Mayflower Fall 2009 Volume 20 Issue 4
Governmental Affairs
Anne Halliday, BSN, RN, CPAN
Health Care Reform and a Super Union?
Anne Halliday, BSN, RN, CPAN
Health Care Reform and a Super Union?
Health Care Reform
As I write this, Congress is on summer recess hearing from concerned constituents about HR3200, The Health
Care Reform Act Bill. Please note that there are really three bills in the House of Representatives and two in
the Senate regarding this complicated and important topic. By the time you read this, Congress will be back in
session debating what should happen next.
As a member of ASPAN’s Governmental Affairs (GA) Committee, I am receiving frequent emails from David
Kay, Chair of the ASPAN GA Committee. There are also numerous articles in newspapers and magazines and
television time devoted to health care reform. The AMA, insurance and pharmaceutical companies, unions,
AARP and other strong organizations all have their points of view which they are lobbying heavily to members
of Congress and to the public.
What is a PeriAnesthesia Nurse to Do?
I recommend:
Read and listen to what you can and consider different points of view.
Look at HR3200 at www.thomas.gov or Goggle where there are many choices to view it.
Gather your thoughts and make a short list of what is most important to you.
Call your Senator and Congressman at 1-877-264-4226 (a toll free number). Press 1 to speak to your Senator
and Press 2 to speak to your Representative. Enter your zip code when prompted.
The outcome will certainly be interesting and will affect every American.
Super Union for Nurses
If you are not a member of the Massachusetts Nurses’ Association (MNA) or working in a facility with MNA
representation, you may not be aware of the potential for the creation of a new National Nurses’ Union. Once
again, I am being bombarded by information, this time from MNA.
Some History
In 2001, there was a meeting of MNA member nurses in Worcester where a vote disaffiliating MNA from
American Nurses Association (ANA) passed. At this meeting, members stated that ANA “didn’t adequately
represent staff nurses on the national stage” and a resolution for the formation of a national nurses’ union was
adopted.
At MNA’s 2008 convention, a vote passed authorizing MNA leadership to “participate as architects of an
independent national nurses union run by and for nurses.” *source: www.massnurses.org
The California Nurses Association (CNA) left ANA in 1995 and eventually formed the National Nurses
Organizing Committee (NNOC). In 2008, the United American Nurses (UAN) and labor arm of ANA which is
affiliated with the AFL-CIO also disaffiliated from ANA.
In October, MNA members will vote whether to join CNA/NNOC and UAN to form a new national nurses
union which would have 150,000 members.
Five Core Objectives
The five objectives of this super union would include:
To build a movement to defend and advance the interests of direct care nurses and patients everywhere.
To unite and organize all direct care nurses into a single organization capable of exercising maximum
influence over the health care industry, governments and employers.
To win health care justice: accessible, quality health care for all, as a human right.
To provide effective collective bargaining representation to UAN/NNOC members and support to UAN/NNOC
affiliates to promote the economic and professional interests of direct care nurses.
To advocate for direct care nurses and patients on all public policy matters related to safe care and nursing
practice, including safe nurse-to-patient ratios and patient advocacy rights.
Even if you are not working in an MNA-represented facility, you should be aware of this potential new Super
union. It has been said by author Suzanne Gordon and others that nurses do not publicize what they do or use
their potential power as a group. This union could change that.
Please see www.massnurse.org for the source for this article as well as for further information.
As I write this, Congress is on summer recess hearing from concerned constituents about HR3200, The Health
Care Reform Act Bill. Please note that there are really three bills in the House of Representatives and two in
the Senate regarding this complicated and important topic. By the time you read this, Congress will be back in
session debating what should happen next.
As a member of ASPAN’s Governmental Affairs (GA) Committee, I am receiving frequent emails from David
Kay, Chair of the ASPAN GA Committee. There are also numerous articles in newspapers and magazines and
television time devoted to health care reform. The AMA, insurance and pharmaceutical companies, unions,
AARP and other strong organizations all have their points of view which they are lobbying heavily to members
of Congress and to the public.
What is a PeriAnesthesia Nurse to Do?
I recommend:
Read and listen to what you can and consider different points of view.
Look at HR3200 at www.thomas.gov or Goggle where there are many choices to view it.
Gather your thoughts and make a short list of what is most important to you.
Call your Senator and Congressman at 1-877-264-4226 (a toll free number). Press 1 to speak to your Senator
and Press 2 to speak to your Representative. Enter your zip code when prompted.
The outcome will certainly be interesting and will affect every American.
Super Union for Nurses
If you are not a member of the Massachusetts Nurses’ Association (MNA) or working in a facility with MNA
representation, you may not be aware of the potential for the creation of a new National Nurses’ Union. Once
again, I am being bombarded by information, this time from MNA.
Some History
In 2001, there was a meeting of MNA member nurses in Worcester where a vote disaffiliating MNA from
American Nurses Association (ANA) passed. At this meeting, members stated that ANA “didn’t adequately
represent staff nurses on the national stage” and a resolution for the formation of a national nurses’ union was
adopted.
At MNA’s 2008 convention, a vote passed authorizing MNA leadership to “participate as architects of an
independent national nurses union run by and for nurses.” *source: www.massnurses.org
The California Nurses Association (CNA) left ANA in 1995 and eventually formed the National Nurses
Organizing Committee (NNOC). In 2008, the United American Nurses (UAN) and labor arm of ANA which is
affiliated with the AFL-CIO also disaffiliated from ANA.
In October, MNA members will vote whether to join CNA/NNOC and UAN to form a new national nurses
union which would have 150,000 members.
Five Core Objectives
The five objectives of this super union would include:
To build a movement to defend and advance the interests of direct care nurses and patients everywhere.
To unite and organize all direct care nurses into a single organization capable of exercising maximum
influence over the health care industry, governments and employers.
To win health care justice: accessible, quality health care for all, as a human right.
To provide effective collective bargaining representation to UAN/NNOC members and support to UAN/NNOC
affiliates to promote the economic and professional interests of direct care nurses.
To advocate for direct care nurses and patients on all public policy matters related to safe care and nursing
practice, including safe nurse-to-patient ratios and patient advocacy rights.
Even if you are not working in an MNA-represented facility, you should be aware of this potential new Super
union. It has been said by author Suzanne Gordon and others that nurses do not publicize what they do or use
their potential power as a group. This union could change that.
Please see www.massnurse.org for the source for this article as well as for further information.
Previous Governmental Affairs Columns ~ May be Edited for Space Restrictions
Visit Archives for Previous Columns
Visit Archives for Previous Columns
Mayflower Spring 2009 Volume 20 Issue 2
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
This is both an exciting and worrisome time in state and federal government. As a state and as a nation, our fiscal
woes seem unending. But change has come to the White House and it is a fascinating time to observe and participate
in politics both at home and in Washington, DC.
State News
It is still quite early in the legislative calendar in Massachusetts; currently 6,000 bills have been filed. Following the
change in leadership in the House, members are still waiting their committee assignments. The following are brief
updates on nurse related news from the Massachusetts State House.
