Capitol Update, brought to you by the American Nurses Association
Capitol Update, a legislative newsletter for nurses
Volume 6/Issue Number 6 August 1, 2008
Article Photo Nurses Storm Capitol Hill to Advocate for Safe Staffing Legislation

On Tuesday, June 24th, over 60 CMA presidents, executive directors, N-PALS, and members participated in ANA's Lobby Day. These members visited their Representatives and Senators to discuss safe staffing and other issues of importance to the nursing profession.
Congress Passes Medicare Package, Overrides Bush Veto

On July 15th the House and Senate voted to override President Bush's veto of the Medicare Improvements for Patients and Providers Act (MIPPA, P.L. 110-275), a Medicare package which includes a number of provisions important to beneficiaries and providers. With the House vote of 383-41, and the Senate vote of 70-26 both bodies secured the 2/3 vote necessary to enact the bill into law despite Presidential objections.
ANA Testifies on Nurse Immigration

ANA has been working to educate Congress about the many pitfalls associated with the use of international immigration to solve nursing shortages. Through this work we were able to secure an invitation to provide public witness testimony before the House Judiciary Subcommittee on Immigration for a hearing held on June 12, 2008. ANA Senior Policy Fellow Cheryl Peterson, MSN, RN represented ANA at this hearing focused on "the need for green cards for highly skilled immigrants."
Higher Education Act Reauthorization Supports Nursing

Congress passed the Higher Education Opportunity Act (H.R. 4137) on July 31, 2008. President Bush is expected to sign this bill into law shortly. This marks the first reauthorization of the Higher Education Act (HEA) in a decade, and pays homage to the tireless efforts of Senator Ted Kennedy (D-MA) a long-time supporter of higher education. ANA supported provisions in the bill that will create a capitation program to support schools of nursing, a new loan repayment program for nursing students, and support for nursing faculty programs.
House Bill Would Expand APRN Home Health Authority

Representative Allyson Schwartz (D-PA) introduced the Home Health Care Planning Improvement Act (H.R. 6826) with 39 original co-sponsors on August 1, 2008. This bill is a companion to the Senate version (S. 1678) introduced on June 21, 2007. This ANA-endorsed legislation would change Medicare law to grant Nurse Practitioners, Clinical Nurse Specialists, and Certified Nurse Midwives the ability to order home health services and to sign home health plans of care.
Bill including Mental Health Parity Compromise Fails in Senate

Supporters of Mental Health Parity Legislation were encouraged in late July when the Compromise language on the issue agreed to by House and Senate negotiators was added to a bill coming before the Senate: the Jobs, Energy, Families and Disaster Relief Act of 2008 (S. 3335). Unfortunately, on July 30th, the Senate failed to invoke cloture on S. 3335, the so-called "tax extenders" bill, by a vote of 51 to 43. The vote effectively halted movement on the legislation, including its ANA-supported mental health and addiction parity provisions.
Congress Moves Toward a Safer Chemicals Policy

Congress has taken a giant step in the right direction toward creating a more protective U.S. chemicals policy. The House and Senate achieved a compromise on their consumer product safety reform bills that would ban 6 types of phthalates, a chemical found in plastics, from children's toys and other products.

Medicare/Medicaid: Recognizing RNs' Contributions

In June and July 2008, the ANA presented written comments regarding three proposed rules issued by the Centers for Medicare & Medicaid Services (CMS). Two rules involved Medicaid home and community-based services (HCBS) and Medicare Skilled Nursing Facilities (SNFs). The third addressed the Medicare Inpatient Prospective Payment Systems (IPPS). In each submission, ANA advocated for greater recognition and support of the unique role which RNs play in providing patient services under Medicaid & Medicare. We plan to begin posting the complete text of ANA's public comments on Nursing World soon.

