Looking Forward: ANA’s 2022 Legislative and Regulatory Priorities

  

2021 represented a very difficult year for nurses and patients. The ongoing pandemic has exasperated many underlying challenges nurses have been forced to endure for decades. Despite this, ANA staff and the united voice of our RNAction advocates were able to secure funding for the Nurse Corps Loan Repayment and Scholarship programs, mental health resources, testing, vaccines, therapeutic COVID-19 treatments, public health infrastructure and more through the American Rescue Plan. Meanwhile, the ANA-PAC remained effective in its mission to support members of Congress passionate about ANA’s nursing priorities on both sides of the aisle and continue building our coalition of lawmaker support in Congress.

Progress in continuing to be made, but our work is not complete. Nurses do not feel valued, and it is easy to see why. They are forced to contend with long-standing staffing shortages, mandatory overtime, the recent sunsetting of workplace protections, and at least 1 in 4 nurses having experienced workplace violence.

What did ANA’s advocacy efforts look like in 2021 as nurses across the country were saving lives? ANA’s Policy and Government Affairs team met with numerous stakeholders; members of Congress, staff from the U.S. Department of Health and Human Services (HHS), the Occupational Safety and Health Administration (OSHA), the Centers for Disease Control and Prevention, and other health care associations and coalition partners. In addition, ANA conducted several hours of listening sessions on the nursing shortage with ANA members and nurse advocates.

This shortage has affected many additional factors of daily life for nurses. Unlike the beginning of the pandemic when nurses were being furloughed, many now find themselves working even longer hours, contributing to exhaustion and burnout. In many cases, hospitals brought in travel nurses to relieve the shortages. Some nurses left for agencies for better pay, while long-time staff nurses learned to contend with temporary staff who were not familiar with the facility. It is obvious to ANA leadership and staff that we must be laser-focused on workforce challenges, including work environment and retention, the workforce pipeline, well-being, and the value of nurses as four areas of focus to help curb the staffing crisis.

Workforce

Our goal is to ensure that the nursing workforce is properly funded with an emphasis on staff retention and proper talent pipelines. ANA continues to work with other nursing organizations and our champions in Congress to pass the Future Advancement of Academic Nursing Act (FAAN Act). This legislation would provide a billion dollars in funding for increasing faculty to:

• Enroll and retain nursing students;
• Support educational programs, including creating and modernizing curriculum and establishing nurse-led intradisciplinary and inter-professional educational partnerships;
• Hire and retain a diverse faculty to educate the future nursing workforce;
• Modernize technological and educational infrastructure;
• Support schools of nursing, in partnership with facilities that provide health care, to establish or expand clinical education and;
• Support schools of nursing as they help prepare future nurse scientists and researchers who are essential as health challenges arise.

The FAAN Act passed the House of Representatives as part of the Build Back Better legislation but stalled in the Senate in December. Negotiations on revival of the legislation remain ongoing.

In addition, on January 19, 2022, ANA CEO Dr. Loressa Cole DNP, MBA, RN, NEA-BC, FAAN participated in a listening session with HHS Secretary Xavier Becerra. ANA was one of only nine organizations asked to weigh in during the roundtable which highlighted the opportunities for retention and entry into the workforce for nurses and health care providers.

Work Environment

The Policy and Government Affairs team continues working with Congress and the Administration on the need to address workplace violence which most nurses recognize as having only increased since the start of the pandemic. ANA and nurse advocates were instrumental in the House-passed Workplace Violence legislation last year and is working to identify Senate sponsors for introduction.

In addition, the Policy team has been working side by side with the Administration to reinstate OSHA’s Emergency Temporary Standards. Our team has a leading role in the ANA Enterprise-wide #EndNurseAbuse team which focuses on workplace violence and nurse abuse in ways beyond legislation and policy. Be sure to be on the lookout for additional campaigns related to our #EndNurseAbuse pledge throughout the year as well.

Well-Being

Our legislative team has made significant progress with Congress towards getting the Dr. Lorna Breen Health Care Provider Protection Act passed into law. This legislation will identify and disseminate best practices to reduce and prevent mental and behavioral health conditions, suicide, and burnout, as well as increase access to evidence-based treatment for nurses and other health care professionals.

Advocates such as you were instrumental in getting this bill passed by the House in December. The Senate is negotiating technical changes and we await it to be moved through the process and be sent to the President’s desk. Be on the lookout for this news as it is a monumental win for nurses, providers, and ANA.

