Category: Congress

Ahead of the congressional recess in August, the American Nurses Association has been hard at work advocating for the profession on Capitol Hill.

Here is what you need to know: 

The House Appropriations Committee recently advanced its Fiscal Year (FY) 2025 Labor, Health and Human Services, and Education (LHHS-ED) bill. The bill proposes an $18.343 million decrease in funding to the Title VIII Nursing Workforce Development Programs, elimination of the Nursing Workforce Diversity Program, and the elimination of the National Institute of Nursing Research (NINR) as part of a proposed restructuring of the National Institutes of Health (NIH).

ANA and its allies in the nursing community continue to urge Congress to appropriate at least $530 million to the Title VIII Programs and at least $210 million to NINR. 

In other news, the House Education and Workforce Committee recently advanced the Improving Access to Workers’ Compensation for Injured Federal Workers Act (H.R. 618). The bill would eliminate outdated barriers in the Federal Employees’ Compensation Act (FECA) that limit the ability of nurse practitioners (NPs) to provide care and treatment for injured or ill federal employees. HERE is the letter that ANA submitted to the committee ahead of the markup. 

ANA engaged Congress in a variety of other ways throughout the second quarter of 2024: 

Establishing Long-Term Care Staffing Standards

ANA recently submitted a letter to House and Senate Leadership that urges Congress to oppose ongoing efforts on Capitol Hill to overturn the Centers for Medicare and Medicaid Services’ final rule that would establish safe staffing standards in long-term care facilities. The final rule was issued by CMS in April. The House Ways and Means Committee passed HR 7513 in March to prevent the implementation of the rule, and a pair of resolutions (HJ Res. 139 / SJ Res. 91) were introduced in May that would fast-track the process for overturning the final rule pursuant to the Congressional Review Act. 

Improving Access to APRNs

ANA recently sent a letter to the Senate Finance Committee that highlights ways that Congress can ensure Medicare patients’ access to nursing care through Medicare Part B Payment Reform. 

ANA recently submitted a letter to Senators Sheldon Whitehouse (D-RI) and Bill Cassidy, MD (R-LA) that highlights how Congress can expand Medicare patients’ access to primary care services provided by APRNs. In the letter, ANA calls on Congress to reform how CMS determines reimbursement rates for APRNs and ensure that nurses have a seat at the table when those decisions are made. 

Improving Care and Access to Nurses Act (ICAN) Congressional Briefing

ANA co-hosted a congressional briefing with American Association of Nurse Anesthesiology (AANA), the American Association of Nurse Practitioners (AANP), and the American College of Nurse-Midwives (ACNM) to bring awareness of the Improving Care and Access to Nurses (ICAN) Act (H.R. 2713/S. 2418) and its effort to remove regulatory barriers that Medicare patients face when attempting to see advanced practice registered nurses (APRNs). 

Minority Fellowship Program Congressional Briefing

ANA participated in a congressional briefing with the American Psychological Association, the American Psychiatric Association, and the National Board for Certified Counselors to commemorate the 50^th anniversary of the Minority Fellowship Program (MFP). Administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), the MFP provides training, career development, and mentorship to mental health professionals from minority and ethnic backgrounds who are dedicated to serving patients of color and other marginalized communities. 

During the first quarter of 2024, the American Nurses Association’s Policy & Government Affairs Department collaborated with lawmakers on Capitol Hill on several legislative priorities. Here is a highlight of several initiatives that aim to rebuild the nursing workforce and address work environment challenges facing the nursing profession. 

ANA Responds to Problematic Staffing Bill 

The House Ways and Means Committee recently approved the Protecting America’s Seniors’ Access to Care Act (HR 7513), which would prohibit the U.S. Centers for Medicare and Medicaid Services (CMS) from finalizing its proposed long-term care safe staffing regulation.  

ANA sent a letter to House Leadership expressing its concerns about the bill’s adverse impact on the nursing workforce and the importance of ensuring safe staffing in long-term care facilities. ANA urged Congress to work with the Administration and stakeholders to find a balanced approach to addressing healthcare workforce challenges. It remains to be seen whether House Leadership brings the bill to the floor. Thankfully, the bill is dead on arrival in the Democratic-controlled Senate. 