States Are Moving Safe Nurse Staffing

Massive reductions in nursing budgets have resulted in fewer nurses working longer hours, while caring for sicker patients. Although provisions for staffing patient care units exist in Joint Commission standards and Federal regulations, protections for patients and nurses still need strengthening. Elected officials on the state level have been responding to nurses' pleas to protect patients by holding hospitals accountable for the provision of appropriate nurse staffing. In 2008 alone, four states enacted safe nurse staffing legislation, Connecticut and Ohio most recently. Although that brings the total number of states that have addressed this critical issue to thirteen, there have been varying approaches. Additionally there have been changes since bills passed: Maine modified the original legislation while the District of Columbia waived implementation of their safe staffing law.
Mandatory Overtime Protections Expanded to NY Nurses

New York is the 14th state to prohibit mandatory overtime for nurses. Legislative protections also exist in Connecticut, Illinois, Maryland, Minnesota, New Hampshire, New Jersey, Oregon, Rhode Island, Washington, and West Virginia. Three states have regulations addressing the issue: California, Missouri, and Texas.
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ANA Hosts Senators Hillary Clinton and Barack Obama at House of Delegates

The American Nurses Association was pleased to host Senator Hillary Clinton (D-NY) and Senator Barack Obama (D-IL) at its biennial House of Delegates Thursday, June 26 - Friday June 27, 2008.
ANA's Virtual Voting Booth - Coming Soon to a Computer Near You!

No matter where you turn these days, everyone seems to have an opinion on who will be our country's next President. Beginning August 1, 2008, ANA member nurses will have the opportunity to vote for the candidates they believe will be the strongest advocate for the nursing community while serving in the White House. ANA's Election 2008 Action Center will be home to the "virtual voting booth," an online poll that will give voice to the presidential candidate most preferred by nurses.
August Recess: An Opportunity to Advocate!

With an exciting election season in full gear, members of Congress are anxious to meet with their constituents while they are back in the district. Meeting with your elected officials either at a town hall meeting, or setting up a meeting with them in their district office is a great way for ANA's message to be heard.
ANA-PAC Hosts Successful Fundraising Events at the 2008 House of Delegates

ANA-PAC and it's complementary political education programs are key to ANA's legislative success in US Congress. The $40,000 raised at the House of Delegates will be used to support Congressional candidates running for office who will advocate for nurses on the Hill.

ANA Takes Part in Annual National Conference of State Legislators Legislative Summit

Once again ANA staff interacted with several hundred state legislators and their staff during the annual Legislative Summit for the National Conference of State Legislators (NCSL) held in New Orleans from July 21st through 25th. ANA's outreach at the meeting focused on safe staffing and safer toys legislation. Legislators had the opportunity to determine how their state compared to others on legislation in each of the areas, and were invited to take part in an ANA co-sponsored a breakfast briefing, "Toxics in Toys", designed to support the effort for chemicals policy reform as part of the ANA/CMA Nationwide State Legislative Agenda.
House and Senate Propose Funding Increases for Nursing

In June, Senate and House Committees approved bills that would provide fiscal year (FY) 2009 funding increases for the Title VIII Nursing Workforce Development Programs
Moratorium on Medicaid Regulations Signed by President

President Bush has signed into law a wartime supplemental spending bill (P.L. 110-252) that included an ANA-supported moratorium on six controversial Medicaid regulations.
ANA Advocates for Nurses at American Medical Association Meeting

Rose Gonzalez & Eileen Carlson of ANA Government Affairs attended the AMA (American Medical Association) House of Delegates annual meeting on June 14-17, 2008, as official observers. We formally objected to AMA Resolutions 214 and 232 (formerly 303), limiting the independence of DNPs (Doctors of Nursing Practice) and use of the term "doctor" by non-physicians with doctorate degrees. These resolutions passed with amendments, including one which would "make it a felony to represent oneself as a physician." Several other resolutions and reports impacting the nursing community were considered.
ANA, Tri-Council Members Send Letter Opposing Office of the National Nurse

On July 2, the Tri Council for Nursing, which brings together the four professional organizations of the American Association of Colleges of Nursing (AACN), the American Nurses Association (ANA), The American Organization of Nurse Executives (AONE), and the National League for Nursing (NLN), sent a letter to The President of the National Nursing Network Organizing Network expressing continued opposition to the proposal to create an office of the National Nurse.
ANA-PAC Welcomes New Trustees to Board

ANA-PAC proudly welcomes new Trustees to the ANA-PAC Board. Linda Gural, RN, CCRN, Kim Armstrong, RNC, BSN, Carrie Houser James, MSN, RN, CNA, BC, CCE, Karen Daley, MS, MPH, RN, FAAN and Lori Lioce, FNP-C, NP-C. The new Trustees bring many years of fundraising knowledge and expertise to their positions which will be assets as the ANA-PAC Board addresses the Presidential election and endorsement of Congressional candidates.