ANA’s Summary of $1.5 trillion Omnibus Includes Several Nursing Priorities


Below is ANA’s legislative breakdown of the nursing provisions included in the $1.5 trillion omnibus appropriations bill that will fund the Federal government through the end of the current fiscal year. The bill, which also includes Ukraine emergency spending attached, was signed into law on March 15, 2022.


Title VIII Nursing Workforce Development programs received $280.472 million, which is a $16 million increase over Fiscal Year 2021.

National Institute of Nursing Research received $180.862 million, which is a $5.905 million increase over FY enacted levels.

Sexual Assault Nurse Examiners Program – The bill includes $13 million, an increase of $4 million within the total for Advanced Education Nursing to expand training and certification of RNs, APRNs, and Forensic Nurses to practice as sexual assault nurse examiners.

RN Shortage – The bill includes $4.750 million within the Nurse Education, Practice, Quality, and Retention to address the shortage of RNs. The agreement directs Health Resources Service Administration (HRSA) to give priority in new funding announcements to public entities for training of additional RNs, specifically for acute care settings. In addition, it directs HRSA to give priority to applicants in States listed in the HRSA publication “Supply and Demand Projections of the Nursing Workforce 2014-2030” as having the greatest shortages.

Nurse Practitioner Optional Fellowship Program – The agreement includes $6 million for this program.

Impact of COVID-19 on the Rural Nursing Workforce – This agreement directs HRSA to submit a report within one year of enactment on the impact of the current public health emergency on the nursing workforce, especially in rural areas, and summarize strategies to mitigate and address these impacts.

Nursing and Allied Health Workforce Shortages – The Committee notes that in a March 2021 survey conducted by the HHS Office of the Inspector General, hospitals reported that nursing shortages during the COVID–19 pandemic significantly strained health care delivery and were a significant obstacle to addressing the public health emergency. The survey found that these shortages exacerbated longstanding challenges in health care delivery, access to care, and health outcomes. The Committee requests a report within 180 days of enactment of this Act addressing the role of Medicare funding in supporting the training of nursing and allied health professionals. Such report should also include an assessment of how CMS can exercise its discretion under existing payment rules to further address shortfalls in the nursing and allied health workforce.

Department of Veterans Affairs Nurse and Physician Assistant Retention and Income Security Enhancement Act (VA Nurse and PA Raise Act) – This will lift the salary caps at the U.S. Department of Veterans Affairs (VA) for APRNs and PAs.


The legislation includes provisions to extend and expand telehealth flexibilities for 151 days after the end of the COVID-19 public health emergency. Provisions of note include:

  • Expanding originating site to include any site at which the patient is located, including the patient’s home;
  • Extending the ability for federally qualified health centers (FQHCs) and rural health clinics (RHCs) to furnish telehealth services;
  • Delaying the six month in-person requirement for mental health services furnished through telehealth until 152 days after the emergency, including the in-person requirements for FQHCs and RHCs;
  • Extending the coverage and payment for audio only telehealth services;
  • Extending the ability to use telehealth services to meet the face-to-face recertification requirement for hospice care;
  • Requiring the Medicare Payment Advisory Commission to conduct a study on the expansion of telehealth services and to require the Department of Health and Human Services (HHS) Secretary to publicly post data with respect to telemedicine utilization.

Maternal Health

The Maternal Health Quality Improvement Act would provide for Public Health Service Act grants to develop and disseminate best practices with authorization of $45 million for 2023-2027; accredit health professional schools to train health care professionals about perceptions and biases with authorization of $15 million for 2023-2027; support states and tribal organizations for integrated health care services with authorization of $50 million for 2023-2027; and instruct HHS to include pregnant and postpartum women as part of their public awareness campaign.

The Improving Rural Maternal and Obstetric Care Data which would amend the Public Health Service Act to improve rural maternal and obstetric care data collection and care networks with authorization of $15 million for 2023-2027, as well as establishes grants to support health care professional training and telehealth resources with authorization of $25 million for 2023-2027.


Health and Human Services: $108.3 billion in total spending, an increase of $11.3 billion. As part of this appropriation, Congress would establish and/or fund the following agencies, among others:

Centers for Medicare & Medicaid Services: $4 billion in total spending, an increase of $50 million.

Advanced Research Projects Agency for Health (ARPA-H): $1 billion to establish ARPA-H with the intent of accelerating the development of scientific breakthroughs for diseases such as ALS, Alzheimer’s disease, diabetes and cancer.

National Institutes of Health: $45 billion, an increase of $2.25 billion with a particular focus on investments in research to address cancer, HIV and dementia, among other conditions.

Centers for Disease Control and Prevention: $8.5 billion, an increase of $582 million, with a particular emphasis on improving the nation’s public health infrastructure, including data collection and monitoring.

Substance Abuse and Mental Health Services Administration: $6.5 billion, an increase of $530 million to invest in a number of mental health programs, including those particularly targeted at children and youth.

Health Resources and Services Administration: $8.9 billion, an increase of $1.4 billion, to improve access to care in underserved communities, develop the workforce, and improve maternal and child health outcomes.

Food and Drug Administration: $3.3 billion, representing an increase of $102 million with new investments to address the opioid crisis, improve medical supply chain surveillance, facilitate the development of treatments for rare cancers and accelerate medical product development as authorized in the 21st Century Cures Act.

Federal Emergency Management Agency: $23.9 billion, representing an increase of $2.19 billion with a particular focus on disaster response and recovery efforts.