Value

Value is an essential point of emphasis of our work in 2022. Our latest message to Congress highlights the staffing constraints mentioned above, but also calls on Congress to work with key stakeholders to change current payment structures to finally recognize nurses as a value instead of ‘overhead’. For a brief, fleeting moment, nurses were celebrated as heroes at the beginning of the pandemic. Now they have gone back to only being viewed as a number at the bottom of a ledger.

As the most trusted profession for 20 straight years and the largest segment of health care providers, nurses need to be at the center of every conversation regarding health care. They need to be valuable members of the decision-making team whether that is at the staff level of the local facility, or the decisions being made by Congress and the Administration. Our work throughout this year will focus on empowering nurses and help restore the dignity of the profession. It starts with focusing on addressing the nursing shortage crisis.

2022 will likely present similar challenges to 2021 for nurses and their patients as the COVID-19 pandemic and the staffing shortage remain. Rest assured, the Policy and Government Affairs team continues to listen to its members, nurses, and nurse advocates. Please take a moment to sign up for our RNAction alerts and follow us on Twitter and Facebook and please check out our Latest News page for the latest advocacy news and information.

Recognizing the U.S. Cadet Nurse Corps this Veterans Day

  

On Veterans Day, we have a responsibility to take a moment and reflect on what this day means for our country as a whole and as individuals. If you ask your neighbor, family member, colleague – they have a story of how impactful Veterans Day is for each of them.

We thank all of our nurses for serving tirelessly each and every day. But today we thank all of our uniformed nurses while taking a moment to highlight the U.S. Cadet Nurse Corps. The U.S. Cadet Nurse Corps represent 124,000 members who served in the largest all-female, fully integrated service in World War II and stepped up to address the nursing shortage at the time. These women bravely decided to put their country first. They not only gave life-saving care to serious physical and psychological wounds but once they served their country, they came home and continued to promote and work in public health.

The U.S. Cadet Nurse Corps’ sacrifice cannot go unrecognized. ANA is grateful to have champions in the U.S. House and Senate who have introduced legislation that would finally officially recognize these individuals as veterans. S.1220/H.R. 2568, the U.S. Cadet Nurse Corps Service Recognition Act, would distinguish them as honorary veterans and provide a burial plaque or grave marker honoring their service.

Recently, the House Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs held a Congressional hearing and this legislation was discussed. In addition, the bill was reported unanimously out of the Senate Veterans Affairs Committee. While this legislation has momentum, we need your help to keep it going. The U.S. Congress needs to pass this legislation in both chambers so the President can sign it into law and finally recognize these heroes as veterans. It’s long overdue.

H.R. 3635 Promises to Strengthen PPE Stockpile for Future Emergencies

  

This Capitol Beat article was guest-written by Debbi Waters, MSN, RN, MJ, CHC, a student in the McKendree University Doctor of Nursing Practice (DNP) in Ethical Leadership Program, who is completing her leadership practicum in partnership with ANA Senior Policy Advisor Lisa Stand.

This month, Congress took a positive step in preventing a repeat of the catastrophic shortages of personal protective equipment (PPE) experienced by nurses at the outset of the COVID-19 pandemic. With bipartisan support, the House of Representatives passed H.R. 3635, the Strengthening America’s Strategic National Stockpile Act of 2021.

It has been nearly two years since the COVID-19 pandemic began to rapidly spread across the United States (U.S.), triggering the worst public health emergency the nation has witnessed in more than a century. From the beginning of the pandemic in 2020, nurses quickly found themselves fearing for their personal safety, as well as the safety of their patients and families, as PPE supplies were being depleted at an extraordinarily fast pace. Nurses on the frontlines were directed to abandon evidence-based infection prevention standards, for instance, by being required to wear the same PPE for extended periods of time, and to reuse PPE across multiple shifts. In an American Nurses Association (ANA) survey in May of 2020, 45 percent of nurses reported experiencing PPE shortages, with 79 percent of nurses reporting being encouraged or required to reuse PPE, of those 59 percent felt unsafe in doing so. The ANA completed a second survey, ending on August 14, 2020, with 47 percent of nurses reporting intermittent to occasional PPE shortages. Forty-two percent of participating nurses reported an increase in PPE availability, as compared to 36 percent reporting no change; however, 68 percent continued to report being required by their facility to reuse single-use PPE, with 62 percent reporting feeling somewhat to very unsafe. The enormity of the impact of COVID-19 on healthcare workers is yet to be determined; however, the failure to provide basic PPE to frontline nurses and healthcare workers was profound and consequential to physical and mental well-being of our nation’s nursing workforce.

