The Recovery Enhancement for Addiction Treatment Act (TREAT Act) Senator Edward J. Markey (D-Mass.)

Maappn members we would like to hear your thoughts on the Treat Act. You can read about it below.


Overdoses from opioids, including prescription pain relievers and heroin, have increased dramatically in the United States. Nationwide, drug overdoses now claim more lives than car accidents. Opioid addiction is a chronic disease that, untreated, places a large burden on the healthcare system. Roughly 480,000 emergency room visits each year are attributable to the misuse and abuse of opioid pain killers. Effective medication-assisted therapy for opioid addiction, such as buprenorphine, combined with social and behavioral supports, can decrease overdose deaths, be cost-effective, reduce transmissions of HIV and viral hepatitis, and can reduce other social harms such as criminal activity.


Unfortunately, of the approximately 2.4 million Americans who abused or were dependent on opioids in 2013, only half received treatment for their condition. That’s because access to effective and evidence based treatments to help treat opioid addiction in outpatient and primary care settings, remains limited in part due to current federal restrictions.


More than ten years of experience in the United States with buprenorphine (Suboxone) to help treat opioid addiction has informed best practices for delivering successful, high quality care for patients with opioid use disorders. Thoughtfully expanding existing federal restrictions, with a focus on expertise and quality will help increase the number of patients who have access to life-saving treatment and will decrease long waiting lists that currently exist for many treatment facilities.


Unlike any other treatment regimen for any other disease, under current law in order for physicians to prescribe and use certain opioid addiction medicines, they must meet specific conditions and apply for a special federal waiver. Even with such a waiver, physicians are severely limited in the number of patients they can treat, contributing to long waitlists and the inability of patients to get treatment for their addiction when they need it.


The Recovery Enhancement for Addiction Treatment Act (TREAT Act):


  • Increases the number of patients a provider is initially allowed to treat from 30 patients to 100 patients per year.
  • Allows certain nurse practitioners and physicians assistants to treat up to 100 patients per year, provided they:
    • Are licensed in a state that already allows them to prescribe controlled substances
    • Complete approved training on opioid addiction treatment and
    • Are supervised by a physician who is approved to prescribe opioid addiction medicine, or are certified addiction treatment nurse practitioners who practice in collaboration with such a physician in a “qualified practice setting,” where allowable by state law.
  • Allows certain physicians, after one year, to request removal of the limit on the number of patients they can treat. To be eligible:
    • Physicians must be substance abuse treatment specialists, as recognized by specific board or society certifications, or
    • Non-specialist physicians must complete approved training and practice in a “qualified practice setting.”
  • “Qualified practice settings” are named in the legislation and include clinical settings that have defined oversight, performance metrics, or quality review, or that are part of systems serving populations with high need.
  • Requires the GAO to examine changes in treatment availability and utilization; quality of treatment programs; integration with routine healthcare services; diversion; impact on state-level policies and legislation; and use of nurse practitioner and physician’s assistant prescribers.

The TREAT Act is supported by the following organizations:


  • American Medical Association (AMA),
  • American Society for Addiction Medicine (ASAM),
  • Trust for America’s Health (TFAH),
  • American Association of Nurse Practitioners (AANP),
  • Association of American Medical Colleges (AAMC),
  • Harm Reduction Coalition,
  • Big Cities Health Coalition,
  • National Association of State and Territorial AIDS Directors (NASTAD),
  • Drug Policy Alliance,
  • Association of State and Territorial Health Officials (ASTHO),
  • National Association of County and City Health Officials (NACCHO),
  • Massachusetts Sheriffs’ Association,
  • Association for Behavioral Healthcare Massachusetts,
  • Connecticut Certification Board, Inc.,
  • Massachusetts Medical Society,
  • Massachusetts Association of Behavioral Health Systems, Inc.
  • The Massachusetts Hospital Association

Hearing Before the Health Care Financing Committee on Wednesday

Hospital profits and executive compensation came under fire on Wednesday, what is your opinion as a Maappn member to the hearing yesterday in Boston? Nurses and Union leaders are calling for a bill to force hospitals to disclose their financial information. Your thoughts and comments on this topic have meaning to our membership.

