The Power of Hill Day

  

Every membership group has an iteration of “Hill Day,” “Legislative Conference,” or “Fly-in” where its members come to Washington, DC, to speak directly to their members of Congress on issues of importance to the association. Hundreds of members of the American Nurses Association (ANA) will be on Capitol Hill on June 20 for our annual Hill Day. This is a powerful experience and, in many ways, the most basic form of the democratic process. These constituents have the ability to schedule a meeting with their elected representatives or their staffs to discuss issues of importance to them and the association.

Members of Congress will always feel the weight of an issue when the constituent is able to make a personal connection and being able to draw upon those stories is quite effective. For nurses, this might be an instance where you have encountered workplace violence or a lack of resources to effectively perform your job for example.

With the 116th Congress a quarter of the way into its session, it has already been bombarded with special interest groups seeking to meet with members of Congress and their office staffs. These groups have been introducing themselves to freshman members of Congress while solidifying previous relationships with the more experienced lawmakers.

It is truly an incredible experience for nurses and nurse advocates to head up to Capitol Hill for the first time – as well as for those more experienced participants. When a constituent advocates on behalf of a cause they believe in and are passionate about, it empowers them to become more engaged politically and professionally. It enables a person to tangibly connect with their history, with the policies they are fighting for, and allows them to fulfill their civic duty of participating in democracy. Advocating for a cause on Capitol Hill provides citizens the platform to provide critical feedback to a lawmaker and serves as a check on the legislative branch by those it represents.

It is an especially important time for nurses and nurse advocates to take their experience and insights to Capitol Hill. There are many pieces of legislation impacting nurses and their patients gaining momentum in Congress. The Workplace Violence Prevention for Health Care and Social Service Workers Act (H.R. 1309), the Home Health Care Planning Improvement Act of 2019 (H.R. 2150), and the Title VIII Nursing Workforce Reauthorization Act of 2019 (H.R. 728) are all being discussed by over 400 nurses making their way to Capitol Hill this week. To read more on these pieces of legislation, please visit RNAction. Nurses and nurse advocates must speak in a clear, united voice because when nurses speak, Washington listens. And regardless of the issue our members are advocating for, or whether it is called a fly-in or Hill Day, when you are advocating on behalf of your profession on an issue you care about, it is a powerful feeling. This communication makes a real impact on members and their staffs. We are excited for ANA’s upcoming Hill Day and look forward to the feedback our members will share about their experiences.

Looking forward to this year’s #ANAHillDay

  

In just under three weeks ANA members and registered nurses from across the country will gather on Capitol Hill to demonstrate the power of nurse advocacy firsthand. As we prepare for our annual #ANAHillDay on June 20th, we wanted to offer some helpful tips and reminders for those attending and encourage those who might still be on the fence to register before it’s too late. With momentum building around a number of bills in Congress that will help advance the nursing profession, now is the perfect time to join us for our biggest advocacy event of the year.

Prior to arriving in Washington for the big day, please take some time to get to know the lawmakers with whom you’ll be meeting (your federal representative and both Senators). In particular, determine whether they’re already supportive of the legislation we’ll be discussing in our in-person meetings. That includes:

  • Workplace violence legislation in the House and Senate;
  • Title VIII nursing workforce development reauthorization in the House and Senate, and;
  • Home health legislation for APRNs in the House and Senate.

For additional background on these bills, please visit our RNAction issues page. If you’re unsure who represents you in the House, please find out here. Rest assured, we’ll be going into greater detail on all these bills at our morning breakfast briefing before you head up to Capitol Hill for your meetings. We’ll also be hearing from ANA leadership as well as the newest nurse in Congress, Rep. Lauren Underwood (D-IL-14).

Once you’re on the Hill, you and members of your state delegation with whom you’ll be paired will have the unique opportunity to share your professional perspective on why each of these bills matters to you. While it’s important to know what these bills are working to accomplish and how they would do so, it’s just as important for your representatives and their staff to hear your firsthand account on how you’ve encountered these issues in your job. Representatives and staff will always respond better when you are able to make a personal attachment to the issue at hand. Please spend some time thinking about if and how these issues have impacted your work, and decide which ones you feel most confident speaking to during your meetings.

And if you can’t join us here in our nation’s capital, rest assured you’ll still have plenty of opportunities to join through our virtual Hill Day campaign. To ensure you’re getting these and other timely nurse advocate updates, please sign up for our RNAction updates.