Nurse Practitioners as Primary Care Providers
Recently passed legislation in Massachusetts (Chapter 305) allows nurse practitioners to be recognized as primary
care providers. This legislation is very timely. Following the recent enactment of mandatory health insurance for all
Massachusetts residents, more than 300,000 previously uninsured residents are enrolled in Commonwealth Care and
need primary care providers. The Massachusetts Medical Society estimated that patients wait up to 12 weeks for a
primary care appointment. With this new legislation, all health insurers in Massachusetts are required to recognize
nurse practitioners as primary care providers, thus allowing patients to choose them to provide and coordinate their
health care. Included in this legislation is a section that grants tuition reimbursement for physicians and nurse
practitioners who choose a career in primary care.
Massachusetts Health Insurance
According to a recent State House News Brief, newly appointed Speaker of the House, Representative DeLeo
acknowledged that health care reform is currently the biggest budget buster in the state legislature. While denying
any thoughts of scrapping the universal health insurance coverage plan for all Massachusetts residents, DeLeo
stated that it may need to be “tweaked” to bring it more in line with the current fiscal situation.
Safe Staffing Legislation
Senator Moore has reintroduced legislation aimed at ensuring safe staffing levels in acute care hospitals. Senate Bill
# 1272, An Act to Promote the Nursing Profession and Promote Safe Patient Care. This bill proposes that every acute
care hospital implement a nurse staffing plan based on the recommendations of a nurse staffing committee comprised
of at least 50% direct care RNs.
Representative C. Canavan has also reintroduced safe staffing legislation, House Bill # 4783, An Act Relative to
Patient Safety. This bill would require the Department of Public Health (DPH) to develop standards for nurse’s patient
assignments and set limits for the maximum number of patients per RN.
Federal News
SCHIP
President Obama recently signed legislation to increase funding for the State Children’s Health Insurance Program (S-
CHIP). This legislation will expand current SCHIP coverage to include 4 million additional children. In addition, it
reauthorizes SCHIP for four and one-half years and allows $32.8 million in new spending. Children eligible to receive
coverage under SCHIP are from families who cannot afford private health insurance but do not qualify for Medicaid.
Economic Stimulus Package
President Obama’s economic stimulus package, titled “American Recovery and Reinvestment Act,” has not yet been
approved by both sides of the Legislature. However, the House approved an $819 billion package that includes more
than $80 billion for state Medicaid budgets and more than $20 million for healthcare information technology. Other
potential benefits to healthcare include increased funding for Cobra health insurance subsidies, preventative care
programs, and renovation and expansions of community health centers.
Impact of the Economy on Healthcare
A recent electronic newsletter from AMN Healthcare, a well known staffing agency, highlighted the impact of the
current financial crisis on healthcare organizations nationwide. In 2008, 9,700 hospital employees filed for
unemployment and 117 hospitals initiated mass layoffs. A survey conducted by the American Hospital Association
(AHA) noted that 56% of hospitals are delaying expansions, potentially impacting patients’ access to healthcare. The
AHA also reported that hospitals are reaching their full capacity for patients and the number of uninsured patients is
rapidly rising due to unemployment. The Kaiser Family Foundation reported that uncompensated health care costs
account for more than $40 billion per year for hospitals.
Who American Owes
An article published in the Boston Globe revealed an interesting perspective on America’s financial woes. The U.S.
government owes an estimated $2.67 trillion to foreign governments and investors. The debt is sold to other countries
in the form of U.S. Treasury Securities. In a few years, the loans will need to be repaid and a large amount of
governmental monies will need to be spent to repay this debt. Countries that own the most U.S. debt: Japan, $585.9
billion; China, $541 billion; United Kingdom, $307.4 billion; OPEC nations, including Algeria, Iran, Iraq, Libya, Saudi
Arabia, $179.8 billion; Caribbean banking centers, $147.7 billion.
(Parade Magazine, Boston Globe, Nov. 9, 2008) Mandated Staffing
Mayflower Fall 2008 Volume 19 Issue 4
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
In July, the Massachusetts Senate passed a re-drafted staffing legislation bill with additional amendments that
strengthened language banning mandatory overtime and addressed quality measures for hospitals with fewer
than 100 beds. The Senate Bill # 2805 was sent back to the House of Representatives, which had previously
passed a mandatory staffing ratio bill. The Legislative Session ended on July 31st without action on either bill.
The Nurse Staffing bill failed to pass for the 2008 Legislative year. (www.marnonline.org)
Nurse Practitioners
The Massachusetts Legislature approved An Act to Promote Cost Containment, Transparency, and Efficiency
in the Delivery of Quality Health Care. Contained in this Bill is language that permits Nurse Practitioners to be
recognized as primary care providers. (www.marnonline.org)
Nurse Immigration
The US House of Representatives convened a Judiciary Subcommittee on Immigration, Citizenship, Refugees,
Border Security and International Law and in early August met to consider H.R. 5924, the Emergency Nursing
Supply Relief Act of 2008. This bill would, for a period of three years, increase the number of permanent
employment based visas available for registered nurses and physical therapists by 20,000. Health care
facilities using these newly available visas to employ foreign-trained RNs would be assessed a fee of $1,500
per visa. The fees generated through this program would be invested in a newly authorized program that
provides capitation grants to domestic schools of nursing.
Representatives from the American Nurses Association (ANA) met with the subcommittee and voiced
concerns regarding the use of immigration to solve domestic nursing workforce shortages, given that nurses
and nursing organizations are continually seeking funding from Congress for schools of nursing and nursing
related programs. The ANA representative stated that the United States should direct its efforts towards active
planning to build a sustainable nursing workforce internally versus focusing on the short-term relief from
foreign nurses.
(Capitol Update, Volume 6, Issue 6)
Higher Education Act
In July, Congress passed the Higher Education Opportunity Act (H.R. 4137) which reauthorizes the Higher
Education Act created a decade ago. This bill provides a $10,000 loan repayment program for nurses in higher
education and designates registered nursing as an ‘area of national need.’ Also included is a capitation
program for schools of nursing, which encourages these schools to increase enrollment by providing $3000
grants for each matriculated nursing student above the average number of nursing students calculated over
the previous four years. Grants are also provided for post baccalaureate nursing education. Finally, H.R. 4137
authorizes the Institute of Medicine to conduct a study on the capacity constraints at schools of nursing.
(Capitol Update, Volume 6, Issue 6)
Mandatory Overtime
New York became the 14th state to prohibit mandatory overtime for nurses, following Connecticut, Illinois,
Maryland, Minnesota, New Hampshire, New Jersey, Oregon, Rhode Island, Washington, and West Virginia.
Effective in July, 2009, no health care employer may require nurses to work more than the nurses’ regularly
scheduled hours, except during a health care disaster, emergency, or when there is an ongoing surgical
procedure in which the presence of the nurse is essential for the safety of the patient. Also included in the
bill is language that states that refusal of the nurse to work beyond the nurses’ regularly scheduled hours of
work will not constitute patient abandonment or neglect.
