Laboratory Licensure:  The 2009 Legislative Journey

The Minnesota Laboratory Licensure Coalition made much progress during the 2009 legislative session.  We worked with a variety of stakeholders to modify the bill and saw forward progress in the legislative process.  On April 1, the coalition was informed by co-chairs Rick Panning and Kathy Hansen and lobbyist Vic Moore that the process would end for this year, the first in a 2-year legislative session.  Although it is disappointing to have to make a decision to not continue, it is important to understand the progress that was made and to plan the next steps as we prepare for 2010.

We had successful committee votes in three Senate committees – Health, State and Local Government Operations and Judiciary.  We will also need to go through the Health Finance committee and the full Senate Finance committee to get the bill to the floor of the Senate.  In the House, we were preparing for our first hearing in the Licensing Division, an 8 member committee, requiring a vote of 5-3 to pass and move on to the full Health Committee.  We predicted a 4-4 vote and it was not wise to risk a losing vote.  We could choose to continue in the Senate and work towards a floor vote, but it is likely that if we tried to continue, the Senate would be aware that we were not able to start our House process and decide not to act on our bill.  This could have meant starting over in the Senate next year.  Vic Moore advised us that we were better off holding our position in the Senate, preparing for the House process and starting from a position of strength in early 2010.  We also need to be aware that the all-consuming priority of the legislature is the budget, and our representatives must focus on that issue.

This does not mean that we just wait until the beginning of the 2010 part of the session and start where we left off.  We have work to do in the interim to place us in a better position.  The tasks and process are outlined below.

• House of Representatives

• Representative Cy Thao (St. Paul), Chair of the Licensing Division (Subcommittee), will formally request that the Council of Health Boards do a complete review of our bill and report back to the committee before the 2010 session.  The Council of Health boards is an independent body established as a resource by the legislature specifically for this purpose, but has only been used minimally.  In both legislative sessions that we have been active, we submitted the Council’s questionnaire as our bill was introduced (one of the few professions that did).  It was always the prerogative of the committee chairs to ask for a review of the bill.  We decided to be proactive and have this completed and made available for 2010.  There is a good chance that there will actually be a bill introduced next session to require this review for all licensure bills.
• Advocacy:  The coalition will work to gain support of the members of the Licensing Division and the complete House Health Committee.  Since there is no election in 2009 the members will be exactly the same.  We will identify the communities and hospitals, clinics and laboratories in each of their districts.  We will make specific requests for individual laboratory professionals who live and work in the district to invite legislators to their laboratories and to visit with the legislators when they are back in the district.  We MUST develop personal one-to-one connections with the legislators to be effective.  We know that it does make a difference.

• Senate

• Senator Gary Kubly (Granite Falls), our Senate sponsor, will formally ask the Minnesota Department of Health to prepare a fiscal note for the finance committees.  This step is necessary for the legislators, public and our professionals to understand what the fees will be to assure that that the implementation of licensure will have no cost impact on the State of Minnesota.  The cost of the licenses to our professionals must cover the cost of administering the program.  This is an important step and provides in an important piece of missing information.
• Advocacy:  Similar to above, we will be identifying the members of the Senate Health Finance subcommittee and the full Senate Finance Committee.  The first committee has 10 members and we will need a 6-4 vote.  The second committee has 20 members and we will need a 11-9 vote.  This doable if we do our homework.

Other steps:

• Communication to Minnesota laboratory professionals:  This article will be circulated through the various laboratory professional societies and by other means.
• We thank those organizations that worked with us to assure that we made forward progress in this session.  This includes the Minnesota Society for Pathology (specifically their current president and past president, Dr. Larry Burgart and Dr. Sue Wheaton, and their executive committee).  They worked with us at a detailed level to make a number of changes to the bill.  It also includes Mayo Clinic laboratory administration where Dr. Curt Hanson and his team worked closely with us to make changes that would help assure that the bill could be acceptable to the Mayo Clinic.  In both of these cases the organizations were officially neutral with no opposition.   Finally, the Minnesota Hospital Association (MHA) worked closely with us to assure that the bill would meet the needs of the hospitals and MHA was officially (and in writing) unopposed to our bill.  We still have some work to do with this organization and their members to demonstrate why licensure is needed.
• Work to address issues brought forward by opposition during Senate testimony and privately.  We have already proposed changes to our bill, approved by the coalition, that would address some of the concerns of the opposition.  In other cases, we cannot make some of the requested changes because it would go against some of the basic principles of our bill (for example requiring a Bachelor’s degree to be licensed at the CLS/MT level.)

• Although some specific hospitals and hospital systems are supportive of our effort, others are still opposed and their concerns have been voiced directly to some legislators.  Within the organizations where we work, we must find a way to discuss this issue with administration and convince them of the need for licensure and the value of qualified laboratory professionals working in healthcare.

The licensure coalition will be meeting in the near future to organize the work that needs to be done.  We did make significant progress this year!  It has become apparent that each of our laboratory professionals can make a difference in this legislative and political process.  A few examples are:

• In the Senate Health Committee hearing, Karen Renaud (laboratory manager in Mora, MN) gave very powerful testimony about the need for well-educated, certified laboratory professionals in a small community, where often one individual is working alone and having to make very important decisions.
• Our colleagues in Duluth, who over a weekend, when I was calling and emailing them on a Friday night and a Saturday morning, called a Senator at her home to make the case for licensure.  This is a district, however, where we still need hospital administration engaged.
• Cheryl Swinehart, a CLS from the U of M Clinical Laboratory Science program, was able to contact the representative from her district, persuaded him change his mind and agree to hold a hearing on the bill, when initially he was a “no” vote.

Each one of you can make a difference.  Your support has been invaluable and we will continue to need it as we go forward.  In the survey of laboratory professionals in January , only 11% of the 1200 CLS/MT and CLT/MLT professionals who responded were opposed to licensure.  This level of support is important to our effort.  Thank you!

Rick Panning, CLS(NCA) and Kathy Hansen, CLS(NCA) – Coalition Co-chairs