Why is H.R. 3635 Important?
H.R. 3635 would address key vulnerabilities within the federal government’s ability to adequately respond to such large-scale public health emergency, particularly with the medical supply chain.

The U.S., as with most other countries around the globe, utilized unprecedented amounts of PPE during the COVID-19 pandemic. At times, the PPE burn rate was nearly a 100 percent increase over historical levels. Very early in the pandemic as hospitals exhausted PPE supplies and began experiencing challenges in purchasing supplies through the usual “just in time” supply chain channels, and as local and state supplies became depleted, states called up the federal government for assistance through the Strategic National Stockpile (SNS)

The SNS, long considered to be the contingency plan for public health emergencies, was ill-prepared to respond to a threat the size and scope of this pandemic, certainly not for a threat simultaneously affecting all 56 states, territories, and the District of Columbia. The SNS endured years of underfunding and budget cuts by Congress that, compounded by a failure to replenish and rotate stock, led not only to inadequate amounts of PPE, but also to the delivery of PPE that was expired, rotting, and inappropriate for safe use in protecting nurses from the dangers of COVID-19.

Maintaining the Stockpile
H.R. 3635 would address the issue of expired and unsafe supplies by allowing the U.S. Department of Health and Human Services (HHS) to distribute supplies from the SNS to any federal department or agency, on a reimbursable basis, if the supplies are within one year of expiration and can be replenished within the SNS. In addition, HHS would be required to ensure that supplies and equipment within the SNS are in working order.

Domestic Production
The COVID-19 pandemic also exposed the risks associated with U.S. dependence on foreign sources for nearly 60 percent of the nation’s medical supplies. This dependence created cataclysmic sourcing and price challenges for American hospitals and healthcare providers, caused by stockpiling of supplies and price gouging, at one point upwards of 1,000 percent the customary cost, for supplies that were of poor quality and at times counterfeit. The inability of domestic manufacturing proved to be detrimental to nurses who were providing care to COVID-19 patients. H.R. 3635 calls for the creation of a pilot program designed to strengthen the U.S. supply chain by increasing domestic manufacturing. Specifically, the pilot requires HHS to establish and maintain geographically dispersed domestic reserves of critical medical supplies, including PPE, and increased emergency stock of those critical supplies through cooperative agreements or partnerships with manufacturers to produce and maintain supplies. Additionally, the bill provides temporary authorization for HHS to disperse grants to states for use in maintaining or expanding state strategic stockpiles of critical supplies that are deemed essential by the State in preparation for future public health emergencies.

Transparency and Tracking
Strengthening America’s Strategic National Stockpile Act of 2021 would require HHS to develop a transparent process for distribution and use of supplies from the SNS by January 1, 2022. This would include a process for states, localities, tribes, and territories (SLTT) to request supplies; the decision-making process HHS will follow when determining if the request will be fulfilled or denied; and the process for the prioritization of distribution to the SLTT. In addition, the bill would require a monthly report to be provided detailing the requests submitted by SLTT, including the amount of materials and supplies requested, along with the outcomes of those requests. In the event a supply request is only partially filled or denied, the rationale for those outcomes must be included.

Our nation must begin building upon the lessons learned during the COVID-19 pandemic by planning and preparing a response to future public health emergencies. We must remain vigilant, as COVID-19 will not be an isolated incident, if we are going to prevent a repeat of the catastrophic failures experienced during the COVID-19 response. H.R. 3635 is a positive step towards ensuring the U.S. response to upcoming public health emergencies will be more efficient and effective, while protecting the health and safety of our frontline healthcare workers and we thank Representative Elissa Slotkin for her leadership in addressing this critical issue.

Next Steps
There is still work to be done to ensure the Strengthening America’s Strategic National Stockpile Act of 2021 is signed into law. This legislation now moves to the Senate where a companion bill S.1974 was introduced in June 2021. As you know, things tend to move slowly in the Senate and they need a groundswell of support from their constituents to pass legislation. Without action, nurses will be no more protected in future pandemics, than we were in March of 2020. Please visit our Latest News page for updates on the legislation and a chance for every nurse and health care advocate to take action and message their members of Congress soon.