ANA Co-Hosts Workplace Violence Briefing on Capitol Hill 

On March 22, ANA co-hosted a congressional briefing on workplace violence in emergency departments along with the Emergency Nurses Association and the American College of Emergency Physicians. Katie Boston-Leary, Director of Nursing Programs at ANA, represented ANA’s perspective on workplace violence in healthcare, its adverse impact on the nursing workforce, and potential solutions for addressing the crisis. 

 Congress Acts to Provide Mental Health Support for Health Professionals 

The House Energy and Commerce Committee recently voted to approve H.R. 7153, a bill that would reauthorize the Dr. Lorna Breen Health Care Provider Protection Act to provide mental health support to healthcare professionals. A companion bill, S. 3679, is pending in the Senate. On that same day, the U.S. Senate passed Senate Resolution 567 to recognize March 18, 2024 as the inaugural “Health Workforce Well-Being Day of Awareness.” A companion resolution is pending in the House (H. Res. 1089). 

Congress Invests to Attract More Registered Nurses 

Congress recently approved appropriations legislation to fund the federal government through the remainder of Fiscal Year 2024, which ends on September 30, 2024. While most of the Title VIII Nursing Workforce Development Programs and the National Institute of Nursing Research received static funding, Congress approved an increase of $5 million for Title XIII’s Nurse Education, Practice, Quality, and Retention Program for grants to increase the supply of registered nurses, specifically in long-term and acute care settings and in states having the greatest shortages. 

ANA Advocates for National Standards at the VA  

The House Veterans’ Affairs Committee held an oversight hearing to examine veterans’ access to healthcare services in rural settings through the U.S. Department of Veterans’ Affairs. ANA submitted a statement for the record, urging the VA to develop national practice standards for certified registered nurse anesthetists (CRNAs) that allow them to practice at the top of their license wherever they are needed within the VA health system. 

Lawmakers Introduce Bill to Restrict Mandatory Overtime for Nurses 

A bipartisan group of lawmakers in both chambers recently introduced the Nurse Overtime and Patient Safety Act (H.R. 7546/S. 3860). This bill would restrict the use of mandatory overtime for nurses with exceptions for federally-declared emergencies. The bill also includes whistleblower and nondiscrimination protections, transparency requirements, and civil penalties. The bill would require the Agency for Healthcare Research and Quality (AHRQ) to conduct a study on standards for safe working hours and the use of mandatory overtime. 

House Introduces Legislation to Attract Nurse Faculty 

The House recently introduced the Nurse Faculty Shortage Reduction Act (H.R. 7002), which would allow nursing schools to apply for grants from the Health Resources & Services Administration (HRSA) to supplement the difference between what faculty nurses are paid versus what equally trained nurses in clinical practice earn. It is bipartisan and was introduced in the Senate over the summer. 

Congress Reintroduces Measure to Support Nursing Workforce Pipeline 

The Future Advancement of Academic Nursing (FAAN) Act (H.R.7266/S.3770) was reintroduced in Congress. This legislation calls for critical investments to address immediate nursing education needs, while providing proactive measures to meet future workforce demands, including enrolling and retaining nursing students; hiring and retaining a diverse faculty to educate the future nursing workforce; support schools of nursing in partnership with healthcare facilities, to establish or expand clinical education; and to modernize educational infrastructure.

UPDATE: Since this blog was posted, Congress passed a new continuing resolution that funds the first four appropriations bills (Ag-FDA, Energy-Water, MilCon-VA, and T-HUD) until March 1 and the remaining eight bills (including Labor-HHS) until March 8.