Hearing Before the Health Care Financing Committee on Wednesday

STATE HOUSE, BOSTON, JUNE 3, 2015…..Hospital profits and executive compensation came under fire Wednesday from nurses and union leaders who packed a hearing to urge the Legislature to pass a bill forcing hospitals to disclose their financial holdings and pay penalties on excessive profits and pay.

Fueled by the closures over the past year of full-service hospitals in North Adams and Quincy, health care workers associated with the Massachusetts Nurses Association lamented that critical services, including mental health and pediatric care units, are being shuttered while executives are taking home larger paychecks and hospitals are stashing funds in offshore accounts in the Caribbean.

“Hospital CEO’s should not get rich while our families struggle to secure basic services for our children,” said Susan Wright Thomas, from Cambridge Health Alliance.

Bills filed by Rep. Josh Cutler in the House and Sen. Michael Moore in the Senate (H 979/S 623) would require hospitals to report to the Center for Health Information Analysis all assets and financial holdings, including those held by offshore financial institutions and investments outside the United States.

“Transparency of health care costs is one of the key ingredients to our health care system,” said Cutler, a Duxbury Democrat.

Hospitals with less than 60 percent of patients on Medicaid that report profits in excess of 8 percent or any hospital that receives state funding and compensates its CEO at a rate greater than 100 times the annual salary of the facility’s lowest paid employee would also have to pay penalties. Those fines would be put into new Medicaid account to increase rates for hospitals with larger low-income patient populations.

The bills were the subject of a hearing before the Health Care Financing Committee on Wednesday, co-chaired by Rep. Jeffrey Sanchez, of Boston, and Sen. James Welch, of Springfield.


Once Again It’s Time For Our Annual Maappn Membership Drive

Dear Friends and Supporters,

Once again it’s time for our annual membership campaign drive. Your support really means a lot to us and allows us to continue to represent the interests of advanced practice psychiatric nurses and the clients we serve.

Our members have enabled us to accomplish so much this year. We were able to redesign our website The new website features a completely redesigned layout in addition to several new pieces of functionality. Among the new changes are:

  • Online Streamlined Membership Enrollment – The new website includes membership enrollment through a “create and join MAAPPN” form. The new website design is user-friendly, educational, and informative. We want to ensure that our members are equipped with the latest information.
  • Career Center Services – Thanks to this new feature, for a small fee, employers can post employment and internship opportunities and job candidates can post their resumes.
  • Opportunities for Advertising – We are nothing without our loyal sponsors who support our efforts and advertise with us. Our new website provides for advertising opportunities on myriad levels.

In the coming year we will continue our work on behalf of our members on a number of projects including strategic lobbying at the state level, providing resources for psychiatric mental health nursing, continually improving our website, supporting self-advocacy, creating networking opportunities, gaining sponsorships, and membership recruitment.

This year we are celebrating our 40th anniversary as an organization, and our goal is to double our membership. As an incentive for joining MAAPPN we are offering 20% off of quarterly membership meeting fees (use coupon code: maappndiscount) , along with the opportunity to post your resume or post a job opening on our website for 1-month duration free of charge. For more information on current initiative on members behalf please see the following link

Funds that we raise through our membership campaign help us to continue to pay for legislative consultation and representation, fund our membership drive, make more improvements to our web site, and to create and disseminate brochures and handouts, used to communicate with advocates and supporters.

Thanks again for helping to make this a successful membership fund-raising campaign. Please continue to share the goals and work of MAAPPN with people you know in your workplace and community. You can help us spread the word by encouraging others to become members and by inviting colleagues to attend quarterly MAAPPN member meetings. We are also interested in having new and existing members join our committees. Financial donations are always welcome as another form of support for the work ahead.

New members please click on the following link to register and start the process in becoming a MAAPPN member. If you are renewing your membership please click on this link.

Thanks again for your generous support!

Diane Grimaldi, DNP, PMHCNS, BC

In July 2013 APNA released a position statement supporting expansion of APRN prescriptive authority

In July 2013 APNA released a position statement supporting expansion of APRN prescriptive authority to include buprenorphine/naloxone for the treatment of opioid addiction: APNA Supports the Expansion of APRN Prescriptive Authority to Include Prescription of Buprenorphine & Buprenorphine/Naloxone (Suboxone)

This week, U.S. Senators Markey and Paul were joined by bipartisan group of Senators, as well as sponsors in the House of Representatives, to introduce legislation that would expand treatment for heroin and prescription drug addiction, including prescriptive authority of buprenorphine/naloxone for APRNs. The legislation, the TREAT Act, would increase access to evidence-based medication-assisted treatment according to this press release issued by Senator Ed Markey’s office. You can view a one page summary of the legislation here.

