NPAC-AIIPC Council Meeting Minutes – November 5, 2018

NPAC-AIIPC Council Meeting Minutes – November 5, 2018

Download the NPAC NP Council Meeting Minutes – Nov 5, 2018


NPAC NP Council Meeting Minutes

November 5, 2018 7:00PM EST


LOCATION Teleconference QUARUM (Y/N) Yes
ATTENDEES Dani Daigle (NNPBC), Frankie Verville (SANP), Cindy Fehr (NPAM), Claudia Mariano (NPAO), Laura Gould (NPNB), Raelynn Lagace (NPNB), Chelsea Rogerson (PEINPA), Deb Hart (NPANS), Lenora Brace (NPAC), Alison Ross (NPAC), Lindsey Cassell (NPAC)
REGRETS Becky Sheppard (SANP), Ashley Pylypowic (NPAM), Dawn Tymianski (NPAO), Marnee Wilson (NPAO), Kirk Dawe (NLNPA), Alisa Fowlow (NLNPA)




Welcome & Introduction –     Lindsey opened the meeting at 7:04 EST as the NP Council Chair

–     Welcome to all provincial partner attendees

NP Council

–     Approval of agenda

–     Approval of past meeting minutes

–     Terms of Reference

–     NPC future dates/times

–     Lindsey proposed meeting agenda for approval. Motion approved by Deb Hart and seconded by Frankie Verville.

–     Motion to approve past NPC meeting minutes held Sept 6, 2017. Chelsea Rogerson motioned to approve. No one else present to second the motion, and Dani Daigle suggested contacting Sue Peck to second the motion.

–     Terms of Reference reviewed. No changes have been made to TOR since they were approved last year. For information only.

–     Discussion: No questions or concerns voiced over current TOR.

·         Lenora informed that NPAC is currently reviewing organizational items to be amended, including adding NP Chair to NPAC Bylaws. To be voted on at next AGM (date for AGM to TBD).

–      Lindsey proposed that future NP Council meetings be held on the 1st Monday of every second month at 7 pm EST. It was suggested if the 1st Monday falls on a holiday, the meeting will be held the following Monday. There were no objections for the proposed NPC schedule. Motion approved by Deb Hart, and seconded by Laura Gould.




Lindsey to get Sue Peck to approve minutes of last meeting.

Platform for NP Council Communications ·         Mailchimp showing less than 50% of recipients opening emailing sent by NPAC. Open to suggestions with regards of format type and frequency of communication from NPAC.

·         Discussion: Deb Hart (NPANS) mentioned a possibility of having information posted to website and email membership link to information as they do at NPANS. Deb also sends out a 1-pager informal update monthly to members. Frankie Verville with SANP does the same.

·         Laura Gould (NPNB) sends a newsletter every 2-3 months to their members with updates.

·         Cindy Fehr (NPAM) sends bulletins through e-blasts with important items only on a regular basis. Better update from membership in this format.

·         Claudia Mariano (NPAO) sends 1 email per week to members.

·         Lenora approached by member about collecting data from all provinces and disburse information that can be relevant to all provinces through NPAC.

Will bring ideas back to NPAC BOD to develop and incorporate communication strategies suggested by NP Council.






Provincial partners to copy Lindsey and Lenora on newsletters/bulletins to be considered for distribution to all members across the country

NP Week

·         Proclamation

·         Tool Kit

·         Funding for NP Week celebrations

·         NP of the Year Award

·         NP Week is a way to increase awareness for NPs in Canada and is scheduled for Nov 11-18. Coincides with American NP Week.

·         We are requesting the Federal Health Minister to issue a proclamation declaring this week as NP week. Stan Marchuk is currently tasking this item with the health minister. NP Week will go ahead regardless of proclamation. Manitoba has declared a “NP Day” for their province.

·         A resource guide/tool was created and available for the jurisdictions to utilize for NP Week with the goal to unify the jurisdictions during NP Week. Email has been sent to provincial partners

·         NPAC will reimburse up to $500 per provincial partner for funding to hold celebrations within their jurisdiction during NP Week. This money can be utilized for social events, advertisements, MLA/MP invites. Cannot be used for gifts/prizes. Receipts to be submitted within one week after NP week celebrations.

