Your voice matters – watch your email for the AMSN 2020 Legislative Survey! So that AMSN’s agenda and advocacy may align with the issues and actions members find most important, watch your email inbox and click to answer. Your voice will help ensure that AMSN’s voice is strong and consistent with the values and priorities of med-surg nursing! What Medicare policy barriers exist between patients and their health care professionals? The Medicare agency posted a notice Dec. 26 asking the public’s insights into eliminating or changing policy that keeps Medicare patients from access to the care they need, or having to pay higher prices for care. AMSN is reviewing the notice, which is available here. The notice is consistent with a June 24 presidential “Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First.” Public comments are due to Medicare by Jan. 17, 2020. In the New Year, many states are beginning their legislative sessions this month. AMSN is monitoring key issues for med-surg nurses and their patients. For example: • In Pennsylvania, the state House is set to take up SB 637, promoting expanded licensure opportunities for ex-offenders without affecting voluntary certification programs like MSNCB. This important bill passed the Senate last fall. AMSN worked through the Professional Certification Coalition (PCC) to help block an earlier bill (HB 811) that would have interfered with important voluntary licensing programs for med-surg nurses and other health care professionals. • In Illinois labor groups are organizing to move legislation in 2020 establishing mandatory nurse-patient staffing ratios. AMSN policy supports med-surg nurses making staffing decisions at the local level, not one-size-fits-all government staffing plans. In 2019, AMSN sent a letter of opposition to Springfield about a previous staffing ratio mandate bill that died in the legislature and was not enacted into law. • In New York Gov. Andrew Cuomo signed legislation eliminating prior authorizations for medication-assisted treatment (MAT) in commercial health plans, but vetoed similar legislation expanding access to care for persons with opioid use disorder with Medicaid health plans. Because the opioid crisis affects so many people including med-surg nurses, AMSN monitors opioid crisis legislation as part of its legislative agenda.
Support Title 8 Legislation with strong funding for key AMSN workforce development and research priorities cleared its first hurdle in Congress April 30. The House Labor-HHS-Education Appropriations subcommittee approved a bill (not yet numbered) providing increases in Title 8 nurse workforce development and the National Institutes of Nursing Research. It also provided level funding for the Agency for Health Care Quality and Research (AHRQ), though overall AHRQ funding was cut from expiration of a key funding source authorized by the Affordable Care Act (ACA). Along with the Nursing Community Coalition, AMSN and its members have been urging Congress to support these vital funding priorities. Their next step is in the full House Appropriations Committee, expected to act early May. However, the long-term prospects for such funding increases are in question, as the bill’s overall $11 billion increase in funding depends on bipartisan congressional leaders and the Administration agreeing to increase overall domestic spending for 2020. See AMSN’s written testimony to Congress: https://www.amsn.org/amsn-news/amsn-submits-testimony-calling-for-appropriations-decisions. Support this legislation: https://docs.google.com/document/d/1exr1Me48UjtfS0qF7u_IfqQZayJ2efXaJVkUYiddIdk/edit Health Information Technology Health information technology industry and policymakers should pay closer attention to the experience of medical-surgical nurses and other end users of health IT systems, AMSN said to the U.S. Department of Health and Human Services May 3. “In the interest of patients, the involvement and leadership of nurses is crucial to successful health information technology policy and systems development and implementation,” wrote AMSN President Robin Hertel, MSN, EdS, RN, CMSRN, in two comment letters to regulatory proposals from the federal Centers for Medicare & Medicaid Services and the Office of the National Coordinator of Health Information Technology. In her comments on behalf of AMSN, Yoder: • Supported an agency proposal to make more patient health information available to health care professionals through trusted exchange networks. “Respecting concerns that health care delivery systems may lack sufficient infrastructure to put such powerful tools to use today, as nurses we know that the more accurate, complete and timely a picture a nurse may have of a patient’s health and care history, the higher quality of care we can provide, and the more effectively we can support transition of the patient’s care and recovery to home or the next care setting,” she said. • Supported a proposal requiring hospitals to improve the effectiveness and reliability of electronic patient notifications. “Medical-surgical nurses are commonly directly engaged in patient discharge and patient care transition. The objective of effective care transition is to support smooth recovery for the patient in a safe and supportive environment, and smooth uptake of information about changes in the patient’s condition among the health care professionals and facilities involved in the patient’s subsequent care,” she said. “The expertise of nurses is vital to care and both governments and information technology industry would be wise to call upon nurses in support of improvement of health IT systems architecture, development, implementation and evaluation,” she concluded. Both AMSN regulatory comment letters appear here: https://www.amsn.org/amsn-news/amsn-has-important-recommendations-health-information-technology After the public comment period closes June 4, 2019, the agency will evaluate the comments and publish a binding final rule in several months’ time. HB 2604 Legislation in Illinois imposing rigid nurse-to-patient staffing ratios in that state conflicts with AMSN policy trusting nurses to develop safe staffing plans. AMSN has responded by sending bill sponsor State Rep. Fred Crespo (D-44th District) and key committee members a letter in opposition to the bill, HB 2604 (http://www.ilga.gov/legislation/billstatus.asp?DocNum=2604&GAID=15&GA=101&DocTypeID=HB&LegID=118738&SessionID=108), on April 26. “AMSN policy states that safe staffing for patient care depends on nurse authority, patient acuity, and the skill and capability of individual nurses in a unit,” wrote AMSN President Hertel. “By contrast, HB 2604 sets fixed nurse-patient ratios in Illinois health care facilities; therefore, our organization is opposed to the legislation in its present form.” The bill would amend state laws that already require local shared governance plans to be given weight in nurse staffing decisionmaking. AMSN also noted that a proposal similar to HB 2604 was put to voters in Massachusetts last November. “The Massachusetts Health Policy Commission estimated its annual costs between $676 million and $949 million and possibly more,” adding that Massachusetts voters defeated it by a 70.2 – 29.8% margin. The full text of the letter is available here: https://www.amsn.org/amsn-news/amsn-responds-illinois-staffing-ratio-legislation HB 811 Could nurses’ CMSRN and CCCTM credentials be put at risk by legislation pending in Pennsylvania? A bill introduced as HB 811 (https://trackbill.com/bill/pennsylvania-house-bill-811-an-act-amending-title-63-professions-and-occupations-state-licensed-of-the-pennsylvania-consolidated-statutes-providing-for-licensing-for-individuals-with-a-criminal-conviction-and-for-occupational-licensing-for-low-income-individuals/1738492/) intended to expand pathways for persons convicted of crimes to reenter the workforce once they have paid their debts to society instead adds confusion to credentialing and licensure vital to safe health care delivery. “We respect that the intent of HB 811 is to open employment and economic opportunity for persons who have criminal records and have paid their debts to society,” wrote AMSN President Hertel to bill sponsor State Rep. Jim Cox (R-129th District). “Our organizations are concerned that HB 811 as introduced includes several problematic and unclear provisions. Its definition of ‘licensing or certifying body’ is unclear whether it applies to governmental or private entities or both. It places unusual parameters on the use of the term ‘certification,’ particularly as they might apply to medical-surgical nurses, other registered nurses, or other individuals engaged in health care delivery and administration of controlled substances.” Consistent with the recommendations of the Professional Certification Coalition (PCC) to which MSNCB belongs, AMSN recommended amending the legislation to clarify that it would apply only to state government licensing agencies and not to voluntary professional credentialing bodies. The full text of the letter is available here: https://www.amsn.org/amsn-news/cmsrn-and-ccctm-credentials-risk-pennsylvania