Please educate your U.S. legislators about the ability of APRNs to provide safe, evidence-based care for opioid dependent patients with approved medication assisted treatment.  In combination with behavioral therapy, medication-assisted treatment for opioid addiction can decrease opioid overdose deaths, reduce transmission of HIV and hepatitis C, and reduce other social harms such as criminal activity and recidivism.

Now is a critical time to advocate for health care policy that will improve access to care and improve health and social outcomes for patients we serve.


Susie Adams, PhD, RN, PMHNP, FAANP
American Psychiatric Nurses Association
3141 Fairview Park Drive, Suite 625
Falls Church, VA 22042

Nurse Manager Geriatric-Psych

Nurse Manager Geriatric-Psych

Mount Auburn Hospital

Cambridge, MA


Mount Auburn Hospital is a Harvard-affiliated teaching hospital providing care to Cambridge, MA, and its surrounding communities. We were voted one of the best places to work in Boston by the Boston Business Journal for 2013-2014.

This is a terrific opportunity for an experienced professional to develop and implement standards of care, policies, and procedures for the unit. The Nurse Manager will continuously evaluate quality of patient care in relation to these guidelines. Additionally he or she will interview, hire, evaluate counsel and discipline personnel according to the hospital policy. Responsibilities will also include development and maintenance of personnel work schedule, preparation and administration of departmental capital, implementation and evaluation of a performance improvement system in compliance with JCAHO standards and DPH requirements, participation in professional meetings and patient care activities. The Nurse Manager will also assume the role of nursing supervisor on weekend and holiday shifts.


  • Knowledge of nursing/management principles and practices, normally acquired through the completion of a bachelor’s degree in nursing or business administration.
  • Current registration from the Massachusetts Board of Registration in Nursing.
  • Previous management experience preferred or demonstrated leadership in previous roles. Three years of experience in nursing.
  • Good interpersonal skills and communication abilities.

To apply, please follow this link:

Resumes may also be faxed to 617-499-5168 or mailed to Human Resources, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02138.

An Equal Opportunity Employer.

Psychiatric Nurse Practitioners wanted

We are looking for Board certified Psychiatric Nurse Practitioners for work in an outpatient setting.

The right candidates must be able to perform psychiatric assessments.

Must be able to treat and follow up on the outcomes of treatment.

Must be able to function in effectively in a multi-disciplinary environment.

Must keep prompt and adequate records of treatment.

In return for services, practitioners will enjoy excellent remuneration.  We offer our Practitioners the options of excellent hourly rates or reimbursement rates from the insurance companies.

For more information, Pls contact Tony Alatise at 508-366-0406 X20 or 860-416-0916 (cell)

Depression Understood: A Layman’s guide to surviving and thriving with depression

Mary Clancy, Psychiatric Nurse Practitioner, has over 30 years of clinical experience. She has worked in private practice, in-patient and out-patient settings and is currently working for the department of corrections. Mary had her first episode of major depression after the birth of her first child. She is intimately familiar with the agony of depression and the recovery process. Mary has survived depression and thrived in life. So can you.

Understanding Depression is a guide for anyone new to experiencing depression. The author provides answers to the most frequent questions asked by the clients she treats. What causes depression? What are the different types of therapy? Do I really need an antidepressant? What is the difference between a social worker or a psychologist? The author translates the findings of the most current clinical research into easily understood language. Mary Clancy NP has recovered from major depression. She knows personally how depression robs a person of his ability to enjoy things that normally bring him pleasure. From her own experience and from treating others with depression she also knows what a person can do to bring about his recovery.


Paper Back $16.00 on Amazon

Former MAAPPN C0-Chair is New Chief Nursing Officer at Arbour Hospital

Tedi P. Hughes, RN, MS, PMHCNS-BC, is the new Chief Nursing Officer for Arbour Hospital. Tedi is a seasoned clinician, leader, educator, and consultant in psychiatric mental health nursing.