·         NP of the Year Award will be announced during NP Week. Some of the nominations received were not NPAC members, and need to ensure nominees are members to receive award.

The resource guide will be posted and notification of its availability will be sent to NP Council Members




Lenora to resend to Deb Hart.

NPAC Call for Nominations for Communications Officer –      The current Communications Director for NPAC has resigned for personal reasons and the position is now vacant. NPAC will put a call out for nominations at the end of November. Being bilingual for the position will be considered a strong asset, to be more inclusive in communicating with our Francophone NPs. The position will be voted on during the AGM in January 2019.

–      NP Council members are asked to share with their jurisdictions to put names forward for nominations once the call goes out from NPAC.

NPAC to issue call for Communications Director
Insurance NP Signing Authority Update –       This is an issue affecting NPs. CNA has also been doing work, along with other jurisdictions with regards to this issue

–       On NPAC’s website, NP members can access a pre-developed letter that they can send to insurance companies of issue. NPs can fill in the blanks on the form and a letter will be auto-populated with their information.

–       Discussion: Many issues still ongoing with consistency amongst acceptance of NP signatures with multiple insurance companies. Issues seem to flare when policies are renewed. Coverage can also be employer driven when they renew policies with insurance companies.

–       There is a meeting schedule this week with CNA to address this issue. Questions were sent out to membership for specific feedback with regards to current insurance companies not accepting NP signatures.

–       NPAO has been in contact with Joan Weir – Director of Health & Disability Policy for the Canadian Life & Health Insurance Association who has a body support NP authority.










Develop a letter for Joan Weir regarding issues with NP authority for prescriptions. Send to all provincial partners to sign the letter prior to sending to Joan.

NP Sample Distribution

– Introduction & Update

–       Still illegal under Federal Drug and Food Act R.S.C., 1985, c.F-27

–       CNA has also been working on this issue. Josette Roussel working on the Food & Drug Act (section 14-2) to be reopened, hopefully through a Compassionate Drug Program. This will not be an easy change as it has not been opened for 15+ years, but CNA are continuing to bring up this issue and ensure that it will be addressed once the Act is opened. There is a push for a national pharmacare program that may allow the opportunity to reopen the Food and Drug Act.

–       Discussion: Claudia Mariano stated that Dawn Tymianski (NPAO CEO) has an upcoming meeting with a local NP who is championing drug sample distribution at the federal level. She is proposing to bring a motion forward in the House of Commons, with the current Act being a barrier (they just need to add NPs to current language within the Act). Patients are able to access medical cannabis, but not drug samples for those that need them, by NPs.

Portability of NP License in Canada

– Introduction & Update

–       NPAC has this item on their radar and still in development. Stan Marchuk and Teresa Chulach with NPAC are currently undergoing research into this issue.

–       Discussion: Issue with NPs that provide care in multiple jurisdictions who are required to have a license in both and consistency with scope of practice between the various provinces.

Stan and Teresa with NPAC BOD researching topic.
Membership Overview –         Looking at developing a web portal for members to renew their membership with NPAC. Stan Marchuk also reviewing various strategies to recruit new membership. Block membership is a tedious process and not user friendly.  
Choosing Wisely Canada –         9 items developed in 2017 that were NP specific guidelines and approved by NPAC and CWC.

–         Lindsey has been assigned within NPAC BOD to take on developing new guidelines for CWC from an NP perspective.

–         Discussion: Claudio Mariano (NPAO) wondering why NPs cannot be included or represented in partnerships with other healthcare providers (ie, physicians) since some of the guidelines are applicable to both groups. CWC guidelines are health provider specific and are group driven. Partnerships would have to be formed for this to happen.

–         Laura Gould (NPNB) states that a partnership was formed between NPs, physicians, and pharmacists to develop specific guidelines to give patients.

To discuss CWC guidelines further at next NPC meeting for new ideas for submission. Possibility of developing a sub committee to take on this work and gather NP best practices across the country.
APN Framework –         CNA proposing new APN framework update. Items in the framework blur the role of the NP and CNS and do not completely represent the differences between the two roles. NPAC developed, recommended and proposed changes to language in the framework. A teleconference with Mike Villenueve and Josette Roussel was held with NPAC BOD to discuss the APN Framework and CNA to take recommendations to the CNA board for discussion.