(Capitol Update, Volume 6, Issue 6)
Mayflower Spring 2008 Volume 19 Issue 2
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
After a Christmas break, Massachusetts legislators are back in session. Bills to watch and offer comment on include:
Senate 1244 ‘An Act to Promote Safe Patient Care and Support the Nursing Profession.’ Lead Sponsor: Senator Moore.
Alternative to the mandated staffing ratios proposed by the MNA and contained in House 2059.
House 1144 and Senate 1236 ‘An Act Relative to Advanced Practice Nursing.’ Lead sponsor Representative Khan and Senator
Montigny. This bill would add Nurse Anesthetists to APN groups that have prescriptive writing authority and remove physician
supervision language from four categories of APN prescription writing authority.
House 2140 ‘An Act Relative to Nursing Advisory Board.’ Lead sponsor Representative Khan. Advisory Board advises and
makes recommendations to the Governor and General Court regarding issues related to the nursing shortage and nursing
policy initiatives.
Senate 2437 ‘An Act Adopting the Nurse Licensure Compact.’ Lead sponsor Senator Moore. This bill would allow
Massachusetts to join the Nursing Licensure Compact.
Senate 685 ‘An Act to Support Pandemic Preparation and Response.’ (Flu Pandemic Bill). Provides appropriations of
essential supplies needed to prepare for a pandemic flu – vaccine, beds, and ventilators. Also strengthens the public health
system and recommends statutory changes needed to mobilize resources to respond to an outbreak.
Senate 689 ‘An Act Relative to Pandemic Disaster Planning by Health Care Providers.’ This bill provides essential liability
coverage and legal protections for health care providers who volunteer to assist during a state-declared disaster or pandemic. It
ensures that no health care provider shall be liable in a suit for damages or administrative sanctions as a result of good faith
acts or omissions while performing their duties rendering emergency care or treatment in a response to a declared disaster.
House 2052 ‘An Act Providing for Safe Patient Handling.’ Lead sponsor Representative Callahan. This bill would set
standards for lifting, moving, and handling of patients designed to curb RN injuries. Provides financial incentives to hospitals
to acknowledge and offset costs associated with compliance.
Senate 1294 ‘An Act to Require the Use of Evidenced-Based Practices for Safe Patient Handling and Movement.’ This bill
contains requirements to address safe patient handling including the use of lift teams, requiring hospitals to purchase
equipment and includes language related to compliance monitoring by the DPH. The bill also addresses the need for training
in nursing and nursing assistance programs.
Senate 674 and House 2109 (passed in the Senate) ‘An Act Relative to the Nursing and Allied Workforce Development Trust
Fund.’ Lead sponsors Senator Moore and Representative Grant. This bill creates a trust fund needed to support and fund the
collaborative initiatives between the Board of Higher Education and the nursing and allied health care partners – initiatives
aimed at increasing the supply of nurses and allied health professionals.
House 4376. ‘An Act to Promote Proper School Nutrition.’ Lead sponsor Representative Koutoujian. This bill would ensure
that school provide nutritious food options for children to help foster good eating habits that will reduce the risk of diabetes,
obesity and other related health problems.
Of note: There were 6, 000 bills filed for the current Legislative calendar year.
Mayflower Winter 2008 Volume 19 Issue 1
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
A summary of the bills currently in the Massachusetts Legislature that affect nursing and/or health care:
Safe Staffing
House Bill (HB) # 2059: this bill, if enacted, will establish nurse to patient ratios in acute care facilities and charge the
Department of Public Health with the responsibility of ensuring compliance.
Senate Bill (SB) # 1244: a broader bill that allows the institutions to establish their staffing patterns. The Department of
Public Health will monitor the staffing plans.
A hearing was held on October 24 in the State House. Legislators heard testimony from various nursing representatives. It is
expected discussion on this key issue will continue after the New Year.
Other Bills:
HB 2052: Safe Patient Handling, sponsored by Representative Jennifer Callahan: requires all health care facilities to develop
and implement safe patient handling policies, to identify, assess, and develop strategies to control risk of injury to patients and
health care workers associated with the lifting, transferring, repositioning, or movement of a patient or equipment. This bill
also regulates implementation of such policies. It would establish credits for costs associated with implementing the above
policies.
HB 921: Ensure Consumer Choice of Nurse Practitioner, sponsored by Rep. Jennifer Callahan: would allow consumers to
choose a Nurse Practitioner of their choice as their primary health provider.
HB 2060: An Act Relative to a Registered Nurse Seat on the Public Health Council, sponsored by Rep. Stephen Canessa:
mandates the inclusion of one registered nurse on the Public Health Council within the Department of Public Health.
HB 2088: An Act Relative to the Shortage of Registered Nurses, sponsored by Rep. Mark Falzone: classifies certified EMT-
paramedics with two years experience and with a Bachelor of Science degree from an accredited college or university as
graduates of an approved school of nursing. *** Please note that MASPAN does not support this bill!!***
HB 2140: An Act Creating a Nursing Advisory Board, sponsored by Rep. Kay Khan: establishes the Nursing Advisory Board in
the Executive Office of Health and Human Services, advising the Governor on matters related to the nursing shortage. It will
consist of eight members representing various areas of nursing practice.
Mayflower Fall 2007 Volume 18 Issue 4
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
There are several bills on the legislative calendar that may affect nurses if enacted.
Massachusetts State Government
Mandated Staffing Ratios
Senate 1244 - An Act to Promote Safe Patient Care and Support the Nursing Profession. Lead Sponsor Senator Richard Moore
Alternative to proposed mandated staffing ratios. Supports funding for nursing education and an analysis of the nursing
workforce.
House 2059 - An Act Relative to Patient Safety. Lead Sponsor Christine Canavan.
This is the mandated staffing ratio bill supported and developed by the Massachusetts Nurses Association (MNA). Please note
that this is not a compromise bill as is often suggested by the MNA. This bill has simply undergone revision and its original
opponents remain opposed to the language and the concept of mandated staffing ratios.
There will be a public hearing on both of these bills on October 24, 2007.
Advanced Practice Nurses
House 1144 and Senate 1236 - An Act Relative to Advanced Practice Nursing. Lead Sponsor Rep. Kay Khan and Senator Mark
Montigny.
This bill would add nurse anesthetists and clinical nurse specialists to Advanced Practice Nurse (APN) groups that have
prescriptive authority.
Nurse Licensure Compact
Senate 1288 - An Act Adopting the Nurse Licensure Compact. Lead Sponsor Senator Richard Moore.
The bill would allow Massachusetts to join the Nursing Licensure Compact, which facilitates interstate communication and
recognition on nursing licensure and disciplinary action. Currently, there are 38 states in the Licensure Compact. Benefits
cited are increased access to nursing care during emergen-
cies and states of disaster, as well as an improved relocation process.
Pandemic Flu Preparation
Senate 685 and Senate 689 - An Act to Support Pandemic Preparation and Response and An Act Relative to Pandemic
Disaster Planning by Health Care Providers. Lead sponsor Senator Richard Moore.
These bills, as indicated by their titles, provide for appropriations for essential supplies to prepare for a pandemic flu. The
latter bill provides liability coverage and legal protection for health care providers who volunteer to assist during a pandemic
event or a state-declared emergency. These bills have currently stalled due to funding issues.
