ANA Advocacy – Transforming Nursing’s Voice on the National Stage

  

Last week, I represented the American Nurses Association (ANA) before the United States Senate Finance Committee to reiterate the urgent need to provide nurses a sufficient supply of personal protective equipment (PPE), safeguard the mental health and well-being of nurses, and address the racial health disparities exacerbated by COVID-19. Participating in a Senate hearing for the first time was an eye-opening experience. It was evident that senators unanimously respect and appreciate the significant sacrifices being made by nurses in response to COVID-19. What came to light during the hearing was that ANA’s bi-partisan approach to advocacy is working –as both sides of the aisle were interested in hearing our message and ensuring that the nation’s 4 million registered nurses are at the witness table as Congressional debate continues over access to PPE. More needs to be done to ensure nurses have access to PPE – therefore I urge each of you to help amplify our collective voice by taking ANA’s latest PPE survey and contacting your members of Congress today.

As ANA president, I am determined to ensure that ANA continues to be at the table to advance the voices of nurses and the patients they serve. This means the association representing the nation’s registered nurses needs to work with those who are elected regardless of political affiliation. Having good working relationships with the Administration and Congress allows for productive conversations even when we disagree. This approach has provided ANA’s leadership, including me, the opportunity to proactively discuss the threats our nurses face on the frontlines of the pandemic while voicing our opposition over the Administration’s defunding of the World Health Organization or the lack of action in authorizing the Defense Production Act. Despite these differences, ANA is recognized on Capitol Hill and within the Administration as the voice of nursing. This has allowed ANA additional opportunities to meet with influential decision makers.

In 2019, ANA’s highest governing body – its Membership Assembly – voted to move away from endorsing presidential candidates. In this presidential election cycle, ANA is focused on equipping nurses with information about the candidates to better engage in the 2020 elections. While ANA is not supporting a specific presidential candidate, I encourage every nurse and nurse advocate to actively participate in the political process, and vote on November 3. The decision not to endorse was based on recommendations of a bi-partisan task force made up of influential nursing leaders. ANA has developed NursesVote to help nurses activate, educate, support and vote for the political candidate of their choice. The ANA-PAC stands by its long history of endorsing pro-nursing Congressional candidates who typically have strong relationships with our Policy and Government Affairs staff and our Constituent/State Nurses Associations.

Since the beginning of the pandemic, ANA has met with the White House and has interacted with a number of federal agencies: the Department of Health and Human Services, the Department of Labor and the Federal Emergency Management Agency to raise concerns about a lack of PPE among other pressing issues. This is in addition to political advocacy efforts on Capitol Hill, which have already resulted in wins for nurses, outlined here in a June Capitol Beat blog. Nurses are at the table – and making a difference.

ANA’s advocacy focus is to ensure our ability to expand and promote nursing’s agenda and to fight for the profession and the patients they serve. We make our concerns known both publicly and in personal meetings with elected officials and their staff. ANA will not remain silent. We continue to lead the charge for nurses.

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. 

LGBTQ+ Pride 2020 Highlights Continuing March Toward Equality

  

June has traditionally been celebrated in the United States as LGBTQ+ Pride month. This annual celebration commemorates the Stonewall riots, which began at the Stonewall Inn in Greenwich Village in New York City on June 28, 1969 and sparked the modern LGBTQ+ rights movement. Like most else in 2020, this year’s Pride celebrations have taken on a different feel due to the ongoing COVID-19 pandemic, as well as the nationwide protests demanding racial and social justice in the wake of George Floyd’s murder in Minneapolis on May 25 (ANA adopted a Resolution on Racial Justice for Communities of Color on June 20). It is important to note that the LGBTQ+ rights movement and the racial justice movement are intertwined in complex ways (the civil rights movement is rightly credited for leading the way for the LGBTQ+ rights movement) and that many of this year’s Pride observances have occurred in support of and in solidarity with these nationwide protests.

This year’s Pride month also brought an unexpected bright spot for the LGBTQ+ movement. On June 15, the U.S. Supreme Court ruled in a 6-3 decision that Title VII of the Civil Rights Act of 1964 protects LGBTQ+ individuals from discrimination in the workplace; individuals can no longer legally be fired from their jobs due to their sexual orientation or the fact that they are transgender. This Supreme Court decision was a long-sought victory for the LGBTQ+ movement and signifies the hard-fought progress that has been made over the course of the past 50+ years.

Despite this progress, however, the LGBTQ+ community still faces significant barriers, particularly with respect to access to comprehensive healthcare. One need look no further than the administration’s June 12 finalization of a rule that rolls back healthcare protections for transgender individuals under Section 1557 of the Affordable Care Act. The administration finalized this rule despite the fact that LGBTQ+ populations experience a significant rate of discrimination in healthcare settings, and experience increased negative health outcomes compared with the overall population. The reasons for this are complex and varied, but many stem from a pattern of societal stigma and discrimination exacerbated by the historical designation of homosexuality as a mental disorder, the onset of the HIV/AIDS epidemic, religious prejudice with respect to homosexuality, and government policy such as Don’t Ask, Don’t Tell.

Negative health outcomes that disproportionately impact LGBTQ+ individuals include: increased instances of mood and anxiety disorders and depression, and an elevated risk for suicidal ideation and attempts; higher rates of smoking, alcohol use, and substance use; higher instances of stigma, discrimination, and violence; less frequent use of preventive health services; and increased levels of homelessness among LGBTQ+ youth. Men who have sex with men (MSM) and transgender women also experience significantly higher rates of HIV/AIDS infections, complications, and deaths; this burden falls particularly heavily on young, African-American MSM and transgender women. As noted above, this disease burden is itself known to contribute to discrimination against LGBTQ+ individuals. Transgender individuals also face particularly severe discrimination in healthcare settings.

Although Pride month draws to a close today, it is important to celebrate LGBTQ+ communities year-round and to remember that these communities experience unique health disparities 365 days a year. As the Code of Ethics for Nurses states, “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” Nurses have often been on the frontlines of providing compassionate care to LGBTQ+ individuals – most notably at the outset of the HIV/AIDS crisis – and will no doubt remain in the vanguard of that care to ensure that these disparities are eliminated.

For additional resources on providing care and other health resources to LGBTQ+ individuals, please explore this guide from Drugwatch: https://www.drugwatch.com/health/lgbtq/

Photo Credit: Matt Charnock/SFist