Author: Kristina Weger

House LHHS-ED Appropriations Committee Recognizes Nursing Priorities in Legislation

  

Each spring starts the annual appropriations process in the U.S. House and Senate. Both the U.S. House and Senate Appropriations Committees have 12 subcommittees that are tasked with compiling legislative bills that provides funding for operations, personnel, equipment, and activities.  

ANA monitors the entire appropriations process and advocates for nursing priorities to be inserted into the Labor Health and Human Services (LHHS-ED) legislation. The LHHS-ED Subcommittee has jurisdiction under the following: the U.S. Department of Education; the U.S. Department of Health and Human Services; the U.S. Department of Labor; and many related agencies.

The House LHHS-ED released its Fiscal Year (FY) 2021 Report and the Full Committee Markup is this week. Upon reviewing the information, ANA was pleased to see several items, including:

  • $10 million increase to Title VIII Nursing Workforce Development Programs for a total of almost $270 million. 
  • $1.454 million increase to National Institute of Nursing Research for a total of $170.567 million in FY 2021.  
  • In January 2017, the Occupational Safety and Health Administration (OSHA) committed to developing and issuing a workplace violence standard, but the agency has not yet completed a required small business review, and there is no estimated date for the issuance of a proposed or final rule. The Committee believes issuing a workplace violence standard to protect workers in health care and social services should be a top priority for the Department of Labor. It has required for OSHA to report to Congress on its progress within 90 days of passage of the appropriations legislation.
  • The Committee provides $5 million to make grants to establish or expand optional community-based nurse practitioner fellowship programs that are accredited for practicing postgraduate nurse practitioner in primary care or behavioral health.  
  • The Committee included $41.7 million for the Mental and Substance Use Disorder Workforce Training Demonstration program – a $15 million increase. This program supports training for medical residents and fellows in psychiatry and addiction medicine, nurse practitioners, physician assistants, and others, to provide SUD treatment in underserved communities. It includes an additional $15,000,000 for new grants to expand the number of nurse practitioners, physician assistants, health service psychologists, and social workers trained to provide mental and substance use disorder services in underserved community-based settings 
  • The Committee asked the Substance Abuse and Mental Health Services Administration (SAMHSA), with the Department of Education, develop a standard for providing all school-based teachers and nurses with suicide prevention training to treat mental health challenges experienced by younger Americans.  
  • Provides funding to strengthen Historically Black Colleges and Universities (HBCUs). This program provides grants to specified colleges and universities making a substantial contribution to graduate education opportunities at the Master’s level in mathematics, engineering, the physical or natural sciences, computer science, information technology, nursing, allied health, or other scientific disciplines.  
  • $2 million dollar increase is included for the Minority Fellowship Program (MFP), for a total of $16.169 million in both the Center for Mental Heath Services and the Center for Substance Abuse Treatment. The MFP aims to improve behavioral health care outcomes for racial and ethnic populations by growing the number of racial and ethnic minorities in the nation’s behavioral health workforce. The program also seeks to train and better prepare behavioral health practitioners to more effectively treat and serve people of different cultural and ethnic backgrounds.

As appropriations work continues in the U.S. House and Senate this summer, ANA Government Affairs staff will continue to monitor its progress and will keep you updated. 

Congress Passes and the President Signs into Law Third COVID-19 Package

  

Today, the U.S. Congress passed and the President signed into law, the Coronavirus Aid, Relief, and Economic Security (CARES) Act. It includes more than $2 trillion in spending and tax breaks to help the economy and health care providers respond to the pandemic.

ANA has been aggressively pushing Congress and the Administration to do something about the lack of personal protective equipment (PPE). Thankfully, the legislation provides $1.5 billion to States for the equipment, contact tracing to identify additional cases, and other public health preparedness and response activities. Additionally, it provides $16 billion for the Strategic National Stockpile (SNS) for critical medical supplies, including more PPE, and life-saving medicine.

Additional details of the agreement include:

  • $150 billion for hospitals and health providers
  • $1,200 checks for middle class Americans
  • $150 billion for states and local governments
  • $500 billion for loan guarantees for businesses
  • $350 billion for small businesses to maintain payroll
  • Reauthorizes Title VIII Nursing Workforce Development Programs
  • Authorizes NPs and CNS’ to certify home health care for their patients
  • Includes United States Public Health Service Modernization – Ready Reserve Corps to respond to public health and national emergencies.

Congressional leaders have indicated there will be additional supplemental packages to come in the following weeks. ANA will continue to be engaged with Congress and the Administration about priorities for nurses in the upcoming packages. Some areas that need to be addressed are:

  • Prioritize treatment of nurses, and other frontline health care providers who contract COVID-19, so those individuals can go back to work as soon as possible.
  • Instruct all manufacturers of respirators providing equal or higher protection as N95s, such as N99 or N100 filtering facepieces, reusable elastomeric respirators with appropriate filters or cartridges, or powered air purifying respirators, to sell their supply to health care facilities at fair market value.
  • Retrofit or repurpose closed or currently running manufacturing plants and put individuals back to work by manufacturing more PPE in the United States.
  • Require the Centers for Disease Control and Prevention to provide science-based information on the transmission of the virus so that nurses can make the best decision on the appropriate level of protection.
  • Require the Department of Health and Human Services to develop reporting requirements to better track shortages of PPE.

As we continue to move forward, ANA will continue to provide updates on what Congress is doing to address COVID-19.

Legislation to End Workplace Violence Passes in the House of Representatives

  

Just prior to the Thanksgiving holiday, the House of Representatives dedicated hours of work, debated, and ultimately passed, another priority of ANA – H.R. 1309, the Workplace Violence Prevention for Health Care and Social Service Workers Act.

Studies show one in four nurses has been assaulted at work – making nurses more likely to be exposed to violence than either prison guards or police officers. H.R. 1309 requires the Department of Labor to address needed protections from workplace violence in the health care and social services sectors. It directs the Occupational Safety and Health Administration (OSHA) to issue a standard requiring health care and social service employers to develop and implement a comprehensive violence prevention plan tailored to the facility and services with the intention to protect employees from violent incidents in the workplace.

We are pleased to report the final vote in the House of Representatives was 251-158 – including 32 Republicans. Unlike other pieces of legislation that ANA supports, including the recently passed H.R. 728, Title VIII Nursing Workforce Reauthorization Act, H.R. 1309 is not as bipartisan. A chief concern amongst Republicans is the worry about smaller hospitals and facilities complying within the given time. With that said, we are very encouraged to hear Republicans and Democrats all acknowledge this is a major issue and something needs to be done. The issue is finding the sweet spot where the legislation can receive bipartisan support.

So, now we look to the Senate knowing we have an uphill battle ahead. We must continue to educate members of Congress about this issue and its severe implications if something is not done soon. To join us in this effort, please go here.

However, ANA is not just focused on Congress. Before the vote in the House of Representatives, the White House issued a statement of administration policy which stated that it opposes H.R. 1309 in its current form. An example given is the Administration believes the bill’s timelines for issuing the interim final, proposed final, and final standards are inappropriate. It notes that OSHA has announced plans for a Small Business Regulatory Enforcement Fairness Act (SBREFA) panel to address these issues. We are calling on the SBREFA panel to come together and make a final decision as soon as possible.

Additionally, ANA staff is meeting with key agencies, including OSHA, to educate agency staff on the importance of this issue and see how we can all work together to move the needle in the right direction.

Safe work environments and quality care are not mutually exclusive; both must be considered in order to promote positive health outcomes for patients and communities. Let’s work together to continue to send that message to Capitol Hill to ensure that nurses are safe in the workplace.