CNPA Board Meeting Notes – November 2018

Brief History of CNPA

  • Rick as president and legislative chair for last 5 years
  • 30-32 CNPA members, last year was 91 members
  • Greatest struggle: money, we pay our bills, not behind, but we’ve been able to do that is from relationships with UB, personal funds from Rick, and one major benefactor
  • When Rick took over records and admin, CNPA was quite disorganized
  • Conference was not well attended and made little or no money
  • Last 5 years have had much better turn out
  • $7-12K/year, with 8-14 vendors attending
  • Dues last year collected $38,000, fell short of our expenses

Current Responsibilities of the CNPA

  • Keeping up list of NDs
  • Pay bills (lobbyists, admin, etc.)
  • Customer service/member management
  • Membership mailings
  • Membership certificates
  • Accounting
  • Website management
  • Legislative support

Current Board Members

  • Rick Liva
  • Lisa Singley
  • Robin Russell
  • Jonathan Goodman
  • Jackie Germain

CNPA Bylaws

  • ACTION ITEM: SARAH to send bylaws and truncated version of bylaws to all on the call
  • 4-8 board members, and there are standing committees that are outlined within bylaws
    • Legislative
    • Professional Affairs
    • Public Affairs
    • Education
    • Practice Management


  • President
  • VP – can have more than one
  • Secretary
  • Treasurer

Online Elections

  • Elections will be held during the first two weeks of December via an online ballot
  • For those interested in running for board positions (and who haven’t already been contacted by Rick or Sarah), please email us at so that we can put you on the ballot!
  • Rick intending to run for re-election of president, including treasurer status
  • Legislative Committee is most important, but we also need folks for fundraising!

Legislative Effort

  • Five years of unsuccessful lobbying for prescriptive authority
  • This summer, survey results indicated that the #1 priority is to have prescriptive authority
  • Will not get full authority first time around, but that is the ultimate goal
  • Expensive to hire lobbyists, especially on top of administrative costs
  • The last five years have been instrumental in building key relationships
    • Speaker of the House
    • House Majority Leader
  • Now waiting to learn who will be on the public health committee – first hurdle is the public health committee raising the bill
  • Last year, they raised a bill within the first two weeks of the session
  • Every other year is a budgetary and fiscal session
    • Much harder to prevail during these types of sessions

This Year’s Priorities

  • Need to include the home district of each ND in the CNPA in order to determine the appropriate legislator for each ND
  • Legislators primarily only respond to their own constituents from their own districts
  • Representatives and Senators, may cover one town or multiple towns
  • Talk to patients about what’s going on in the legislative session and how they can support us by talking to their legislators
  • 358 NDs licensed in CT, not all live in CT (240 live and practice in CT)
  • If we are able to get practices with lists of patients, family, friends, and ask them to communicate with their legislators about prescriptive authority
  • Yearly: when we go to legislator, encourage to raise bill
  • Public hearing if the bill is raised – we are granted 3 minutes of testimony
    • Missing piece: how many people sent testimonies in to support us?
      • These are published online, can track for past five years
      • 20-30 people in the first few years, last year there were 100-200 testimonies
      • “Important to me as citizen of CT…” goal: 600-700 testimonies
    • The most important thing is having each ND write to/chat with their own legislators
    • Helpful to have other groups support us, but not bombard the committee since they need to post each testimony
    • Face to face meeting is ideal
      • CNPA members to communicate with your patients

Patient Donation Letter

  • Letter that tells patients what NDs are after (prescriptive authority)
    • would you be willing to donate toward the cause?
    • Propose to add $1 toward CNPA donation for legistlative effort every time they came into the office for a visit

Linda and Dave’s Notes

  • Legislators are most responsive to those who live in their districts
  • New blood would be very helpful for the cause, so please get involved this legislative cycle
  • New governor, lieutenant governor (supports us!)–some good opportunities to make headway in 2019
  • All of this sounds daunting, but it’s not! We’re all human! We can do this!

Questions and Comments

  • Sandra, ND and APRN – part of a medical freedom group that has actively lobbied at the capitol, concerned with blocking naturopathic medicine on every level because of Ned Lamont’s wife’s business in healthcare investments
    • Linda’s response
      • Process of government changeover: commissioners submit resignation, then governor appoints new commissioners
      • This governor will have his hands full with budget, paid sick leave, etc.
      • Believes the legislators will support prescriptive authority
      • Officials should be finalized within the next several weeks
      • HB 5214 – granting medical assistants the ability to administer vaccinations
        Held up in the house, ultimately failed
  • Jaquel Patterson, Fairfield, CT – AANP
    • Have we done partnerships with other groups that might align with us?
      • Employers, hospitals, etc
      • When someone works with an agency, it is very helpful – may be an untapped source of support
    • In the past, CNPA has worked with UB closely, supported the college and attempted to keep millenials within CT
      • Would like to continue nurturing this relationship
    • CNPA would be very interested in behavioral health support
      • Jaquel offered her connections within behavioral health profession
  • Can Rick outline exactly what the bill proposes for Rx authority in CT?
    • Exclusions and inclusions by category, rather than by individual drug
    • RICK – will provide specifics to anyone who would like to see!
    • Did not want to write a list by drug because other states have done that, most especially Vermont, and have run into trouble
      • VT: DoH had to review their prescriptive authority EVERY YEAR for inclusions and exclusions. After several years of doing it and also years of skipping it, the State gave complete Rx authority within training because it was too much to manage
    • Exclusions: opioids, cardiac drugs, chemotherapy, antipsychotics
    • Inclusions: all injectable and IV nutrients
    • Legislators didn’t know what they were looking at, so changed tactics last year
      • In last version, used different language
      • Only wrote inclusion of categories of drugs
      • Willing to do a refresher pharm course, people would have to take course and pass test in order to get Rx authority
      • Ultimately was never adopted by public health committee
    • NOTE: MDs, APRNs always oppose us
      • Make the argument that people will get hurt because NDs are not educated enough
      • Counter argument: NDs have been Rx in other states from 10-40 years with no incident
    • 1982: CT laws only allowed prescribing food, Rick was instrumental in changing laws to do anything that is non-pharmaceutical or OTC pharmaceuticals, but ORAL ADMINISTRATION only
      • Nasal, dermal, suppositories – technically outside of our scope of practice
      • State doesn’t care about it really, but that’s the law
      • Malpractice insurance doesn’t cover anything other than oral administration of nutrients because it’s technically outside of our scope
      • Even if you are against the movement to get Rx, we need to change the law to include all of the different routes of administration!
  • Dana La Pointe – really likes the conference call format, interested in being on the board (thanks, Dana!)

Raffle Results

  • Free year’s membership and $100 gift card
  • Winner is Jason Bellejack!

Next Meeting

  • End of December to prep for Legislative Session
  • Stay tuned for more information

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Sarah Ouano

Sarah Ouano