Her experience ranges along the continuum of care: inpatient, PHP/ day treatment, outpatient therapy, and crisis. Tedi’s most recent role has been working as Director, Patient Care Services, for New England Baptist Hospital. Prior to this, she worked as a Director, Psychiatric Nursing, for Children’s Hospital. Tedi’s office is located at 49 Robinwood Avenue, Jamaica Plain and she can be reached at 617-390-1319 or

Tedi served as the Co-Chair of MAAPPN at a time when the organization was ‘reconstituting’ and developing its current mission. She was instrumental in creating the forward momentum that the organization needed and provided creativity and clarity during that time. MAAPPN Congratulates Tedi on her new position!


Gov. Charlie Baker’s budget | Massachusetts Medicaid

In a briefing with Secretary of Health and Human Services Marylou Sudders and other top health administration officials, officials said this practice of delaying Medicaid payments has happened in every administration since 2004, when Mitt Romney was governor. In the 2016 budget, $340 million of the so-called “cash management” was inherited from Democratic Gov. Deval Patrick‘s administration, while Baker’s administration pushed another $116 million in costs from year to year.

Baker spokesman Tim Buckley said the administration hopes to limit the practice in future years. “The administration will continue to develop structural reforms to right-size the state budget while pursuing policies to promote economic growth, reducing the need for additional cash management,” Buckley said.

The other big part of the savings comes from “redetermination.” Baker anticipates saving $400 million in Medicaid costs – of which $210 million comes from the state budget and the rest from federal money – by requiring everyone enrolled in Medicaid to prove they are still eligible.

Charles Duane “Charlie” Baker, Jr. (born November 13, 1956) is an American businessman and the 72nd and current Governor of Massachusetts, having been sworn into office on January 8, 2015. He was a cabinet official under two Massachusetts governors, spent ten years as CEO of Harvard Pilgrim Health Care and was also the Republican nominee for Governor of Massachusetts in his unsuccessful bid in 2010.

Mitt Romney and some of his top aides used private email accounts

Some of the emails obtained by AP describe Romney’s internal deliberations on his health care policy and the state’s 2006 budget crisis: “I hate appearing as if I am just playing national politics,” Romney wrote in November 2006 during sensitive negotiations on state budget cuts, when he was preparing his 2008 presidential campaign. Romney chose to use his full name as his Hotmail username.

The emails can be viewed here .

The private email accounts raise questions about why Romney and his aides sometimes bypassed Massachusetts‘ official communications system — and how many of those emails remain and whether they could be disclosed to the public. Late last year, Romney acknowledged that near the end of his governor’s term in 2007 he approved a sweeping purge of executive emails from the state government’s computer servers, and the removal of top aides’ hard drives and computers. Romney justified the purge as legal, prompted by privacy worries.

Read more:

APNs should be very concerned about this legislation and cannot afford to be complacent.

Our opposition has unlimited financial, organizational, and institutional resources. If we are to have any chance at advancing our legislation and preventing further restrictions to APN practice in Massachusetts, we need your engagement.

We will be holding town-hall style meetings with legislators across the state over the coming months, and we ask you to be on the lookout for invitations and attend these meetings in your region. We have received news that the Massachusetts Medical Society is already doing this in support of their Physician-Led Team Based Health Care legislation.

Please read the text of this legislation copied below and let this motivate you to get involved and advocate for your practice!

Please Join Us for Speaker DeLeo

Please join us at an intimate breakfast for Speaker

April 9, 2015
8:30 – 10:00 AM
6 Beacon Street


Suggested Contribution: $100.00 per

Please make donations payable to the Committee for Bob
DeLeo.Corporate checks prohibited by law. $500 maximum per person
percalendar year. $200 annual maximum for registered lobbyists and

Political contributions are not tax deductible.




SECTION 1. Subsection (g) of said section 7 of chapter 94C of the general laws, as appearing in the 2010 Official Edition, is hereby amended  in the second paragraph by striking out, in lines 129 and 130,  and in lines 138 and 139, the words “and psychiatric nurse mental health clinical specialists”.

SECTION 2. Subsection (g) of said section 7 of chapter 94C of the general laws, as appearing in the 2010 Official Edition, is hereby amended by adding at the end thereof the following paragraph;-

The commissioner shall promulgate regulations which provide for the registration of psychiatric nurse mental health clinical specialists  as defined in section 80 B of chapter 112, to issue written prescriptions in accordance with regulations pursuant to section 80I of chapter 112. Prior to promulgating such regulations, the commissioner shall consult with the board of registration in nursing with regard to those schedules of controlled substances for which psychiatric nurse mental health clinical specialists may be registered.