Explanatory Statements

From L-HHS-ED Explanatory Statement:

Experiential learning Opportunities – Within the total for Nurse Education, Practice, Quality, and Retention, the agreement includes $5,750,000, an increase of $2,750,000, to expand competitive grants to enhance nurse education through the expansion of experiential learning opportunities as directed in P .L. 116-260.

Mental and Substance Use Disorder Workforce Training Demonstration – Within the total for BHWET, the agreement includes $31,700,000 for this program. The agreement continues support for 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 as authorized under section 760 of the PHS Act.

Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program – Within the total for BHWET, the agreement includes $24,000,000 for this program.

Opioid Prescribing Guidelines – The agreement applauds CDC’s February 2022 Updated Clinical Practice Guideline for Prescribing Opioids for Chronic Pain, for use by primary care clinicians for chronic pain in outpatient settings outside of active cancer treatment, palliative care, and end-of-life care. The agreement directs CDC to continue its work educating patients and providers, and to encourage uptake and use of the Guidelines. The agreement urges CDC to continue coordination with other Federal agencies in implementation and related updates in safe prescribing practices to ensure consistent, high-quality care standards across the Federal government.

Replenishing Personal Protective Equipment (PPE) – The agreement notes with concern the emergence of counterfeit PPE products in the U.S. healthcare system and the critical need to boost domestic PPE manufacturing. The agreement urges the Secretary to develop a long-term sustainable procurement plan that gives preference to and results in purchases from domestic manufacturers of PPE and PPE raw materials.

From Mil Con-VA Explanatory Statement:

Annual Staffing Report -The Committees appreciate the Department’s efforts to provide useful information regarding its staffing challenges. Building off of the directive included in the Joint Explanatory Statement accompanying Public Law 116-260, the Committees direct the Veterans Health Administration to provide no later than January 31 of each calendar year, beginning in January 2023, a comprehensive report on: 1) staffing shortages generally; 2) staffing needs in rural and remote areas; 3) staffing needs for women’s health providers; 4) the development, use, and refinement of credentialing and staffing models; and 5) its plans to address these workforce issues. The Committees encourage the Department to focus on annually identified occupational shortages, but note that it may from time-to-time request information regarding specific types of shortages, such as mental health providers. As such, the Department is requested to track professions and specialties of interest.

If you have any questions regarding the summary, please feel free to reach out to us at

Samuel Hewitt, Associate Director of Policy and Government Affairs, is a co-author and contributor of this article.

Joint Commission Now Requires WPV Prevention


The American Nurses Association (ANA) has been hearing plenty from working nurses around the country that they deserve a better work environment in which to provide care to their patients. A common refrain, especially in the most recent year of COVID-19, is that their health care institutions are not doing enough to confront workplace violence.  As tensions have escalated during the pandemic, so too have the reports of bullying and assaults against nurses. Frustrations about the health care system, along with decreased staffing levels, very sick patients, and visitor restrictions, have contributed to this epidemic of violence in health care. 

Yet violence on the job is not a new concern for nurses. According to the 2019–2020 survey of 6,000 nurses, conducted by ANA’s Healthy Nurse, Healthy Nation, violence and bullying at work are two of the top 12 hazards that nurses consider a significant risk in the workplace.  That year, 23 percent of nurses said they experienced verbal or nonverbal aggression from a person of authority, 31 percent experienced verbal or nonverbal aggression from a peer, and 35 percent were verbally and/or physically threatened by a patient or patient’s family member. The US Department of Labor indicates that the rate of serious workplace violence incidents (those requiring days off to recuperate) was more than four times higher in health care than in private industry between 2002 and 2012. However, due in part to under-reporting, rates and incidents of workplace violence in health care are difficult to track. 

Given this dismal history, there is no reason to expect that workplace violence against health care personnel will go away when the pandemic recedes from their daily lives. That is, unless institutions make ending workplace violence a priority by ensuring accurate reporting, and implementing effective programs to reduce violence and supporttheir staff. 

Fortunately, health care leaders at the national level are taking note of the negative impact of violence on health care quality and patient safety. For the first time, beginning this year, the Joint Commission (JC) will examine hospital safety under new violence prevention standards. In a June 2021 publication about the new standard, the JC said, “Exposure to workplace violence can impair effective patient care and lead to psychological distress, job dissatisfaction, absenteeism, high turnover, and higher costs.” 

Hospitals are now required to have workplace-focused violence prevention programs, including reporting systems, data review, incident follow-up, and employee training. The language of the standards is general. To expand on the new expectations, the JC offers a Compendium of tools and resources to guide hospitals toward meeting the standards. 

ANA supports the JC’s efforts, and encourages hospital-based nurses to learn more about how their institutions are responding to the new standards. Some questions to ask include: 

  • Are nurses and other healthcare personnel taking part in developing workplace violence prevention programs?
  • What will leaders do to promote a culture where all personnel are comfortable reporting assaults and threats? 
  • How can nurses have input into the design of training and education about workplace violence prevention? 
  • How will the institution measure progress in reducing incidents of workplace violence? 

ANA also supports policies to hold all health care employers accountable if they do not take steps to prevent workplace violence. Congress and the Occupational Safety and Health Administration (OSHA) are working on solutions at the federal level. ANA strongly supports these efforts, and encourages nurses to advocate for policy changes. 

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.


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.


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 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.