Indiana Dietetic Association Legislative Update

Indiana Dietetic AssociationLegislative Update

Martha Rardin, MSM, RD, CDIndiana Dietetic Association Licensure Chair

Future of Healthcare Professions is determined by the Congress of the US, not Associations, your education, or your professional career.

Who Pays For Healthcare?Private Ins-33%Medicare-24%Medicaid-19%Out-of-pocket-12%Other Public-12%

MedicareFederal Health Insurance Program (1965)CMS Administers65, <65 and legally blind, or disabled, End

State Renal Disease (ESRD)Part A (Hospital and Nursing Home)Part B (Outpatient)Part C (Insurance companies contract with

Medicare for HMO and PPO coverage)Part D (Drug Prescription Coverage)

MedicaidJoint Fed and State Program

Medical costs for low/limited income

Vary from state to state

Affordable Healthcare ActPassed by congress in March 2010The rules are being written by the

department of Health and Human Services

Rules will be written as time progressesThe effects are yet to be seenEmphasis on prevention

Influencing Policy

Lobbying = Marketing

Need Access to politiciansAll Politics Is Local

Provide Local Influence Provide Local Insight Provide Local Experiences

Communicating Effectively Who, Why, What, Where, When Attend Town Hall meetings or visit your elected officials

Long Term Relationship (give and take)Making friends outside of your circle and

interest

Two Kinds Of People

Those who choose to be players

Those who choose to be victims

Two Kinds Of PeopleThose who choose

to be players They vote. Communicate with

lawmakers on issues that directly concern them.

They communicate with email or by meeting with officials when they are on recess.

Help elect candidates who best represent them.

Those who choose to be victims

They do not vote (or only vote).

They live with the political decisions that others are able to influence.

They don’t understand the political process and just want someone to “fix it”.

Influence PolicyPersuasion

Have the KnowledgePolitical Power

More Impt than Facts How to get it? You have to be a player

Political Power

36% don’t vote 23% not registered 24% underage

17% decide!

Political Power YOU have Power!Individual Contribution (up to $2,500) to

each candidate per electionPolitical Action Committees

PACS may give up to$2,500/election/candidate

National parties may contribute up to $5,000/election

Politicians are always running for office and always raising money – donate regularly

Who Is My Legislator?www.accessIndiana.govType in elected officeType in zip code

From Idea to Law by the “Book”

Senate House Conference Committee

Subcommittee Full Committee Senate

Full Committee Senate House Full Committee

Member of Congress House Full Committee Subcommittee

President

Public Law Veto

Senate House

How to get a bill passedConstituent input to “right” Rep. or SenatorNeed to know “who” is on “what” committeeFacts to support debateUnderstand Congressional timetables and

committee assignmentsBuild support over period of time, most bills

do not pass first time they are introducedBills introduced in one Congress are not

extended to the next, but must be reintroduced—all bills die when Congress adjourns.

How to communicate with your congressman or legislator

Email is best Legislators don’t get a lot

of mail from constituents May or may not receive a

response Make your message

concise, polite, and ASK for their support for or against your issue

Provide facts but not stacks of facts

Provide data on how this affects his/her constituents

What can you do? VOTE Vote in every primary,

school board election, general election

Volunteer for your candidate

Donate money to a candidate

Place a sign in your yard or window

Read the paper and follow current events daily

American Dietetic Association

What have you done for me lately?ORWhat have YOU done lately for ADA?

ADA’s #1 GoalBe included as the rules for the Affordable

Health Care Act are writtenChronic disease accounts for 75% of the

$2 Trillion spent annually on healthcare Nutrition has been shown to be highly

cost-effective in preventing and managing chronic disease – but nutrition services is usually not a routine covered benefit. ADA Times, Summer 2009, Volume 6, Issue 4

ADA’s Public Policy GoalsFood and Nutrition Is Key To HealthAdvocate for Public Health and

ProfessionSafe and Nutritionally Adequate Diet For

All.Based on ScienceDisease Prevention and TreatmentEvidence-based MNT

ADA’s Public Policy PrioritiesAgingChild NutritionMNT (Medicare and Medicaid)Nutrition MonitoringNutrition Research Obesity and Weight ManagementState Issues

ADA’s Public Policy UpdateAging (Older Americans Act-entitlement

program)Child Nutrition (WIC-entitlement program)Medical Nutrition Therapy (want this

expanded beyond diabetes coverage)Nutrition Monitoring (want this expanded and

funded)Nutrition Research (want this expanded)Obesity and Weight Management-monitorState Issues-monitor

Some Issues we watch at PPW

Medicaid Medicare MNT Act of 2005Ryan White Care ActOlder Americans ActDietary GuidelinesObesityFarm BillState statutes on certification and licensure

2010 Dietary GuidelinesFederal Nutrition Policy/ProgramsHHS/USDA Legislative Every 5 YearsScience-basedCurrently under revision but needs

increased fundingPromote healthy, prevent chronic

disease

ObesityIRS

Allowable Medical Expense Deductions: In total medical deductions amt pd for

weight loss IF Tx for disease diagnosed by MD (obesity, HTN, CVD)

Bariatric Surgery, MNT, Approved Drugs Fees at gym for separate activities Special foods only beyond normal needs

ObesityCMS

Has NOT designated obesity as disease“Treatments for obesity alone remain non-

covered and coverage for treatments resulting in or exacerbated by obesity remain unchanged.”

Current and Past IssuesIndiana School Food Quality BillPhysician’s ReimbursementCertification Status

Licensure or Certification?Licensure defines scope of practice -

defines what you can and cannot do as a dietitian

Certification defines the profession - the educational requirements for someone to call themselves a dietitian

Certification does not define scope of practice

Licensure is preferable but difficult to enact.

Indiana has Dietitian CertificationDietitian Certification Application Formhttp://www.in.gov/icpr/webfile/formsdiv/47

586.pdf

Dietitian Certification-Title 830http://www.in.gov/legislative/iac/iac_title?&

iacv=iac2003&iact=830&iaca=all

Displaying Dietitian Certification Certificatehttp://www.in.gov/legislative/ic/code/

title25/ar14.5/ch4.html

The Pitch!Legislative Involvement

It is up to you and I!Public Policy WorkshopDay at the State HouseYOU are the dietetic

professional – YOU have tospeak up for your interests!

ResourcesOn The Pulsewww.eatright.orgwww.dietetics.com/idaADA’s Medicare MNT Provider

Newsletter

Thank You!

Martha Rardin, MSM, RD, CD

IDA Licensure [email protected]