The last quarter of 2023 was a doozy in Congress. Speaker McCarthy (R-CA) was removed by his own caucus and replaced with Speaker Mike Johnson (R-LA), taking weeks out of the Congressional schedule. It happened because conservatives in his own party didn’t think Mr. McCarthy had negotiated tough enough on the debt limit deal with the Biden Administration. To keep the government from shutting down, Speaker Johnson negotiated a 2-step continuing resolution with government funding for certain agencies expiring on January 19 and funding for others ending on February 2. The February 2 deadline applies to the U.S. Department of Health and Human Services which oversees federal agencies and programs that are relevant to the nursing profession. 

As leaders in both chambers continue to negotiate government spending, ANA will continue to advocate for robust funding for the Title VIII Nursing Workforce Development Program and the Minority Fellowship Program. We have held several meetings with Congressional staff and worked with coalition partners to ensure the best possible outcome for nurses and patients.  

ANA Responds to Congressional Request Relating to Rural Health Access to Care 

In October, ANA submitted a letter to the House Ways and Means Committee in response to a request for information on how Congress can improve healthcare in rural and underserved areas. The committee sought comments on several topic areas, including how Congress can revitalize the healthcare workforce and advance innovative care models and technology. In its letter, ANA called on Congress to invest in education and training for nurses, fund mobile health units, and expand home visiting programs that operate in rural and medically underserved communities. The letter also urged lawmakers to support legislative proposals that remove barriers to in-person and telemedicine services for patients in these settings. 

Emerging Nurse Leaders go to Capitol Hill to Advocate on Nursing Priorities 

Prior to Halloween, ANA convened its American Nurses Advocacy Institute (ANAI) in the nation’s capital. This event gave emerging nurse leaders from 21 states an opportunity to meet with their congressional lawmakers and nursing colleagues to discuss critical issues for the nursing community. Participants received federal legislative and regulatory updates from ANA staff, engaged in open dialogue about nursing priorities, and learned what they can expect while meeting with congressional offices. Then, nurse advocates embarked on Capitol Hill to meet with their lawmakers and staff to advocate for Title XIII appropriations funding to rebuild the nursing workforce, the Improving Care and Access to Nurses (ICAN) Act (H.R. 2713/S. 2418) to remove existing barriers to care of APRNs, and the Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 2663/S. 1176) to address workplace violence in healthcare settings. 

ANA Endorses Federal Legislation Establishing Minimum Staffing Standards 

In November, ANA formally endorsed the Nurse Staffing Standards for Hospital Patient Safety and Quality Care Act (H.R. 2530 and S. 1113). This bill would establish minimum nurse-to-patient ratios for every hospital, examine best practices for nurse staffing, and provide whistleblower protections for nurses who choose to advocate for the safety of their patients. In its press release, ANA stressed that the adoption of safe staffing levels is just one way to address work environment issues that also include workplace violence, mandatory overtime, and reimbursement/compensation issues. 

ANA Participates in Healthcare Workforce Roundtable on Capitol Hill 

Prior to the holiday break, ANA participated in a healthcare workforce roundtable event hosted by Representatives Terri Sewell (D-AL) and Kathy Manning (D-NC). This event brought representatives from several healthcare associations together to discuss workforce challenges facing the healthcare sector and potential solutions. In her testimony, ANA’s Dr. Katie Boston-Leary called on lawmakers to support passage of legislation that would address workplace violence, establish safe staffing levels, prohibit mandatory overtime for nurses, address the nurse faculty shortage, and invest in training and education for new nurses. 

New Bill to Address Nursing Faculty Shortage Introduced 

In September, Sens. Richard Durbin (D-IL) and Lisa Murkowski (R-AK) introduced the Nurse Faculty Shortage Reduction Act (S. 2815). ANA worked with these offices to write and introduce the bill for several months. At the time of publication, the bill was just introduced in the House with bipartisan support by Reps. Dave Joyce (R-OH) and Suzanne Bonamici (D-OR). If passed, the bill would establish a 5-year demonstration project that would allow accredited schools of nursing to apply for grants to supplement the difference between what they can pay nurse faculty and what nurses with similar education and experience could expect to earn in critical care settings in those same geographic areas. The shortage of nursing faculty is one of the largest chokeholds on accepting more nursing students into nursing schools. A companion bill was previously introduced in the Senate.