Lauri Wright, PhD, RD, LD/N, Florida Dietetic Association (FDA) President, started off the legislative workshop by speaking about the legislative process and why it is important for Registered Dietitians to be involved in the process. Public policy is important for the protection of the health of the public as well as for insurance reimbursement and future legislation. FDA has their own Public Policy team consisting of 5 members: Julie Spiker- state policy representative, Jennifer Boutin- public policy coordinator, Sue Stemke- state regulatory specialist, Nadine Pazder- licensure liaison, and Dianne Van Treeck- reimbursement representative. There is no paid lobbyist for Florida Registered Dietitians.
Lauri Wright stressed the importance of dietitian advocacy by identifying and spreading the word about being a Licensed, Registered Dietitian. Lauri also went through specific tips for gaining influence in the legislature. She suggested getting to know your legislators, write, email, and visit them. Planting the seed is the beginning of the process for bills. The most important tip Lauri gave today was to be brief, clear, accurate, persuasive, timely, persistent, grateful, and polite when presenting your position and communicating with your legislators.
In order to understand legislature, one must understand the basics as to how a bill becomes a law. First there is an idea formed by a citizen, group or legislator. A Representative must then decide that the idea should be a bill. A House Bill is then drafted and referred to a committee or subcommittee meeting and is reviewed for inclusion on an agenda. All bills must be read three times before being voted on. A bill can ‘die’ in a council or committee, never being heard. It is the Chair of the committee or subcommittee who decided which bills should be heard. Next the bill is placed on a Special Order Calendar and is voted on prior to the house considering those bills on a specific legislative day. Once the bill has been introduced and read on the Special Order Calendar, it is explained, questions are answered about the bill and amendments are considered. This is the bill’s second reading. This process is then repeated for the bill, it is put on the Special Order Calendar and read for a third time, at which point, the bill is then voted on by the members of the House. Any bill not receiving a favorable vote ‘dies’ on the floor. If the bill is passed by the House, it is sent to Senate with a ‘message’. The Senate can vote to pass the bill without amendments and return the bill to the House, refer the bill to a committee for consideration, or defeat the bill on the Senate floor. The Senate may decide to further amend the bill and pass it. If this happens, the bill is returned to the House. At this point, the bill is in an ‘enrolled’ version and is sent to the Governor for consideration. The Governor has a specific time period to respond to the bill and may take one of three actions: Sign the bill into law, allow the bill to become law without his signature, or veto the bill. If the Governor vetoes the bill, the Legislature may override his/her veto by ⅔ vote of the Legislature during the next session.
Julie Harmon, RDN, LD/N, 2012-2013 FDA’s State Policy Representative showed how to find local representatives. Those interested in becoming part of the legislative process must become familiar with their elected officials, which may be done by visiting myfloridahouse.gov and searching for the representative for his/her geographic area. Julie also spoke about the key messages/current bills and leaders that Registered Dietitians and dietetic students are currently focused on within the legislative process.The following are current bills in the process of becoming approved that Registered Dietitians in the state of Florida have a specific interest in.
The Community Health Workers (HB 241 and SB 894) is aimed at improving the health care services of residents living in medically under served communities, including those in geographic areas with a shortage of health care professionals and those individuals without public or private health insurance and are at or below 185 percent of the federal poverty level. This bill involves Community Health Workers who will serve as liaisons between health care services, social services and the under served community. Community Health Workers are trusted members of the community with an understanding of the community and the residents he or she serves. Their aim is to promote culturally appropriate education, including nutrition education, regarding preventive care and disease management. They also aim provide information regarding available resources, provide social support, assist residents during communication with health care providers and establish referral services and continuation of care. The Community Health Worker Task Force, established under the Department of Health, would provide administrative support and services to the task force. The task force would be established within a state college or university and will include 1 member of the Senate, 1 member of the House, 1 State official, 6 culturally and regionally diverse community health workers, and 3 representatives of the Florida Community Worker Coalition. The inclusion of a Registered/Licensed Dietitians or Dietetic Technician as part of the task force and in the training of Community Health Workers in topics surrounding nutrition education, disease prevention, and disease management is strongly encouraged. This bill has been approved by the house and is currently awaiting approval in the Senate.
The Physical Education in the Public Schools (HB 877 and SB 1144) aim is to revise the criteria to waiver physical education requirements for students in grades 6-8th. Registered Dietitians are in support of this bill because regular physical activity is an important factor in achieving and maintaining a healthy weight. Instilling healthy habits such as physical activity at a young age will positively affect children's health as they grow and develop. The Physical Education in the Public Schools bill will require school district boards to provide 150 minutes of physical education each week for students in grades K-5. This is equal to 30 minutes of physical activity per day during the school week. The bill also will require that 6-8th grade students be provided physical education for the equivalent of one class period per day for one semester each year. This equals 3 semesters of physical education in 3 school years. Exemptions from this requirement for 6-8th grade students are limited to the following criteria: The student is enrolled in a remedial course, the student’s parent has indicated in writing to the school principal or designee and thus been verified that this student is participating in physical activities outside of school that are greater than or equal to the mandated requirement, or a letter is submitted from a licensed physician specifying the health reason to and why the student should not participate in physical education.
The final topic discussed was the Patient Protection and Affordable Care Act (PPACA). This federal law is implemented through state and federal rule making and state legislation. It is referred to as the Acts. The goals of the Acts is to provide coverage for 32 million uninsured Americans, to improve affordability and stability of insurance for those who already have it, and to slow the growth of health care costs to reduce the federal budget deficit. This will be achieved in the hopes of health care’s shift from a current fee-for-service payment model to a preventive care and wellness model, a patient centered approach, and a reformed delivery system that includes more primary providers, medical homes and community based health centers. Registered Dietitians are identified as potential but not required providers. It is the goal of Registered Dietitians to be the required providers for disease prevention and chronic disease management.
After the legislative workshop, Nadine Pazder, FDA’s Licensure Liaison allowed us to shadow her around the Capitol Building. She showed us where to find our specific legislative officials. We followed her to her Senate Representative, Jack Latvala, though unable to set an appointment up with him today, we spoke with his Legislative Assistant, Jennifer Wilson. Nadine explained very briefly who we were and why we were there. There was a quick bullet point summary given to the assistant and explained why the bills are of importance from our perspective. We then went on to another Senator and repeated the process. Again, the Senator was out of office and we spoke with an assistant. Once we were finished we found the Calendar of the House of Representatives and the Calendar of the Senate and looked at the committee meetings occurring at that time.There was one committee meeting we were interested in, however this meeting was not in session at the designated time so we were unable to attend.
Overall, this was a great learning experience and really showed us how important it is to be involved with public policy.
