Congratulations to South Dakota for becoming the most recent State to pass a law to grant full and direct access to Nurse Practitioners! This is the 22nd State to authorize NPs to provide the full scope of services to the public. Certainly, this will enhance patients’ ability to access high quality health care.
Just how are laws made? Let’s take some time here to learn about how you can get one in the law books.
First, you need to find one of your State’s legislators who will “sponsor” and introduce your bill. It’s helpful to seek out members who are on the Health Committee because all bills must first go through Committee.
Except for Nebraska (which has a unicameral legislature of only senators), each State has a House of Representatives and a Senate just like in our Federal government with members being elected officials. As public servants, their job is to vote for or against bills on behalf of their constituents.
For my home State of Indiana and 48 others, there would be 2 different chairs for health committees: one for the House and the other with the Senate. In your State, reach out to the chair of the respective health committees to describe your proposed bill and its purpose. It’s important to share the benefits of your proposed law not only with the chair people and legislators but also with the public to garner backing from individuals and organizations.
Once you get your legislator to introduce it, usually in committee, your bill is assigned a number. Usually the number designations are prefaced by “H.R.” if introduced in the House and “S” in the Senate such as “HR 1501” or “S 1501.”
From there, your bill goes to a committee where it is discussed before being voted on as to either accept or reject it. Or they can make changes (amend) to your bill. If it is approved by the committee, your bill can be moved to a subcommittee for further research, if needed … OR it is moved to that floor of the legislature for debate.
If your bill is promulgated by the House, a vote is taken and, if the majority agrees, advances on to the Senate. The same procedure is followed if your bill began in the Senate, which, at this point, would be passed to the House if the vote is successful.
If both House and Senate have passed your bill, then it goes to the top of the Executive Branch for approval. That is, to the President for Federal legislation or to the Governor for State legislation.
The President/Governor then can do one of three things: (1) they can approve your bill, (2) veto it or (3) allow a “pocket veto” where they choose not to sign your bill within a 10-day period during which the legislature is not in session
If the President/Governor directly vetoes your bill, the legislature can reconsider it and vote whether to accept the veto or to override it, the latter typically with a two/thirds vote of both the House and the Senate.
With the President/Governor’s signature, or with the legislatures action to override a veto, your bill then becomes law.
In Indiana, we have 125,000 nurses, both R.N. and L.P.N., which make up a respectable percentage of the voting population so, it is important for nurses everywhere to meet with legislators to inform them of any concerns we have with health care. We need to step up and speak up in order to make the necessary changes to improve patient care.
I would love to hear your thoughts on what you think we can do, as a profession, to step up and speak up in the comments below.
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