Kristy Wiese, CANP Legislative Advocate and Partner, Capitol Advocacy

In this edition of Connections, we introduce a new regular feature: Focus On... The emphasis of these Q&A style interviews will be to highlight a member, have a conversation with an authoritative expert, spotlight an innovative program, or profile a trend. If you have a suggestion for a person or topic we should consider as a future Focus On... subject, please email Stephanie Jordan, Connections Managing Editor, at sjordan@freelancecomm.com.

Kristy Wiese, a partner with Capitol Advocacy, brings over twenty years of experience in both public and private interests to her diverse array of clients. An expert in health care policy, scope of practice issues, professional licensing, for-profit education and telecommunications, Kristy is a trusted and well-respected policy and political advisor, with established relationships throughout state government. Kristy has represented the California Association for Nurse Practitioners for more than 10 years.

Connections:
How did you become an advocate and when did you join Capitol Advocacy? 

Kristy Wiese:
I have been lobbying professionally since the late 90s when I started working at the Capitol on behalf of one the state’s largest non-profit clinic organizations. It was an amazing way to learn the process and I often describe it as learning to swim by being thrown into the deep end of the pool. After that, I went to work in the Governor Davis Administration, which was an experience that was enormously helpful in learning how state government interacts with the Legislature. I have been a contract lobbyist since 2004 and I have been at Capitol Advocacy for almost nine years. 

Connections:
How did you become an expert in health care policy? 

Kristy Wiese:
My expertise in health care policy has really been developed over years of working on issues relating to the health care delivery system in California, and having the benefit of working with many subject matter experts in the space. As a contract lobbyist, I rely upon the expertise of those experts, my true expertise is in how to influence and navigate the legislative and regulatory environments in order to shape public policy. I have seen firsthand how access to health care, or the lack of it, can dramatically impact a person’s life. 

Connections:
The Association has, at least temporarily, shifted its focus from AB 890 to the recent COVID-19 responses, including Governor Newsom’s recent Executive Order pertaining to health care providers. What do these Department of Consumer Affairs waivers submitted by CANP mean for nurse practitioners?

Kristy Wiese:
California is facing an unprecedented public health crisis, the likes of which we have never seen in our lifetimes. NPs play a critical role in the health care delivery system and are mobilizing to expand their ability to provide care, given the COVID-19 crisis. While the Legislature is shut down, CANP has been focusing on ways to support the Governor’s efforts to mobilize as many health care providers as possible. By granting authority to the Department of Consumer Affairs Director to waive statutory and regulatory requirements as needed, the Administration will allow NPs to work more broadly, should California experience a surge in COVID-19 patients, similar to what other states have experienced. 

Connections:
The California Legislature is currently slated to return to the Capitol on May 4, 2020. Should this hold true (given the uncertainty with COVID-19), with AB 890 currently in the California State Senate, what does this mean for the near and long-term prospects for the bill? 

Kristy Wiese:
It is unclear what the future legislative landscape looks like at this time. There is great uncertainty about the timing and process of the remainder of the legislative session. Both the Senate President Pro Tem and the Assembly Speaker have asked legislators to taper their bill packages to focus more narrowly on the issues that California will be grappling with as a result of the COVID-19 crisis. It is too soon to predict with any certainty what that means for AB 890, but we do know that Assembly Member Wood remains very committed to pursuing AB 890 and has identified it as one of his highest priorities. 

Connections:
What is the most misunderstood political element in the State Capitol as it relates to scope of practice and nurse practitioners; from the perspective of legislators, and that of the nurse practitioner community?

Kristy Wiese:
What is most misunderstood is the reality in which nurse practitioners are actually practicing. There is a perception that “physician supervision” means that the physician is physically present, looking over the NP’s shoulder, when we know that nothing could be farther from the truth. We have lots of education to do to explain to legislators and staff how NPs actually do practice, and how that varies depending upon the many diverse settings in which they see patients.  

Connections:
Given there’s no CANP Lobby Day this year due to COVID-19, if you had one request of nurse practitioners in California as it relates to legislative advocacy or grassroots advocacy, what would you ask them to focus on?

Kristy Wiese:
While we have a number of communications challenges that have been created by COVID-19, there are still opportunities to connect with legislators. All of California’s Assemblymembers and Senators are still looking for ways to connect with legislators, many are taking meetings by phone, hosting virtual town halls, and focusing on how they can continue to dialogue with their constituents. To that end, the ask is much the same as ever — nurse practitioners should be connecting with their legislators, and educating them about their practice, how they are helping provide access to care, how their practice is being impacted by COVID-19, and how they might be able to partner together. Creating relationships and finding opportunities to work together is always key, and while Lobby Day is focused on doing that at the Capitol, there are still opportunities to do it directly (virtually) away from the Capitol. 

Connections:
Why are California's efforts for full practice authority in general, and specifically with AB 890, so controversial with the American Association for Nurse Practitioners (AANP)? What should CANP members take from the AANP messaging consistently opposing California efforts?

Kristy Wiese:
California has one of the most robust legislative processes in the country, which also brings with it very intense politics. On many issues, California is ground zero. There is a saying, “As goes California, so goes the nation” because so much of what we do here is then imported to other states. The AANP has to grapple with this and so naturally, they want any legislation that is passed in California to reflect the model legislation that they have promoted. Unfortunately, given the intense opposition from organized medicine to allowing NPs to work without MD supervision, compromises are necessary to pass this legislation in California. CANP is comfortable with these compromises, as they still move NP practice forward and expand access to patient care in California. The AANP is not comfortable with AB 890, as they are looking at the implications for other states. 

Connections:
What is it about CANP that you admire and makes you committed to work hard on their behalf?

Kristy Wiese:
I love our nurse practitioners! They are truly on the front lines of patient care every day. I admire their commitment to their patients and their passion for their practice. It’s an honor to represent them!