Safe Patient Handling
House 2052 - An Act Providing for Safe Patient Handling. Lead Sponsor Jennifer Callahan.
This bill would set standards for lifting, moving, and handling of patients and is designed to curb injuries suffered by RNs
during the lifting and moving of patients. Many states have either recently enacted or are considering similar legislation.
Violence in the Workplace
House 1700 and Senate 1345 - An Act Relative to Assault and Battery of Health Care Providers and An Act Requiring Health
Care Employers to Develop and Implement programs to Prevent Workplace Violence. Lead Sponsors Rep. Michael Rodrigues
and Senator Jarrett Barrios.
Both of these bills address workplace violence. The Senate bill would require employers to perform an annual assessment of
risk of violence to their employees and develop and implement programs to decrease the risk of workplace violence for their
employees. The House bill would impose punishment by either imprisonment or a fine on patients who assault health care
providers in the process of providing care to the patient.
Massachusetts Universal Health Insurance
According to a recent article in the Boston Globe (Saturday, August 11) the offices that are processing applications for the
state-subsidized health insurance have been overwhelmed, causing a substantial delay in coverage for many residents of
Massachusetts. Many applications have been lost or misplaced, which has led to increased confusion and additional delays.
More than 6,000 people applied per week in the two weeks before the July 1st deadline and it is estimated that in total 105,000
have been enrolled in Commonwealth Care.
Federal Government
Title VIII Funding
The House of Representatives passed their version of FY 2008 appropriations on July 19th. Included was a $16 million
increase in funding for Nursing Workforce Funding. The Senate will be considering their budget in September and it is
expected that their Bill will contain a $20 million increase for Title VIII funding. Overall, H.R. 3043, the Labor and Health
and Human Services funding bill, would appropriate $165.6 million for Title VIII programs. (www.capitolupdate.org)
Wicker Amendment
Rep. Roger Wicker (R-MS) has attempted to introduce an amendment to remove the requirement for annual fit testing of
respirators for health care workers. Opponents to this amendment state that this amendment, if passed, would place health
care workers at an unnecessary risk for contracting an airborne type of disease, such as TB. The Occupational Safety and
Health Administration (OSHA) has recommended that health care workers have annual fit testing of these respirators to
ensure proper fit. The annual cost for fit testing is estimated to be $16.80 per person. Rep. Wicker withdrew his amendment
following active opposition from nurses. (www.capitolupdate.org)
Mandatory Overtime
On July 20th, Senators Kennedy and Kerry, along with 14 other co-sponsors, reintroduced the Safe Nursing and Patient Care
Act, which would prohibit the use of mandatory overtime as a staffing tool. S. 1842 would bar health care facilities that receive
Medicare funding from requiring an RN or LPN to work more than their assigned, predetermined, regularly scheduled shift.
The bill also contains language that prevents facilities from requiring nurses to work more that 12 hours in a 24 hour period
or more than 80 hours in a 2 week period. In addition, the bill would prevent employers from penalizing or retaliating against
a nurse who either refused to work mandatory overtime or who is cooperating in an investigation regarding the use of
mandatory overtime.
There are several states that have prohibited or limited the use of mandatory overtime but at the present time, there are no
federal regulations in place that address the problem. (www.capitolupdate.org)
Mayflower Summer 2007 Volume 18 Issue 3
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
Massachusetts State News
Pay for Performance Plans
MassHealth officials have unveiled their “pay for performance” initiative that is slated to start in October, when hospitals
contracting with the program will be eligible for bonus rate increases by meeting new quality standards. The program seeks to
reward providers for excelling in or improving quality of care delivered to MassHealth members and it is estimated that it will
initially cost $20 million during its first year. MassHealth provides health care coverage to nearly one million financially needy
children, families, seniors, and people with disabilities in the state.
The new initiative is part of the health care reform law enacted a year ago, which calls for MassHealth hospital rate increases
to be contingent on quality standards and performance measures, including the reduction of racial and ethnic disparities.
The ‘pay for performance plan’ stipulates that all acute care hospitals contracting with MassHealth will be asked to provide
information relative to five measures: maternity, pediatric/asthma, pneumonia, health disparities and surgical
infection/prevention. Hospitals will also be required to participate in at least one public reporting initiative, which discloses
basic safety practices.
After the data is assessed, MassHealth would reward “bonus points” to hospitals based on their ability to meet industry
benchmarks, minimum thresholds and improvement markers.
Due to the fact that MassHealth has not collected data on some of the measures, hospitals will be compensated for
improvement in some comparative areas and for reporting only in new areas. (State House News Service, May 23, 2007)
Senate Bill 1288: An Act Adopting the Nurse Licensure Compact
Senator Moore has introduced a bill that would add Massachusetts to the National Council of State Boards of Nursing
Licensure Compact. The Nursing Licensure Compact is a mutual recognition model of nursing licensure that allows a nurse
to have one license in his/her state of residency and to practice in other states, either physically or via the use of technology.
The nurse would be expected to adhere to each individual state’s nursing practice act and regulations pertinent to nursing.
Under mutual recognition, a nurse may practice across state lines unless otherwise restricted. At the present time, 22 states
have joined. (For further information go to: www.ncsbn.org/index.htm.)
In order to achieve mutual recognition, each state must enact legislation that authorizes the Nurse Licensure Compact, such as
Senate Bill 1288. As cited in the text of the bill, the Nurse Licensure Compact: “will increase public access to safe nursing
care, provide for the rapid deployment of qualified nurses in response to a state of emergency, address the emerging practice of
nursing through telecommunications technology, and build effective interstate communication on licensure and enforcement
issues.”
This Bill has not yet been approved.
National News
HRSA Releases Report on RN Survey
The Department of Health Resources and Services Administration’s (HRSA) Bureau of Health Professions has released its
report on its periodic survey of RNs. The latest of these reports is called The Registered Nurse Population: Findings from the
March 2004 National Sample Survey of Registered Nurses. The report includes data from seven recurring surveys, 1980
through 2004. Findings are as follows:
In her comments, HRSA Administrator Betty Duke said, “While we are encouraged by the growth in the number of RNs, we
are concerned about the aging of the nursing work force and how this will impact the future supply of nurses.” (www.ena.
org/government/washington March 2007 edition)
(A copy of this survey is available at www.hrsa.gov)
Breast Cancer Patient Protection Act
Both the Senate and the House in Washington have similar bills related to the hospitalization of mastectomy patients. S. 459
and H.R. 119 are titled ‘Breast Cancer Patient Protection Act of 2007.’ These bills, if enacted would require health insurance
carriers and group health plans to offer benefits for both inpatient and outpatient care related to breast cancer surgery and
breast cancer treatment. It further stipulates that inpatient coverage for a patient who has had a mastectomy or lumpectomy
should not be limited to less than 48 hours and that coverage for procedures for lymph node dissection should not be less than
24 hours. However, if both the attending physician and the patient determine that a shorter hospital stay is medically
appropriate, then that decision will supersede the 48 hour and 24 hour mandate. These bills are in committee at the present
time.
