In 2013, the House of Delegates voted to shorten the Annual Session, and to instead establish broad policy on current major issues that have been determined by the Committee of Delegation Chairs (CDC), Speakers and the Board to be the most important issues affecting members, the Association and the practice of medicine.

In support of achieving this goal, the task of developing an educational report with actionable recommendations on those issues was referred to the appropriate Standing Council, with direction by the report of the Committee of Delegation Chairs.

Below you will find answers to common questions about extractions, amendments and referrals. If you can’t find your questions here, please contact us. 

1. What is being debated at the House?
2. How do I add a topic to the Agenda?
3. How do I extract a recommendation to make an amendment?
4. What is the process for submitting amendments?
5. What else should I know about submitting amendments?
6. What if I want to submit a new idea, instead of amending an existing recommendation?
7. What is referral?

1. What is being debated at the House?

Each report will contain a series of recommendations that can be adopted, debated, amended, referred, or rejected.

2. How do I add a topic to the Agenda?

The House of Delegates voted to limit the agenda of the House to (1) action on council and committee reports addressing the issues specified by the Speakers and the Speakers’ Advisory Committee (2) action on any matters the Board of Trustees may refer to the House; (3) receipt of an annual report on the actions of standing councils and committees during the year preceding the meeting; (4) elections of officers; (5) educational sessions on key issues; and (6) ceremonial functions (speeches, recognitions, etc.).  Additional items, not germane to the presented major issues, cannot be added to the agenda during the HOD, but may continually be submitted under the year round process. Please work with your Delegation Chair to communicate your desired topic(s), so that they may bring your idea forward for consideration, or work to submit your policy idea into the year-round resolution process.  The prior process of late or emergency resolution submission is no longer applicable to the meetings of the House, although pending acceptance of this year’s Rules Committee report, there remains a mechanism for bringing up emergent issues for consideration, subject to approval by the Speakers or appeal to CDC, such subjects being then the business of the Board with an option for the Board to return the issue to the current meeting of the House.

3. How do I extract a recommendation to make an amendment?

Each Major Issues report will contain a series of recommendations, to be presented as a consent calendar at the start of the deliberation on each report. When the Council Chair begins to address the House on a given topic, simply line up at one of the many aisle microphones to request that certain recommendations be extracted. Any recommendations not extracted will be approved as the final consent calendar. Extracted recommendations become the business of the House for debate, amendment and adoption, rejection or referral to the Board.

4. What is the process for submitting amendments?

Amendments containing more than 5 words should be submitted well in advance, so that they can be processed for projection for the House. Amendment submission forms are available in the ballroom near the front left, directly adjacent to the staff seating area. Delegation Chairs have also been given a limited number of forms for your convenience. Forms must be complete, legible, and submitted in a timely way.

Failure to submit amendments longer that five words sufficiently in advance for projection may result in your amendment being passed upon until such a time in which it is ready to be projected. You may be asked to stand aside, to allow debate to continue on an item or other amendments while your amendment is being processed. We request amendments be submitted well before the item will be debated, because the production team has a limited capacity to handle ‘on the fly’ projection requests while actively managing the many projection/production functions.

5. What else should I know about submitting amendments?

An amendment must be germane. Sturgis says that amendments “must be relevant to, have direct bearing upon, the subject of the pending motion.” They also cannot change one type of motion into another type. Entirely new material that was not discussed prior to the opening of the House (as content in the reports, for example), or is not germane to the item at hand, may not be introduced as an amendment by total substitution.  As this process is new, the Speakers have promoted that they will be flexible in interpreting whether new material may be accepted as an amendment so long as it is germane.

6. What if I want to submit a new idea, instead of amending an existing recommendation?

While the House can consider amendments that are germane to the issues at hand, the Delegates should not submit ideas not already contemplated in the reports (via total substitution). The goal of reducing the number of issues considered by the House to several specific Major Topics, and allowing for the Councils to draft the recommendations is to ensure that the House is focusing its time appropriately, with a more robust level of policy-expert consideration. New issues cannot receive the benefit of our policy, legal, and political analyses, nor the thoughtful council-level consideration by physicians that the House has called for. We recommend the following:

• Limit submission of entirely new recommendations only to those that are discussed in the research materials contained in the report.
• Submit your idea to the Year-Round Resolution process. Accepted recommendations are considered on a quarterly basis, and will receive the benefit of broad member feedback, council analysis and debate, and decision by the Board. Unless your recommendation is ‘an emergency;’ CMA will likely be best-served to debate your idea deliberately to ensure that we adopt sound policy.

7. What is referral?

When considering a recommendation in a report, a member may make a motion for referral. This means that, if adopted, the House will have sent the issue to the Board of Trustees, to dispense with as they so see fit. Typically, this means that it will be referred to a Standing Council to develop a recommendation for action by the Board. The issue will not return back to the House, except ‘For Information.” The Board, however, may choose to send an item back to the House, but it cannot be compelled to do so.