CANP Member’s Outreach Leads to
Legislation Preventing Delays in Patient Care

By Stephanie Jordan
Managing Editor, Connections

When a patient came to Sheri Rickman Patrick with a form that required a signature, Rickman Patrick was shocked and dismayed at what she discovered.

The patient, whom Rickman Patrick knew and describes as being particularly savvy, wanted to be allowed a free specialized phone through California Phones that would make it easier for her to hear, dial, and make calls. The patient wanted Rickman Patrick to help her get into the California Telephone Access Program by certifying that her level of impairment qualified her for equipment provided under California state legislation.

“When I looked at the form, I discovered that practically everyone under the sun could certify her need,” exclaimed Rickman Patrick, “except a nurse practitioner!”

Indeed, the form listed a range of health professionals including: Licensed Medical Doctor (MD), Licensed Speech-Language Pathologist, Licensed Audiologist, Licensed Optometrist, Licensed Ophthalmologist, Physician Assistant, Licensed Hearing Aid Dispenser, and a Veterans Administration Medical Doctor, among others.

“I promptly called the program and gave them an earful,” recalls Rickman Patrick. “I told the person on the other end that I knew she couldn’t do anything – but this is causing a delay in my patient’s care.”

Assembly Bill 1514

Advancing the role of NPs in the state and nationally is very important to Rickman Patrick. She strives to fulfill this by being an active member in the California Association for Nurse Practitioners (CANP) Sacramento Chapter and has served on its board for many years from president to scholarship chair.

“A short time after the form signing incident, I happen to receive an email from CANP Legislative Advocate Kristy Wiese,” says Rickman Patrick. “Kristy was asking: ‘What can we help with? What is challenging for you?’ I responded with the need for NPs to be added as a certified agent on this form.”

After analysis of the issue, it was determined that only a change in law could get NPs added to the form to certify a patient’s degree of deteriorated hearing to qualify for the program.

“What we needed was a sponsor for a bill, just so I could request a phone for my patient. It really was kind of silly, considering all the types of other people already on the approved list,” believes Rickman Patrick. “The form could be signed by a physician that might never have seen this patient before, or a physician’s assistant, but not by me.”

Along with working for the advancement of NPs in the state, Rickman Patrick also works toward that goal nationally by serving as the Northern California State Representative for the American Association of Nurse Practitioners (AANP). While she does not consider herself to be “a political animal,” she sees the need to be politically active. Rickman Patrick knew the ability to certify for a phone was seen by many as low-hanging fruit.

This past September, more than 18 months after Rickman Patrick’s patient came to her with the California Phones form, Governor Newsom signed Assembly Bill 1514, introduced by Jim Patterson (R-Fresno). The bill expanded under existing law the Deaf and Disabled Telecommunications Program to additionally authorize a nurse practitioner to certify the needs of an individual who has been diagnosed by a physician and surgeon as being deaf or hard of hearing to participate in the program after reviewing the medical records containing that diagnosis. The bill additionally authorized a nurse practitioner to certify a subscriber for specialized or supplemental telephone communications equipment.

“The more I have done legislatively, the more I realize that the political process is not as straight forward as one might think,” explains Rickman Patrick. “I have learned something new each time. There is no perfect bill. I have learned that if you want to get a change in a bill, you must first get it moving, and then you can get an amendment made to make it better. You also have to make concessions.”

Rickman Patrick goes on to say, political entities can put a lot of pressure on someone and that the loudest voices often win.

“If you were this loud and they were THAT LOUD, the loudest voice is the one that is most heard,” she said. “Many of us NPs were not trained in school to be advocates. I wish I could get across to all NPs in the state that if you want something, you have to be part of the political process. You have to show up and lend your voice to the loudness for what you support. I really encourage CANP members to be active and go to the Capitol and talk.”

A Good Patient Outcome

As for AB 1514, Rickman Patrick believes they found the right person in Assembly Member Patterson.

“Kristy found the right person to take it up. I started it out of frustration, and CANP heard me and went after it,” said Rickman Patrick. "We had a good patient outcome. Nurses and NPs are not great at taking the bow. It was a strong team effort and shows what can be done if you speak up. Now all my NP colleagues from across the state can sign the form for themselves, without a physician. While this may not be a huge step, it makes things easier for patients, and that is a good thing.”