Mayflower Spring 2007 Volume 18 Issue 2
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN
Health Insurance
It is estimated that the cost of health insurance for the average individual in Massachusetts will be as high as $380/month. The
Board that is overseeing the state’s universal health insurance law is requesting bids from insurers in hopes of lowering the
cost passed on to the individual. Individuals in Massachusetts who do not already possess health insurance will be required to
obtain coverage by July 1, 2007 or pay a penalty. The Commonwealth is seeking coverage that offers comprehensive coverage
and would limit out-of-pocket costs to $5000 for an individual and $10,000 for a family and also include prescription drug
coverage. Advocacy groups are concerned that many cannot afford the costs that are being discussed. Senator Moore is
considering supporting the idea of delaying the penalty application for another year.
Safe Patient Handling/Lifting Legislation
H. 2662 is legislation aimed at ensuring safe patient handling. This bill seeks to establish standards for the lifting and
handling of patients to reduce the amount of nurses injured during this patient care activity. Work-related lifting injuries may
significantly contribute to nurses leaving the profession.
Prevent Falls Among Older Adults
Senator Moore is planning on introducing legislation addressing the high number of falls experienced by older adults. This
legislation focuses primarily on education of older adults to reduce falls and prevent repeat falls.
Reforming the Medical Malpractice System
Senator Moore has also introduced legislation that addresses medical malpractice in Massachusetts. This bill, if enacted, would
place stricter control on expert witnesses, require physicians to provide education to their patients to reduce postoperative
complications, and it would also require that hospitals file staffing plans to ensure adequate nursing care is being provided.
Emergency Preparedness
On December 19, President Bush signed legislation aimed at improving America’s preparedness for pandemic flu and a
biological terrorist attack. A bill titled ‘The Pandemic and All-Hazards Preparedness Act, S. 3678, was approved by Congress.
This new legislation establishes an office within Health and Human Services (HHS) that will serve as a single point of
authority for vaccine development.
This law also makes HHS the overseer of the National Disaster Medical System and the lead agency for a public health and
medical response during a national emergency.
In addition, the legislation allocates $1 billion each year in federal grants to states to assist with preparedness. The President
has authorized $474 million in 2007 to help hospitals improve surge capacity and $35 million in grants for improved real-time
disease detection. However, Congress must still appropriate the funding.
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
This is both an exciting and worrisome time in state and federal government. As a state and as a nation, our fiscal
woes seem unending. But change has come to the White House and it is a fascinating time to observe and participate
in politics both at home and in Washington, DC.
State News
It is still quite early in the legislative calendar in Massachusetts; currently 6,000 bills have been filed. Following the
change in leadership in the House, members are still waiting their committee assignments. The following are brief
updates on nurse related news from the Massachusetts State House.
Nurse Practitioners as Primary Care Providers
Recently passed legislation in Massachusetts (Chapter 305) allows nurse practitioners to be recognized as primary
care providers. This legislation is very timely. Following the recent enactment of mandatory health insurance for all
Massachusetts residents, more than 300,000 previously uninsured residents are enrolled in Commonwealth Care and
need primary care providers. The Massachusetts Medical Society estimated that patients wait up to 12 weeks for a
primary care appointment. With this new legislation, all health insurers in Massachusetts are required to recognize
nurse practitioners as primary care providers, thus allowing patients to choose them to provide and coordinate their
health care. Included in this legislation is a section that grants tuition reimbursement for physicians and nurse
practitioners who choose a career in primary care.
Massachusetts Health Insurance
According to a recent State House News Brief, newly appointed Speaker of the House, Representative DeLeo
acknowledged that health care reform is currently the biggest budget buster in the state legislature. While denying
any thoughts of scrapping the universal health insurance coverage plan for all Massachusetts residents, DeLeo
stated that it may need to be “tweaked” to bring it more in line with the current fiscal situation.
Safe Staffing Legislation
Senator Moore has reintroduced legislation aimed at ensuring safe staffing levels in acute care hospitals. Senate Bill
# 1272, An Act to Promote the Nursing Profession and Promote Safe Patient Care. This bill proposes that every acute
care hospital implement a nurse staffing plan based on the recommendations of a nurse staffing committee comprised
of at least 50% direct care RNs.
Representative C. Canavan has also reintroduced safe staffing legislation, House Bill # 4783, An Act Relative to
Patient Safety. This bill would require the Department of Public Health (DPH) to develop standards for nurse’s patient
assignments and set limits for the maximum number of patients per RN.
Federal News
SCHIP
President Obama recently signed legislation to increase funding for the State Children’s Health Insurance Program (S-
CHIP). This legislation will expand current SCHIP coverage to include 4 million additional children. In addition, it
reauthorizes SCHIP for four and one-half years and allows $32.8 million in new spending. Children eligible to receive
coverage under SCHIP are from families who cannot afford private health insurance but do not qualify for Medicaid.
Economic Stimulus Package
President Obama’s economic stimulus package, titled “American Recovery and Reinvestment Act,” has not yet been
approved by both sides of the Legislature. However, the House approved an $819 billion package that includes more
than $80 billion for state Medicaid budgets and more than $20 million for healthcare information technology. Other
potential benefits to healthcare include increased funding for Cobra health insurance subsidies, preventative care
programs, and renovation and expansions of community health centers.
Impact of the Economy on Healthcare
A recent electronic newsletter from AMN Healthcare, a well known staffing agency, highlighted the impact of the
current financial crisis on healthcare organizations nationwide. In 2008, 9,700 hospital employees filed for
unemployment and 117 hospitals initiated mass layoffs. A survey conducted by the American Hospital Association
(AHA) noted that 56% of hospitals are delaying expansions, potentially impacting patients’ access to healthcare. The
AHA also reported that hospitals are reaching their full capacity for patients and the number of uninsured patients is
rapidly rising due to unemployment. The Kaiser Family Foundation reported that uncompensated health care costs
account for more than $40 billion per year for hospitals.
Who American Owes
An article published in the Boston Globe revealed an interesting perspective on America’s financial woes. The U.S.
government owes an estimated $2.67 trillion to foreign governments and investors. The debt is sold to other countries
in the form of U.S. Treasury Securities. In a few years, the loans will need to be repaid and a large amount of
governmental monies will need to be spent to repay this debt. Countries that own the most U.S. debt: Japan, $585.9
billion; China, $541 billion; United Kingdom, $307.4 billion; OPEC nations, including Algeria, Iran, Iraq, Libya, Saudi
Arabia, $179.8 billion; Caribbean banking centers, $147.7 billion.
(Parade Magazine, Boston Globe, Nov. 9, 2008) Mandated Staffing
Mayflower Fall 2008 Volume 19 Issue 4
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
In July, the Massachusetts Senate passed a re-drafted staffing legislation bill with additional amendments that
strengthened language banning mandatory overtime and addressed quality measures for hospitals with fewer
than 100 beds. The Senate Bill # 2805 was sent back to the House of Representatives, which had previously
passed a mandatory staffing ratio bill. The Legislative Session ended on July 31st without action on either bill.
