Working to Impact Change and Health Policy
Donna L. Hamby
Deborah Wolff-Baker
The year 2020 was a virtually lived, but this did not stop the Health Affairs Committee from advocating for geriatric patients and nurse practitioners (NPs) serving this population. Some areas the committee focused on were updates on state and national legislation for geriatric patients and NP practice; advisors to the GAPNA Board of Directors on legislative concerns; annual meeting updates for GAPNA membership; letters sent to regulatory agencies; and committee members who represented GAPNA in eight nursing and healthcare coalitions.
Specific issues the Health Affairs Committee has addressed through our coalitions include:
- COVID-19 related Public Health Emergency legislation regarding personal protective equipment, and workforce, nursing home, and assisted living policies.
- Tracking state-specific regulatory guidance enabling a smooth roll-out of the new CMS Home Health legislation allowing nurse practitioners (NPs) to order, certify, and recertify home health for patients.
- Providing input and tracking for scope of practice issues, both federal and state.
Development of a multi-organizational survey to assess the effects of advanced practice provider inability to sign the Hospice Certification of Terminal Illness on patient access to timely hospice services and provider satisfaction.
Stop the Scope Creep
December brought a major concern regarding NP practice with the campaign, Stop the Scope Creep, to limit scope of practice for NPs and other provider disciplines. Of greater concern is that physicians are using registered nurse (RN) and NP advocates for the physicians’ claim of risk to patient safety. Bringing about change is going to take more than just this committee to address the spread of inaccurate information on NP outcomes.
Nursing as a profession have been under-represented in local, state, and national boards, and government legislations for many years. There are over 5 million RNs in the United States (including NPs) (National Council of State Boards of Nursing, 2021) compared to 1 million licensed physicians (Statista, 2020). The American Nurses Association has been promoting nurses on boards to encourage nursing representation in decision-making leadership roles. To date, over 10,000 nurses have been identified as serving on boards (Nurses on Boards Coalition, 2020). This is a very good start to nursing involvement. The 116th Congress had 20 physicians and two nurses as members (GovTrack.us), which reflects the imbalance of nurses to physicians in national legislative roles.
Promoting Healthcare Policy
Healthcare policy and legislative change can often be difficult to promote due to competing interests, lack of information, and lack of input from all stakeholders or affected disciplines. Opensecrets.org provides information on who donates funding to which party or individual legislator. In 2020, the American Medical Association donated $15,245,000 for lobbying expenses while 11 nursing organizations donated $7,229,514. Advocacy is an important responsibility of RNs and NPs, but what skills are needed to bring about accurate advocacy? Two surveys conducted by Lewinski and Simmons (2018) and Perry and Emory (2017) indicate lack of knowledge of the political process was a key factor in absence of nurse participation in policy change. Nursing may not be able to compete financially; however, active involvement by nurses who are educating themselves on how to affect policy is just as important and effective.
Education Is Essential
Nursing curriculum is including health policy, while nursing organizations are providing health policy-focused conferences. The American Association of Nurse Practitioners is holding a virtual health policy conference February 25-March 11. Several state nursing organizations are sponsoring legislative days. Check with your state NP or nurse organizations for dates. These conferences are an excellent way to learn more about policy and advocacy.
Working with more than one discipline can solve a wicked problem, which is a situation that seems unobtainable (Green & Johnson, 2015). Educating those in alliance with our organization and educating all levels of the nursing profession is essential. It is crucial to ensure the factual evidence of NP outcomes and our patients’ issues reach legislators.
For those hesitant to make that first step due to lack of knowledge, attend a health policy conference. A collective voice of nurses can bring about change (Lewinski & Simmons, 2018). Accomplish a second step of educating yourself by joining the GAPNA Health Affairs Committee. The meeting occurs the third Thursday of each month at 7:45 p.m. ET. Interested persons may email the committee chair, Deborah Wolff-Baker, to join the mailing list. The Health Affairs Committee offers a scholarship yearly for attendance at the AANP Health Policy Conference. Be sure to apply when this is open for application. We must all work as a team to bring change and impact policy to improve patients’ lives and NP practice.
Donna L. Hamby, DNP, RN, ACNP-BC
rdlh2011@gmail.com
Deborah Wolff-Baker, MSN, ACHPN, FNP-BC, GS-C
deborah.baker@ncmahealth.com
References
Green, B.N., & Johnson, C.D. (2015). Interprofessional collaboration in research, education, and clinical practice: Working together for a better future. The Journal of Chiropractic Education, 29(1), 1-10.
Lewinski, A.A., & Simmons, L.A. (2018). Nurse knowledge and engagement in health policy making: Findings from a pilot study. Journal of Continuing Education, 49(9), 407-415.
National Council of State Boards of Nursing. (2021). The national nurse database.https://www.ncsbn.org/national-nursing-database.htm
Nurses on Boards Coalition. (2020). 10,000 board seats filled by nurses in 2020.https://www.nursesonboardscoalition.org/
Perry, C., & Emory, J. (2017). Advocacy through education. Policies, Politics & Nursing Practice, 18(3), 158-165.
Statista. (2020). U.S. physicians – statistics & facts. https://www.statista.com/topics/1244/physicians/