SECTION 3. Section 80E of Chapter 112 is hereby amended by striking out, in lines 1 and 2 and in lines 7 and 8, the words “or psychiatric nurse mental health clinical specialist”.

SECTION 4. Chapter 112 is hereby amended by adding section 80I: –

Section 80I. A nurse authorized to practice as a psychiatric nurse mental health clinical  specialist  pursuant to section 80B, may order and interpret tests, therapeutics and prescribe medications in accordance with regulations promulgated by the board and subject to the provisions of subsection (g) of section 7 of chapter 94C.

MAAPPN Lends Support to MHLA Legislative Priorities

MAAPPN plays an active role in supporting legislation from other MA mental health groups.   As a member of the Mental Health Coalition, MAAPPN has the opportunity to hear of the legislative priorities from the professional groups (the guilds), advocacy and other mental health policy groups.  Susan Fendell, Senior Attorney for Mental Health Legal Advisors Committee announced MHLAC’s legislative priorities for 2015-16 and has asked MAPPN’s support.  MAAPPN will be lending support and endorsement to the following initiatives:

Susan can be reached at  24 School Street, 8th Floor, Boston, MA 02108, 617-338-2345 x129, 617-338-2347 (fax)

Prescription Monitoring Program – FAQ

Massachusetts Online Prescription Monitoring Program Frequently Asked Questions

What is the Massachusetts Online Prescription Monitoring  Program?

 The Massachusetts Online Prescription Monitoring Program (PMP) is a secure website hosted by the Massachusetts Department of Public Health.

The PMP is a database for a patient’s prescription history for controlled substance prescription medications. The PMP shows a patient’s prescription history for the prior 12 months. Data is reported into the PMP by all Massachusetts pharmacies and by out-of-state pharmacies delivering to people who live in Massachusetts.

 Why is the Prescription Monitoring Program Important?

 Controlled substance medications can play an important role in a patient’s medical treatment and care. When not properly prescribed, however, they can lead to patient harm from duplicate drug therapy, prescription drug misuse or abuse, and illegal use.

Having this information available to prescribers before they prescribe a controlled substance prescription helps them to make the best possible clinical decision for their patient.

 Who is (the) allowed to use the Prescription Monitoring Program  (Important)*?

 Physicians, dentists and podiatrists have been automatically enrolled in the PMP since January 1, 2013. The Massachusetts Department of Public Health’s Drug Control Program (DCP) automatically enrolls these providers when they obtain a new Massachusetts Controlled Substance Registration (MCSR) or have their existing MCSR recalled (renewed).

Beginning on January 1, 2015, the Drug Control Program began automatically enrolling nurse practitioners and physician assistants as participants in the PMP. This will be done when they obtain a new MCSR or renew their MCSR.

Physicians, dentists, and podiatrists also can now grant access to the PMP to users under their direct supervision, such as a registered nurse or medical assistant working in their office.  Known as delegates, these individuals will be enrolled in the PMP and have access to view a patient’s controlled substance prescription history.

Though voluntary, pharmacists may also enroll in the PMP.

*this question contains errors in syntax as issued by the DPH  

 When does my physician have to use the  PMP?

 A registered individual practitioner (physician, dentist, podiatrist, nurse practitioner, physician assistant) must utilize the PMP, prior to prescribing a narcotic prescription drug in Drug Enforcement Agency (DEA) Schedule II or III, or a prescription drug containing a benzodiazepine, to a patient for the first time.

“First time” refers to patients who have not received a narcotic prescription drug in Schedule II or III, or a drug containing a benzodiazepine, from another authorized prescriber within the previous 12 months.

Medications considered Schedule II or III are defined as drugs with a high potential for abuse, with use potentially leading to psychological or physical dependence.

Benzodiazepines are a broad class of medications commonly referred to as tranquilizers.

Authorized prescribers are, however, encouraged to utilize the PMP each time they are prescribing a controlled substance prescription to a patient.

 Where is the PMP and how do I access it  PMP?