The Nurse Staffing bill failed to pass for the 2008 Legislative year. (www.marnonline.org)
Nurse Practitioners
The Massachusetts Legislature approved An Act to Promote Cost Containment, Transparency, and Efficiency
in the Delivery of Quality Health Care. Contained in this Bill is language that permits Nurse Practitioners to be
recognized as primary care providers. (www.marnonline.org)
Nurse Immigration
The US House of Representatives convened a Judiciary Subcommittee on Immigration, Citizenship, Refugees,
Border Security and International Law and in early August met to consider H.R. 5924, the Emergency Nursing
Supply Relief Act of 2008. This bill would, for a period of three years, increase the number of permanent
employment based visas available for registered nurses and physical therapists by 20,000. Health care
facilities using these newly available visas to employ foreign-trained RNs would be assessed a fee of $1,500
per visa. The fees generated through this program would be invested in a newly authorized program that
provides capitation grants to domestic schools of nursing.
Representatives from the American Nurses Association (ANA) met with the subcommittee and voiced
concerns regarding the use of immigration to solve domestic nursing workforce shortages, given that nurses
and nursing organizations are continually seeking funding from Congress for schools of nursing and nursing
related programs. The ANA representative stated that the United States should direct its efforts towards active
planning to build a sustainable nursing workforce internally versus focusing on the short-term relief from
foreign nurses.
(Capitol Update, Volume 6, Issue 6)
Higher Education Act
In July, Congress passed the Higher Education Opportunity Act (H.R. 4137) which reauthorizes the Higher
Education Act created a decade ago. This bill provides a $10,000 loan repayment program for nurses in higher
education and designates registered nursing as an ‘area of national need.’ Also included is a capitation
program for schools of nursing, which encourages these schools to increase enrollment by providing $3000
grants for each matriculated nursing student above the average number of nursing students calculated over
the previous four years. Grants are also provided for post baccalaureate nursing education. Finally, H.R. 4137
authorizes the Institute of Medicine to conduct a study on the capacity constraints at schools of nursing.
(Capitol Update, Volume 6, Issue 6)
Mandatory Overtime
New York became the 14th state to prohibit mandatory overtime for nurses, following Connecticut, Illinois,
Maryland, Minnesota, New Hampshire, New Jersey, Oregon, Rhode Island, Washington, and West Virginia.
Effective in July, 2009, no health care employer may require nurses to work more than the nurses’ regularly
scheduled hours, except during a health care disaster, emergency, or when there is an ongoing surgical
procedure in which the presence of the nurse is essential for the safety of the patient. Also included in the
bill is language that states that refusal of the nurse to work beyond the nurses’ regularly scheduled hours of
work will not constitute patient abandonment or neglect.
(Capitol Update, Volume 6, Issue 6)
Mayflower Spring 2008 Volume 19 Issue 2
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
After a Christmas break, Massachusetts legislators are back in session. Bills to watch and offer comment on include:
Senate 1244 ‘An Act to Promote Safe Patient Care and Support the Nursing Profession.’ Lead Sponsor: Senator Moore.
Alternative to the mandated staffing ratios proposed by the MNA and contained in House 2059.
House 1144 and Senate 1236 ‘An Act Relative to Advanced Practice Nursing.’ Lead sponsor Representative Khan and Senator
Montigny. This bill would add Nurse Anesthetists to APN groups that have prescriptive writing authority and remove physician
supervision language from four categories of APN prescription writing authority.
House 2140 ‘An Act Relative to Nursing Advisory Board.’ Lead sponsor Representative Khan. Advisory Board advises and
makes recommendations to the Governor and General Court regarding issues related to the nursing shortage and nursing
policy initiatives.
Senate 2437 ‘An Act Adopting the Nurse Licensure Compact.’ Lead sponsor Senator Moore. This bill would allow
Massachusetts to join the Nursing Licensure Compact.
Senate 685 ‘An Act to Support Pandemic Preparation and Response.’ (Flu Pandemic Bill). Provides appropriations of
essential supplies needed to prepare for a pandemic flu – vaccine, beds, and ventilators. Also strengthens the public health
system and recommends statutory changes needed to mobilize resources to respond to an outbreak.
Senate 689 ‘An Act Relative to Pandemic Disaster Planning by Health Care Providers.’ This bill provides essential liability
coverage and legal protections for health care providers who volunteer to assist during a state-declared disaster or pandemic. It
ensures that no health care provider shall be liable in a suit for damages or administrative sanctions as a result of good faith
acts or omissions while performing their duties rendering emergency care or treatment in a response to a declared disaster.
House 2052 ‘An Act Providing for Safe Patient Handling.’ Lead sponsor Representative Callahan. This bill would set
standards for lifting, moving, and handling of patients designed to curb RN injuries. Provides financial incentives to hospitals
to acknowledge and offset costs associated with compliance.
Senate 1294 ‘An Act to Require the Use of Evidenced-Based Practices for Safe Patient Handling and Movement.’ This bill
contains requirements to address safe patient handling including the use of lift teams, requiring hospitals to purchase
equipment and includes language related to compliance monitoring by the DPH. The bill also addresses the need for training
in nursing and nursing assistance programs.
Senate 674 and House 2109 (passed in the Senate) ‘An Act Relative to the Nursing and Allied Workforce Development Trust
Fund.’ Lead sponsors Senator Moore and Representative Grant. This bill creates a trust fund needed to support and fund the
collaborative initiatives between the Board of Higher Education and the nursing and allied health care partners – initiatives
aimed at increasing the supply of nurses and allied health professionals.
House 4376. ‘An Act to Promote Proper School Nutrition.’ Lead sponsor Representative Koutoujian. This bill would ensure
that school provide nutritious food options for children to help foster good eating habits that will reduce the risk of diabetes,
obesity and other related health problems.
Of note: There were 6, 000 bills filed for the current Legislative calendar year.
Mayflower Winter 2008 Volume 19 Issue 1
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
A summary of the bills currently in the Massachusetts Legislature that affect nursing and/or health care:
Safe Staffing
House Bill (HB) # 2059: this bill, if enacted, will establish nurse to patient ratios in acute care facilities and charge the
Department of Public Health with the responsibility of ensuring compliance.
Senate Bill (SB) # 1244: a broader bill that allows the institutions to establish their staffing patterns. The Department of
Public Health will monitor the staffing plans.
A hearing was held on October 24 in the State House. Legislators heard testimony from various nursing representatives. It is
expected discussion on this key issue will continue after the New Year.
Other Bills:
HB 2052: Safe Patient Handling, sponsored by Representative Jennifer Callahan: requires all health care facilities to develop
and implement safe patient handling policies, to identify, assess, and develop strategies to control risk of injury to patients and
health care workers associated with the lifting, transferring, repositioning, or movement of a patient or equipment. This bill
also regulates implementation of such policies. It would establish credits for costs associated with implementing the above
policies.
HB 921: Ensure Consumer Choice of Nurse Practitioner, sponsored by Rep. Jennifer Callahan: would allow consumers to
choose a Nurse Practitioner of their choice as their primary health provider.