–         Discussion: Deb Hart (NPANS) identifies that even amongst health care professions, there is confusion over the NP role and agrees that the NPAC definition of NP provides more clarity and will bring forward the new definition to NPANS executive.

–         Dani Daigle with NNPBC also agrees with Deb and notes that work of NPAC is excellent and doing really important work.

–         Frankie Verville (SANP) also meeting with Sask. regulators to remove registered nurses from their definition of NP. Need a pan-Canadian definition that everyone uses that provides clarity to NP role across the country. NPAC definition could be used for this purpose.

Other Discussions –         Prescribing medical marijuana. Some provinces have still restricted NPs from prescribing medical marijuana. Discussion over whether NPs are permitted to prescribe based on federal or provincial regulations.  
–         Further membership engagement. Frankie Verville proposed that our NP Education partners be approached to include and encourage NP students about leadership roles and advocacy work and how to operationalized that when they begin practice. CASN would be a great organization to approach this idea with.  
–         Lenora discussed NPAC developed a new definition of a Nurse Practitioner. Previous definitions used by national organizations create a blurring of the RN and NP roles. Definitions for NP need to remove the inclusion of registered nurses and move to the term regulated nurses within the definition.

–         CASN was asked to use NPAC NP definition in the E-prescribing Guideline Glossary. New definition has also been shared CNA for use within the organization. The new definition now on NPAC website.

–         Discussion: NP definition has be clear and without confusion for the public and amongst healthcare professions, where there is still confusion regarding the role of NPs. More safe, and politically correct conversations about NP role and definition are needed. Many members stated that they would also like to update their definitions on their provincial websites to reflect NPAC’s definition and agreed with the current language and definition NPAC has developed.

  – Deb Hart (NPANS) informs that Nova Scotia will be hosting the ICN NPAPN Conference in 2020. The committee is asking for more members across Canada to help out and join sub committee to help carry out the work of planning the conference. Forward on to all associations across Canada. Deb to send an email to Lenora to send out information to all NPAC members.
  – Deb Hart (NPANS) asked if the NP Council members can access NP Council documents on the NPAC website portal. Currently cannot gain access to this area on the website. Lenora to bring forward to BOD and pose the question.
  –     Laura Gould (NPNB) discussed new agreement with

CNFU and with general practitioners within New Brunswick that allows NPs to fill in/replace fee-for-service GPs when they are on leave. NPs will be salaried/shadow billing and cannot bill MCP, but this new model will allow NPs to shine and prove that NPs can do fee-for-service work as well.

  – Cindy Fehr (NPAM) brought new issue forward with regards to NPs ability to sign off on passports, but unable to sign off on any travel documents. This is causing issues for NPs, particularly when working with their immigrant/refugee clients, which is significant. Cindy feels this is a federal issue and wondering if NPAC can advocate this issue. Need to verify if the basis of the issue is a provincial or federal barrier.

– Cindy also on a provincial advisory taskforce (PNATF). Willing to help with the Health Canada work that’s ongoing. Would also like to help with engaging more NPs in advocacy. There is a struggle of not knowing what work NPAC is involved with. Willing to help with communication strategies to promote engagement.

– The CEO at NPAMS (Cindy Fehr) is in a paid role for 20 hours per month. This role provides continuity when members within the executive change out and new members join. Recommended that NPAC also have a person in a paid role that provides that level of continuity and proposed that it be discussed at next AGM.

Lindsey to check with NP in NL who works with the refugee population.
Next Steps

·         Upcoming Meeting Schedule

·         Required Actions from NP Council

–         Next meeting January 7, 2019 at 7:00PM EST

–         Provide any agenda items for future meetings to Lindsey

–         Meeting minutes will be sent to Lenora and Alison for review, and then will be sent to NP Council members for review and any corrections.

Adjournment Motion to close: Deb Hart. Seconded by Chelsea Rogerson. Meeting was adjourned at 8:42 PM EST