Do you know who decides how you will practice as a CRNA in Georgia?
It is the elected members of the Georgia General Assembly who represent each of our communities. The state legislature is comprised of 56 State Senators and 180 House Representatives. The bills they develop and laws they create have a direct impact on your practice and ability as a CRNA to serve your patients to the fullest extent of your training.
First, you have to know what a bill is and how it is created. A bill starts out as an idea from an individual or group. For example, someone thought it was a good idea to set up speed limits. This group must then convince a legislator that the idea is worth pursuing. If the legislator agrees, they write a bill (a proposal that is the first step to creating a law) and works to get it introduced.
Once the bill is introduced it then must go through multiple steps in order to become law. In GA, it takes several procedural steps prior to reaching the governor’s desk for final enactment. There are multiple ways to ensure a bill moves through the process a) smoothly, b) with several bumps in the road or c) not at all. If you want to create a bill, and ultimately turn the bill into a law, you need to know a legislator that is willing to work with you and your idea. Together you work with this person to create the bill and get it introduced. One legislator is likely not enough to get this “idea” off the ground. You will want to establish other friends in the legislature to help support the process. These might later become sponsors of the bill. Sponsors are basically law makers that support the bill and work toward getting the bill passed. There is a schedule or process that goes on in the majority party’s caucus that plays a role in which bills will be introduced in the legislature, thus relations with members of the majority party is a plus. Ultimately, the leadership has the final say in which bills will be pursued in any given legislative session.
After the introduction of the bill, it is referred to the appropriate committee. Next, you have to make sure the committee chair is willing to take up the debate over the bill in committee. Should that occur, what follows is a public hearing, where all interested parties are invited to speak of their support for or against with the bill. That hearing is followed by a vote of the entire committee to determine whether to proceed. If it is recommended, then the bill is voted on. Once it passes on the House side, it goes to the Senate, where the whole process is repeated. If the bill passes the Senate, it is then sent back to the House to confirm that no further changes (if any were made along the way) have been made. The bill then heads to the governor’s office.
The best way to ensure this works, is to KNOW YOUR LEGISLATOR!!!!! The more legislative friends you have, the better your chances to create a law. Continuous education must be done in order to ensure success. It is also wise to form allies outside of the legislature with groups that will potentially support your bill and be willing to testify on your behalf.
There are numerous opportunities during this process to prevent a bill from becoming law. If no one supports the “idea”, the bill is not created. If the bill is created, and there is no support, the bill is never introduced. Let’s assume it is introduced….Does the committee chair to which it is introduced feel the bill has merit? If there is a public hearing, voice your opinion against the bill. The committee may vote to not refer to the full house or senate. If it passes one house, the same steps are repeated until passage in the next house. Every step is an opportunity to stop a bill (or advance it). Once both houses pass the bill, the house and senate versions are consolidated before going to the governor’s desk. The governor can veto the bill, sign the bill or do nothing. A veto means the bill dies permanently, or temporarily, if the house and senate pass the bill by a 2/3 majority on a revote after which the bill becomes law. If the governor signs the bill or does nothing (no action for 6 days), the bill becomes law.