HB 2060: An Act Relative to a Registered Nurse Seat on the Public Health Council, sponsored by Rep. Stephen Canessa:
mandates the inclusion of one registered nurse on the Public Health Council within the Department of Public Health.
HB 2088: An Act Relative to the Shortage of Registered Nurses, sponsored by Rep. Mark Falzone: classifies certified EMT-
paramedics with two years experience and with a Bachelor of Science degree from an accredited college or university as
graduates of an approved school of nursing. *** Please note that MASPAN does not support this bill!!***
HB 2140: An Act Creating a Nursing Advisory Board, sponsored by Rep. Kay Khan: establishes the Nursing Advisory Board in
the Executive Office of Health and Human Services, advising the Governor on matters related to the nursing shortage. It will
consist of eight members representing various areas of nursing practice.
Mayflower Fall 2007 Volume 18 Issue 4
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
There are several bills on the legislative calendar that may affect nurses if enacted.
Massachusetts State Government
Mandated Staffing Ratios
Senate 1244 - An Act to Promote Safe Patient Care and Support the Nursing Profession. Lead Sponsor Senator Richard Moore
Alternative to proposed mandated staffing ratios. Supports funding for nursing education and an analysis of the nursing
workforce.
House 2059 - An Act Relative to Patient Safety. Lead Sponsor Christine Canavan.
This is the mandated staffing ratio bill supported and developed by the Massachusetts Nurses Association (MNA). Please note
that this is not a compromise bill as is often suggested by the MNA. This bill has simply undergone revision and its original
opponents remain opposed to the language and the concept of mandated staffing ratios.
There will be a public hearing on both of these bills on October 24, 2007.
Advanced Practice Nurses
House 1144 and Senate 1236 - An Act Relative to Advanced Practice Nursing. Lead Sponsor Rep. Kay Khan and Senator Mark
Montigny.
This bill would add nurse anesthetists and clinical nurse specialists to Advanced Practice Nurse (APN) groups that have
prescriptive authority.
Nurse Licensure Compact
Senate 1288 - An Act Adopting the Nurse Licensure Compact. Lead Sponsor Senator Richard Moore.
The bill would allow Massachusetts to join the Nursing Licensure Compact, which facilitates interstate communication and
recognition on nursing licensure and disciplinary action. Currently, there are 38 states in the Licensure Compact. Benefits
cited are increased access to nursing care during emergen-
cies and states of disaster, as well as an improved relocation process.
Pandemic Flu Preparation
Senate 685 and Senate 689 - An Act to Support Pandemic Preparation and Response and An Act Relative to Pandemic
Disaster Planning by Health Care Providers. Lead sponsor Senator Richard Moore.
These bills, as indicated by their titles, provide for appropriations for essential supplies to prepare for a pandemic flu. The
latter bill provides liability coverage and legal protection for health care providers who volunteer to assist during a pandemic
event or a state-declared emergency. These bills have currently stalled due to funding issues.
Safe Patient Handling
House 2052 - An Act Providing for Safe Patient Handling. Lead Sponsor Jennifer Callahan.
This bill would set standards for lifting, moving, and handling of patients and is designed to curb injuries suffered by RNs
during the lifting and moving of patients. Many states have either recently enacted or are considering similar legislation.
Violence in the Workplace
House 1700 and Senate 1345 - An Act Relative to Assault and Battery of Health Care Providers and An Act Requiring Health
Care Employers to Develop and Implement programs to Prevent Workplace Violence. Lead Sponsors Rep. Michael Rodrigues
and Senator Jarrett Barrios.
Both of these bills address workplace violence. The Senate bill would require employers to perform an annual assessment of
risk of violence to their employees and develop and implement programs to decrease the risk of workplace violence for their
employees. The House bill would impose punishment by either imprisonment or a fine on patients who assault health care
providers in the process of providing care to the patient.
Massachusetts Universal Health Insurance
According to a recent article in the Boston Globe (Saturday, August 11) the offices that are processing applications for the
state-subsidized health insurance have been overwhelmed, causing a substantial delay in coverage for many residents of
Massachusetts. Many applications have been lost or misplaced, which has led to increased confusion and additional delays.
More than 6,000 people applied per week in the two weeks before the July 1st deadline and it is estimated that in total 105,000
have been enrolled in Commonwealth Care.
Federal Government
Title VIII Funding
The House of Representatives passed their version of FY 2008 appropriations on July 19th. Included was a $16 million
increase in funding for Nursing Workforce Funding. The Senate will be considering their budget in September and it is
expected that their Bill will contain a $20 million increase for Title VIII funding. Overall, H.R. 3043, the Labor and Health
and Human Services funding bill, would appropriate $165.6 million for Title VIII programs. (www.capitolupdate.org)
Wicker Amendment
Rep. Roger Wicker (R-MS) has attempted to introduce an amendment to remove the requirement for annual fit testing of
respirators for health care workers. Opponents to this amendment state that this amendment, if passed, would place health
care workers at an unnecessary risk for contracting an airborne type of disease, such as TB. The Occupational Safety and
Health Administration (OSHA) has recommended that health care workers have annual fit testing of these respirators to
ensure proper fit. The annual cost for fit testing is estimated to be $16.80 per person. Rep. Wicker withdrew his amendment
following active opposition from nurses. (www.capitolupdate.org)
Mandatory Overtime
On July 20th, Senators Kennedy and Kerry, along with 14 other co-sponsors, reintroduced the Safe Nursing and Patient Care
Act, which would prohibit the use of mandatory overtime as a staffing tool. S. 1842 would bar health care facilities that receive
Medicare funding from requiring an RN or LPN to work more than their assigned, predetermined, regularly scheduled shift.
The bill also contains language that prevents facilities from requiring nurses to work more that 12 hours in a 24 hour period
or more than 80 hours in a 2 week period. In addition, the bill would prevent employers from penalizing or retaliating against
a nurse who either refused to work mandatory overtime or who is cooperating in an investigation regarding the use of
mandatory overtime.
There are several states that have prohibited or limited the use of mandatory overtime but at the present time, there are no
federal regulations in place that address the problem. (www.capitolupdate.org)
Mayflower Summer 2007 Volume 18 Issue 3
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN, CAPA
Massachusetts State News
Pay for Performance Plans
MassHealth officials have unveiled their “pay for performance” initiative that is slated to start in October, when hospitals
contracting with the program will be eligible for bonus rate increases by meeting new quality standards. The program seeks to
reward providers for excelling in or improving quality of care delivered to MassHealth members and it is estimated that it will
initially cost $20 million during its first year. MassHealth provides health care coverage to nearly one million financially needy
children, families, seniors, and people with disabilities in the state.
The new initiative is part of the health care reform law enacted a year ago, which calls for MassHealth hospital rate increases
to be contingent on quality standards and performance measures, including the reduction of racial and ethnic disparities.
The ‘pay for performance plan’ stipulates that all acute care hospitals contracting with MassHealth will be asked to provide
information relative to five measures: maternity, pediatric/asthma, pneumonia, health disparities and surgical
infection/prevention. Hospitals will also be required to participate in at least one public reporting initiative, which discloses
basic safety practices.