To watch our Facebook briefing with additional information on everything Hill Day-related, please click here. And if you’re interested in attending but still haven’t registered, please do so here

Opioid Bill Contains Victories for Medicaid – as the Administration Undermines Medicaid Access

  

This week the Senate passed a landmark piece of legislation, the SUPPORT for Patients and Communities Act, that aims to curb the nation’s ongoing opioid-use disorder crisis. The legislation includes a critical provision that enables nurse practitioners and physician assistants to prescribe buprenorphine permanently – once they obtain a waiver required by any provider to prescribe medication-assisted treatment (MAT) – and expands MAT prescribing authority for five years to other advanced practice registered nurse (APRN) specialties: certified nurse-midwives, clinical nurse specialists and certified registered nurse anesthetists.

Medicaid Provisions in the SUPPORT for Patients and Communities Act

The bill also includes several critical Medicaid provisions aimed at treating individuals who suffer from an opioid-use disorder and preventing others from developing an opioid-use disorder. Taken together, these provisions will significantly increase access to opioid-use disorder treatment and counseling services for some of the nation’s most vulnerable populations and will decrease the rate of new opioid-use disorders.

These provisions include:

  • A temporary suspension (from Fiscal Year 2020 through FY 2023) of the Medicaid institution for mental disease (IMD) exclusion for short-term stays (less than 30 days per year) and the codification of regulations that allow managed care organizations to receive federal funding for patients who are in an IMD for 15 days or less per month (current law does not allow federal payment for patient stays in IMD facilities with greater than 16 beds);
  • A requirement for states to cover MAT, including methadone and counseling services, for opioid-use disorders from FY 2021 through FY 2025;
  • A provision that allows states to cover care for infants with neonatal abstinence syndrome at a residential pediatric recovery center and an extension of enhanced federal match provided under Medicaid for health home services to treat individuals with substance use disorders;
  • A requirement for state Medicaid programs to not terminate coverage for juvenile inmates under the age of 21 while they are incarcerated and an extension of Medicaid coverage for former foster youths ages 18 to 26 who move states, and;
  • A requirement for states to comply with drug review and use requirements as a condition of receiving federal Medicaid funding and a provision that allows state Medicaid programs access to state prescription drug monitoring programs.

Trump Administration Approval of Medicaid Work Requirements

It is ironic, then, that as the SUPPORT for Patients and Communities Act heads to President Trump’s desk, his administration is actively taking steps that will create barriers for Medicaid beneficiaries to remain covered under the program. CMS Administrator Seema Verma recently defended the administration’s policy of approving Medicaid waivers for demonstration projects that impose work requirements on certain Medicaid populations (i.e., the Medicaid expansion population of low-income, childless adults).

CMS recently faced criticism after 4,300 Arkansans lost Medicaid coverage in September as a result of not meeting the state’s new work requirements; this is the first time in the Medicaid program’s 53-year history that beneficiaries have lost coverage for not meeting work requirements. The administration has approved work requirements for Indiana and New Hampshire, and waivers to impose work requirements are pending in South Dakota, Kansas, Mississippi, Ohio, Maine, Utah and Arizona. Kentucky’s work requirements waiver was struck down in federal court in July, though the administration is currently working with Kentucky to revise implement those requirements nonetheless.

Studies show that work requirements for Medicaid beneficiaries have little to no impact on employment and, as demonstrated in Arkansas, result in coverage losses. According to a December 2017 Kaiser Family Foundation issue brief, roughly 6 in 10 of the 22 million non-disabled adults receiving Medicaid benefits are employed either full- or part-time, while 8 in 10 of these adults live in a working family. Most of these individuals work either for small firms or in low-paying industries which do not offer healthcare coverage and thus rely on Medicaid for such. Further, among those adults who are not working, most report a major barrier to employment such as illness, disability, or care-giving duties. According to the same Kaiser issue brief, Medicaid expansion has not negatively impacted labor market participation; in fact, some research demonstrates that Medicaid coverage supports work.

ANA Commends Congress and Urges Its Members to Vote in the Midterms

ANA applauds Congress for its hard work and dedication in passing the SUPPORT for Patients and Communities Act and for recognizing the role that RNs and APRNs play in patient care for those with an opioid-use disorder.

However, ANA firmly believes in universal access to comprehensive and affordable healthcare services for all Americans. The recent moves by both the Trump administration and state governments fly directly in the face of that goal and represent major steps backward in the effort to ensure that all Americans – especially vulnerable populations such as low-income women and those with pre-existing conditions – have access to all necessary healthcare services. These moves also undermine the progress made in Congress with the SUPPORT for Patients and Communities Act.

Healthcare stands to be a major issue in the upcoming 2018 midterm elections – 22 percent of respondents to a June 2018 NBC News/Wall Street Journal poll named healthcare as the most important factor in deciding their vote. These elections are right around the corner and are an incredibly important opportunity for ANA’s members to make their voices heard when it comes to determining the future of healthcare in this country. When nurses vote, lawmakers in Washington, DC, and in statehouses across the country listen. Visit ANA’s #NursesVote Action Center today and help us make this the most meaningful election for nurses yet.