 The Massachusetts Online Prescription Monitoring Program (PMP) is a website hosted by what’s known as the Virtual Gateway – the. The Virtual Gateway is the secure web portal of the Executive Office of Health and Human Services (EOHHS).

To access this system, you need to obtain a user name and password to login into the Virtual Gateway and you need to be granted access to the PMP.

This process begins when the prescriber completes an application for enrollment into the PMP and sends it to the DPH Drug Control Program for processing.

Because the PMP is a web-based application, you can access it from any computer.

How is the information in the PMP  used?

 To guarantee patient confidentiality and ensure absolute privacy of patient health information, the PMP operates exclusively on a secure web portal and requires nothing more than the entry of basic patient demographic information (name, date of birth, gender, and address). Additional information such as prescriber name, name of the medication, directions for use, and quantity to be dispensed are also required.

PMP data about a patient’s controlled substance prescription history is viewable by the prescriber at the time he or she is considering prescribing a controlled substance medication to that patient. Prescribers will also receive automatic electronic notifications advising them of concerns in their prescribing.

This information is also available to select DCP staff to help develop statistical reports such as the number of prescriptions prescribed for a certain medication. These reports contain no patient specific information (i.e. patient name, address).

Select DCP staff also develops analyses for Department of Public Health such as comparing the number of controlled substance prescriptions prescribed in each county in Massachusetts each year or comparing the total number of controlled substance prescriptions prescribed from one year to the next. Again, these analyses contain no specific patient information.

APRNs to be automatically Enrolled in Massachusetts Prescription Monitoring Program

Sharon Reynolds, MAAPPN Board member, recently checked with DPH and the Fact Sheet that came out in January was not accurate in that all APRNS and PAs  are supposed to be automatically enrolled this year (not just NPs and PAs).  As they are having a difficult time implementing the change, it won’t be happening until May renewal dates. We don’t have to wait to enroll in the PMP program but once enrolled we are expected to comply with “first time” user checks.  For more info:


MAAPPN, through its ties with the Mental Health Coalition will be monitoring the activities of the Task Force on Behavioral Health Data Policies.  The task force is charged with data collection for behavioral health system improvements but is also focusing on data pertaining to Long Term Stays. MAAPPN is seeking clarification from the task force on if the data focus will also include other behavioral health system issues such as data related to service gaps and nondiscriminatory access to mental health providers. The task force meets monthly from now until June, 2015, at which time it must file a report.   The Task Force has had 2 meetings so far – in Nov and Dec and the next one will be Tues. 1/27 from 9:30 – noon at the CHIA offices.  MAAPPN members are asked to respond to contact if you have input into this issue. You can read more about the Task Force on the CENTER FOR HEALTH INFORMATION AND ANALYSIS (CHIA) website but here are its focus areas:
  1. Make recommendations on how best to evaluate performance of the behavioral health system;
  2. Identify data needed to evaluate performance based on initial Task Force recommendations
  3. Make recommendations on what investments in data systems or resources or policies are needed to allow policy makers to make informed decisions that lead to improved care delivery;
  4. Make recommendations on how to reduce the number of long-term care patients in DMH continuing care facilities, acute psychiatric units and emergency depts..  Read more.



MAAPPN will  re-file the bill seeking supervisory independence by January 15, 2015.  The bill will act to eliminate mandated, career-long, physician supervisory requirements placed on seasoned, advanced practice psychiatric nurses.

With the law as it stands now, nurses practices are dependent on the physician supervisory arrangement. Should the physician re-locate out of state, become ill or otherwise disabled, the nurse would legally be required to close his/her practice.  MAAPPN believes that this bill will eliminate those risks and barriers.  The Practice Committee, will issue a document of educational points to refer to when educating supporters of the bill.

The next steps involve seeking co-sponsors by the end of January. Following that the Speaker with assign the bill to a committee for review, debate and hearings where eventually it will be voted on.  There will be key points along the way where MAAPPN members will be asked to contact their legislators. Additionally,  MAAPPN will  continue to concentrate efforts on finding common ground with the Board of Registration in Medicine and the Mass Psychiatric Society.

Other states in New England and across the nation continue to change their legislative statutes giving independent practice to Psych CNSs and Psych NPs, though some states require a set number of hours or years of practice before independence is achieved. When we have the bill information, we will be notifying you to get in touch with your legislators to request their co-signing onto the bill.