After the data is assessed, MassHealth would reward “bonus points” to hospitals based on their ability to meet industry
benchmarks, minimum thresholds and improvement markers.
Due to the fact that MassHealth has not collected data on some of the measures, hospitals will be compensated for
improvement in some comparative areas and for reporting only in new areas. (State House News Service, May 23, 2007)
Senate Bill 1288: An Act Adopting the Nurse Licensure Compact
Senator Moore has introduced a bill that would add Massachusetts to the National Council of State Boards of Nursing
Licensure Compact. The Nursing Licensure Compact is a mutual recognition model of nursing licensure that allows a nurse
to have one license in his/her state of residency and to practice in other states, either physically or via the use of technology.
The nurse would be expected to adhere to each individual state’s nursing practice act and regulations pertinent to nursing.
Under mutual recognition, a nurse may practice across state lines unless otherwise restricted. At the present time, 22 states
have joined. (For further information go to: www.ncsbn.org/index.htm.)
In order to achieve mutual recognition, each state must enact legislation that authorizes the Nurse Licensure Compact, such as
Senate Bill 1288. As cited in the text of the bill, the Nurse Licensure Compact: “will increase public access to safe nursing
care, provide for the rapid deployment of qualified nurses in response to a state of emergency, address the emerging practice of
nursing through telecommunications technology, and build effective interstate communication on licensure and enforcement
issues.”
This Bill has not yet been approved.
National News
HRSA Releases Report on RN Survey
The Department of Health Resources and Services Administration’s (HRSA) Bureau of Health Professions has released its
report on its periodic survey of RNs. The latest of these reports is called The Registered Nurse Population: Findings from the
March 2004 National Sample Survey of Registered Nurses. The report includes data from seven recurring surveys, 1980
through 2004. Findings are as follows:
- The number of licensed RNs in the United States grew by almost 8% between 2000 and 2004 to a new high of 2.9
million - Real earnings for RNs grew significantly.
- Average age of the RN work force 46.8 years in 2004. This represents the highest average age since the first comparable
report was published in 1980 - Just over 41% of RNs were 50 years of age or older in 2004, a dramatic increase from 33% in 2000 and 25% in 1980.
- Only 8% of RNs were under the age of 30 in 2004, compared to 25% in 1980.
- More than 83% of RNs with active licenses were employed in nursing in 2004, the highest employment rate since1980
- Average annual earnings for RNs in 2004 were $57,785, a nearly 14% increase in salaries since 2000 and the first
significant increase since 1992 - The number of RNs with master’s or doctorate degrees rose to 376,901 in 2004, an increase of 37% from 2000 and up
from 85,860 in 1980.
In her comments, HRSA Administrator Betty Duke said, “While we are encouraged by the growth in the number of RNs, we
are concerned about the aging of the nursing work force and how this will impact the future supply of nurses.” (www.ena.
org/government/washington March 2007 edition)
(A copy of this survey is available at www.hrsa.gov)
Breast Cancer Patient Protection Act
Both the Senate and the House in Washington have similar bills related to the hospitalization of mastectomy patients. S. 459
and H.R. 119 are titled ‘Breast Cancer Patient Protection Act of 2007.’ These bills, if enacted would require health insurance
carriers and group health plans to offer benefits for both inpatient and outpatient care related to breast cancer surgery and
breast cancer treatment. It further stipulates that inpatient coverage for a patient who has had a mastectomy or lumpectomy
should not be limited to less than 48 hours and that coverage for procedures for lymph node dissection should not be less than
24 hours. However, if both the attending physician and the patient determine that a shorter hospital stay is medically
appropriate, then that decision will supersede the 48 hour and 24 hour mandate. These bills are in committee at the present
time.
Mayflower Spring 2007 Volume 18 Issue 2
Governmental Affairs
Maureen McLaughlin, BSN, RN, CPAN
Health Insurance
It is estimated that the cost of health insurance for the average individual in Massachusetts will be as high as $380/month. The
Board that is overseeing the state’s universal health insurance law is requesting bids from insurers in hopes of lowering the
cost passed on to the individual. Individuals in Massachusetts who do not already possess health insurance will be required to
obtain coverage by July 1, 2007 or pay a penalty. The Commonwealth is seeking coverage that offers comprehensive coverage
and would limit out-of-pocket costs to $5000 for an individual and $10,000 for a family and also include prescription drug
coverage. Advocacy groups are concerned that many cannot afford the costs that are being discussed. Senator Moore is
considering supporting the idea of delaying the penalty application for another year.
Safe Patient Handling/Lifting Legislation
H. 2662 is legislation aimed at ensuring safe patient handling. This bill seeks to establish standards for the lifting and
handling of patients to reduce the amount of nurses injured during this patient care activity. Work-related lifting injuries may
significantly contribute to nurses leaving the profession.
Prevent Falls Among Older Adults
Senator Moore is planning on introducing legislation addressing the high number of falls experienced by older adults. This
legislation focuses primarily on education of older adults to reduce falls and prevent repeat falls.
Reforming the Medical Malpractice System
Senator Moore has also introduced legislation that addresses medical malpractice in Massachusetts. This bill, if enacted, would
place stricter control on expert witnesses, require physicians to provide education to their patients to reduce postoperative
complications, and it would also require that hospitals file staffing plans to ensure adequate nursing care is being provided.
Emergency Preparedness
On December 19, President Bush signed legislation aimed at improving America’s preparedness for pandemic flu and a
biological terrorist attack. A bill titled ‘The Pandemic and All-Hazards Preparedness Act, S. 3678, was approved by Congress.
This new legislation establishes an office within Health and Human Services (HHS) that will serve as a single point of
authority for vaccine development.
This law also makes HHS the overseer of the National Disaster Medical System and the lead agency for a public health and
medical response during a national emergency.
In addition, the legislation allocates $1 billion each year in federal grants to states to assist with preparedness. The President
has authorized $474 million in 2007 to help hospitals improve surge capacity and $35 million in grants for improved real-time
disease detection. However, Congress must still appropriate the funding.
Governmental Affairs
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Governmental Affairs Director
Anne Halliday, BSN, RN, CPAN
Welcome to the Governmental Affairs web page.
The mission of this web page is to keep
members and viewers informed about state
legislative activities.
The governmental affairs articles that are
published in the Mayflower will be posted here
as well.
In addition, there is a link to the ASPAN
governmental affairs web site, which will
contain legislative activities at the federal level.
www.aspan.org
To go to ASPAN Governmental Affairs:
click on "Resources" then "Legislative Resources" near
the bottom of the pull-down menu.
Governmental Affairs Archived Pages
Anne Halliday, BSN, RN, CPAN
Welcome to the Governmental Affairs web page.
The mission of this web page is to keep
members and viewers informed about state
legislative activities.
The governmental affairs articles that are
published in the Mayflower will be posted here
as well.
In addition, there is a link to the ASPAN
governmental affairs web site, which will
contain legislative activities at the federal level.
www.aspan.org
To go to ASPAN Governmental Affairs:
click on "Resources" then "Legislative Resources" near
the bottom of the pull-down menu.
Governmental Affairs Archived Pages
