing MNPA Kathy Coleman, ANP is a member of the Integrative Wellness Council of Maine.  She would like to extend participation in the council's work to the nurse practitioners of Maine.  Please check out the website and feel free to contact eitherTisha Bremner, council chair,, or Meneah Haworth, for more information.

The Integrative Wellness Council of Maine is a group of like-minded medical providers and holistic health practitioners who are joining together in an opportunity to network and create a platform for continued community support and education of the ways in which complementary and alternative therapies may help our patients, clients, and students lead healthy, well, and whole live.

We would love to see more APRN's involved with the Integrative Wellness Council of Maine!

Home Health Care Bill Introduced by Senator Susan Collins
S.578 Would Permit NPs to Certify Medicare Patients for Care

     On February 26th, Senators Susan Collins (R-ME) and Charles Schumer (D-NY) introduced S. 578, the Home Health Care Planning and Improvement Act of 2015. This legislation, once enacted, will have an immediate impact on the quality of life and timeliness of care for Medicare patients by allowing NPs to certify home health care orders.
Currently, NPs are recognized under state laws and regulations that allow them to complete and sign physical examination forms and other medical certification documents.  However, under current Medicare law, NPs with patients who need home health care services must locate a physician who will document the NP's assessment for this care.  Enactment of the Home Health Care Planning and Improvement Act of 2015 would make it possible for NPs to provide the required certification for Medicare patients under their care.  Passage of this legislation will reduce Medicare spending by eliminating duplicative services while also improving the quality and timeliness of care for beneficiaries who need home health care services.
     MNPA thanks Senators Collins and Schumer for taking this important first legislative step toward improving patients' lives, and the organization pledges its continued support for swift action this year.  For more information on S. 578, click here
     We ask that you contact your Senators and ask them to support this important legislation.
 Home Health ICD-10 Handbook 2015
With the healthcare industry on edge over preparations for the ICD-10 transition, now is the critical time for home health coders to master the new code set. Don’t wait to update your agency about the code structure differences and the changes to commonly-used home care diagnosis codes.  This handbook will help you make the transition from ICD-9-CM to ICD-10-CM.
For more information about this handbook or to order, click here.


MaineCare Reimbursement Update

Back in April, we received an email from a MNPA member regarding what looked like a reduction in MaineCare rates paid to certain categories of NPs.  Since then we have had discussions with the Director of MaineCare Services, Stefanie Nadeau and her staff, leading to a face-to-face meeting to help Bob Howe and Pam Cahill better understand MaineCare reimbursement issues as they relate to NPs.